Systematic Screening for Behavior Disorders by alicejenny


									  Systematic Screening
Approaches for Students in
  Tier 2/3 Interventions

       Tricia Robles M. Ed.
       Jinna Risdal M. Ed.
     Highline School District
•   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
                   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.

                   Curriculum based measurement                 SSBD, record review, gating

  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
                     awareness, phonics, fluency,        supervision, behavioral contracting, group
                      vocabulary, comprehension          contingency management, function-based
                                                                 support, self-management

                       Core, strategic, intensive             Primary, secondary, tertiary tiers
 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
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
       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,
    How Screening relates to
• Academic success inextricably linked to
  social/behavioral skills
   – Five predictor variables concerning student
     skills or behaviors related to success in
   – (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
    2. Has Technical Adequacy
    3. Useable - efficient, feasible, easy to
      - 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,
• 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 &

          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)


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


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)
     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-
• 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
  – Phase 2: 10 items five academic and five academic enabling
    behaviors rating of students who passed through phase 1 (from
  – 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
    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
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
                                 Shin Ji
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

 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
• 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
– 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
      Highline Public Schools
• South of Seattle in Washington State
• 17,605 students
• 65% eligible for free & reduced-meals
• 2,305 students qualify for special
• 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
                        2.0 FTE District Coordination
                        PBIS P-12 35 Different Sites


PBIS in Highline

                   35                                                               1998-1999







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
• 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




                                                                        All ODR
                                                                        Major ODR



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




800                                                             OSS
                                                                OSS & ISS




       2007-2008    2008-2009        2009-2010      2010-2011
Why has screening been such
 an important part of PBIS in
    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
• Prevent worsening of existing problem behaviors
• Redesign learning/teaching environments to
  eliminate triggers & maintainers of problem
• Teach, monitor, & acknowledge prosocial
       How Did We Screen?
• Conduct SSBD Screening at October staff
• Counselors & psychologists help define
  externalizers & internalizers & lead process
• Teachers identify & rank students in order of
• 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
  ( )
• SSBD - Systematic Screening for
  Behavior Disorders
• 08-09 compared the SRSS -Student
  Risk Screening Scale & SSBD in 4 HSD
• 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
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
  *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









      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





 80                                                   2010-2011




       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

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

 Program Phases                          Daily Program Routine

Basic Program                                       Morning

                Basic Plus Program
                                          Parent                Teacher
                    (as needed)          Feedback               Feedback

 Self-Monitoring                                    Afternoon

Non-responders to SWPBIS,
but 70% responding to Tier 2
    How has screening changed
     the way we do business in
• 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

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