Systematic Screening for Behavior Disorders by alicejenny

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									  Systematic Screening
Approaches for Students in
  Tier 2/3 Interventions

       Tricia Robles M. Ed.
     roblesph@hsd401.org
       Jinna Risdal M. Ed.
      risdaljm@hsd401.org
     Highline School District
          Acknowledgments
•   Hill Walker, University of Oregon
•   Doug Cheney, University of Washington
•   Kathleen Lane, Vanderbilt
•   Bridget Walker - Seattle University
•   Wendy Iwaszuk - Seattle University
                                   5 Minutes
           Turn and Talk

• How do we determine what students
  need services at Tiers 2 & 3?
• How do we determine the “level of risk”
  in a school?
In academics, universal screening
instruments are widely recognized as
adequate measures to identify students
at-risk for developing further problems
(Ardoin et al., 2004; Elliott, Huai, &
Roach, 2007).

However, agreement is lacking about the
best screening practices to identify
behaviorally and emotionally at-risk
students.
                   RtI Application Examples

                    EARLY READING/LITERACY                          SOCIAL BEHAVIOR


                  General educator, special educator,       General educator, special educator,
     TEAM          reading specialist, Title I, school       behavior specialist, Title I, school
                          psychologist, etc.                        psychologist, etc.


  UNIVERSAL
                   Curriculum based measurement                 SSBD, record review, gating
  SCREENING

  PROGRESS                                                ODR, suspensions, behavior incidents,
                   Curriculum based measurement
  MONITORING                                                      precision teaching


                                                           Direct social skills instruction, positive
                  5-specific reading skills: phonemic      reinforcement, token economy, active
  EFFECTIVE
                     awareness, phonics, fluency,        supervision, behavioral contracting, group
INTERVENTIONS
                      vocabulary, comprehension          contingency management, function-based
                                                                 support, self-management


DECISION MAKING
                       Core, strategic, intensive             Primary, secondary, tertiary tiers
     RULES
 How most schools determine
  student need for services
• Only 2% of schools screen all children
  for mental heath reasons (Romer &
  McIntosh, 2005)
• Office discipline referrals &
  Teacher/Staff referrals are commonly
  used
Screening for “At-risk” Students
     Office Discipline Referrals
• Implemented widely in SWPBIS where 2-5
  ODR is considered threshold for at-risk (Horner
  et al., 2005)
• Issues with Consistent Use of ODR
• May miss a number of students
  – One study found that 35% of students who
     qualified as at risk on SSBD did not have
     multiple ODRs (Walker, Cheney, Stage, &
     Blum, 2005)
          Washington Schools: Study 1
       Walker, Cheney, Stage, & Blum (2005)

• 3 Elem. Schools, 80/80 SET, 1999-2003
• 124 students (70 Ext./54 Int.) Ext. > 1 s.d. on
  Social Skills and Prob Behs./ Not Int.
• Screening & ODR > ODR
• Screening+ODR increases # of at-risk students
• Screening and use of school supports
  maintains students at SST level (Gate 2 Tier 2),
  and fewer FBA/BSP or referred to Special Ed
  (Gate 3, Tier 3)
        Why Universal Screening
           benefits schools
• Establishes a schools risk level and allows for
  monitoring of responsiveness through shifts in this
  risk level (Lane, Kalberg, Bruhn, Mahoney &
  Driscoll, 2008)
• Informs the use of Tier 2 & 3 interventions - where
  to target limited funds
• Preventative supports reduce the need for more
  intensive supports later (Cheney & Stage, in
  press; Walker, Cheney, Stage, & Blum, 2005)
• Monitor overall effectiveness of the three-tiered
  model
       Why Universal Screening
         benefits students.
• Promotes early intervention in place of “wait to fail”
  (Glover & Albers, 2007);
  – Of the 20% of school-aged children who
     experience mental health difficulties, only 30%
     receive services (US Public Health Service, 2000).
  – 65% of students identified for EBD are 12 years or
     older (US Dept of Ed, 2001)
• A reduction in over-representation of children of color
  – African American students are twice as likely to be
     identified as EBD than White students (Alliance for
     Excellence Education, 2009)
• Addresses the issue of under-identifying girls and
  students with internalizing issues (Hosp & Reschly,
  2004)
    How Screening relates to
         Academics
• Academic success inextricably linked to
  social/behavioral skills
   – Five predictor variables concerning student
     skills or behaviors related to success in
     school:
   – (a) prior achievement,
   – (b) interpersonal skills,
   – (c) study skills,
   – (d) motivation, and
   – (e) engagement (DiPerna and Elliott,1999, 2000)
             Choosing A
          Universal Screener
•   Choose a Screener that:
    1. Is appropriate for its intended use and
       that is contextually and developmentally
       appropriate and sensitive to issue of
       diversity
    2. Has Technical Adequacy
    3. Useable - efficient, feasible, easy to
       manage
      - Calderella,Young, Richardson & Young, 2008
     Systematic Screening for Behavior
   Disorders (SSBD; Walker & Severson, 1992)
• Originally normed K-6, recently normed for middle and
  Jr High (Calderella,Young, Richardson & Young,
  2008)
• Multiple gating procedures following mental health &
  PBS model
• Externalizing and Internalizing dimensions
• Evidence of efficiency, effectiveness, & cost benefits
• Exemplary, evidence-based practice
     • US Office of Special Education, Council for Children with
       Behavior Disorders, National Diffusion Network
    SSBD: Sample Questions
• Critical Events (Behavioral Earthquakes):
   – Is physically aggressive with other students or
     adults (hits, bites, chokes, or throws things)
   – Has tantrums
   – Exhibits painful shyness
• Maladaptive Behavior
   – Requires punishment before s/he will terminate behavior.
   – Child tests teacher imposed limits.
• Adaptive Behavior
   – Produces work of acceptable quality given her/his skill level.
   – Expresses anger appropriately, e.g. reacts to situation
     without being violent or destructive.
 Multiple Gating Procedure (Severson et al. 2007)
                      Teachers Rank
Gate 1                Order 3 Ext. & 3
                      Int. Students

                      Pass Gate 1
                   Teachers Rate Top 3
Gate 2
                   Students on Critical
                   Events, Adaptive &
                   Maladaptive Scales
                                                        Tier 2,3
                        Pass Gate 2
 Gate 3                                                 Intervention
                         Classroom &
                         Playground
                        Observations

          Tier 3 Intervention or Special Ed. Referral
SSBD Differentiates Grads , Non-
     grads, Comparisons

                Graduates       Non-Graduates    Comparison


SSBD Critical    5.9 (2.8)         5.4 (3.0)      5.2 (2.8)

Events

SSBD            31.2 (10.5) a     37.2 (5.7) b   32.2 (7.8) a

Maladaptive

SSBD Adaptive   32.3 (8.0) a      28.0 (4.8) b   30.6 (6.8) a
      Student Risk Screening Scale
          (Drummond, 1994)

• Originally normed at elementary level, recently normed at
  middle and high school (Lane, Kalberg, Parks, & Carter, 2008)
  – Classroom teacher evaluates and assigns a frequency-based,
    Likert rating to each student in the class in relation to seven
    behavioral criteria
  – Score indicates the level of risk (low, medium, high)
• Scores predict both negative academic and
  behavioral outcomes
• Effective, Efficient and Free
    Student Risk Screening Scale
        (Drummond, 1994)
–   lies,
–   cheats,
–   sneaks,
–   steals,
–   behavior problems,
–   peer rejections,
–   low achievement,
–   negative attitude,
–   Aggressive.

– Rated on a 4-point Likert scale (never, seldom,
  sometimes, frequently)
SRSS
     Student Internalizing Behavior
      Screener (SIBS, Cook 2008)
•   Nervous or Fearful
•   Bullied by Peers
•   Spends Time Alone
•   Clings to Adults
•   Withdrawn
•   Seems Sad or Unhappy
•   Complains About Being Sick or Hurt


    – Rated on a 4-point Likert scale (never, seldom,
     sometimes, frequently)
  BASC- Behavior and Emotional Screening
   Scale (BESS, Pearson Publications)

• Based on BASC by Reynolds & Kamphaus, 2002
• Universal screener with norms for preschool & K-
  12,
• Includes teacher, parent, and self-rating forms
  grades 3-12. 3-5 minutes per form. Completed on
  all students in class
• Hand scored and scannable forms, ASSIST
  software available
• Provides comprehensive summary of student
  scores and teacher ratings across the school
        Brief Academic Competence
         Evaluation Scales System
 (BACESS; Elliott, Huai, Roach, 2007)
• Intended to be a universal screener (cover both
  academic and academic “enabling” behaviors)
  – Phase 1: Criterion referenced Academic Screening used on ALL
    students
  – Phase 2: 10 items five academic and five academic enabling
    behaviors rating of students who passed through phase 1 (from
    ACES)
  – Phase 3: Teachers complete the entire ACES measure for
    students with specific cut score (less than 26)
• Academic Competency Evaluation Scale (ACES; DiPerna
  and Elliott,1999, 2000) is normed K-12, with teacher forms
  and student forms for grades 3-12. - Pearson
       Integrating
    Screening into
RTI/PBS Initiatives

        How is it done?
 2009 Bridget Walker, Ph.D.
 Sample List of Students Identified Through
 Schoolwide Screening
                   Kdg A         Kdg B         Grade 1 A      Grade 1 B    Grade 2 A
                   Sam Spade     Frederico     Lina Ruis           onson
                                                              Jack J       Kim
                                 Latica        Char Beyer                  Signorelli
                                 Charles       Rana Wilcox                 Mike
How could this                   Brown         Renny                       Majewski
                                               Linquist
information help
                   Grade 2 B     Grade 3 A     Grade 3 B      Grade 4 B    Grade 5 A
you determine      Lin Wu        Howard        Peggy Hunt     Tim Leary    Scott Stage
                   Monico Leon   Muscott       Pat            Peppermint
where your                       Doug Cheney   Harrington     Patty

limited support    Grade 5 B
                   Kelli Jane
                                 Grade 6 A
                                 Alex Tapps
                                               Grade 6 B
                                               Robert Weir
resources          Paula
                   Seabright
                                 Shin Ji
                                 Lauren
                                               Chris
                                               Norman
should focus?                    Anderson
                                 Dave Drobek
                                               Kate Davis
                                               Dennis Chipp
                                 Jerome        Rashan
                                 Garcia        Lincoln


                   Names listed in blue are students who have passed Gate 2 of SSBD.
                   Names listed in red are students who have been identifi ed with
                   academic issues
                   Names in green are students who have been identifi ed by both
                   academic screening & SSBD.
                   The Support team is meeting to determine appropriate supports for
                   each group
                                                                             Bridget Walker, Ph.D.
      Supporting Doug Cheney, A New Kindergartner in Your School

Socio-Emotional Screening Process                   Academic Screening Process

                    SSBD                              Curriculum Based Measures

     Teacher identifies for screening as        Schoolwide screening indicates low levels of
                externalizer                       letter identification and problems with
                                                             phonemic awareness

Passes Gate 2 with concerns in prosocial and       Teacher observes similar concerns in
            problem behaviors                                  class work

   2 Office discipline referrals for fighting


Student Support Team meets with teacher, reviews screening data, teacher feedback and
                   discusses additional risk factors affecting family

                           Referred for secondary interventions

 Meets with school counselor once weekly         Meets twice weekly with reading specialist

 Check, Connect, and Expect program daily                                                 n
                                                Supplemental instruction in areas of concer
                                                                   daily

 Family Support Coordinator connects with        Reads daily with volunteer reader or older
                  family                                         peer tutor

       Progress is monitored by teacher, CCE Coach, and by Student Support Team
    Factors Related to Screening
            Effectiveness
• Teachers are reliable evaluators/judges of student
  academic & behavioral performance when given a clear,
  overt structure to facilitate the decision making (Elliott ,
  Huai , Roach, 2007)
• Screening occurs across all students in the areas of
  health, academic, and social-emotional functioning.
• Schools need to be ready to move away from reactive
  systems of responding only to long standing need
  (Severson, Walker, Hope-Doolittle, Kratchowill &
  Gresham, 2007)
• Most effective when in the context of a comprehensive
  RTI/PBS initiative
         Issues with Implementing
                Screening
– Procedural considerations in implementation of the
  process of screening (implemented consistently and
  with fidelity to the instructions and process)

– General training in behavioral and mental health
  issues that improves teachers’ understanding of the
  purpose and content of the screening process,
  provided prior to implementation (e.g. internalizing vs.
  externalizing behaviors) as well as potential concerns
  and misconceptions
  (Severson, Walker, Hope-Doolittle, Kratchowill &
  Gresham, 2007)
    Issues with Implementation 2:
 Informed Consent, Student Privacy
• Determine threshold for specific informed consent in
  your district/community
  – Minimum includes; parents clearly informed as part of
    schoolwide academic/social screening, use of passive
    consent process for screening, outline confidentiality
    policy and follow up procedures for students who are
    identified as at-risk, no interventions at that level without
    informed parental consent
• Establish procedure to protect student privacy
  throughout the process
• Review confidentiality guidelines and follow up
  procedures with staff
      Universal Screening in
     Practice: Highline School
       District, Washington
 We cannot wait for students to fail. We must
    identify students in need of support and
provide early intervention. We can change the
   trajectory of a child from at-risk of school
      failure to socially and academically
                   successful.
      Highline Public Schools
• South of Seattle in Washington State
• 17,605 students
• 65% eligible for free & reduced-meals
• 2,305 students qualify for special
  education
• 78 languages spoken
• 3,679 English Language Learners

                              HPS Report
                              Card 2010
      Highline Ethnic Diversity
•   2.3% American Indian/Alaskan Native
•   16.8% Asian
•   5% Pacific Islander
•   14% Black
•   30% Hispanic
•   31.1% White




                                          Fall 2010
           Our Schools
• 18 K-6 Elementary Schools
• 4 Middle Schools Grades 7 & 8
• 10 High Schools
• 2 Alternative High Schools
• 1 Skills Center
• 1 Early Childhood Center
            Our PBIS Story
• 1997-1999 WA Task Force on Behavioral Disabilities
• 1998 US Office of Special Education & OSPI Fund BEACONS
  Demonstration Project to reduce referrals to EBD via PBIS
• 1998-2002 4 schools in 4 districts serve as WA demonstration
  sites Seahurst Elementary was Highline’s 1st PBIS School
• 2003-06 OSPI, OSEP, & WEA Outreach BEACONs Project
   – Six districts, 28 schools join network
   – Five Highline Elementary Schools
• 2004-05 WA State CIP/SIG Project w/ 15 Schools in 6 districts
• 2004-08 – OSEP funded CC&E Project 3 Districts 18 Schools
  Check, Connect, and Expect - 6 Highline Schools
• 2007-2008 Share Project School Results with Administrators
                                                                                    2011-2012
                                                                                    2010-2011
                                                                                    2009-2010
                        2.0 FTE District Coordination
                        PBIS P-12 35 Different Sites




                                                                                    2008-2009
                                                                                    2007-2008
                        2011-2012




                                                                                    2006-2007
PBIS in Highline




                                                                                    2005-2006
                                                                                    2004-2005
                                                                                    2003-2004
                                                                                    2002-2003
                                                                                    2001-2002
                                                                                    2000-2001
                                                                                    1999-2000
                   35                                                               1998-1999



                                            30



                                                        25



                                                             20



                                                                  15



                                                                       10



                                                                            5



                                                                                0
2010-2011 PBIS in Highline
• District PBIS Coordinator
• District PBIS Team – Representative
• Establishing PBIS Coaches Cadre
• Monthly Meetings
• 25 Schools – Tier 1 School-wide PBIS
• 12 Schools – Tier 2 Screening & CC&E
• 7 ES Schools – Tier 3 Technical Assistance
  Teams
• PBIS Baseline offered for High Schools
  From 6 to 18 Elementary
 Schools Implementing PBIS
• 2007-2008 - 6,284 Office Discipline
  Referrals = 262 Days of time Lost
• 2009-2010 - 5,690 Office Discipline
  Referrals = 237 Days of time Lost
          -3,457 Major ODRs= 144 Days
• 2010-2011 – 4,193 Office Discipline
  Referrals = 174 Days of time lost
          - 2,113 Major ODRs = 88 Days
             Highline Elementary Schools Office Discipline Referrals
7000




6000




5000




4000

                                                                        All ODR
                                                                        Major ODR
3000




2000




1000




   0
       2008-2009                  2009-2010                 2010-2011
                   HPS Elementary Suspension Data
1600




1400




1200




1000




800                                                             OSS
                                                                OSS & ISS


600




400




200




   0
       2007-2008    2008-2009        2009-2010      2010-2011
Why has screening been such
 an important part of PBIS in
          Highline?
    We know we have students exhibiting
           problem behavior?
•    486 incidents of violence/gang/weapons in 4 middle school

•    13 elementarys processed 6284 Major Office Discipline Referrals =
     1,571 hours or 262 days of instructional time lost - fighting,
     aggression, bullying, non-compliance, etc

•    1713 Major incidents of defiance/disobediance/disruptive conduct
     were reported in 4 middle schools

•    4 middle schools processed 3827 Major ODRs = 957 hours or 159
     days of instructional and leadership time lost

Elementary and Middle School ODR data in O7-08 School Year
       Prevention Logic for All
                 (Walker et al., 1996)


• Decrease development of new problem
  behaviors
• Prevent worsening of existing problem behaviors
• Redesign learning/teaching environments to
  eliminate triggers & maintainers of problem
  behaviors
• Teach, monitor, & acknowledge prosocial
  behavior
       How Did We Screen?
• Conduct SSBD Screening at October staff
  mtg.
• Counselors & psychologists help define
  externalizers & internalizers & lead process
• Teachers identify & rank students in order of
  concern
• Teachers complete the screening protocol on
  top 3 internalizers & 3 externalizers
• Bldg. PBS Team scores screening, compares
  screening to previous years ODRs &
  identifies targeted group and individuals for
  intensive supports
    What tools did we use?
• SWIS ODRs - Office Discipline
  Referrals Web-based System
  (www.swis.org )
• SSBD - Systematic Screening for
  Behavior Disorders
• 08-09 compared the SRSS -Student
  Risk Screening Scale & SSBD in 4 HSD
  schools
• Teacher Nomination
   Who was identified for Check,
     Connect, and Expect?
• 488 students in 4 years were identified & given
  permission for CC&E
• 15 schools screen and use screening for targeted
  group interventions
• About 70% of students are successful
• 15% of students need a little more
   – Academic tutoring, social skills instruction, problem solving
• 15% of students need more intensive individualized
  function-based supports or a different intervention
                The Power of Key
                  Relationships
Students who build strong positive relationships
  with school staff have significant long term
  reductions in:
  aggressiveness            substance abuse
  delinquency              teen pregnancy
  school drop outs         suspensions and expulsions
  court adjudications       academic failure
(Hawkins, Catalano, & Arthur, 2002)

A strong positive alliance with school staff is a
 key aspect of the development of resiliency.
                               WAREA 2007
        Key Relationships Cont’d
Students who build strong positive relationships
  with school staff showed significant increases
  in:
  *academic performance
  *positive social relationships
  *improved parent relationships
  *student self-esteem
  *work completion
  *sense of safety at school
(Hawkins, Catalano,&Arthur, 2002)

                              WAREA 2007
PBIS Highlights from Individual
    Schools: Cedarhurst
                                         Cedarhurst Elementary SET Data
100



 90



 80



 70



 60


                                                                                                                           2008-2009
 50
                                                                                                                           2009-2010
                                                                                                                           2010-2011
 40



 30



 20



 10



  0
      Expectations   Expectations   On-Going   Response to   Data Monitoring Management   District Support   Total Score
        Defined         Taught       Reward     Violation
Cedarhurst Total Office
Discipline Referrals from
      1,228 to 352
Cedarhurst ODRs Below the National
   Rate for Elementary Schools
      Suspension Data Cedarhurst
180



160



140



120



100

                                                      2005-2006
 80                                                   2010-2011



 60



 40



 20



  0
       Events   Suspensions   Students   Expulsions
                                       Tertiary Prevention:
CONTINUUM OF                           Specialized
SCHOOL-WIDE                 FEW        Individualized
INSTRUCTIONAL &              ~5%       Systems for
POSITIVE                               Students with High-
BEHAVIOR                               Secondary
                            ~15        Risk Behavior
SUPPORT                    SOME
                            %          Prevention:
                                       Specialized Group
  Primary Prevention:                  Systems for
  School-/Classroom-                   Students with At-
  Wide Systems for                     Risk Behavior
  All Students,
  Staff, & Settings


                            ALL
                        ~80% of Students
                                                       56
   Cedarhurst Elementary
Response to Intervention (RtI)
         19% = 73       2% = 12
         Students      Students
100%
                                     9% or 54
90%
                                     Students
80%
        21% = 80
70%     Students
60%                                               6+ ODR
                                     90% or 530   2-5 ODR
50%
                                      Students    0-1 ODR
40%
30%    60% = 233
        Students
20%
10%
 0%
           2005-2006     2010-2011
                  Student Meets CC&E Criteria
          Via SSBD Screening, ODRs,Teacher Nomination



 Program Phases                          Daily Program Routine


Basic Program                                       Morning
                                                    Check-in

                Basic Plus Program
                                          Parent                Teacher
                    (as needed)          Feedback               Feedback


 Self-Monitoring                                    Afternoon
                                                    Check-out



   Graduation
Non-responders to SWPBIS,
but 70% responding to Tier 2
          CC&E
    How has screening changed
     the way we do business in
             Highline?
• Helps us match students to building supports
• Provided teams with common language
• Strengthened behavioral expertise for all staff
• Students are identified earlier & more
  efficiently without having to “qualify”Oct.vs Apr
• Helped make the shift in thinking about
  addressing behavioral concerns the same
  way we address academic concerns -
• Teach! Re-teach! Model! Practice & Motivate!
How might screening work in
      your school?
 What questions do you have for
              us?

								
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