Providing Intensive Intervention Using Data-Based Individualization in Behavior

1. Providing Intensive Intervention Using Data-Based Individualization in Behavior Joseph Wehby, Ph.D. NCII Senior Advisor Vanderbilt University January 2013

2. Today’s Webinar • The need for intensive intervention • Using Data-Based Individualization (DBI) to provide intensive intervention in behavior • DBI process with student example • Ryan- behavior • Time for questions

3. Intensive interventions are designed to address severe and persistent learning or behavior difficulties. These interventions should be data driven and are characterized by increased intensity (e.g. smaller group, expanded time) and individualization of academic instruction and/or behavioral supports.

4. The Need for Intensive Intervention • The school completion rate for youth with emotional disturbances (56%) is lower than the rate for all other categories, with the exception of youth with multiple disabilities or intellectual disabilities (NLTS-2). • More than one-third of dropouts with disabilities have spent a night in jail, three times the rate of youth with disabilities who finished high school. Controlling for other differences between them, dropouts are 10 percentage points more likely to have been arrested than youth with disabilities who finished high school (NLTS-2). • Integrating intensive behavioral intervention into tiered systems is challenging and complicated work. Kids at the top tier of support continue to have poor outcomes.

5. The Need for Intensive Intervention • Not all students respond to standardized, evidence-based interventions… • Analysis of student response data from controlled studies suggests that approximately 3-5% of students do not respond to standard, evidence-based intervention programs (Fuchs et al., 2012; Wanzek & Vaughn, 2009; Conduct Prevention Problems Research Group, 2002). • Despite interventions being generally effective for students demonstrating difficulty • Categorization of ‘risk’ may be too broadly defined in these studies to generalize to students with the most intensive needs

6. What does this suggest? • Although standardized, evidence-based (i.e., secondary or Tier 2) interventions are effective for many students, they may be insufficient for those with the most intensive needs. • There is likely no single intervention program(s) that will meet the needs of all students who have significant and persistent academic or behavior challenges. • For some students, individualized, intensive intervention will be necessary to facilitate progress. Student data and guiding principles for intensifying intervention should drive these decisions. Note: Many good teachers already adjust their behavioral interventions to meet student needs; DBI is a process that helps them to do so in a more systematic and data-driven way.

7. Who needs intensive intervention? • Students with disabilities who are not making adequate progress in their current program • Students with disabilities who present with very low academic achievement, and/or high-intensity or high frequency behavior problems • Students in a tiered program who have not responded to secondary intervention programs delivered with fidelity

8. NCII’s Approach to Intensive Intervention: Data-Based Individualization (DBI) Data-Based Individualization (DBI) is a systematic method for using data to determine when and how to provide more intensive intervention: • Origins in data-based program modification first developed at the University of Minnesota (Deno & Mirkin, 1977) • DBI is a process, not a single intervention program or strategy • Not a one-time fix—Ongoing process comprised of assessment-linked interventions

9. Is DBI the same as RTI? Special Education? • Many components of DBI are consistent with elements of special education and tiered service delivery systems. The individualization aspect of DBI is aligned with the principles of serving students with special needs. • Tiered Interventions (RTI, MTSS, PBIS) • Universal, secondary, and tertiary interventions • Progress monitoring • Team-based decisions based on data • Special Education • Individualized instruction/intervention • Progress monitoring • Team-based decisions based on data

10. Is DBI the same as RTI? Special Education? • DBI is best accomplished in the context of systems with these components. • DBI is designed to work in concert with these systems. Despite the existence of these systems, students with the most intensive needs continue to struggle academically and behaviorally. • DBI addresses non-responsiveness in RTI and special education.

11. Before starting DBI, consider the secondary intervention platform… • Has the student been receiving an evidence-based secondary behavioral intervention that is appropriate for his/her needs? • Has the behavioral intervention been implemented with fidelity? • Content • Dosage/schedule • Group size • Has the program been implemented for a sufficient amount of time to determine response?

12. NCII’s Intervention Tools Chart provides reviews of secondary intervention platforms • Behavior Tools: In progress • Academic Tools: http://www.intensiveintervention.org/chart/instructional-intervention-tools

13. NCII’s Approach to Data-Based Individualization

14. Sample Behavioral Progression *NCII does not endorse products. We use Check-in/Check-out for illustrative purposes.

15. Implement Secondary Intervention

16. Secondary Intervention: Student Example Ryan • Background: Ryan was identified as having externalizing behavior problems in January of his 4th grade year. Ryan had an excessive number of office disciplinary referrals (ODRs) and frequently instigated fights with other students. • Intervention Platform: Because of Ryan’s excessive ODRs, a Check-in/Check-out system was implemented.

17. Ryan’s Check-in/Check-out Card 0 = Goal not met 1 = Goal partially met 2 = Goal fully met

18. Secondary Intervention: Student Example Check-in/Check-out Procedures • Dedicated staff person “checks in” with the student to get ready for the day • Teachers provide feedback on student goals (aligned to school-wide expectations) throughout the day • Dedicated staff person “checks out” with the student to reflect on the day • Student accumulates points that can be traded at pre-determined times for activities, prizes, or free time • Staff collect data daily and review student progress weekly

19. Secondary Intervention: Student Example Check-in/Check-out Fidelity

20. Progress Monitoring:Are we doing what we said we would do?Is it working? • Progress Monitoring tool: Check-in/Check-out card • Measure(s): 1. Percent of daily Check-in/Check-out points 2. ODR’s 3. Teacher fidelity • Outcome: Although some progress was evident, Ryan continued to have an unacceptable number of ODRs based on school cut points, and met his daily report card goal of earning 80% of his CICO points only 40% of the time. *Unlike academics, it may be unrealistic to expect behavior to change along a linear progression.

21. Progress Monitoring: Is it working?

22. Next Steps • Despite secondary interventions delivered with fidelity, Ryan continued to make insufficient progress. • The intervention teams decided that more intensive supports were needed. • The team needs to problem solve and hypothesize what modifications may be effective.

23. Problem Solving

24. Team Problem Solving:What could be intensified to make the intervention more effective for Ryan? • The team met to analyze Ryan’s progress. • Review student data: • Ryan’s CICO cards showed that he had difficulty earning points for “Be Respectful”. • Define the problem: • Ryan’s teachers noted that Ryan often disrupts class with both verbal (yelling out) and physical (throwing pencils, touching peers) outbursts. • Hypothesize: • The team hypothesized that Ryan may benefit from social skills instruction surrounding appropriate ways to get attention from others, as well as instruction and monitoring in goals specific to his needs.

25. Intensify the Secondary Intervention

26. Intensify Intervention:Student Example • Social Skills group: Ryan will join a social skills group working on goals of showing respect with language and physical interaction. • Social goals: Ryan will work toward specific goals related to his social skills curriculum and school wide expectations. Ryan’s Modified CICO Card

27. Progress Monitoring:Are we doing what we said we would do?Is it working?

28. Next Steps • Ryan is making some progress, and is now meeting his CICO goal 50% of the time. • However, the rate of Ryan’s progress is insufficient and Ryan continues to receive ODRs almost weekly. • After 1-2 more attempts to modify Ryan’s secondary (tier 2) intervention, the team should move to a more intensive (tier 3) intervention.

29. Intensive (Tier 3) Intervention

30. Functional Behavior Assessment: Student Example • After clearly defining Ryan’s problem behavior and gathering more information (teacher and parent reports, observations of student behavior, review of existing data), the team began to analyze the function of Ryan’s behavior. • In determining the function of Ryan’s behavior, the team will be better equipped to address Ryan’s problem behaviors by encouraging replacement behaviors that will provide Ryan with the same function. *Functional Behavior Assessment will be discussed in more detail in a webinar in spring 2013

31. Developing a Behavior Intervention Plan • The next step is to develop a behavior plan based on the Functional Behavior Assessment. • The plan should be clearly linked to the hypothesized function(s) of behavior. • The plan should be ambitious but feasible, targeting prioritized behaviors and setting achievable goals. • The plan will draw from principles of intensive intervention.

32. Sample Principles of Intensive Behavioral Intervention • Present examples of desired behaviors, explain why each is important, when they should be used, model the behavior, and have the student practice the behavior. • Break behavior goals into smaller steps as students learn new skills.  Provide reinforcement for implementation at shorter intervals to begin with. • Explicitly link behavior plans to the function identified in the FBA. Revisit the plan as often as needed. • Conduct ongoing assessment information to determine effectiveness of FBA-based plan. • Teach appropriate social skills and behavioral expectations to independence and fluency. • Address practice, maintenance, and generalization of behavioral skills.

33. Ryan’s Behavior Intervention Plan • Designed based on the functions noted in the FBA • Gain attention from peers • Avoid difficult tasks/Gain attention from peers • Addressed the functions of Ryan’s behavior by teaching and reinforcing positive replacement behaviors • Ryan was explicitly taught strategies for initiating contact with peers and appropriately making requests. Instruction included examples, a rationale for why the behaviors are important, modeling, and practice. • Check-ins were continued, with modified goals, to provide increased opportunity for practice and prompting, as well as reinforcement for appropriate behavior.

34. Monitoring Progress for Intensive Intervention:Direct Behavior Rating (DBR) • DBR uses ratings of a general outcome behavior following a specified observation period (e.g., lunch, class period). • The team defined two behaviors to track using DBR: • Disruptive behavior • Academic engagement • Teachers also kept a tally of appropriate requests for assistance.

35. Evaluation of Ryan’s Progress • Review of Ryan’s DBR and ODR data after 6 weeks indicated that his behavior plan was working. His DBR data had reached typical class levels (80% for academic engagement, 10% for disruptive behavior). His ODRs decreased and he reached his goals on his daily report card 90% of the time. • Ryan’s teachers reported that he was making progress in his social interactions. A tally kept by Ryan’s teacher indicated that he appropriately asked for help with a task when he did not understand 70% of the time. • The team determined that Ryan continued to need this level of support to be successful, so they decided to continue to implement the plan, collect, and regularly evaluate progress data.

36. In Summary • DBI is an ongoing process that comprises ongoing assessment, intervention, evaluation, and adjustment to maximize student outcomes. • Intensive interventions will not look the same for all students • Students requiring intensive intervention are likely to need it for a significant amount of time. • There is no quick fix.

37. Caveats & Implementation Tips • DBI is intense. If more than 3-5% of students in a school appear to need it, consider evaluating core instruction, school-wide behavior supports, and secondary intervention programs. • Academic and behavior supports do not exist in isolation; They are often most successful when combined to meet students’ individual needs. • When making intervention adaptations, consider choosing a small number to try at a time. This will allow you to be more systematic in your ongoing progress monitoring and analysis. • Every student presents unique needs. While our examples provide an illustration of the DBI process, it will vary based on individual needs. Some DBI processes will be much more involved than others.

38. References Conduct Prevention Problems Research Group (2002). Evaluation of the first 3 years of the Fast Track prevention trail with children at high risk for adolescent conduct problems. Journal of Abnormal Child Psychology, 30(1), 19–35. Deno, S. L., Mirkin, P. K., & Leadership Training Inst. for Special Education, M. n. (1977). Data-Based Program Modification: A Manual. Fuchs, D., Fuchs., L.S., & Compton, D.L. (2012). Smart RTI: A next-generation approach to multilevel prevention. Exceptional Children, 78, 263-279. Lane, K. L., Weisenbach, J. L., Phillips, A., & Wehby, J. (2007). Designing, implementing, and evaluating function-based interventions using a systematic, feasible approach. BehavioralDisorders, 32, 122–139.

39. References Wagner, M., Newman, L., Cameto, R., Levine, P., Garza, N., Institute of Education Sciences (ED), W. C., & SRI International, M. A. (2006). An Overview of Findings from Wave 2 of the National Longitudinal Transition Study-2 (NLTS2). NCSER 2006-3004. National Center For Special Education Research. Wanzek, J., & Vaughn, S. (2009). Students demonstrating persistent low response to reading intervention: Three case studies. Learning Disabilities Research & Practice, 24(3), 151-163. doi:10.1111/j.1540-5826.2009.00289.x

40. Disclaimer • This webinar was produced under the U.S. Department of Education, Office of Special Education Programs, Award No. H326Q110005. Celia Rosenquist serves as the project officer. • The views expressed herein do not necessarily represent the positions or polices of the U.S. Department of Education. No official endorsement by the U.S. Department of Education of any product, commodity, service or enterprise mentioned in this website is intended or should be inferred.

41. 1050 Thomas Jefferson Street, NW Washington, DC 20007- 3835 Email: ncii@air.org Website: www.intensiveintervention.org While permission to redistribute this webinar is not necessary, the citation should be: National Center on Intensive Intervention. (2013). Providing Intensive Intervention using Data-Based Individualization in Behavior. Washington, DC: U.S. Department of Education, Office of Special Education Programs, National Center on Intensive Intervention.