Systematic Screening for Emotional and Behavioral Challenges in

Systematic Screening for Emotional and Behavioral Challenges in Tiered Systems Kathleen Lynne Lane, Ph. D. , BCBA-D, University of Kansas Mark D. Weist, Ph. D. , University of South Carolina

Agenda • The Need for Emotional and Behavioral Disorders Screening • Challenges • General Recommendations • Interconnecting School Mental Health and PBIS • Comprehensive Example • Interactive Discussion

Thanks Kathleen Wendy Oakes, Holly Menzies, Jemma Kalberg, Robin Ennis, Emily Cantwell, David Royer, Eric Common, Liane Johl, Ashley Quell, Meredith Cox, Abbie Jenkins, Mallory Messenger Mark Susan Barrett, Lucille Eber, Nancy Lever, Kelly Perales, Bob Putnam, Joni Splett, Sharon Stephan, Bob Stevens, Jessica Swain-Bradway

Rationale: Prevalence Rates • How prevalent are emotional disorders among school -age children and youth? Study Citation % of sample with any impairment % of sample with serious impairment Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Shaffer et al. , 1996 21% 5% Great Smoky Mountains Study of Youth Burns et al. , 1995 20% 11% National Health & Nutrition Examination Survey (NHANES) Merikangas et al. , 2010 13% 11%

Rationale: Early intervention is vital • Research suggests that there’s a ‘window of opportunity’ ranging between 2 -4 years when prevention is critical Great Smoky Mountains Study: Age Between First Symptom and Initial Diagnosis Source: O’Connell, Boat, & Warner, 2009

American School Health Association Task Force, 2005 • Students’ emotional and behavioral disorders needs far exceed our capacity to respond to them • Need communities to rally around schools as screening is conducted (emphasize middle schools? ) • Need to navigate parental approval process • Need for achievable, gated strategies • Use data to underscore urgent public health need • See Weist, M. D. , Rubin, M. , Moore, E. , Adelsheim, S. , & Wrobel, G. (2007). Mental health screening in schools. Journal of School Health, 77, 53 -58.

Mental Health Screening and Assessment in Schools Published by the Center for School Mental Health, Baltimore, Maryland 2016 Permission is given to duplicate this document for professional use, as long as it is unaltered and complete. This document should be cited as Center for School Mental Health (2016). Mental Health Screening and Assessment in Schools. CSMH, 2016

Other Concerns about Screening Student confidentiality and privacy Assuring consistency with state and federal regulations Insufficient data system infrastructure Expense and limitations of measures (e. g. , concerns about agreement between student, teacher and parent ratings) Under-identification and over-identification Liability and cost http: //flpbs. fmhi. usf. edu/pdfs/October%202014%20 Universal%20 Screening. pdf CSMH, 2016

State of the Field: What the Research Literature Tells Us Literature Review of 35+ articles � Universal screening is occurring across the country, in all grade levels � Many high quality universal screening tools have been developed and tested. Tools are being selected based on: Predictive validity (grades, office referrals, other screening measures) Sensitivity vs. specificity considerations Specific area(s) of mental health risk of interest � Most studies report on 1 time point of screening � Most studies conducted screening at a grade level CSMH, 2016

Increasing concern about cost of measures � Many companies selling products to schools � Measures may have considerable initial and ongoing expenses (e. g. , to purchase additional forms, for computerized scoring) � There is increasing use of measures that are in the public domain � Growing focus on the achievability or user-friendliness of screening and assessment measures in schools � (see Workgroup on Evidence-Based Assessment, Quality and Evidence-Based Practice Group, CSMH) CSMH, 2016

For a list of free assessment measures, visit: http: //csmh. umaryland. edu/Resources/Clinician Tools/index. html Click on “Free Assessment List” Copies of these instruments can be found here: https: //drive. google. com/folderview? usp=sharing&id=0 B 0 GTQg 4639 jj. VGMyd 3 Ra. OHh. CQXc&ddrp=1# CSMH, 2016

POSITIVE BEHAVIOR INTERVENTIONS AND SUPPORTS AND SCHOOL MENTAL HEALTH

SMH Strengths and Limitations Strengths Areas for Improvement • Improved access • Improved early identification/intervention • Reduced barriers to learning, and achievement of valued outcomes • WHEN DONE WELL • SMH programs and services continue to develop in an ad hoc manner, and • LACK AN IMPLEMENTATION STRUCTURE

PBIS Strengths and Limitations Strengths Areas for Improvement • Promotes effective decision making • Reduces punitive approaches • Improves student behavior • Improves student academic performance • WHEN DONE WELL • Many schools implementing PBIS lack resources and struggle to implement effective interventions at Tiers 2 and 3 • Lens of “Behavior”

What is the Interconnected Systems Framework (ISF)? • Built upon the foundation of PBIS and SMH to increase quality of services offered to youth through an MTSS framework • Focuses on the organizational structure of education and school mental health • Bridges two national centers (SMH and PBIS) and includes a number of states • Monograph and national work group formed in response to ISF model

What is ISF cont… • Brings together key stakeholders to create crosssystem teams involving state, district, school, and community stakeholders • A strong, committed and functional team guides the work, using data at three tiers of intervention • Sub-teams having “conversations” and conducting planning at each tier • Evidence-based practices and programs are integrated at each tier • SYMMETRY IN PROCESSES AT STATE, DISTRICT AND BUILDING LEVELS

A Continuum of Screening Approaches • Educate/train staff and have them mediate referrals • Use data available through school records to determine students at risk • Use brief measures by themselves (e. g. , teacher nominations, student self-report measures) • Use more comprehensive approaches (as in our Ci 3 T example presented shortly)

At Risk Alert System, Bob Stevens, Charleston County School System LEVEL 1 Motivated (Low) LEVEL 2 Vulnerable (Moderate) LEVEL 3 Critical (High) 0 -5 days absent 6 -14 days absent 15+ days absent <1. 0 years above appropriate age for grade 1. 0 to 2. 0 years above appropriate age for grade 2+ years above appropriate age for grade Passing both ELA and Math last quarter Failing either ELA or Math last quarter Failing both ELA and Math last quarter Lunch Student’s meals status None (full-pay) Reduced Free Suspensions (ISS) Total number of incidents 1 -2 suspensions 3 -7 suspensions 8+ suspensions Suspensions (OSS) Total number of incidents 0 suspensions 1 -2 suspensions 3+ suspensions PACT/HSAP ELA Performance Level Proficient or Advanced Basic Below Basic PACT/HSAP Math Performance Level Proficient or Advanced Basic Below Basic INDICATORS Attendance Number of missed instruction days Age Comparing age to current grade level Grades Passage of current ELA and Math courses

Comprehensive, Integrated, Three-Tiered Model of Prevention (Lane, Kalberg, & Menzies, 2009) Goal: Reduce Harm Specialized Individual Systems for Students with High-Risk ≈ Tertiary Prevention (Tier 3) ≈ Secondary Prevention (Tier 2) Goal: Reverse Harm Specialized Group Systems for Students At-Risk PBIS Framework Goal: Prevent Harm School/Classroom-Wide Systems for All Students, Staff, & Settings Validated Curricula ≈ Primary Prevention (Tier 1) Academic Behavioral Social

Tier 1 Social Skills Component Process • Social Skills curricula examined for evidence to support desired student outcomes. • Curricula options narrowed and stakeholder input sought. • One curricula with sufficient evidence selected. • Materials ordered, professional development planned. • Specific lessons and dosage determined. • Responsibilities in primary plan. • Plans for monitoring social validity and treatment integrity. Teacher and Counselor led lessons

• www. positiveaction. net • Positive Action is an evidence-based program that improves academics, behavior, and character. Positive Action uses a curriculum-based approach to effectively increase positive behaviors and decrease negative behaviors. Connect with Kids Positive Action Elementary Schools Middle and High Schools http: //connectwithkids. com Connect with Kids is a social skills program supporting awareness and discussion of important social and emotional skills among students, parents, and teachers. Evidence reported by WWC and SAMSHA National Registry of evidence -based programs and SOCIAL SKILLS AND CHARACTER EDUCATION COMPONENT Tier 1: Social Skills Curricula

PA: Examine the Outcomes: Evidence Positive Action: a K-12 program which aims to promote character development, academic achievement, and social-emotional skills and to reduce disruptive, problem behavior. Improves • Behavior • • • Academic Achievement Behavior Character Academic Achievement Attendance Character Health Attendance Family Literacy Health Family Literacy Reduces • • • Disciplinary problems Absenteeism, suspensions, and truancies Dropping out Drug, alcohol, and tobacco use Violence Obesity (Positive Action, 2008)

• Positive effects on elementary school students’ behavior and academic achievement (IES, 2007) • Statistically significant lower suspension rates, use of alcohol, binge drinking, use of tobacco and illegal drugs (Flay, Acock, Vuchinich, & Beets, 2006) • Statistically significant lower rates of violent behavior and suspension (Flay & Allred, 2003) Behavior Academic Achievement Rating of Effectiveness Positive Effects Improvement Index Average: +19 percentile points Range: -12 to +36 percentile points Average: +14 percentile points Range: +8 to +36 percentile points SOCIAL SKILLS COMPONENT PA: Evidence-base

CWK: Examine the Outcomes: Evidence Connect with Kids: promotes prosocial attitudes and positive behavior of elementary (grades 3– 5) and secondary (grades 6– 12) school students by teaching core character values. Lesson plans include videos, story summaries, discussion questions, student games, and activities for both core and supplemental character traits. The classroom curriculum is reinforced by a website component and a schoolwide and community outreach components. Improves • • • Honesty Kindness Perseverance Responsibility Self-control Tolerance Reduces • Physical aggression • Verbal aggression • Drug use • Alcohol use

CWK: Evidence-base • Potentially positive effects on middle and high school students’ behavior (What Works Clearinghouse, 2006) • Effectiveness improvement index ranged from +19 to +23 percentile points for middle/high school student surveys (What Works Clearinghouse, 2006) • Statistically significant differences in middle/high school student reports of their own and their classmates’ behavior (Page & D’Agostino, 2005) Behavior Rating of Effectiveness Positive Effects Improvement Index Middle/high school student surveys only: Average: +21 percentile points Range: +19 to +23 percentile points

ES: Primary Plan Responsibilities Students are expected to: • Participate in instruction • Engage • Apply learning

Primary Plan Responsibilities Faculty and staff are expected to: • Teach • Model • Reinforce

Primary Plan Responsibilities Parents are invited to: • Understand • Discuss • Reinforce

Primary Plan Responsibilities Administrators are expected to: • Coordinate with faculty and staff • Ensure fidelity

Primary Plan Procedures for Monitoring

Essential Components of Primary Prevention Efforts Social Validity Treatment Integrity l a c i t i Cr r o f n o ati m r o f in nd a l o scho teams ct i r t s i d Systematic Screening Academic Behavior

See Lane, Menzies, Oakes, and Kalberg (2012) In Ci 3 T Models, screenings focus on teacher-completed screening tools to inform instruction. Parent-completed and student-completed screening tools would require active parent consent. What screening tools are available?

Systematic Screener for Behavior Disorders (SSBD 2 nd ed. ; Walker, Severson, & Feil, 2014)

SSBD Screening Process Pool of Regular Classroom Students STAGE 1: TEACHER SCREENING on Externalizing and Internalizing Behavioral Disorders 3 Highest Ranked Pupils on Externalizing and on Internalizing Behavior Criteria PASS GATE 1 STAGE 2: TEACHER RATING on Critical Events Index and Combined Frequency Index Exceed Normative Criteria on CEI of CFI PASS GATE 2 STAGE 3: DIRECT OBSERVATION AND/ OR SARS of Process Selected Pupils in Classroom and on Playground Exceed Normative Criteria on AET and PSB PASS GATE 3 Pre-referral Intervention(s) Child may be referred to Child Study Team 35

SSBD Results – Winter 2007 through Winter 2009 Risk Status of Nominated Students 80 70 Internalizing Externalizing Number of Students 60 50 40 47 62 59 43 56 60 30 Exceeded Normative Criteria 20 10 17 13 7 0 Nominated But Did Not Exceed Criteria 6. 18% 3. 50% 7 3. 18% 8. 90% 13 6. 50% 6 2. 73% Winter 2007 Winter 2008 Winter 2009 (N=60) (N=69) (N=66) (N=60) (N=69) 1. 44%(N=66) % computed based on total # students screened Screening Time Point Source. Lane, Menzies, Oakes, & Kalberg, 20120. Figure 2. 2 WES Elementary Systematic Screening for Behavior Disorders (SSBD; Walker & Severson, 1992) results comparing the percentage of students nominated and exceeding normative criteria for both externalizing and internalizing behavior disorders over a three year period.

0 2 1 Low Academic Negative Aggressive Achievement Attitude Behavior Peer Problem Rejection SRSS Score: Sum Items 1 -7 (Range 0 - 21) Student Risk Screening Scale (SRSS) DATE TEACHER NAME 0 = Never 1= Occasionally 2 = Sometimes 3 = Frequently Use the above scale to rate each item for each student. Lie, Cheat, Steal Sneak Student Name Student ID Smith, Sally 11111 0 0 3 Drummond, T. (1994). Student Risk Screening Scale. Grants Pass, OR: Josephine County Mental Health Program. 7 0 0 0 0

Student Risk Screening Scale (Drummond, 1994) The SRSS is 7 -item mass screener used to identify students who are at risk for antisocial behavior. Uses 4 -point Likert-type scale: never = 0, occasionally = 1, sometimes = 2, frequently = 3 Teachers evaluate each student on the following items - Steal - Low Academic Achievement - Lie, Cheat, Sneak - Negative Attitude - Behavior Problems - Aggressive Behavior - Peer Rejection Student Risk is divided into 3 categories Low 0– 3 Moderate 4– 8 High 9 - 21 (SRSS; Drummond, 1994)

Student Risk Screening Scale (Drummond, 1994) 2 0 1 0 0 11111 Lie, Cheat, Behavior Low Academic Negative Aggressive Sneak Problem Peer Rejection Achievement Attitude Behavior Student ID Smith, Sally Student Name Steal SRSS Score: Sum Items 1 -7 (Range 0 - 21) DATE TEACHER NAME 0 = Never 1= Occasionally 2 = Sometimes 3 = Frequently Use the above scale to rate each item for each student. 1 3 7 0 0 0 0

Student Risk Screening Scale Middle School Fall 2004 - Fall 2011 n = 12 n = 20 Percentage of Students n = 507 N=534 N=502 N=454 N=470 N=477 N=476 N=524 N= 539 Fall Screeners Lane, K. L. , Oakes, W. P. , & Magill, L. (2014). Primary prevention efforts: How do we implemented and monitor the Tier 1 component of our Comprehensive, Integrated, Three-Tiered (CI 3 T) Model? Preventing School Failure. 58, 143 -158.

SAMPLE DATA: SRSS Middle School Study 1: Behavioral & Academic Characteristics of SRSS Risk Groups Variable Risk Low (n = 422) M (SD) Moderate (n = 51) M (SD) ODR 1. 50 (2. 85) 5. 02 (5. 32) 8. 42 (7. 01) L<M<H In-School Suspensions 0. 08 (0. 38) 0. 35 (1. 04) 1. 71 (2. 26) L<M<H GPA 3. 35 (0. 52) 2. 63 (0. 65) 2. 32 (0. 59) L>M, H M=H Course Failures 0. 68 (1. 50) 2. 78 (3. 46) 4. 17 (3. 49) L<M, H M=H Lane & Oakes High (n = 12) M (SD) (Lane, Parks, Kalberg, & Carter, 2007) Significance Testing

STUDENT RISK SCREENING SCALE High School: Behavioral & Academic Characteristics of SRSS Risk Groups Non-Instructional Raters Variable Risk Low Moderate (n = 328) (n = 52) High (n = 35) M (SD) Significance Testing 8. 27 (7. 72) 8. 97 (9. 39) L < M, H M=H 2. 45 (0. 84) 2. 38 (0. 88) L > M, H M=H M (SD) ODR 3. 53 (5. 53) GPA 3. 10 (0. 82) (Lane, Kalberg, Parks, & Carter, 2008)

STUDENT RISK SCREENING SCALE-IE Aggressive Behavior Lonely Negative Attitude Low Academic Achievement Obsessive-Compulsive Behavior Peer Rejection Behavior Problem Anxious Sad; Depressed Shy; Withdrawn Emotionally Flat Lie, Cheat, Sneak 0 = Never Steal TEACHER NAME 2 = Sometimes 3 = Frequently Use the above scale to rate each item for each student. Validation Study Student Name Original SRSS-IE 14 12 items retained for use at the elementary level 14 items under development in middle and high schools Self-Inflicts Pain 1= Occasionally

SRSS-IE: SRSS-E 7, SRSS-I 5 Cut Scores • Enter ‘practice’ data into that one sheet so that the total scores and conditional formatting are tested. • Items 1 -7 (The SRSS externalizing scale) 0– 3 4– 8 9 – 21 low risk moderate risk (yellow) high risk (red) • Items 8 -12 (The SRSS-IE internalizing items)*preliminary cut scores for elementary only 0 – 1 low risk 2 – 3 moderate (yellow) 4 – 15 high (red) • Confirm the “Count” column is completed (students’ numbered sequentially). Formulas are anchored by the “Count” column; it must contain a number for each student listed for accurate total formulas.

How do we score and interpret the SRSS-IE at the Elementary Level? • All scores will be automatically calculated. • SRSS scores are the sum of items 1 – 7 (range 0 – 21) • Internalizing scores are the sum of items 8 -12 (range 0 -15)

Sample Elementary School … Fall % of Students Screened SRSS-E 7 Results – All Students 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% N = 25 4. 56% 6. 93% N = 86 9. 97% 23. 82% N = 250 N = 35 N = 300 85. 47% 69. 25% School F 14 N = 16 School F 15 Time School Screening Point. F 16 Low Risk (0 -3) Moderate (4 -8) School F 17 High (9 -21)

Sample Elementary School … Fall 2015 SRSS-E 7 Comparison by Grade Level K 1 st 2 nd N Screened Low (0 -3) Moderate (4 -8) High (9 -21) 65 54 (83. 08%) 7 (10. 77%) 4 (6. 15%) 53 45 (84. 91%) 3 (5. 66%) 5 (9. 43%) 46 31 (67. 39%) 8 (17. 39%) 7 (15. 22%)

Sample Elementary School … Fall 2015 SRSS-E 7 Comparison by Grade Level 3 rd 4 th 5 th N Screened Low (0 -3) Moderate (4 -8) High (9 -21) 68 64 (94. 12%) 4 (5. 88%) 0 (0%) 57 52 (91. 23%) 5 (8. 77%) 0 (0%) 62 54 (87. 10%) 8 (12. 90%) 0 (0%)

Sample Elementary School … Fall % of Students Screened SRSS-I 5 Results – All Students 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% N = 72 N = 19 5. 41% 19. 94% N = 85 12. 25% N = 43 23. 55% N = 204 N = 289 82. 34% 56. 51% School F 14 School F 15 Time School Screening Point. F 16 Low Risk (0 -1) Moderate (2 -3) School F 17 High (4 -15)

Sample Elementary School … Fall 2015 SRSS-I 5 Comparison by Grade Level K 1 st 2 nd N Screened Low (0 -1) Moderate (2 -3) High (4 -15) 65 49 (75. 38%) 9 (13. 85%) 7 (10. 77%) 53 40 (75. 47%) 9 (16. 98%) 4 (7. 55%) 46 36 (78. 26%) 6 (13. 04%) 4 (8. 70%)

Sample Elementary School … Fall 2015 SRSS-I 5 Comparison by Grade Level 3 rd 4 th 5 th N Screened Low (0 -1) Moderate (2 -3) High (4 -15) 68 60 (88. 24%) 6 (8. 82%) 2 (2. 94%) 57 51 (89. 47%) 5 (8. 77%) 1 (1. 75%) 62 53 (85. 48%) 8 (12. 90%) 1 (1. 61%)

Sample High School … Fall % of Students Screened SRSS Results – All Students 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2. 42% 8. 02% N = 29 N = 96 N = 1072 89. 56% School F 15 School F 16 School F 17 School F 18 Screening Time Point N = 1197 Low Risk (0 -3) Moderate (4 -8) High (9 -21) School F 19

Sample High School … Fall 2015 SRSS Comparison by Grade Level N = 1197 Screened Low (0 -3) Moderate (4 -8) High (9 -21) 327 287 (87. 77%) 32 (9. 79%) 8 (2. 45%) 10 th 318 271 (85. 22%) 34 (10. 69%) 13 (4. 09%) 11 th 289 264 (91. 35%) 19 (6. 57%) 6 (2. 08%) 263 250 (95. 06%) 11 (4. 18%) 2 (0. 76%) 9 th 12 th

Examining your screening data … … implications for primary prevention efforts … implications for teachers … implications for student-based interventions See Lane, Menzies, Bruhn, and Crnobori (2011)

NYES Winter % of Students Screened SRSS-E 7 Results – All Students 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% N = 45 13. 66% 22. 73% N = 57 25. 37% N = 28 N = 52 28. 79% N = 96 60. 98% 48. 48% W 14 N = 125 W 16 Screening Time Point Low Risk (0 -3) Moderate (4 -8) School W 17 High (9 -21)

NYES Winter % of Students Screened SRSS-I 5 Results – All Students 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% N = 64 18. 54% 32. 32% N = 38 16. 10% 21. 72% N = 43 N = 33 N = 91 N = 134 65. 37% 45. 96% W 14 W 15 W 16 Screening Time Point Low Risk (0 -1) Moderate (2 -3) School W 17 High (4 -15)

Student Risk Screening Scale Middle School Fall 2004 - Fall 2011 n = 12 Percentage of Students n = 20 n = 507 N=534 N=502 N=454 N=470 N=477 Fall Screeners N=476 N=524 N= 539 Lane & Oakes

Examining your screening data … … implications for primary prevention efforts … implications for teachers … implications for student-based interventions See Lane, Menzies, Bruhn, and Crnobori (2011)

Teacher-Level Considerations 1. Instructional Considerations 2. General Classroom Management 3. Low-intensity Strategies

Examining Academic and Behavioral Data: Lane, K. L. , Menzies, H. M. , Ennis, R. P. , & Oakes, W. P. (2015). Supporting Behavior for School Success: A Step-by-Step Guide to Key Strategies. New York, NY: Guilford Press.

Low-Intensity Strategies Opportunities to Respond Behavior Specific Praise Active Supervision Instructional Feedback Self-monitoring High p Requests Precorrection Incorporating Choice Behavior Contracts

Ci 3 T. org

Examining your screening data … … implications for primary prevention efforts … implications for teachers … implications for student-based interventions See Lane, Menzies, Bruhn, and Crnobori (2011)

Comprehensive, Integrated, Three-Tiered Model of Prevention (Lane, Kalberg, & Menzies, 2009) Goal: Reduce Harm Specialized individual systems for students with high-risk Tertiary ≈5% Prevention (Tier 3) ≈15% Secondary Prevention (Tier 2) Goal: Prevent Harm School/classroom-wide systems for all students, staff, & settings Goal: Reverse Harm Specialized group systems for students at-risk PBIS Framework ≈80% Validated Curricula Primary Prevention (Tier 1) Academic Behavioral Social

BASC 2 – Behavior and Emotional Screening Scale Spring 2012 N = 24 Percent of Students 100% 90% 80% 70% 60% 50% 40% 30% N = 67 Normal Elevated 3. 85 10. 74 Extremely Elevated 5. 45 3. 65 8. 68 12. 38 2. 46 11. 33 N = 533 85. 42 87. 67 82. 18 86. 21 20% 10% 0% Total N = 624 Sixth n = 219 Seventh Subgroup n = 202 Eighth n = 203

Sample Secondary Intervention Grid Support Description Schoolwide Data: Entry Criteria Data to Monitor Progress Exit Criteria mod to high risk Academic: 2 or more missing assignments with in a grading period completion, or other behavior addressed in contract Treatment Integrity Social Validity Completion of behavior contract Students who score in the abnormal range for H and CP on the SDQ; course failure or at risk on CBM Work completion and accuracy in the academic area of concern; passing grades Passing grade on the report card in the academic area of concern Sample Secondary Intervention Grid. Successful Behavior: SRSS Work Behavior Contract A written agreement between two parties used to specify the contingent relationship between the completion of a behavior and access to or delivery of a specific reward. Contract may involve administrator, teacher, parent, and student. Selfmonitoring Students will monitor and record their academic production (completion/ accuracy) and on-task behavior each day. Treatment Integrity

Counseling Intervention Grids 2015 2016 IES Ci 3 T Implementation 69

K-12: Intervention Grid Support Description Schoolwide Date: Entry Criteria Small group Social Skills Instruction: Social Skills Improvement System (SSi. S) Intervention Guide Small group instruction by counselor or other trained educator. Lessons taught based on student identify needs in group. 30 min, 4 times per week. SRSS-IE: E 7 or I 5 = Moderate or High Risk Assessments to guide instruction Data to Monitor Progress ODRs earned and reason. Treatment OR Integrity Office disciplinary Component referrals (ODR): 2+ checklist of for social lesson, challenges (peer attendance in related problems) group. OR • SSi. S – Rating Scale Needs (Pearson Education, Improvement on 2008) Report Card social • Use data to identify: indicators acquisition deficits* AND performance deficits Parent permission Social Validity Teacher: IRP 15 Student: CIRP Exit Criteria SRSS-IE low risk ODRs earned = 0 Improvement on report card social indicators Completion of lessons related to target skill(s) To monitor growth SSi. S Rating Scale

Support Description Mentoring Program (Sophomor es/ Juniors/ Seniors) Focus is on academic achievement, character development, problemsolving skills, improving self -esteem, relationships with adults and peers, and school attendance. Volunteer teachers serve as mentors; meeting weekly (30 – 60 min) with students during the school day. Schoolwide Data: Entry Criteria (1) 10 th/11 th/ 12 th graders (2) Behavior: SRSS: High (9 -21) or Moderate (4 -8) by either 2 nd or 7 th period teacher ODR ≥ 2 Absences ≥ 5 days in one grading period (3) Academic: GPA ≤ 2. 75 Lane, K. L. , Oakes, W. P. , Menzies, H. M. , Oyer, J. , & Jenkins, A. (2013). Working within the context of three-tiered models of prevention: Using school wide data to identify high school students for targeted supports. Journal of Applied School Psychology, 29, 203 -229. Data to Monitor Progress: Exit Criteria Student Measures: Yearlong support (1) Increase of GPA at mid-term and semester Students who no report cards. longer meet criteria (2) Decrease of ODR next fall monitored weekly. (3) Reduced absences Seniors: graduation (fewer than one per quarter) Treatment Integrity: Mentors complete weekly mentoring checklists to report meeting time and activities. Social Validity: Pre and post surveys for students and mentors.

Comprehensive, Integrated, Three-Tiered Model of Prevention (Lane, Kalberg, & Menzies, 2009) Goal: Reduce Harm Specialized individual systems for students with high-risk Tertiary ≈5% Prevention (Tier 3) ≈15% Secondary Prevention (Tier 2) Goal: Prevent Harm School/classroom-wide systems for all students, staff, & settings Goal: Reverse Harm Specialized group systems for students at-risk PBIS Framework ≈80% Validated Curricula Primary Prevention (Tier 1) Academic Behavioral Social

Changes in Harry’s Behavior Baseline 1 Intervention 1 Baseline 2 Intervention 2 100 90 Percentage of AET 80 70 60 50 40 30 20 10 0 4/27 4/28 4/29 4/30 5/5 5/10 5/13 5/14 5/17 5/18 5/19 5/20 5/21 5/24 5/25 5/26 5/27 5/28 Date of Session Cox, M. , Griffin, M. M. , Hall, R. , Oakes, W. P. , & Lane, K. L. (2012). Using a functional assessment-based intervention to increase academic engaged time in an inclusive middle school setting. Beyond Behavior, 2, 44 – 54.

Methuen Public Schools Methuen, MA John Crocker Comprehensive School Mental Health System National Quality Initiative Summit April 26, 2016

Example – Screening for Internalizing Problems Two large scale screenings at Methuen High School GAD-7 anxiety screener (January) PHQ-9 depression screener (April) Electronic screening using Google forms Parent notification and opt-out process in advance 100% of students who required follow-up received it within 7 days of the screening

Methuen HS, cont. The two screenings yielded the following data: GAD-7 (January) 840 responses (approx. 45% of the high school pop. ) 85 students scored in the severe range (10. 1% of respondents) 104 students scored in the moderate range (12. 4% of respondents) PHQ-9 (April) 853 responses (approx. 45% of the high school pop. ) 69 students scored in the severe range (8. 1% of respondents) 102 students scored in the moderate range (12. 0% of respondents) 8. 1% of students scored in the moderate or severe range on both screeners 2. 3% of students scored in the severe range on both screeners

Getting Started with Systematic Screening …

Recommendations to Consider • Recommendation #1: Build Stakeholders’ Expertise • Recommendation #2: Develop the Structures to Sustain and Improve Practices • Recommendation #3: Conduct Screenings in a Responsible Fashion • Recommendation #4: Consider Legal Implications- know your state laws (Lane & Oakes, 2012)

PBIS. org On Demand Resources • Very useful to find research on specific interventions • Power. Point presentations are available for some interventions • Training modules are available on PBIS aspects and interventions • Some tools and measures are available to be viewed • Quick FAQs on secondary and tertiary interventions

Moving Forward … thank you! Learning outcomes: Participants will learn how systematic screening data can be used to 1. examine students’ overall performance 2. inform low-intensity teacher-level interventions 3. connect students to Tier 2 and 3 supports