INTENSIVE LEVEL WRAPAROUND. Day 2

Transcription

1 INTENSIVE LEVEL WRAPAROUND Day 2

2 Agenda for Week Monday Tuesday Wednesday Thursday Strand 1. Introductions 2. Wrap & PBIS 3. Tier 2/3 Review 4. Team Visit 1. Universal Screening 2. FBA/BIP 3. Matching Interventions 4. Wrap Intro 1. Engagement 2. Team Development 3. Big Needs 4. Using Wrap Tools 1. Planning to Implementation 2. Evaluating progress 3. Transition 4. Action Steps Team Time Finish Activity #1 BAT School Act Plan BAT School Act Plan Screening FBA Engagement BAT School Act Plan School Act Plan

3 Today s Agenda: Reminders & Introductions Universal Screening Functional Behavior Assessment & Behavior Intervention Planning (FBA/BIP) Matching Needs & Interventions Wraparound Phase 1: Engagement Team Time Planning

4 Dr. Cath Burns Clinical Director Children, Youth and Families Washington County Mental Health Working with schools and mental health personnel in Washington County Conducting and providing training in FBA/BIPs Facilitating wraparound teams

5 BEST Summer Institute Theme & Vision: Working Smarter Not Harder

6 BEST Expectations Be present Engage with others Support each other Team solutions

7 (Tiny) Community of Practice Wraparound Principles in Action Working Smarter / Not Harder Low-Tech Resources High-Tech Resources

8 UNIVERSAL SCREENING

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10 Interventions with an Evidence Base 1. Advance organizers 2. Anger Management Skills Training 3. Behavioral Interventions 4. Choice 5. Class Wide Peer Tutoring 6. Cognitive organizers 7. Cognitive Restructuring 8. Cognitive-Behavioral Therapy 9. Computer-Assisted Instruction 10. Contingency Management 11. Daily Behavior Report Cards 12. Exposure-Based Techniques 13. Family Therapy 14. Functional Assessment 15. Functional Communication Training 16. Integrated Cognitive-Behavioral Therapy 17. Interdependent Group-Oriented Contingency Management 18. Interpersonal Therapy for Adolescents 19. Milieu Language Teaching 20. Mnemonics 21. Modeling 22. Modified Task Presentation Strategies 23. Moral Motivation Training 24. Multimodal Interventions 25. Multisystemic Therapy 26. Opportunities to respond 27. Pacing 28. Parent Training 29. Peer Mediated Interventions 30. Peer tutoring 31. Peer-Mediated Conflict Resolution and Negotiation 32. Picture Exchange Communication System 33. Pivotal Response Training 34. Pre-correction 35. Presentation Strategies 36. Problem Solving 37. Procedural prompts and behavioral momentum 38. Replacement Behavior Training 39. Self instruction 40. Self mediated strategies 41. Self monitoring 42. Self-Management 43. Social Skills Training 44. Task Modification 45. Task Selection Strategies 46. Token Economy System 47. Verbal Mediation 48. Video Modeling Vannest K, Reynolds CR, Kamphaus RW. BASC-2 intervention guide for emotional and behavioral problems. Bloomington, MN: Pearson Assessments; 2009.

11 Why Universal Screening? To find students whose problems are not immediately obvious (internalizers) and identify problems with a high degree of accuracy Early identification leads to early intervention Schools that implement Universal Screening select interventions based on results of rating scales on the screening tools. This is effective and efficient.

12 Universally Accepted Types of Screening in School Readiness Academic Vision Why not? Behavior Hearing Dental

13 Features of Good Universal Screening Accurate Cost efficient Acceptable Useful

14 Aren t ODRs Enough? Students with externalizing problems? Students with internalizing problems?

15 Multi-Stage & Multi-Gate Approach Stage 1 Universal Screen Stage 2 Elevated? Screen #2 Not elevated? Done. Stage 3 Elevated? Refer to team Not elevated? Done.

16 BASC-2 Approach Vannest (2008) Interventions for Externalizing & Internalizing Behaviors at Tier 2 & Tier 3

17 Stage 1 Stage 2

18 Results of screens helped teams choose which interventions to develop, use, or expand (4 schools) 20 TES DPE RES TIS

19 PBIS-NH Approach Stage 1 Systematic Screening for Behavior Disorders Teachers rank order students with: Externalizing problems Internalizing problems Choose top 3 Stage 2 BASC-2 BESS Teacher Teachers rate those passed gate 1 Elevated risk Extremely elevated risk Stage 3 Referral to School Team Link with appropriate intervention No elevation Exit No elevation Exit

20 Systematic Screener for Behavior Disorders 1. Select 10 students 2. Rank order them 3. Choose top 3 List Externalizers 1 Richard Boltax 1 Richard Boltax 2 Cath Burns 2 Jesse Suter 3 Mandy Couturier 3 Sherry Schoenberg 4 Kilie Demar 4 Ernest Hart 5 Ernest Hart 5 Jennifer Repinski 6 Dan Mapes 6 Sherri Nichols 7 Sherri Nichols 7 Dan Mapes 8 Jennifer Repinski 8 Mandy Couturier 9 Sherry Schoenberg 9 Kilie Demar 10 Jesse Suter 10 Cath Burns Rank Order Externalizers

21 Student Internalizing Behavior Screener (2010) 1. Rate each student: 0 = Never, 1 = Rarely, 2 = Sometimes, 3 = Frequently 2. Risk Level: Low (0-3), Moderate (4-8), High (9-21) Students Nervous Bullied by peers Seems sad Clings to adults Total Score 1 Richard Boltax Cath Burns Mandy Couturier Kilie Demar Ernest Hart Dan Mapes Sherri Nichols Jennifer Repinski Sherry Schoenberg Jesse Suter

22 Student Risk Screening Scale (1994) 1. Rate each student: 0 = Never, 1 = Rarely, 2 = Sometimes, 3 = Frequently 2. Risk Level: Low (0-3), Moderate (4-8), High (9-21) Students Nervous Bullied by peers Seems sad Clings to adults Total Score 1 Richard Boltax Cath Burns Mandy Couturier Kilie Demar Ernest Hart Dan Mapes Sherri Nichols Jennifer Repinski Sherry Schoenberg Jesse Suter

23 ACTIVITY # 4 Review all & complete one for your student BASC-2 BESS Teacher Form, Systematic Screening for Behavior Disorders, Student Risk Screening Scale, Student Internalizing Behavior Screener

24 Screening Tips Recommended twice / year (October & February) Group administration of Stage 1 Teachers should have known students for at least one month Review definitions / examples of externalizing and internalizing problems

25 So pretty simple, right? Well Family s right to privacy (opt out option) Clear & efficient systems to support process Training & TA Availability of supports Policy and liability issues What else?

26 NH-PBIS Recommended Steps to Readiness Need identified P&P shared with families (opt out) P&P for notifying families shared Approval secured Policies & procedures developed Point of contact for oversight Team formed Evidence based system identified Point of contact at SU/SD Supports identified Policies for other screening reviewed Resources available

27 ACTIVITY #5 1. Review Universal Screening Steps to Readiness 2. Where s your school in this process?

28 Perhaps Step 1 is Workshop M? Howard Muscott Early Identification of Students at Risk of School Failure Due to Social, Emotional and/or Behavior Problems: Nomination and Activation of Secondary Prevention (Targeted) Behavior Supports within an RTI for Positive Behavioral Interventions and Supports Framework

29 FBA / BIP

30 Functional Behavioral Assessment / Behavior Intervention Program (FBA/BIP) Foundation of all intensive level interventions Behavior support is the redesign of environments, not the redesign of individuals. Positive behavior support plans define changes in the behavior of those who will implement the plan. A behavior support plan describes what we will do differently.

31 FBA BIG IDEAS FBA is a problem solving process a way to think about behavior systematically. FBA identifies the events that reliably predict and maintain problem behavior. Best conducted by teams of educators who are skilled in the process Those who implement the strategy need to be actively involved in designing it or it probably won t work! Trigger Behavior Consequence Function

32 Levels of FBA (Crone & Horner, 2003) Full FBA Brief FBA

33 Brief FBA The FBA that can be done in your head. Simple description of the behavior Antecedents Consequences Likely function

34 FBA Team Process Steps 1. Collect information a. What does the problem look like? b. What series of events predicts behavior? c. What is the maintaining consequence of the observable behavior? d. Hypothesis statement? 2. Develop competing pathways and replacement behaviors 3. Develop BIP. 4. Develop strategies for monitoring & evaluating implementation of BIP.

35 ACTIVITY #6 1. Get into school groups 2. Prepare brief presentation on student from your school (Next slide) 3. Group problem-solving

36 Consultation Time with Colleagues Discuss the student and the FBA you prepared Identify type of FBA you completed: Brief à Full FBA protocol? Recreate the Competing Behavior Pathway on chart paper List interventions the team developed Describe the Behavior Intervention Plan Describe your plan for evaluating ongoing progress with plan List your building s Go TO FBA person List questions you have for the group Review these questions and chart paper with larger group

37 ACTIVITY #7 Benchmarks for Advanced Tiers (BAT) Tier 3: Assessment & Plan Development

38 BAT: 46. BIPs are developed by a team of individuals with knowledge in school context, student, and behavioral theory. A B C Fully in Place All BIPs developed by such teams Partially in Place Some BIPs developed by such teams or some areas Not Yet Started BIPs developed by teams expertise in 1 area or less

39 BAT: 48. BIPs include problem statement with definition of problem behavior, antecedents, and consequences. A B C Fully in Place BIPs include all 3 Partially in Place BIPs include 2, or components inconsistent Not Yet Started Problem statements not developed

40 BAT: 47. Tier 3 includes procedures allowing a continuum of strategies to match student needs. A B C Fully in Place Range of Tier 3 supports are available to match needs simple to complex Partially in Place Only one Tier 3 process Not Yet Started School lacks system for supporting students needing Tier 3

41 CHOOSING INTERVENTIONS BASED ON DATA

42 Continuum of Behavior Supports Continuum of Behavior Supports: New Hampshire s System of Care and Education School-wide and General Education Classroom Systems for Preventative Instructional ti and dbehavior Management Practices Systematic Screening Promote Positive Parent Contact Efficient Systematic Intervention for Students Who Do Not Respond to SW and Classroom Prevention and Response Systems Intensive Behavior Support Plans and Crisis Intervention Linkages to Community-based Supports Array of Evidence-Based Group Interventions Addressing Prevalent Functions of Behavior Available for Students Who Don t Respond to SW and Social Contracting Mann & Muscott (2007) Function-Based Support Planning (Functional Assessment and Intervention Planning) Available for SW and Group non-responders School-based Intensive Supports Linkages to Wrap-NH Coordinator Facilitation School-based Intensive Supports Linkages to Case Centered Collaboratives

43 Why We Need MH Partnerships One in 5 youth have a MH condition About 70% of those get no treatment School is defacto MH provider Students with EBD are 2 to 4 grade levels behind in academics. Best predictor of delinquency and incarceration Suicide is 4th leading cause of death among young adults

44 Old Approach à Each school works out their own plan with Mental Health (MH) agency; A MH counselor is housed in a school building 1 day a week to see students; No data to decide on or monitor interventions; Hoping that interventions are working; but not sure. New Approach District has a plan for integrating MH at all buildings (based on community data as well as school data); MH person participates in teams at all 3 levels; MH person leads small groups based on data; MH person co-facilitates FBA/BIP or wrap individual teams for students.

45 Interventions Based on Functions of Behavior Access Adult Attention/ Support: Access Peer Attention/ Support: Academic Skills Support Check-In/Check-Out Adult Mentoring Programs Social Skills Instruction Peer Mentoring Self-Monitoring with Peer Support (function: academic task escape) Organization/Homework planning support Homework completion club Tutoring

46 Interventions Based on Types of Behavior 20 TES DPE RES TIS

47 Interventions for Aggressive Behaviors 1. Problem Solving Training 2. Cognitive Restructuring 3. Verbal Mediation 4. Social Skills Training 5. Peer Mediated Conflict Resolution and Negotiation 6. Replacement Behavior Training

48 Interventions for Attention Problems 1. Contingency Management 2. Daily Behavior Report Cards 3. Modified Task-Presentation Strategies 4. Self-Management 5. Classwide Peer Tutoring 6. Computer Assisted Instruction 7. Multimodal Interventions

49 Interventions for Anxiety Disorders 1. Exposure-Based Techniques 2. Contingency Management 3. Modeling 4. Family Therapy 5. Integrated Cognitive-Behavioral Therapy

50 Interventions for Depression I. Cognitive- Behavioral Therapy A. Psychoeducation B. Problem-Solving Skills Training C. Cognitive Restructuring D. Pleasant Activity Planning E. Relaxation Training F. Self- Management Training G. Family Involvement II. Interpersonal Therapy for Adolescents

51 Separate Interventions to Individualized Teams Mentor CBT CICO Individualized Team

52 WHAT KINDS OF STUDENT TEAMS HAVE YOU JOINED?

53 Individualized Teams at the Intensive Level Are unique to an individual child & family Task facilitator with engaging family and bringing team together Blend the family s supports with the school representatives who know the child best Designed to improve quality of life as defined by the youth/family (i.e., BIG Needs ) Meet frequently Identify, develop & review interventions

54 Who Benefits from Intensive Supports? Youth with needs across home, school, & community Youth with needs in multiple life domains The adults in youth s life who are not effectively engaged in comprehensive planning

55 Targeted/Intensive Level Skill Sets Understands the conflict cycle and uses de-escalation strategies Develops FBAs and BIPs Uses effective engagement strategies with students, families and teams Develops targeted interventions that are functionbased. Familiar with academic modifications and accommodations Integrates data-based decision-making into comprehensive processes (home-school-community)

56 WRAPPING BACK TO WRAPAROUND

57 What is Wraparound? Wraparound is a family-driven, team-based process for planning and implementing services and supports. Teams create plans that are geared toward meeting the unique needs & strengths of children and youth with complex needs and their families. The wraparound team members meet regularly to implement and monitor the plan to ensure its success.

58 Life Physical Domains Legal Family Job Student Safety Education Socialization Emotional Cultural

59 Wraparound and PBIS The wraparound process is a key component on the continuum of a school-wide system of PBIS. Value-base: Quality of Life; Voice/Ownership Data-based Decision-Making: Efficient & Effective Actions

60 Voice to Engagement WE have to ask the youth/family how they will know if thing are getting better Family has to define success for the team If they define progress/success, as well as strengths and needs, then they are likely to be engaged in the interventions.

61 Wraparound Principles Voice & choice Natural supports Collaboration Communitybased Culturally Competent Team-based Individualized Strengthsbased Unconditional Outcomesbased

62 Four Phases of Wraparound 1. Engagement & Team Preparation Orient family, stabilize crises, assess strengths & needs, form vision, identify team members 2. Planning Hold initial meeting(s), orient team, create plan focusing on Big Needs, identify services & supports 3. Implementation Hold regular meeting, implement plan, review progress, revise plan 4. Transition Define when vision / goals have been met, unwrap celebration, follow up with familiy

63 T3-W Components SYSTEMS District Team, District Coach, & School Teams monitor resources, evidence based practices, planning, & implementation PRACTICES Facilitators lead collaborative wraparound process plus identify and coordinate evidence based practices DATA Teams at student, school, & district levels use data on fidelity and progress for decision making T3-W Outcomes SHORT-TERM MID-TERM LONG-TERM Focus on most important needs identified by family Strategies based on strengths Team cohesiveness & follow-through Satisfaction and engagement with wraparound Experiences of efficacy and success Services & supports are a better fit Evidence based practices are chosen based on individualized needs Better coordination of services Increased social supports Improved self-efficacy & self-esteem Increased capacity for coping & problem-solving Evidence based practices & natural supports are more effective Improved access, engagement, and commitment to services/supports REDUCTIONS IN: School disciplinary problems Need for restrictive placements IMPROVED QUALITY OF LIFE OUTCOMES: Needs met; teamidentified outcomes achieved Improved emotional & behavioral functioning Improved academic performance (e.g., grades, curriculum based measures) Stable living situation Supportive relationships

64 Wraparound is: An ongoing planning process used by: A team of people Who come together Around family strengths/needs To create a unique plan of interventions & supports Based upon a process of unconditional care no blame, no shame Wraparound is Not: A set of services A one or two time meeting A special education evaluation An individual counselor who links with the family or student Only for families and students we judge as workable The presence of flexible funds QUICK Reflection: Similarities/Differences with your past experiences/knowledge of wraparound?

65 ACTIVITY # 8 How is wraparound similar and different from typical service delivery in your school / district? Use worksheet to answer questions

66 Tier 3 Student Action Plan Illinois PBIS Network Tier 3/ Student Action Plan & Progress Update Purpose: This document is a working record of the team structure and plan of support for each individual student receiving tier-3 support. This document should be shared and updated at every individual student team meeting to ensure that: a) changes and progress are recorded, b) interventions are agreed upon by all team members and c) teams are accountable for ongoing progress monitoring. If information is stated clearly, the plan can also be shared with others who may be supporting this student in the future. Team facilitators are encouraged to document all components clearly. Clarity of actions and decisions (rather than length) makes the written plan useful to the student and his/her team currently as well as in the future. Student: School: School Contact: Grade: Age: SIMEO ID#: Student Intervention History Check interventions that the student has received. Include start date and end date; if not applicable indicate N/A OR data not available-only if intervention has just begun: Simple Secondary Interventions (CICO) Social/Academic Instructional Groups Simple Secondary Interventions with Individual Features(CnC) Brief Function-Based Behavior Plan Complex/Multiple-Life - Domain FBA/BIP Wraparound Support Start Date End Date Start Date End Date Start Date End Date Start Date End Date Start Date End Date Start Date End Date Pre Data Post Data Pre Data Post Data Pre Data Post data Pre Data Post Data Pre Data Post Data Pre Data Pre Data

67 ACTIVITY #9 TEAM TIME Review Activity #9 Worksheet Student Intervention History Complete during team time today

68 Team Members SECTION 1: Team Development/Sign-In Sheet Youth/Student: Parent Guardian: Facilitators: Date of 1 st Meeting: 2nd 3rd 4 th 5 th 6 th 7 th 8 th 9 th 10 th ***set meeting date before ending current meeting*** CONFIDENTIALITY AND ATTENDANCE: I agree to honor the rights and privacy of any persons discussed in this meeting. I agree not to divulge any information regarding any family, person, or agency, which may be referred to in the course of this meeting. Team members present today: Relationship/Role Team members not present today:

69 ACTIVITY #10 TEAM TIME Review Activity #10 Worksheet Assessing Team Composition Complete during team time today

70 Team Time Day 2 Complete Benchmarks of Advanced Tiers (BAT) VTPBiS Action Plan for Intensive Level: Sections H, I, & J What are your goals and action steps for Universal Screening? (Steps to Readiness) Improving FBA/BIP process? (BAT) Identifying evidence based interventions? Activity #9 Student Intervention History Activity #10 AssessingTeam Composition

71 Step 1: Workshop N Joy Prior, Christine Kilpatrick, Kathleen Holsopple Collaborating with Families In order to meaningfully include parents and parenting caregivers in activities related to the systems, data and practices that help students achieve both academically and behaviorally, educators need to have an understanding of what does and does not work in assisting and partnering with parents in the educational process.