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Using Response to Intervention with Adolescents At‐Risk for Emotional Disturbance
Ramón B. Barreras, Ph.D., BCBA‐D Litzy Z. Ruiz, M.A. Department of Special Education Azusa Pacific University
Today’s Plan… • The Problem and Mess ▫ poor treatment and outcomes ▫ current ED identification
• The Solution (RtI makes sense) • The Program (how to do it)
Sobering Statistics • Secondary students with EBD:
Poor Service Delivery and Outcomes
▫ 1‐5% account for <50% of office discipline referrals ▫ Average GPA of 1.4 ▫ 44.2% drop out of school (25.4% of all students with disabilities) ▫ 11% are involved in the criminal justice system ▫ 58% dropout of school Of those that dropout, 73% are arrested within 2 years ▫ 50% arrested within 1 year of leaving school ▫ 68% are unemployed up to 5 years after school Special Education Elementary Longitudinal Study (SEELS, 2003); National Longitudinal Transition Study of Special Education Students (NLTS, 1995; 2005, 2006)
The Problem: Service Delivery
Prevalence Rate Relative to Student Population
• Schools need to improve the way at‐risk adolescents are identified and treated for social/emotional competence deficits.
Eligibility
• Schools typically intervene with reactive and punitive actions (Mayer, 1995; 2001). • Special education services are often delayed until early adolescence; greatest proportion of students classified as EBD between the ages of 13‐15 (United States Department of Education, 2001). • Approximately 20% of the school‐age population demonstrate deficits that would qualify them for a psychiatric diagnosis; but, less than 1% receives services under EBD (Angold, 2000; Hoagwood & Erwin, 1997).
DataQuest (2008‐2009)
28th Annual Report to Congress (2006)
CA (6-21 yrs.)
US (6-21 yrs.)
ED
0.32%*
0.7%
SLD
7.30%
4.2%
MR
0.46%
0.8%
*CA is well on its way to “curing” ED relative to national norms, however, SLD is becoming an epidemic in CA
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CALIFORNIA SPED‐DATA (2008‐2009*)
DataQuest: California Department of Education Database
Workshop Purpose ▫ This workshop will discuss findings from a service delivery model that will assist school personnel establish a preliminary response to intervention design to the identification of EBD.
Participant Outcomes • Participants will: 1. learn how to administer a universal screener in order to identify students at‐risk for behavioral difficulties, and, 2. learn how to collect at least one direct behavioral measure, and develop one decision rule regarding special education eligibility of non‐responders to Tiered interventions.
Significance of Project 1. Will focus on urban adolescents at‐risk for EBD, which is a vastly under‐researched population in the EBD field. 2. Will evaluate the effectiveness of interventions when implemented by everyday school personnel (effectiveness research).
Screening
Identification
Intervention
Response to Intervention
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Response to Intervention and Medicine?
Response to Intervention and Education?
• Physicians universally assess basic vital health signs:
• Schools universally assess basic vital achievement signs:
▫ Weight
▫ Reading/Writing Skills
▫ Blood pressure
▫ Math Skills
▫ Heart rate...
▫ Social Skills
▫ Why? Scientifically‐established indicators of overall health
• Tx II: Core Program + Phonics/Social Skills Training
• Tx II: diet/exercise + medication • Tx III: diet/exercise + {
▫ Why? Well‐established indicators of overall educational health
• Tx I: Core Reading Program/Schoolwide‐Classwide Behavior Expectations
• Tx I: diet/exercise /Δmedication}
surgery
• Tx IV: SURGERY • Other vital measures/tests taken as Tx intensifies
• Tx III: Core Program + Intense Phonics/FBA‐BIP • Tx IV: Special Education: Supports and Related Services • Other achievement measures taken as Tx intensifies
Medical Response to Intervention
Educational Response to Intervention
the practice of providing high‐quality medical treatment matched to patient needs and using vital sign rate over time and level of health to make important medical decisions
the practice of providing high‐quality instruction/intervention matched to student needs and using learning rate over time and level of performance to make important educational decisions (National Association of State Directors of Special Education, 2005)
What is Response to Intervention? MEDICINE
EDUCATION
Universally Screen Vital Physical Health Signs
Universally Screen Vital Educational Health Signs
Targeted Treatment to Improve Physical Health Performance
Targeted Treatment to Improve Educational Health Performance
Intensive Treatment to Improve Physical Health Performance
Intensive Treatment to Improve Educational Health Performance
Do No Harm…
Achievement For ALL…
RtI Pilot Project
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School Demographics •
7th ‐ 8th grade middle school (1223 students) ▫ Teacher student ratio = 23.1 ▫ 46 teachers (only 9 participated for the remainder of the study) ▫ 67.7% Latino; 25.4% Caucasian; 3.6% Africa‐American; 1.6% Asian‐American ▫ English language learners (24.8%); special education (12.7%) ▫ 92% of students receive free and reduced meals ▫ Title I and Program Improvement (PI) school ▫ 2 years implementing Schoolwide Positive Behavior Supports (SW‐PBS)
• 10 male adolescents (demographic info will follow) • School Counselor and 4 MFT Interns (Interventionists)
RtI Screening Example: Behavior SCHOOLWIDE SCREENING Teacher Nomination Student Risk Screening Scale (Multiple‐Gating Model) TARGETED INTERVENTION
Basic Social Skills Instruction
INTENSIVE INTERVENTION Prescriptive Social Skills Instruction
Special Education Evaluation
RtI Team • Assistant Principal (Discipline) • General Education Teacher (7th & 8th) • Resource Teacher (Title I) • RSP Teacher • School Counselor • MFT Intern • School Psychologist • Paraprofessional (Data Collector)
Intervention Programs • Tier 2: Non‐deficit based (Treatment Integrity = 97.9%) ▫ “Typical” social development or social skills/problem solving training ▫ Not matched to social skills deficits ▫ Not based on any form of a pre‐assessment ▫ Implemented once a week for 60 minutes, for a period of 8 weeks • Tier 3: Acquisition‐deficit based (Treatment Integrity = 93.8%) ▫ Modeling, coaching, and behavioral rehearsal utilized to teach and promote skill acquisition ▫ Implemented once a week for 60 minutes, for a period of 8 weeks • Tier 3: Performance‐deficit based (Treatment Integrity = 96.9%) ▫ Peer‐mediated strategies, cuing, prompting, contingent reinforcement, and group‐oriented contingency systems used to enhance skill performance ▫ Implemented once a week for 60 minutes, for a period of 8 weeks
Barreras (2008)
Student Demographics P
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P P
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P
3
A A
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A A
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Tier 1
Tier 2
Tier 3
Tier 4 SPED
Non‐responder: ED (ACQ)
Tier 1
Tier 2
Tier 3
Tier 2
Discussion Responder: Non‐ED (ACQ)
Discussion and Implications • Can be used as a model for RTI in the identification of students with EBD • Cost‐benefit of screening • Proactive approach to intervention before labeling • Long‐term effects a deficit‐based SST program on later adolescent outcomes such as discipline referrals, delinquency, high school graduation, and academic achievement
TIER IV: Special Education Intensive Behavior Therapy
Behavior Therapy Function‐based Behavior Plan Classwide Mental Health Curriculum All Students have a Behavior Plan
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