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Prevent-Teach-Reinforce (PTR):  An Evidence-Based Functional Behavior Assessment/Behavior Prevent-Teach-Reinforce (PTR):  An Evidence-Based Functional Behavior Assessment/Behavior

Prevent-Teach-Reinforce (PTR): An Evidence-Based Functional Behavior Assessment/Behavior - PowerPoint Presentation

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Prevent-Teach-Reinforce (PTR): An Evidence-Based Functional Behavior Assessment/Behavior - PPT Presentation

Rose Iovannone PhD BCBAD iovannoneusfedu 8139741696 The contents of this training were developed under grant H324P04003 from the Department of Education Agenda Overview PTR PTR Process ID: 779291

teacher behavior jeff intervention behavior teacher intervention jeff mike step activity team preferred ptr student reinforce teach day choice

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Slide1

Prevent-Teach-Reinforce (PTR): An Evidence-Based Functional Behavior Assessment/Behavior Intervention Process for Students Needing Tier 3 Supports

Rose Iovannone, Ph.D., BCBA-D

iovannone@usf.edu813-974-1696

The contents of this training were developed under grant H324P04003 from the Department of Education

Slide2

AgendaOverview PTRPTR ProcessStep 1-Teaming/goal setting/progress monitoringStep 2 Functional assessmentStep 3a-Behavior intervention plan

Step 3b-Coaching/FidelityStep 4-Monitoring and making data-based decisionsNext steps

Slide3

ObjectivesParticipants will:Describe the 4-step PTR Tier 3 support modelIdentify the critical components that enhance the success of Tier 3 supportsDetermine how the PTR process is applicable within their setting

Slide4

Prevent-Teach-ReinforceThe Model

Slide5

What is Prevent-Teach-Reinforce (PTR)?Research project funded by U.S. Department of Education, Institute of Education SciencesUniversity of South Florida Three central Florida school districtsUniversity of Colorado, Denver

Two Colorado school districtsPurposes:Answer the call for rigorous researchEvaluate effectiveness of PTR vs.

“services as usual” using randomized controlled trialEvaluate effectiveness of “standardized “ approach

Slide6

Where is PTR in a Multi-tiered System of Supports (MTSS)?

Slide7

Participants in PTR 245 students—100 treatment, 100 comparisonK-8th gradeGeneral and Special Education

All cognitive levelsAll disabilitiesTeacher-nominated top externalizers

Systematic Screening for Behavior Disorders (SSBD)Behavioral difficultiesDuration– minimum 6 monthsFrequency— minimum of 1 time per weekIntensity– disruption to the learning environment

Slide8

PTR Preliminary Outcomes

Slide9

Student Demographics by Primary Disability

Disability

N

Percent

Autism25

9.8

Developmental Delay

5

2.0

Emotional Disturbance

38

14.9

Intellectual Disability

28

11.0

Multiple Disabilities

4

1.6

OHI (not ADD/ADHD)

1

.4

OHI (ADD/ADHD)

8

3.1

Specific Learning Disability

20

7.8

Speech/Language Disability

10

3.9

Visual Impairment

2

.8

General Education

99

38.8

TOTAL

245

Slide10

Student Description

Grade Level

K

1

2345678

N

34

53

53

41

30

16

7

8

3

%

13.9

21.6

21.6

16.7

12.2

6.5

2.9

3.3

1.2

Lunch Status

Regular

Free/Reduced

77

150

31.4

61.2

Gender

Female

Male

45

200

18.4

81.6

Slide11

Randomized Controlled Trial Results

Slide12

Wait-List Control to Treatment Results

Slide13

Teacher OutcomesFidelityMajority of teachers achieved .80Mean # coaching/training sessions = 3.5Prevention higher than Teach and Reinforce

Social ValidityModified Teacher Acceptability Rating Form (TARF; Reimers & Wacker, 1988)—15 items5-point Likert Scale124 teachers

Overall—4.16 (.52)Willingness to carry out plan—4.80 (0.42)Like the procedures—4.46 (0.64)AllianceTeachers rated PTR consultants highly (4.80 mean)Highest—trust, follow-through, collaborative

Slide14

Other Research

Slide15

Research in PTRTwo randomized controlled trialsOriginal for kindergarten through grade 8 (5 years to ~ 14 years of age)Young children (3 years to 6 years of age)Several single subject studies

General educationAutismChild care settingsFamiliesHigh school students with emotional disorders

Slide16

Research OutcomesRCT-Students receiving PTR significantly improved social skills, problem behaviors and academic engagement compared to those who received services as usual (SAU)Single subject—multiple baseline designs showed PTR improved the dependent variable in all studiesTeachers implemented the interventions with high (e.g., 80% or greater) fidelity

Teachers found PTR to be socially valid

Slide17

Sullivan, Crosland, Iovannone, 2016

PTR High School EBDDirect Observation

Slide18

Sullivan, Crosland, Iovannone, 2016

PTR High School EBDTeacher IBRST Ratings

Slide19

Barnes,

Iovannone, Blair, Crosland, & George, 2016

An Evaluation of the Prevent-Teach-Reinforce Model in a General Education Setting

Slide20

Kulikowski

, Blair, Iovannone

, & Crosland, 2015An Evaluation of the Prevent-Teach-Reinforce (PTR) Model

in a Community Preschool Classroom

Slide21

The PTR Process

Slide22

PTR Model

Student-Centered Team

FacilitatorMember(s) who know studentMember(s) who know school/district

Start here

Slide23

Teaming (Before the Process is Started) Teaming: A collaborative processDetermine relevant team membersSuggestions—3 levels of knowledge represented:Members

Person with knowledge of student (e.g., Classroom teacher, instructional assistant, parent)Facilitator—Someone with knowledge of functional assessment, behavioral principles (PTR consultant, school-based consultant)Someone with knowledge of context (e.g., administrator or designee)

Slide24

Collaboration Activity-

p. 3 Activity Packet

Slide25

Teaming (PTR Style)Optional forms Best used for situations in which the team may not be collaborating effectively

Forms for creating an effective cohesive teamClassroom Team Survey (

68-69)Teacher Work-Style Survey (70)Paraeducator Work-Style Survey (71)PTR Work-Style Comparison Sheet

(72-used by facilitator) Purposes: To identify potential issues enhancing and impeding effective intervention implementation

Slide26

Step 1-Goal SettingIdentify the problem

Slide27

Step 1: Goal SettingPurpose: Identify behaviors of greatest concern to the team and possible replacement behaviors (teach)Prioritize and operationalize behaviors targeted for interventionDevelop teacher friendly baseline data collection system

Areas that can be targeted:Problem behaviorsSocial skillsAcademic behaviorsDifferent options/versions in

PTR Tools handout (11-19)

Slide28

Slide29

Slide30

Slide31

Case Study 1Mike9-year-old maleESE Classification: AutismPlacement: Self-contained, autism classroom with 6 students

Nonverbal: Uses signs, Dynamite, pictures to communicate Team: Teacher and two aides, PTR Consultant

Slide32

Mike’s Team-Goal Setting

BEHAVIORS TO DECREASE

Target Behavior:ScreamingHitting

Getting out of seatBossing peersOperational Definition:Loud, high pitched noise heard outside the classroom

Touching peers or adults with open hand, fist, foot, or object while screamingBEHAVIORS TO INCREASETarget Behavior:Transition from preferred to non-preferred activitiesExpress frustration using his communicationAsk for a break or attentionInitiate peer interactions using communicationOperational Definition:Moving to non-preferred activity and engaging in communication at inside voice volume and pitchUse communication (voice output device, signs, pictures) to request a break or attention

Slide33

Case Study 2-Jeff General EducationRetained second graderClass had 19 studentsTeam included two co-teachers

both with their own second grade classrooms

Slide34

Jeff’s Behaviors

BEHAVIORS TO DECREASE

Target Behavior:Disruptive behaviors

Negative commentsOperational Definition:Tapping pencil, making loud comments without raising hand, tapping person seated near him, getting out of seat to sharpen pencil without permission.BEHAVIORS TO INCREASE

Target Behavior:On-task behaviorIndependent work completionInteract with peers at appropriate timesOperational Definition:Actively participating in group instruction by raising hand to speak and looking at teacher; during independent work, keeping pencil moving on paper in a way that gets task completed, letting neighbors work, raising hand to ask for help(this is part of on-task behavior-was measured by %age of assignments completed)

Slide35

Step 1: Progress Monitoring SystemIndividualized Behavior Rating Scale Tool – IBRST Direct Behavior Rating (DBR)—Hybrid assessment combining features of systematic direct observations and rating scalesEfficient and feasible for teacher use

Provides data for decisionsPrioritized and defined behaviors measuredRequires minimum of 1 appropriate and 1 inappropriate behavior

Slide36

Components of IBRSTScale—5 point foundationCan be flexible and add or subtract Likert scale pointsCan be creative and use columns/rows for different time periods/people, etc.Key—Vital for teacher Definition of behavior

Directions—over what time period of day will they be rating the behavior? What do each of the anchor points represent as perceptual estimates?PracticeAfter setting up, ask teacher to rate student

’s behavior from earlier in the day or previous dayAdjust if necessary

Slide37

Defining Behaviors

NonexamplesGrabs

Hits Examples

Grabs clothing of peers by pinching and bunching fabric with his fistHits peers and adults on their bodies by slapping with hand (moderate intensity), pinching flesh with fingers (leaves mark), punching by making a fist with hand and making contact with peer/adult bodies

Slide38

Case Study 1- Mike: Behavior Rating Scale

Behavior

Screaming

9+ times

7-8 times

5-6 times

3-4 times

0-2 times

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

Hitting

8+ times

6-7 times

4-5 times

2-3 times

0-1 times

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

54321543215432154321543215432154321Expressing Frustration40%+30-40%20-30%10-20%0-10%543215432154321543215432154321543215432154321543215432154321Transition to Non-preferredWhimper or squealLouder than indoor voiceOutdoor play voiceLouder than outdoor playEar penetrating543215432154321543215432154321543215432154321543215432154321

01/15

Slide39

IBRST—Key for MikeScreaming: Loud, high-pitched noise heard outside the classroom. Rate your perception of Mike’s screaming episodes over the entire day. 5 = Terrible day; 4 = Typical bad day; 3 = So-So day; 2 = Good day; 1 = Fantastic day.

Hitting: Touching peers or adults with open hand, fist, foot, or object while screaming. Rate your perception of Mike’s hitting episodes over the entire day.

5 = Terrible day; 4 = Typical bad day; 3 = So-So day; 2 = Good day; 1 = Fantastic day.Expressing frustration: Using communication (voice output device, signs, pictures) to request a break or attention. Rate your perception of the percentage of opportunities Mike used appropriate communication 5 = Fantastic day; 4 = Good day; 3 = So-so day; 2 = Typical bad day; 1 = Terrible dayTransition to non-preferred:

Moving to non-preferred activity and engaging in communication at inside voice volume and pitch. Rate your perception of the overall intensity of Mike’s transitioning behaviors. 5 = Fantastic day; 4 = Good day; 3 = So-so day; 2 = Typical bad day; 1 = Terrible day

Slide40

Slide41

IBRST Inter-rater Reliability (Iovannone, Greebaum, Wang, Kincaid, & Dunlap, 2014)Kappa coefficients of:

Problem Behavior 1 (n = 105): .82Problem Behavior 2 (n = 90) : .77

Appropriate Behavior 1 (n = 103): .65Appropriate Behavior 2 (n = 56): .76

Slide42

Agreement of IBRST and Direct ObservationIn recent multiple baseline study, Problem Behavior-74% of ratings in exact agreement, 16% within one scaled scoreAppropriate Behavior-75% exact agreement, 14% within one scaled score.

Cohen’s Kappa = 0.70 (p<0.001)Barnes, Iovannone, Blair, Crosland, & Peshak-George, (in review).

Slide43

Secondary Level ModificationsTeams with 3 or more membersSelect one team member who will be the primary interventionistBehavior identification and IBRST development will be focused on that person’s situation

Other team members provide input/supportIf desired, other team members can record IBRST data in their settings—rating descriptions can stay the same or minor modifications can be madeEach row of BRS can represent a different teacher OR

Each teacher can keep own IBRSTFacilitator collects all IBRST ratings at specified times

Slide44

Variations of the Individualized Behavior Rating Scale Tool (IBRST)

Slide45

Slide46

Slide47

Slide48

Slide49

Slide50

Slide51

Slide52

Facilitation TipsHave team members submit the goal setting table as homeworkHave a visual that summarizes all of the inputDo not reword input—wait until meeting to have team provide clarificationIf step is conducted during problem solving meeting, use group processes to ensure all team members participate

Use post-it notes or index cards and provide several to each team memberUse 2 minute thinking time, have team members write input on notes/cardsUse round robin to get input from all

Slide53

TroubleshootingIBRST Data CollectionDecide upon a method of prompts to remind teachers/team to:Rate the behaviors on the IBRST daily (or frequency determined by the team)Have data ready for analysis at ALL meetings related to the student and the plan

Identify a key person (who likes Excel or other spreadsheet/data chart software) who can transfer the scores into a graphToo many behaviors identifiedAsk teachers/team if they could select one problem behavior that, if reduced, would make each day at least 50% better for everyone (student, school, family)

Defining behaviorsIf teachers/team have difficult time using words to define the define the behavior, ask them to demonstrate the student doing the behavior. Write down the motor movements, verbal communication, other key features that define the behavior.

Slide54

Practice TimeSetting up a behavior rating scale

One volunteerIdentify a behavior of concern

As a group, walk through the steps to set up the scale

Slide55

Behavior

Ratings

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2

1

5

4

3

2154321543215432154321Key:

Slide56

Activity—Step 1

Slide57

Step 1 Activity 2b InstructionsPage 4 of ACTIVITY PACKETWatch the video of ParisIdentify one problem behaviorWith your team, agree upon an operational definition of the behavior

Write it on the goal form under problem behaviorWhat would you target as a replacement behavior?Define the behavior in measurable/observable terms

Slide58

ParisFirst grade student in general educationTeam included teacher, school psychologist, guidance counselor, and special education coordinatorSchool was considering referring Paris for special education eligibility assessment due to behavior problems

Slide59

Step 2: Functional behavior assessmentAnalyze the Problem

Slide60

Given 60 seconds, use 4 straight lines to connect all of the dots without lifting your pen (

PAGE 7 ACTIVITY

)

Slide61

A box to think outside of:

Slide62

Step 2: PTR Assessment (FBA) Problem AnalysisPTR Assessment (FBA) Prevent: Antecedents/triggers of problem behaviorTeach: Function(s) of problem behavior, possible replacement behaviors

Reinforce: Consequences associated with problem behavior, possible reinforcersAssessment form completed by each team member Facilitator summarizes input on Assessment Summary Table and develops draft hypothesis

Team reaches consensusFacilitator has conducted at least ONE direct observation of student and context prior to this step

62

Slide63

Several Versions of PTR AssessmentElementary Version (pp. 20-25)Secondary Version (pp. 26-32; 33-38)

Student Version (pp. 39-44, 45-49)

Slide64

Learned Functions of BehaviorsGETObtainActivities, people, tasks, tangibles, sensory, pain attenuation GET OUT OF

Escape/Avoid/DelayActivities, people, tasks, tangibles, sensory, pain

Slide65

NAME THAT FUNCTION!

Slide66

Are Power, Control, Jealousy, Revenge Functions?

Iovannone, Anderson, & Scott, 2013

Slide67

Completing the PTR Assessment Organization Table

Slide68

Step 2: Case Study – MikeAssessment Summary Table of Problem Behavior

Antecedent/Prevention Data

Teach/Function Data

Consequences/ Reinforce Data

Non-preferred tasks

Reading, Math—when in a group

Told to fix an error

Other students upset/mad

Teacher attending to others

Transition

Preferred (one-one) to

non-preferred (group reading/math)

Change in schedule

Denied item, told no,

Gain attention

Peers, adults

Delay

Access to items

Redirected

Reprimanded

Calm/soothe

Personal space

Later must

complete task

Loss of or delay in

reinforcement

Screaming, Hitting

Slide69

Step 2: Case Study – MikeAssessment Summary Table of Absence of Problem Behavior

Antecedent/ Prevention Data

Teach Data

Reinforce Data

Independent work

One-on-one

attention

Specials

Peer interaction

Getting attention

Raising hand

Sharing attention

Conversation skills

Taking turns

Waiting

Self-management

Asking for break

Expressing emotions

Treasure box

Movie

Attention

Helping teacher

Going to media

center

Going outside

Walk

Food

Absence of Screaming, HItting

Slide70

Mike’s Hypotheses

When….

he will

As a result…

1. Mike is (a) asked to complete non-preferred tasks in small groups (Reading, Math), stop a preferred one-one activity or transition to a non-preferred group activity, or fix an error, or

2. When the teacher is attending to other students,

scream and hit.

scream and hit

Mike (a) delays the transition or non-preferred activity and (b) gets attention from teachers and peers

Mike gets attention from teachers and peers

1. Mike is (a) asked to complete non-preferred tasks in small groups (Reading, Math), stop a preferred one-one activity or transition to a non-preferred group activity, or fix an error, or

2. When the teacher is attending to other students,

(a) express his frustration appropriately and (b) transition from preferred to non-preferred tasks

Ask for attention

Mike (a) delays the transition or non-preferred activity and (b) gets attention from teachers and peers

Mike gets attention from teachers and peers

Inappropriate

Appropriate

Slide71

Slide72

Jeff’s Hypothesis

When….

he will

As a result…

Jeff is presented with demands to start non-preferred academic tasks, specifically independent writing,

Walk around the room, talk to and touch peers, put his head down, tap his pencil, and not initiate writing

He avoids/delays non-preferred tasks

Jeff is presented with demands to start non-preferred academic tasks, specifically independent writing

Be academically engaged and independently complete tasks within the time assigned

He avoids/delays non-preferred tasks

Inappropriate

Appropriate

Slide73

Step 2 Activity: Paris

Slide74

Step 2: Activity InstructionsPage 20-21 ACTIVITY PACKETReview the PTR Assessment Summary for Paris (page 20)Develop a problem behavior and appropriate behavior hypothesis (page 21)

Feel free to use the cheat sheet (page 22)Be ready to share

Slide75

Facilitation TipsTeam members complete for homeworkDuring meeting, use as an interviewDuring meeting, give each team member 15 minutes to complete. Give 15 minute break to allow time for facilitator/coach to synthesize information in Assessment Organization TableSecondary: May want to change forced choice options to make appropriate for secondary environments (although very few words need to be changed)

Family version of PTR Assessment availableCategorizing/aligning: Ensure that your pathway/table is aligned (e.g., triggers are categorized, function is identified for each set of triggers)

Slide76

TroubleshootingTeam select all options/boxes after questionAsk them to select the top 3-5 that they have 100% confidence is related to the behavior occurrenceExample—Prevent Question 4 almost all boxes selectedSay to the team,

“If I came into your classroom tomorrow and would give you $1 million to make Sarah’s behavior happen, which of these would you do first to get the money? Second? Third?Not sure of function

First, separate antecedents/triggers by categories (e.g., triggers related to demands to do non-preferred tasks, triggers related to peer interactions, etc.). Ask team what function seems to best fit with these categories (e.g., non-preferred tasks—is behavior’s purpose to delay/escape the non-preferred task or to get attention)If not sure between escape/attention, probe the team furtherFor example, if the child was doing a preferred activity, would the behavior still occur? If yes, it may be attention. If no, it may be escape.

Slide77

Step 3: PTR Intervention PlanDeveloping and implementing an intervention

Slide78

“The problem is not that people resist change, but they resist being changed.”Michael Kim, Founder and CEO of Habit Design

Slide79

Behavior Intervention Plan Development: Essential FeaturesBehavior interventions selected by team from PTR MenuTeam/teacher provides description on how interventions will look in classroom settingFacilitator guides the team/teacher by using ABA principles to develop most effective intervention that matches the team/teacher context

Each intervention selected is described in detail by task-analyzing steps, providing scripts, describing adult behaviors, NOT student behaviorsAfter plan developed, time is scheduled to train the team/teacher the strategies prior to implementationPlans for training students and other relevant individuals

Support provided once plan is implemented

Slide80

Slide81

Slide82

Slide83

Replacement BehaviorsFunctional Equivalent vs. Alternate SkillFunctional Equivalent (examples)

Escape functionsAsk for a breakAsk to waitAsk to terminateAccess attention functionsAsk for attention

Ask for a hugAccess specific object or activityAsk for an objectAsk for a specific activityAlternate Skill (examples)Raise hand for help or answering questions/participation

Independently complete workAppropriately transition from point a to point bBe academically engagedInitiate social interactionsMake appropriate social comments

Slide84

Linking Hypothesis to Interventions

When Michael is: (a) required to transition from non-preferred to preferred activities, within and outside of the classroom, when corrected or told to stop/wait during transitions

PREVENTION INTERVENTION:

What intervention will modify the

transition request, correction, reprimand so that it is no longer a trigger?

Slide85

Linking Hypothesis to Interventions

He/She will scream (behavior)

What do we want the student to do instead of screaming? What is the replacement behavior/skill to be taught to the student?

Slide86

Linking Hypothesis to Interventions

He/She will scream (behavior)

What do we want the student to do instead of screaming? What is the replacement behavior/skill to be taught to the student?

Slide87

Linking Hypothesis to Interventions

As a result, he/she (a) escapes/avoids/delays the transition from a non-preferred to a preferred activity and protest the transition

How will we make sure that the replacement behavior gets the same outcome as did the problem behavior (e.g., escape)?

Slide88

Writing the Intervention PlanTask analyze each step of the planNon-Example: Give student choicesExample: Prior to the start of independent reading, tell the student, “

We have 2 worksheets today.” Show student both worksheetsSay, “

Which worksheet would you like to do first?”Teachers need to know exactly what to do or the intervention may not be implemented as intended.

Slide89

Which One Will More Likely be Consistently Implemented?Provide choices of where to sit

Provide Choices: The teacher will provide Don with a choice immediately after assigning him independent work in class. Choice options are: (a) materials to use for assignment; choice of leadership activities; (b) where to sit; (c) who to do the assignment with

Steps for Provide Choices:Immediately after giving the class the independent math assignment, go over to Don and present him with a choice option.When presenting him with a choice, say “Don, where do you want to sit? X or X?”

After Don makes his choice, say, “Thanks for making a great choice” and release him to his choice.

BIP-Prevention StrategiesBIP-Prevention Strategies

OR

Slide90

Prevent Strategies

Specific Strategy steps

Environmental Support

Mike

s visual schedule will be modified to detail the number of and type of activities he is to complete during non-preferred activities. For example, if math involves listening to a lesson, doing a hands-on activity, and completing a worksheet, his visual schedule will list each activity under math using either a picture of the type of activity or using numbers that correspond to a number on the worksheet.

Environmental Support Steps:

Each week, an adult will review Mike’s schedule and activities and ensure that the visual schedule matches the activities.

Before a non-preferred activity, the teacher will review the visual schedule with Mike and the tasks he will do by reviewing the visual schedule and pointing to each task while describing it.

After reviewing the schedule, the teacher will ask Mike some questions to make sure he knows the order of activities.

The teacher will remind Mike that after he finishes each activity, he will put an X over it to show it is finished.

After Mike completes each activity, the teacher (initially) will prompt Mike to place an X over the activity on his schedule.

Mike

s Intervention Plan

Slide91

Mike’s Intervention Plan

Prevent Strategies

Specific Strategy steps

Curricular Modification

Mike will be given an easy, independent activity, such as a worksheet, to complete upon transitioning to a non-preferred activity or an activity that requires him to wait, such as group activities.

Curricular modification steps:

At the beginning of each week, the teacher will identify the transitions that would be appropriate for the curricular modification strategy.

Immediately after the transition signal for the specified transitions, the teacher will say

Mike, how about doing this __ first before going to __?

Wait for Mike to complete the activity. During this time, provide minimum attention (e.g., limited talking, eye contact)

At the end of the activity, prompt Mike to transition (if he does not transition) or prompt him to use his replacement behavior (

I need to calm down).

91

Slide92

Mike’s Intervention Plan

Teach Strategies

Specific Steps

Replacement Behavior:

Appropriately express his need to calm down

Mike will be taught to use his Dynamite to express his need to calm down.

Replacement Behavior Steps:

An adult will

program Mike’s AAT device to say

I need to calm

down.

A choice board will be built into the device by identifying 3-4 options from which Mike can select as his activity to calm down and identifying buttons to represent those choices.

One minute before transitioning from a preferred to a non-preferred activity or at the end of a preferred activity (if the timer has not gone off), the teacher/adult will remind Mike to use his replacement behavior.

Remember, If you start to get mad when you go to X,

you can tell us you need to calm down.

At the first sign of Mike beginning his screaming behavior (initial squeal), redirect Mike to use his replacement behavior by prompting him (most-to-least hierarchy) while saying

“What do you need?”

For example, initially the teacher will use physical prompting (hand-over-hand) to guide Mike in telling the adults that he needs to calm down.

Once Mike communicates

I need to calm down

,

present

him with the choice board of calming strategies and

ask

him,

What do you want?

As soon

as he is calm, praise him by saying

thank you for telling us what you need to calm down.

.

Allow

Mike to engage in his choice until he is calm for 1-min.

If Mike does not return to his area, then start having a fun time in that area with those students present

Slide93

Reinforce Strategies

Specific Steps

Replacement Behavior:

Appropriately express his need to calm down

Whenever Mike

says

,

I need to calm down

, give him the choice board, praise him for using his communication, and release him to his choice.

Immediately after Mike indicates he needs to calm down, ask him

“What do you want?”

while showing the choices.

Immediately after Mike makes his choice, say

Thank you for telling us what you

need.

Depending upon his choice, release him or provide him with the selection.

When he makes his transition, praise him (with a warm tone) for returning to the group; “thank you for coming over.”

Discontinue reinforcing problem behavior

Minimal attention will be provided to Mike when he is calming down and when he is starting to scream.

Steps:

As soon as Mike begins to show signs for screaming, the adult will immediately prompt Mike to say he needs to calm down by presenting the device and saying

“What do you need?”.

If necessary, provide physical or partial physical prompting to have Mike say what he needs.

Immediately after Mike says “I need to calm down”, present the choice board and ask him “What do you want?”.

Provide positive praise for Mike saying what he needs,

“thank you for telling us what you need.”

Allow him to engage in his choice for one minute.

Mike

s Intervention Plan

Slide94

Jeff: PTR Intervention Plan Prevent

Prevent Strategies

Description

Choice-Making

Using a choice matrix, decide upon the choice that will be offered to Jeff each day with his writing assignment. The following choices will be rotated: (a) Within—writing tool to use (pen/pencil), color notebook paper, color of eraser, topic; (b) Who—peer for writing partner; (c) Where—Robin’s room, round table, desk; (d) When—part now, part later, whole task nowSteps:Right before giving the writing assignment to Jeff

, decide upon the choice to be offered.

Once the choice is determined, present it to Jeff by saying, “

What do you want to use for writing today? The pen or the pencil?

Praise Jeff for making the choice—”Thank you for making a choice.” and

honor the choice

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Jeff—Intervention Plan Prevent

Prevent Strategies

Description

Environmental Support

Visual Timer: Set a visual timer for the amount of time agreed upon with Jeff to complete the writing assignment.Steps:At the beginning of the writing period and while reviewing Jeff’s self-management writing chart for the day, and before providing Jeff a choice, either call Jeff to the teacher’s desk or go over to Jeff.

Discuss the goal for completing the writing assignment. Say, “I think you can complete the assignment in ___ minutes. What do you think?”

Set the timer by saying, “Jeff, let’s see if you can beat the timer. Today, you have ___ minutes (time from step 1) to complete the writing. Ready, set, go.”

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Jeff— Teach Intervention Plan

Teach Strategies

Description

Incompatible Replacement Behavior—Academic Engagement

Jeff will be taught how to remain engaged on a writing assignment. Engagement is defined as: working on a task without disrupting by raising hand to speak, keeping pencil upright, and letting neighbors workSteps:Each day, divide Jeff’s writing task into 3 major sections—starter, details, conclusion

Initially, tell Jeff that for each section completed, he earns a “dot” that he should place in the envelope hanging at the side of his desk.

Inform him that he can use the dots later to get out of work and to get special rewards for himself and the rest of the class.

Each day after giving the writing assignment to Jeff, review his self-management checklist/dot total sheet. Review each section of the writing assignment (step 1), his goal (time for completion), and the academic engaged behaviors.

On Monday, a weekly goal should be discussed and set.

Immediately after reviewing Jeff’s goals and expected behaviors, provide him a choice and set the timer.

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Jeff—Reinforce Intervention Plan

Reinforce Strategies

Description

Reinforce Pro-academic Replacement Behavior—Academic Engagement

Jeff will be reinforced for academic engagement and meeting his daily goal with allowable/earned escape represented by the dots. Jeff can use his dots to get out of doing work/problems during independent work times.Steps:At the end of the writing period or when Jeff completes his writing (whichever event occurs first), review Jeff’s self-management checklist.

For each behavior on the checklist, discuss with Jeff whether he performed the activity. If yes, place a check in the box. If no, place an “x” in the box. For each check, Jeff should be given a dot. When reviewing, say, “Jeff, did you write a starter sentence?”… Did you stay on task? Did you meet your goal?” When giving dots, say “Jeff, how many checks do you have today? How many dots do you earn?”

Jeff uses dots by sticking it over a problem/question he doesn’t want to do and showing the teacher when he uses a dot. He can escape as long as he has dots in his envelope.

If Jeff uses a dot to get out of work, immediately say “You used a dot to get out of ____. You earned it!”

If Jeff meets his weekly goal, he can go to his brother’s kindergarten class and read a book to them.

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Jeff—Reinforce Intervention Plan

Reinforce Strategies

Description

Group Contingency (Modified)

If Jeff meets his daily (time) goal for completing his writing assignment within the time agreed upon, the class earns a bonus letter toward the mystery reinforcer of the week. When Jeff earns the class this letter, the class provides attention to Jeff by thanking him and celebrating (clapping hands, saying “Yeah”.Steps:

After reviewing Jeff’s self-management sheet, ask him, “Did you meet your goal today?”

If yes, “You did meet your goal. Let’s tell the class they’ve earned a letter for the mystery reinforcer.”

Tell the class, “Jeff met his goal today. We get another letter on the board.”

Prompt the class to thank Jeff (if they haven’t done so spontaneously).

If no, “You worked hard and tried. You’ll do it tomorrow!”

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Jeff—Reinforce Intervention Plan

Reinforce Strategies

Description

Discontinue reinforcement of problem behavior

If Jeff gets disruptive (disengaged) during academic tasks, redirect him to his replacement behavior.Steps:At the first sign of Jeff starting to get disengaged, calmly walk over to Jeff and gesture to his self-management chart by pointing to it. Provide no or minimal verbal comments.

If Jeff continues to be disengaged, calmly redirect him to use one of his dots (if he has any) to escape. Say “Jeff, it looks as if you need to use one of your dots to get out of some work.”

If Jeff continues to be disengaged and doesn’t use one of his dots, walk over to his desk, pick out one of his dots out of his envelope, and say “It looks as if you need to use one of your dots to get out of some work. Where should I put the dot?”

Continue to use dots if Jeff continues to be disengaged.

If all of the dots are used, calmly remind Jeff how he will earn dots to get out of work.

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Switching Activities

Michael’s Story

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High School Examples

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Plans for High School Students with E/BDDCDSNC

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Step 3 Activity: Paris Intervention Plan

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Step 3 Paris: Activity InstructionsPAGE 24 OF ACTIVITY PACKETLook at your hypothesis developed for Paris.Identify one or two prevent, teach, and reinforce strategies you might want to try with Paris

One for each component (prevent/teach/reinforce)For the Teach strategy, make certain one behavior you are teaching is a replacement behavior.Develop the specific steps (task analysis) of the replacement behavior intervention for Paris

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Additional ConsiderationsWhen developing the behavior intervention plan, ask the team how they will do the following:Pre-teach the student the planPrompts they will need to use in the initial stagesFading prompts

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Coaching/Fidelity

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Teacher CoachingTeacher and Staff TrainingInitial training with no students present 30 -90 minutesModel, Role Play, Q & A, Discussion

Coaching/Fidelity Checklist (page 60-63 Tools Handout Packet)Used by PTR Consultant for training evaluation Evaluate teacher accuracy on each step prior to implementation with student

Comfort and competence measuredCan also be used as fidelity measure after intervention is implemented

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Coaching StepsCore components of each behavior intervention strategy listed on coaching/fidelity form. (alternative form)Primary adult behaviors (physical or verbal actions) & materials If applicable, student behaviors included. During coaching session, facilitator gives teacher behavior intervention plan and coaching form.

Facilitator introduces coaching form, e.g., “We’re going to go over the steps of the behavior plan strategies to make sure they are still making sense to you and are things that can be done by you in your classroom. If there is anything that you feel isn’t going to work, we can make changes today.”

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Coaching StepsSeveral methods for coaching the teacher.Can choose one method, combination of two, or all threeDiscussion—facilitator asks teacher to verbally describe (in his or her own words) each of the interventions. Ensures teacher describes each step of the interventionTeacher can refer to coaching form to cue core steps

Q & A—facilitator asks teacher questions about strategies. For example, choice-making “When are you going to offer the choices to X?”; “What kind of choices will you offer X?”; etc.Role Play (preferred method)-facilitator plays role of student and asks teacher to perform plan steps as they would with student.

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Coaching StepsCheck ‘Y’ or ‘N’ whether teacher demonstrated competence with plan stepsRemediation: For any step teacher did not demonstrate correctly or skipped,Review step with teacherProvide another opportunity for teacher to demonstrate competenceIf successful, coaching session finished

If unsuccessful, choose from the following: Provide more opportunities to review and practice stepAsk teacher what features make step difficult and adapt to make feasible Select different intervention checked on PTR intervention Checklist that matches hypothesis.

Schedule another meeting to develop new intervention Schedule another coaching session

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Coaching StepsSuccessful training: Decide who else needs to be trained (e.g., student, other school staff, parent)Try to be there when teacher trains student or offer to train studentDetermine start date of intervention planCan choose to implement the intervention in phases.

Prevent first, then teach/reinforceTeach/reinforce first, the preventTraining checklist can be used as fidelity measure rather than developing separate checklist

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Mike: Coaching/Fidelity

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Jeff Coaching/Fidelity Plan

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Step 3: In-Class Support Provide support to teacher in implementationBe present on first day of implementationDetermine when to debriefMeasure fidelity

Discuss and modify if necessary

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Step 3: Training/Fidelity ChecklistCase Study - ParisGroup Activity: Look at the task analysis for Paris’ replacement behaviors

Select the core strategies you would include on a coaching/training and fidelity measure

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Paris’ Fidelity Checklist

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Teach Intervention Strategy

Fidelity

Replacement Behavior:

Y/N/NA

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Step 3: Facilitation TipsTeams can select interventions for homework or can select during team meetingFocus on one routine, class, subject for developing interventionMake sure the facilitator is asking guiding questions-allow the teacher to describe how the intervention will be in their classroom

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Step 3: Facilitation TipsIf meeting time is limited, break up strategies:One meeting, focus on full development of Prevent, next meeting develop Teach/Reinforce ORFirst concentrate on Teach/Reinforce; next meeting develop Prevent.Fidelity measurements can be done once or twice a week rather than daily

One form can be used for training and fidelity

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Step 3: Facilitation TipsUse technology (video, Skype, Wiki, Facebook) to provide support to teachersFidelity observations and coaching sessions should NEVER be used as teacher evaluation toolsFidelity and training are coaching supportsTrust is essential for coaching and fidelity to work as intended

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Step 4: Progress Monitoring

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Step 4: Evaluation Progress MonitoringData-Based Problem-SolvingWhat is working? What is not working?What changes need to be made?

Is more data needed? (additional data collection measures)Implementation Fidelity DataIs the plan being implemented consistently and accurately?Student outcome data

Is the problem behavior decreasing? Is the replacement behavior increasing?Expanding the planRoutines, times of dayGeneralize across settings and/or staff

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Steps for Evaluating OutcomesMake sure you have both fidelity measures (self and/or observation scores) AND student outcomes (IBRST measures)Decision rulesWhat constitutes adequate fidelity? 80%, 70%, something else?What constitutes adequate student progress? (e.g., 3 or more consecutive ratings at or above goal line?)

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Primary DecisionsIf Fidelity scores are inadequate, determine the reasons (intervention too difficult, not feasible, not described adequately….)

Retrain/coach the teacher/implementerModify the interventions so that they are feasible, simplerSelect different interventions that match the hypothesis If student outcomes are in the right direction (decision contingent upon outcome trend)

Maintain interventionModify interventionFade intervention componentsShape behavior outcomes to become closer approximations of desired behaviorExpand the intervention (additional people, additional settings or routines)

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Primary DecisionsIf student outcomes are remaining flat or data are showing that behavior problems are increasing and fidelity scores are adequate:Intensify interventionModify interventionConduct another FBA if hypothesis is suspect, team has new data, or context has changed

Conduct a functional analysisExpand team to include other experts

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Step 5: Mike Evaluation

Intervention changed

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Step 5: Evaluation

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Step 5: Evaluation

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Step 5: Evaluation

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Jeff Data

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Review PTR ProcessFour-step team-based process Teacher/team drivenStandardized/manualized processSupport provided to teacher/team to implement interventionsEvery intervention plan includes 3 componentsPrevent

TeachReinforcePlans are task analyzed

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PTR PublicationsPTR ManualsDunlap, G., Iovannone, R., Kincaid, D., Wilson, K., Christiansen, K., Strain, P., & English, C., 2010. Prevent-Teach-Reinforce: The school-based model of individualized positive behavior support. Baltimore, MD: Paul H. Brookes. (Second edition coming soon)

Dunlap, G., Wilson, K., Strain, P., & Lee, J. K. (2013). Prevent-Teach-Reinforce for young children: The early childhood model of individualized positive behavior support. Baltimore, MD: Paul H. Brookes.Journal ArticlesBarnes, S., Iovannone, R., Blair, K. S. W., Crosland, K., &

Peshak-George, H. (under review). An evaluation of the Prevent-Teach-Reinforce model within a multi-tiered intervention system. Journal of Positive Behavior Interventions.DeJager, B. W., & Filter, K. J. (2015). Effects of Prevent-Teach-Reinforce on academic engagement and disruptive behavior. Journal of Applied School Psychology, 31, 369-391.Dunlap, G., Iovannone, R., Wilson, K., Kincaid, D., & Strain, P. (2010). Prevent-Teach-Reinforce: A standardized model of school-based intervention. Journal of Positive Behavior Interventions, 12, 9-22.Dunlap, G., Lee, J. K., Joseph, J. D., & Strain, P. (2015). A model for increasing the fidelity and effectiveness of interventions for challenging behaviors: Prevent-Teach-Reinforce for young children. Infants & Young Children, 28, 3-17.

Iovannone, R., Anderson, C. M., & Scott, T. M. (2013). Power and control: Useful functions or explanatory fictions? Beyond Behavior, Iovannone, R., Greenbaum, P., Wei, W., Kincaid, D., & Dunlap, G. (2014). Interrater agreement of the Individualized Behavior Rating Scale Tool. Assessment for Effective Intervention, 39, 195-207.Iovannone, R., Greenbaum, P., Wei, W., Kincaid, D., Dunlap, G., & Strain, P. (2009). Randomized controlled trial of a tertiary behavior intervention for students with problem behaviors: Preliminary outcomes. Journal of Emotional and Behavioral Disorders, 17, 213-225.Kulikowski

, L. L., Blair, K. S. C., Iovannone, R., & Crosland (2015). An evaluation of the Prevent-Teach-Reinforce (PTR) model in a community preschool classroom. Journal of Behavior Analysis and Supports, 2, 1-22.Sears, K. M., Blair, K. S. C., Iovannone, R. & Crosland, K. (2013). Using the Prevent-Teach-Reinforce model with families of young children with ASD. Journal of Autism and Developmental Disorders, 43, 1005-1016. doi:10.1007/s10803-012-1646-1.Strain, P. S., Wilson, K., & Dunlap, G. (2011). Prevent-Teach-Reinforce: Addressing problem behaviors of students with autism in general education classroom. Behavior Disorders, 36, 160-171.

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Questions?