Designing and Delivering Intensive Intervention in Behavior - PowerPoint Presentation

Slide1

Designing and Delivering Intensive Intervention in Behavior

Name

Position

January 2014Slide2

Introduction

Review of previous NCII modules

Training goalsExamples of evidenced-based interventions (EBIs)Summary

Today’s Agenda

2Slide3

3

A Bird’s-Eye View of

DBISlide4

Relate assessment to function.

Select EBIs that align with the functions of behavior.

Link assessment and progress monitoring. Connect data with the selected EBI.

Learning

Objectives

4Slide5

5

.

Designing and Delivering Intensive Intervention

Tying It All Together!Slide6

Design and implement interventions

carefully but quickly.

Collect data in a highly feasible manner.

Establish a consistent manner of

data analysis

that is

efficient

and easy for anyone to

do.

Another Way of Thinking About It6

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide7

Part 1

Relating Assessment to FunctionSlide8

A review of Functional Behavior

Assessment (FBA)

Definition of FBA: FBA is a process for identifying the events that reliably predict

and maintain problem behavior

.

Function refers to the purpose of behavior.

Relating

Assessment

to Function

8Slide9

Assessment

(in FBA):

Need to quickly select the likely reason for the behavior.Time is a precious commodity. Educators need to be efficient when problem solving.

Under many circumstances, the most efficient thing to do is to test the easiest hypothesis first, implement an intervention,

monitor,

and

then evaluate the outcomes

.

Relating Assessment to Function

9Source: Evidence Based Intervention Network (http://ebi.missouri.edu)

/Slide10

A student

has not learned the

behavior.Inappropriate behavior removes a student from what he or she does not want to do (escape).

Inappropriate behavior gets a student something (typically attention).

A student has not had to do the behavior in that way before.

Common Reasons Why

Students Misbehave

10

Source:

Evidence Based Intervention Network (http://

ebi.missouri.edu)

/Slide11

If starting with a reasonable hypothesis fails

to improve student performance, then something progressively more time intensive can be attempted until the probable cause of failure is identified

.Note: Easier solutions are more likely to be implemented

consistently, whereas solutions that are more time consuming or technically difficult for teachers and support personnel are less likely to be implemented correctly (Gresham, 1989)

.

Start With a Reasonable Hypothesis

11

Source:

Evidence Based Intervention Network (http

://ebi.missouri.edu)

/Slide12

Identify the hypothesized function of behavior and then select the intervention.

Selecting an intervention with the appropriate level of rigor based on the problem is essential.

After the intervention is selected, the analysis phase can begin. It is only in the analysis phase where a team will find out if the assessment phase was successful.

Importance of Identifying

Function First

12

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)/Slide13

Part 2

Selecting Evidence-Based Interventions That Align With the Functions of BehaviorSlide14

EBIs

are treatments that have proven effective through rigorous outcome

evaluations.Selecting Evidence-Based Interventions

14

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide15

Medicine

and clinical and counseling psychologyLots of discussion and debate about the pros and cons of an EBI approach

Field agreement with a deep understanding of EBIEducation and school psychology

Very little discussion (if any) about

whether

we should use EBI

Field agreement with no real understanding of EBI

Th

e History of Evidence-Based Interventions Across Professions

15

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide16

16

The History of Evidence-Based Interventions (Handout 1)Slide17

Tier

I: Whole-school

best practicesTier II: Functionally related small- group practicesTier III: Individually functionally based practices

What Are Evidence-Based Interventions in Schools?

17

Source:

Evidence Based Intervention Network

(http

://

ebi.missouri.edu)

/Slide18

Why is it important to pick the “right” EBI for each case if they are all evidence based?

There are important limitations in EBI that we like to call the “fine print,” which are important to understand to effectively use this technology.

Selecting

Evidence-Based Interventions That Align With Function

18

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide19

EBIs are validated for a specific purpose with a specific

population.

Implication: EBIs are useful only for a range of problems and, as such, must be paired

up with the right situation.

“A

hammer is an effective

tool

but not with a

screw.”Fine Print I: Tiers 2 and 3

19

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide20

Evidence-based Tier 3 interventions assume

implementation

integrity.ImplicationsChanging parts of an intervention, while typical, can invalidate

an EBI.How can an intervention be changed—

frequency

,

materials

,

t

arget, style, and so on?

Fine Print II

20

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide21

EBIs are

typically validated with

large-group research or a series of small-group studies.Implications

EBIs have been documented as likely effective, not surely

effective.

Even the most effective interventions are often ineffective with a specific

case.

As

such, you cannot assume an EBI will

work for every student in every situation.Fine Print III

21

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide22

A

list of

EBIs is just a good place to start, but even if selected carefully, they may not be effective.Additional steps are necessary.

Need

to select

EBIs

that make sense for the current

case.

Need to implement EBIs

with integrity.Need to collect outcome data—progress and outcomes.

Need to evaluate the effectiveness in some manner to see if it

worked and make adaptations as necessary.

Implications of Evidence-Based Interventions

22

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide23

23

A Bird’s-Eye View of

DBISlide24

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Decoding the Terminology:

EBI and DBISlide25

What the intervention will look like (i.e., steps or procedures)

What

materials and/or resources are needed and whether these are available within existing resourcesRoles and responsibilities with respect to intervention implementation (i.e., who will be responsible for running the intervention and preparing materials)

What Should Tier 3

Intervention Plans Include?

25

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide26

The

intervention

schedule (i.e., how often, for how long, and at what times in the day) Context (i.e.,

where and with whom)

How the intervention and its outcomes will be

monitored

(i.e., what measures, by whom, and on what

schedule)

and analyzed (i.e., compared to what criterion).

What Should Tier 3 Intervention Plans Include?26

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide27

When considering an intensive intervention, teams are asked to consider what they think are the most likely reasons for the problem behavior.

Once selected, these hypothesized reasons are then used to select interventions.

If there is more than one likely reason selected, try rank ordering from most to least likely.

Considerations for Tier 3 Interventions: The “How”

27

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide28

Selected interventions should be customized to the student with care so as to not alter the function

.

Change the icing, not the core ingredients. For example, although praise is often suggested in reinforcement-based interventions, other reinforcements can be used if praise does not act in a reinforcing manner for the target student. That being said, you cannot remove the reinforcement fully from such an intervention.

Implement.

Collect outcome data.

Analyze.

Considerations for Tier 3 Interventions: The “How”

28

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide29

The true documentation that an intervention is

evidence based

for a specific case occurs only when there are outcome data indicating a change in the target behavior.  Considerations for Tier 3 Interventions: The “How”

29

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide30

A student has not learned the behavior.

Inappropriate behavior removes a student from what he or she does not want to do (escape).

Inappropriate behavior gets a student something (typically attention).A student has not had to do the behavior in that way before.

Common Reasons Why

Students Misbehave

30

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)/Slide31

NCII does not endorse any of the interventions presented in this training. We would like to acknowledge that these examples were selected for training and illustrative purposes and in large part because they are commonly used in tiered systems and have an intriguing evidence base.

However, NCII, through

its Technical Review Committee (TRC), has not yet validated any of the strategies or interventions listed in this training. It is planning to review interventions in the next several years to provide endorsed options.

Selecting Evidenced-Based Interventions That Align With Function

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Check In Check Out (CICO)

Non-contingent reinforcement (NCR): attention seeking

Antecedent modification: escape Instructional match: prerequisite skill or ability

Examples of Evidence-Based Interventions

32

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide33

An empirically supported strategy for reducing problem behavior

Relatively quick and easy; provides structure

Increases positive adult contact

Excellent intervention when the

function of behavior is attention seeking

Also useful for students

who escape because they do n

o

t want to do a task if teach praise is more reinforcing than the task is punishing.

Check In Check Out

33

Source:

Michigan’s Integrated Behavior and Learning Support Initiative (http

:/

/miblsi.cenmi.org)

/Slide34

Focus on teaching

Check-

in check-out system

Daily classroom report card

Home-school partnership

Collaborative team-based process

Elements of Check In Check Out

34

Source:

Michigan’s Integrated Behavior and Learning Support Initiative (http

:/

/miblsi.cenmi.org)

/Slide35

Students engaging in externalizing behaviors

Less than 15 percent of students

Students with multiple referrals (two to five major referrals)

Students who receive several minor referrals

Students who receive referrals in multiple settings

Students who find adult attention rewarding or reinforcing

For Whom Should

Check In Check Out Be Used?

35

Source:

Michigan’s Integrated Behavior and Learning Support Initiative (http

:/

/miblsi.cenmi.org)

/Slide36

On a daily basis, there are increased structure, feedback,

and adult

support. There are daily home and school communications and collaborations.

Data are collected, reviewed, and used to make decisions about the intervention success (or lack there of).

The Benefits of Check In Check Out

36

Source:

Michigan’s Integrated Behavior and Learning Support Initiative (http

:/

/miblsi.cenmi.org)/Slide37

.

37

Source:

Michigan’s Integrated Behavior and Learning Support Initiative (http

:/

/miblsi.cenmi.org)

/Slide38

Non-contingent Reinforcement

.

38

Photo Credit:

http

://www.flickr.com/photos/familymwr/4919451795

/

; http://creativecommons.org/licenses/by/2.0/deed.enSlide39

NCR

is a powerful method to reduce

attention-seeking problem behavior. NCR involves giving a

student access to a reinforcer frequently enough so that

he or she is

no longer motivated to exhibit disruptive behavior to obtain that same

reinforcer (e.g., saturate

the environment with the reinforcer

before the behavior

occurs).What Is Non-contingent Reinforcement?

39

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide40

Example

:

A student wants teacher attention and calls out or engages in disruptive behaviors to get attention consistently during a group activity, such as art or story time.

Possible solution: The teacher will provide appropriate attention prior to the student “asking” for attention with the “problem behavior” (e.g., have the student sit with the teacher while she is reading a book to the class).

An Example of Non-contingent Reinforcement

40Slide41

You need to identify the reinforcer for the problem behavior. NCR will not work if you do not know the function of the disruptive behavior.

The problem behavior must be attention seeking.

You need a schedule for NCR delivery that minimizes problem behavior.NCR is most effective with a heavy dose of reinforcement early in the day.You must ignore problem behavior after the schedule is initiated.You should fade the process as problem behavior declines but make sure the student does not reengage in behavior by fading too quickly.Slowly reduce the amount of NCR given. Note: NCR is good teaching practice, so it should never be “stopped.”

a

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Critical Components for SuccessSlide42

.

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Antecedent Modification

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)/

Photo

credit:

http://www.flickr.com/photos/edenpictures/2969677793

/

; http

://creativecommons.org/licenses/by/2.0/

The “Great Escape”Slide43

The student does not have to do something when he or she exhibits the problem behavior.

The problem behavior is “working” for the

student by allowing him or her to escape

something that he or she does not want to do.

What Is Antecedent Modification

?

43

Source:

Evidence Based Intervention Network (http

://ebi.missouri.edu)/Slide44

Example:

A student wants to escape a non-preferred activity, such as mathematics or physical education. Every time the teacher announces the start of

a specific activity, the student starts engaging in disruptive behaviors (e.g., runs away, shouts out, pretends

to sleep).

Possible

solutions:

Minimize

the need

for the escape by making the target activity less punishing!

Alter antecedents to increase task engagement, appropriate behaviors, and general success (e.g., preteaching, offering choice, and modeling).

An Example of Antecedent

Modification

44Slide45

Positive reinforcement (e.g., praise) for engaging

in the

activityReinforce appropriate behaviors in shorter intervals initially (e.g., change the schedule of reinforcement or task demand)

Critical Components for

Success

45

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)/Slide46

Instructional Match

.

46

Photo credit:

http

://www.flickr.com/photos/charlottel/154443920

/

;

http://www.flickr.com/photos/dno1967b/8703319368

/

; http

://creativecommons.org/licenses/by/2.0/Slide47

Escape behavior related to academic tasks that are simply “too hard.”

For example, a student might not be successful because the instructional materials are too difficult, or he or she may not have the prerequisite skills.

.

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What Is Instructional Match?

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide48

There is a

mismatch between student skill and

the level of difficulty of the task: the assessment of a student’s current instructional level is inaccurate in some way (e.g., knowledge, difficulty, pace,

and/or level).Students

who are

failing academically

are frustrated and often

act out

!Characteristics of Instructional Match

48Slide49

Examples:

Doing addition problems

without being able to countJournal writing without being able to form two- or three-word sentencesDrawing without fine motor skills, such as pencil grip

Running without proper gait (e.g., can walk only on tippy toes)

Possible Solutions

:

Preteach

content

or skill.

Reduce the difficulty of the task.Break down tasks into smaller, more manageable subtasks.Use curriculum-based measurement (CBM) to determine

the appropriate

instructional

level.

Examples of Instructional Match

49

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide50

Must be able to accurately assess a student’s current level of ability and implement a curriculum and teaching materials that are appropriate to the student’s instructional level.

Must match task demands with current skill levels to ensure success.

Differentiate instruction whenever possible and appropriate..

50

Critical Components for Success

Source:

Evidence Based Intervention Network (http

://

ebi.missouri.edu)

/Slide51

51

Source:

Seligman & Maier (1967)

Learned Helplessness StudiesSlide52

Part III

Linking Assessment and MonitoringSlide53

Determine the plan and who is responsible for execution at each

step.

Identify training and resources.

Monitor the plan.

Use a cycle

of

support.

Implementing and Monitoring Outcomes

53Slide54

Teaching

Coaching and feedback

Scripts for adults to follow Data

collection

Follow-up support meetings

Follow-up

data

evaluation

Plan for Integrity of Implementation

54Slide55

Evaluate the effects of

interventions,

comparing baseline data to data during intervention. Is your plan working?

If your plan is not working, consider some reasons why it might not be working.

What

changes are needed in your plan?

Make

those changes

.Monitor the Plan:

Five Considerations55Slide56

If your plan is working, consider what you will do next. Will you simplify the plan to make it more efficient?

Will

you fade, change, or terminate your interventions?

Continue to implement your interventions until you feel they are no longer needed or

working.

After terminating the plan, continue to collect data to determine whether any positive effects are maintained following

plan termination

.

Monitor the Plan:

Five Considerations56Slide57

Were

the goals

of the support plan achieved?Was implementation done consistently and with integrity?Is more assessment needed?

How should the plan be modified?

Data-Based Decisions

57Slide58

Part IV

Connecting Data With the Evidence-Based Intervention SelectedSlide59

Connecting

Data

W

ith the Selected Evidence-Based Intervention

59Slide60

Direct Behavior Rating

60Slide61

Comparing Non-intervention and Intervention Patterns: Example 1

61Slide62

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Comparing Non-intervention and Intervention Patterns: Example

2Slide63

Comparing Non-intervention and Intervention Patterns: Example 3

63Slide64

What is an EBI?

What are some of the reasons why it is important to align EBIs and the function of behavior?

What are the four EBIs we mentioned today and can you give a quick description of them?

Bonus question: Can you describe the components of the DBI process and where EBIs fit in? (

Hint:

Think of all the NCII trainings.)

Quick Review

64Slide65

Direct behavior ratings. (2010). Storrs, CT: University of Connecticut. Retrieved from

http://www.directbehaviorratings.com/cms

/Gresham, F. M. (1989). Assessment of treatment integrity in school consultation and prereferral intervention. School Psychology Review, 18, 37

–50.Michigan Department of Education. (n.d.). Michigan’s integrated behavior and learning support initiative.

Lansing, MI: Author. Retrieved

from

http://miblsi.cenmi.org

/

National Center on Intensive Intervention. (2013). Data-based individualization: A framework for intensive intervention. Washington, DC: Author. Retrieved from http://www.intensiveintervention.org/sites/default/files/DBI%20a%20Framework%20for%20Intensive%

20Intervention.pdfReferences

65Slide66

School of Psychology at Mizzou. (2011). Evidence Based Intervention Network.

Columbia, MO: University of Missouri. Retrieved from

http://ebi.missouri.eduSeligman, M. E. P., & Maier, S. F. (1967). Failure to escape traumatic shock. Journal of Experimental Psychology, 74(1). Retrieved from

http://psych.hanover.edu/classes/learning/papers/seligman%20maier%201967.pdf

References

66Slide67

This

presentation

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.

DisclaimerSlide68

/

Name:

Title:

E-mail:

National Center on Intensive Intervention

1000 Thomas Jefferson Street NW

Washington, DC 20007-3835

866-577-5787

www.intensiveintervention.org

Email: ncii@air.org