Universal School-wide Screening to Identify Students for Tier 2/Tier 3 Interventions 2008 National Forum for Implementers of School-Wide PBS Doug Cheney,

Universal School-wide Screening to Identify Students for

Tier 2/Tier 3 Interventions

2008 National Forum for Implementers of School-Wide PBS

Doug Cheney, Ph.D., Washington PBIS Coordinator, University of Washington, Seattle, [email protected]

Kimberli Breen, M.S., C.A.S., M.A., Technical Assistance Director, IL-PBIS Network,[email protected]

Jennifer Rose, M.Ed., Loyola University Chicago, [email protected]

AcknowledgementsSchools in the Washington PBIS network

Schools in the Illinois PBIS network

Paul Rose, Counselor, Cowherd Middle School - East Aurora School District: [email protected]

Dr. Meda Thompson, Principal, B.J. Ward Elementary - Valley View School District: [email protected]

Carolyn Olander, School Psychologist, B.J. Ward Elementary - Valley View School District: [email protected]

Session Agenda

• Background and Context for using Screening

• Some evidence from Washington schools using SSBD

• Application of using SSBD in Illinois

• Discussion of using Screening Tools

Universal Screening

• Reliable Tools available for past 20 years

• Universal screening offers opportunity for prevention, yet….

• Schools reluctant to conduct behavioral screening:– Fear of “stigmatizing kids”– Concerns regarding efficient/effective

methods of supporting identified youth

Source: Walker, Cheney, Stage, Blum (2005)

PBIS Systems Often:

• Develop behavior support team

• Monitor ODRs and teacher referral

• Use school or ODR criteria (2-5 ODR) to nominate students for Tier 2

• Capture externalizing disruptive students

Universal (school-wide) behavioral screening :

• Addresses prevalence of emotional/behavior problems among school-age children ranges between 9%-13% (Tier 2 & 3 Students)

• Provides a valid and reliable approach for identifying student behavioral issues– Externalizing and Internalizing students are identified

• Highlights schools as an ideal environment for addressing mental health-related issues– “Less stigmatizing” than clinics– Potential to reach large groups of youth and families– Successfully identify kids with internalizing behaviors

Universal Screening• Behavioral screening viewed as normative,

e.g., Vision, Hearing, Literacy • Good fit with RTI behavior model• Links to prevention programs & reduces

need for more intensive services later– Untreated emotional/behavioral issues

correlate with negative outcomes• Poor grades & personal relationships• High school dropout & Unemployment• Incarceration, Substance abuse, Suicide

Systematic Screening for Behavior Disorders (SSBD; Walker & Severson, 1992)

• Research in the 1980s on predictors

• Multiple gating procedures following mental health model

• Externalizing and Internalizing dimensions

• Evidence for efficiency, effectiveness, & cost benefits

• Exemplary, evidence-based practice• US Office of Special Education, Council for Children with

Behavior Disorders, National Diffusion Network

Multiple Gating Procedure (Severson et al. 2007)

Teachers Rank Order 3 Ext. & 3 Int. Students

Teachers Rate Top 3 Students on Critical Events, Adaptive & Maladaptive Scales

Gate 1

Gate 2

Pass Gate 1

Classroom & Playground

Observations

Gate 3Pass Gate 2 Tier 2,3

Intervention

Tier 3 Intervention or Special Ed. Referral

Gating Procedures

• Gate 1 – Nomination based on Definitions• Gate 2 – Score and Criteria for:

– Critical Events – Steals, Tantrums, Assaults adults, Damages property, Painful Shyness

– Combined Frequency Index

• Adaptive Behavior – Follows rules, Gains peer attention positively, Expresses anger appropriately, Positive socials with peers

• Maladaptive Behavior – Refuses to participate in activities, Challenges teacher limits/rules, Manipulates peers, pouts/sulks

SSBD History in Washington

• Used in research over the past 10 years– 10 districts statewide

• School psychs review & adopt for district• Teachers informed & process reviewed in

staff meeting• Screening takes 1-2 hours per teacher to

complete• Tier 2 Students identified

Washington Schools: Study 1Walker, Cheney, Stage, & Blum (2005)

• 3 Elem. Schools, 80/80 SET, 1999-2003

• 124 students (70 Ext./54 Int.) Ext. > 1 s.d. on Social Skills and Prob Behs./ Not Int.

• Screening & ODR: >ODR, >Prob. Behs.

• Screening+ODR increases # of at-risk students

• Screening and use of school supports maintains students at SST level (Gate 2 Tier 2), and fewer FBA/BSP or referred to Special Ed (Gate 3, Tier 3)

Study 2:Cheney, Stage, Hawken, Lynass,

Mielenz, & Waugh (in review)

• 119 Tier 2 CCE Intervention, 86 Comparison Students in 18 schools

• 73/119 students (61%) graduate within 2 yrs

• SSBD & Behavioral Measures differentiate graduates, comparisons, nongraduates.

• Graduates lower problem behaviors & increase social skills in growth curve model.

SSBD Differentiates Grads , Non-grads, Comparisons

Graduates Non-Graduates Comparison

SSBD Critical

Events

5.9 (2.8) 5.4 (3.0) 5.2 (2.8)

SSBD

Maladaptive

31.2 (10.5) a 37.2 (5.7) b 32.2 (7.8) a

SSBD Adaptive 32.3 (8.0) a 28.0 (4.8) b 30.6 (6.8) a

Decrease in Problem Behavior, SSRS

Universal Screening in Illinois• 6 school districts, 18 schools• Spent 1 year focused on creating

Secondary & Tertiary Level Systems– Specifically Check-in/Check-out

• Emphasis on building “system capacity”• Identify youth early• Support youth with effective interventions• Exit/transition youth off of interventions• Progress-monitor

– Individual youth response to interventions– Interventions themselves

Summary: 2007 SSBD Screening Results

4%

3%

6.7%

0%

1%

2%

3%

4%

5%

6%

7%

1

At-risk students identified by SSBD

Perc

ent

of

tota

l enro

llment

Kids identified as externalizers as percent of total enrollment Kids identified as internalizers as percent of total enrollment

Kids identified as a percentage of total school enrollment

At-risk students identified by 2007 SSBD screening

3.4%

1.3%

23.2%

2.8%

7.1%6.4%

8.3%

4.3%5.0%

6.8%

14.8%

7.2%6.1%

8.0%

6.0%

8.0%8.6%

0%

6.7%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

Schools

Pe

rce

nta

ge

of

tota

l e

nro

llm

en

t

Kids identified as a percentage of total school enrollment

At-risk students identified by 2007 SSBD screening-North

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

9.0%

School A School B School C School D School E School F School G School H School I Average

Schools

Perc

en

t of

tota

l en

rollm

en

t

Kids identified as a percentage of total school enrollment

Universal Screening in Illinois: Preparation Process

• District-level commitment

• Secondary PBIS system in place– Provides seamless transition from

screening to intervention

• Logistics of preparation• SSBD Coordinator• Overview for all staff• Schedule & organize ‘day of administration’

Universal Screening: School Profile

• K-5 Elementary in southwest suburban Chicago• 65+% low income• Total enrollment of 580 reflects diverse student population

• 65% Hispanic• 17% Black• 13% White• 5% Asian/Other

• 24% Mobility• Truancy concerns

Universal Screening: Illinois Application

• Implemented universal screening in mid-March– Identified total of 82 students

• Represents 14% of enrollment

– Majority of students classified as externalizers• 56% of identified students

– However a significant percentage (43%) met criteria as internalizers

Universal Screening:Illinois Application

• Capitalized upon existing system of secondary interventions– Recruited additional adult volunteers for CICO– Paired 2-4 students for CICO with adults, prior to

sending permission slips– Tailored secondary level interventions to meet

unique needs of internalizers (e.g., using social skills groups)

– Contacted parents of internalizers prior to sending home permission slips

– Used SWIS/CICO data collection system

Universal Screening:Illinois Application

• Lessons learned:– Address slow response for granting

permission• Incorporate area on permission slips for

parents to request additional information• Anticipate need for follow-up phone calls,

sending additional permission slips

Universal Screening:Illinois Application

• Lessons learned:– Pair students and teachers based on physical

proximity– Increase size of CICO groups– Keep a “reserve” of adults to add to CICO– Review data weekly

• Identify students ready to transition to less intensive level of support/students who are not responding to CICO

Resources

Severson, H.H., Walker, H.M., Hope-Dolittle, J., Kratochwill, T.R., Gresham, F.M. (2007). Proactive, early screening to detect behaviorally at-risk students: Issues, approaches, emerging innovations, and professional practices. Journal of School Psychology. 45, 193-223.

Walker, H.M., Severson, H.H. (1992). Systematic screening for behavior disorders. Longmont, CO. Sopris West.

Walker, B., Cheney, D., Stage, S., Blum, C. (2005). Schoolwide screening and positive behavior supports: Identifying and supporting students at risk for school failure. Journal of Positive Behavior Interventions. 7(4) 194-204.