Building Fluency with Tier 3 Wraparound Lucille Eber, Statewide Director, IL PBIS Network Susan Bruce, Iowa Department of Education Becky Halbur, East.

Building Fluency with Tier 3 Wraparound

Lucille Eber, Statewide Director, IL PBIS NetworkSusan Bruce, Iowa Department of Education

Becky Halbur, East Sac Schools Julie Nadrchal, Prairie Lakes Area Education Agency

National PBIS Leadership ForumHyatt Regency O’Hare, Rosemont, IL

October 9, 2009

Session E-4

Individualized Teams at the Tertiary Level

• Are unique to the individual child & family– Blend the family’s supports with the school

representatives who know the child best• Meeting Process

– Meet frequently – Regularly develop & review interventions

• Facilitator Role– Role of bringing team together– Role of blending perspectives

Individualized Comprehensive Teams/Plans

What?The development of a very unique, individualized, strength-based team & plan with the youth and family that is designed to improve quality of life as defined by the youth/family.

Who?• Youth with multiple needs across home, school, community• Youth with multiple life domain needs • The adults in youth’s life are not effectively

engaged in comprehensive planning (i.e. adults not getting along very well)

Individualized, Comprehensive Teams/Plans

What Do Tertiary Plans include?Supports and interventions across multiple life domains and settings (i.e. behavior support plans, academic interventions, basic living supports, multi-agency strategies, family supports, community supports, etc.)

What’s Different?Natural supports and unique strengths are emphasized in team and plan development. Youth/family access, voice, ownership are critical features. Plans include supports for adults/family, as well as youth.

What is Wraparound?

• Wraparound is a tool (e.g. a process) used to implement interagency systems of care in achieving better outcomes for youth and their families.

• The wraparound process is similar to person-centered planning, the individualized Positive Behavior Support (PBS) planning process.

• Wraparound is a process for developing family-centered teams and plans that are strength and needs based

– (not deficit based)

– across multiple settings and life domains.

• Wraparound plans include natural supports, are culturally relevant, practical and realistic.

What is Wraparound?

Implementing Wraparound:Key Elements Needed for Success

Engaging students, families & teachers Team development & team ownership Ensuring student/family/teacher voice

Getting to real (big) needs

Effective interventions Serious use of strengths Natural supports Focus on needs vs. services

Monitoring progress & sustaining System support buy-in

What’s New in Wraparound?

• Skill set specificity• Focus on intervention design/effectiveness• Integration with school-wide PBS• Phases to guide implementation/supervision• Data-based decision-making• Integrity/fidelity assessment (WIT)• Tools to guide teams:

– Home School Community– Education Information Tool

Wraparound Skill Sets

1. Identifying “big” needs (quality of life indicators)• “Student needs to feel others respect him”

2. Establish voice/ownership 3. Reframe blame4. Recognize/prevent teams’ becoming immobilized by

“setting events”5. Getting to interventions that actually work6. Integrate data-based decision-making into complex

process (home-school-community)

Four Phases of Wraparound Implementation

I. Team Preparation- Get people ready to be a team- Complete strengths/needs chats (baseline data)

II. Initial Plan Development- Hold initial planning meetings (integrate data)- Develop a team “culture” (use data to establish voice)

III. Plan Implementation & Refinement- Hold team meetings to review plans (ongoing data collection

and use)- Modify, adapt & adjust team plan (based on data)

IV. Plan Completion & Transition- Define good enough (Data-based decision- making)- “Unwrap”

Scenario for Activity 5• You are at a coach’s network meeting and the

following questions are asked?1. How do we know if were supposed to do complex

fba/bip or wraparound?

• Follow up Questions?1. So what is the difference between big need and

function?2. How do I go about assessing/determining what a

student (and/or family)’s “ big needs” are?

Deciding Which Tertiary Level Intervention is Most Appropriate

Complex FBA/BIP (T200):• Brief FBA/BIP was not successful

AND

• NONE of Wraparound criteria are present

Wraparound (T300+):• Youth with multiple needs

across home, school, community & life domains

• Youth at-risk for change of placement

• The adults in youth’s life are not effectively engaged in comprehensive planning (i.e. adults not getting along well)

Function

• The purpose/reason for demonstrating a specific type of behavior within a specific context/routine.

• Specific behaviors have been strengthened by consistent reinforcement.

• Family voice is not necessary to identify function of behavior in the school setting.

• Once Function is correctly identified, putting a plan in place can produce rapid behavior change. This can be accomplished in a single meeting.

Big Need

• The underlying reason preventing successful experiences/interactions in multiple settings/contexts/routines

• When a big quality of life need is unmet, it impacts perception/judgment, often resulting in chronic problem behavior.

• Family voice is necessary to identify the Big Need for the school setting.

• Once Big Need is identified, it takes a while to achieve and involves action planning across multiple life domains. Meeting the big need always involves multiple Child & Family Team meetings.

Function

• Function is identified through structured interviews focusing on the problem behavior, antecedents, consequences, and setting events

• Focus is on developing function-based support plan (replacement behavior, antecedent, consequence, and setting event supports).

• When achieved, situations improve for the youth or those engaged with the youth on a regular basis (e.g., the family, the teacher).

Big Need

• Big needs are identified through open-ended conversation and use of SIMEO tools with those engaged with the youth on a regular basis.

• Big Need statements motivate a family to participate on the team (know we are working on something ‘bigger’ than specific behaviors).

• If met, the need will improve quality of life for the youth or those engaged with the youth on a regular basis (e.g., the family, the teacher).

Big Need: “Andy needs to feel like he belongs at

school”

• School Behaviors: Aggressive with peers, excessive absences/tardies, history of academic failure

• Other indicators: Family frequently relocated, lack of home school communication, community support needs

Starting with FBA would not have been an effective approach—why?– Discussing problem behaviors would not have motivated family to

participate on team.– Probably not the first time schools have approached family in this

manner (“let’s talk about behavior”)– Open-ended conversation and use of SIMEO tools helped engage family– Bigger needs to work on to improve quality of life for youth and family

Scenario for Activity 6

• You are at a coach’s network meeting and the following questions are asked:

1. What if the family or teacher does not want to engage in wraparound?

• Follow up Questions:1. How do I use the SIMEO tools to engage them? To keep the

team going?2. Wraparound seems really hard, why should we spend so much

time?

Why Do Wraparound???

Points to Remember:

Engaging Families

Apply RtI to Family Engagement: don’t keep doing what hasn’t worked up

If engagement didn’t happen, how would you change your approach to effectively engage?

Professionals don’t get to choose or judge how families raise their kids.

Always start with a conversation (not a meeting) with the family, getting their trust and permission before talking with others.

Apply RtI to Teacher Engagement: don’t keep doing what hasn’t worked.

Just like we do for kids and families, recognize teacher strengths and needs. Teacher voice in the plan will ensure better outcomes.

Always start with a conversation (don’t hand off data tools). Teachers need to be prepared for the wrap meeting and kept “in the loop”.

Use data to bring teacher and family together.

Points to Remember: Engaging Professionals

Using Data to Drive Decision-Making with Wraparound

• More efficient teams, meetings and plans• Less reactive (emotion-based) actions• More strategic actions• More effective outcomes• Longer-term commitment to maintain

success

Baseline Data -• Enhances the initial conversations with family and team

members.• Creates more efficient team meetings. • Takes the emotion out of team meetings. • Gives us a starting point for planning.• Helps us plan across all environments – Home, School and

Community• How have you used baseline data?

Wraparound: Data-based decision-making

Wraparound Case Study “Ozzie” cont.

Getting to Strengths and Needs at BaselineUsing Data and Voice & Choice

Follow-up Data (Time2, Time 3…)

• Helps us CELEBRATE progress• Shows us small increments of progress that can be

missed.• Helps us progress monitor – remember, if the plan is not

working, re-work the plan!• Helps us get buy-in from staff, administration, and

skeptical team members.• How have you used follow-up data?

Wraparound: Data-based decision-making

Transition Planning for “Jacob”Using Data to get buy-in from the new team

Becky Halbur, MS School Counselor

Internal PBIS CoachEast Sac County Elementary Schools

Julie Nadrchal, LISWSchool Social WorkerExternal PBIS Coach

Prairie Lakes Area Education Agency

What we learned…

• PBS in Iowa• We needed to beef up our tier 2

interventions• Implemented Check In Check Out• Implemented Check and Connect• Tier 3 Team Developed

• The power of Phase 1: Initial conversation– “Cinder” family …listening to the story– Identifying strengths through soft data– When we prove that we heard the parent, they

will listen to us. • What was different about wraparound

– Moving from the expert model to Voice and Choice of the family.

What we learned…

• Re-engagement is sometimes necessary• Mental Health Advocate for Sherrie

• Everyone needs to leave the meeting with a job

• Everyone’s job needs to be connected with the big need• Mental Health Advocate

• Wraparound facilitates partnership between agencies, school, and family

What we learned…

• The power of data• Using the HSC tool• Using SIMEO data at a team meeting• The power of co-facilitators

What we learned…

SIMEO Strength Data on HSC Tool

SIMEO Needs Data on HSC Tool

We’re still learning…

• Need to have a systems approach• Understanding and using the behavior

pathway– Blake’s story

• Tier 2 and Tier 3 teams meeting monthly

WHAT’S WORKING

Iowa’s Project LINCS

Implementation Evaluation

Sites visits3 to 4 hoursInterviews

School team Parents/caregivers Students

Parent Informed Consent Document

Visit format

Case Study/Focus Group Iowa DE group and Full Wrap Team

Interviews occurring simultaneously One team interviewed student and

reviewed student materials One team interviewed parent and

reviewed team notebook /materials DE Team discussionFocus Group and exit briefing

Interview Case Study QuestionsSchool Staff

What about the implementation is working?

What about the implementation is not working?

What do you need to improve the implementation of wraparound?

What do you view as the indication of greatest success to date?

In regard to the wraparound training and materials: What do you see as most valuable? What do you see as least valuable?

What access does the wraparound team have to community mental health services?

In regard to services provided to your student: What community resources were utilized

prior to the implementation of wraparound?

What community resources are now being utilized?

Good thingsGood things Not so goodNot so good

Develop relationshipsHSC Tool - initiating

conversationsSIMEO user friendlyTA – DE and LucilleStrength basedPositive change in

parent attitudeIncreased use of

community resourcesStudent success

Getting all to attend meetings

Conference calls with other schools

Communication with community resources

Use of all the forms

What did we find out from the school staff?

Parent Interview

What supports, services or activities are working well for your child?

What supports, services or activities are not working well for your child?

What do you think your school needs to improve supports, services or activities for your child?

This school year, what do you view as the indication of your child’s greatest success?

What access do you and your child have to community mental health services?

In regard to services provided to your child: What community resources were used

prior to the implementation of wraparound?

What community resources are now being used with the implementation of wraparound?

Good thingsGood things Not so good Not so good

Team working together toward same goal

Feel like a valuable, equal member

Strength basedAdditional supports

(therapists, CICO) and resources

Child’s success is obvious

What did we find out from parents?

Student Interview

What at school is working well for you?What is not working well for you?What do you think the school needs to do to

improve your success at school?This school year, what do you feel has been

your greatest success?What new supports or people have you

decided to work with?

Good thingsGood things Not so goodNot so good

Teachers support behavior plans

Like CICOMore friendsHelp with personal

issuesLess angryMom and dad are

more helpfulFeel good about doing

better

CICO can be embarrassing

Peers behaviors don’t change

What did we find out from students?

Overall Themes

Wraparound was positive for school, parents and students and resulted in a new way to work together.

Enhanced relationships and increased trust.Increased communication, improved transitions

and decreased duplication of work involved.Greatest indicator of successful implementation

was student success.Strength based focus and increase of effective

strategies put in place to help student succeed.