v The Pyramid Framework within Early Intervention Programs: Promoting the Social Development of Infants and Toddlers

What we hope to accomplish in this webinar  Provide rationale for Teaching Pyramid  Explain why the Teaching Pyramid is a useful model for thinking about social emotional development of infants and toddlers.  Examine some of the key features of model as applied to very young children and their families.  Talk about some of the promise and the challenges of such an approach. 2

The Teaching Pyramid: Promoting Social and Emotional Competence and Addressing Challenging Behavior High Quality Supportive Environments Nurturing and Responsive Relationships Individualized Intervention Focus on Caregiver-Child Interaction Intensive Interventions Universal Promotion Prevention Treatment/Focused Intervention 3

Key Ideas Underlying Multi- Tiered Models  Pyramid provides a tiered intervention framework of evidence-based intervention for promoting the social, emotional and behavioral development of young children.  Model describes 3 tiers of intervention practice: Universal promotion for all children. Secondary prevention to address the needs of children at risk for social-emotional challenges. Intensive or tertiary intervention for children with persistent challenges. 4

Strong foundation is important in all multi-tiered systems of support.  Foundation: If this is in place, most children won’t need more intensive interventions.  In Teaching Pyramid, Foundation is: Nurturing and Responsive Relationships High quality Environments 5

Intensive Intervention Targeted Social Emotional Supports Nurturing and Responsive Relationships AND High Quality Environments Systematic approaches have preventive and remedial effects on social emotional develop- ment. Supportive, responsive relationships among adults and children are necessary for promoting social emotional development High quality environments promote positive outcomes for all young children CSEFEL Pyramid Model: Promoting Social Emotional Competence in Infants and Young Children 6

The Teaching Pyramid – Key Ingredients for Supporting Social Emotional Development  Focus on promotion and prevention rather then reactive procedures Positive interactions Consistency and predictability in the classroom routine Clearly defined expectations Engaging activities  Focus on intentional teaching of social skills and emotional competencies Acknowledging the relationship between social skills and challenging behavior Understanding the function of children’s behavior and matching our strategies to the function of behavior Teaching across the day rather then in response to challenging behavior Giving children strategies that they can use in a variety of situations 7

BENEFITS OF THE PYRAMID APPROACH Program Perspective 8

Benefits: Stronger Relationships  Teacher/child interactions are more intentional & meaningful.  Teaching staff understand what “trips their trigger” and how their reactions can escalate challenging behavior.  There is a real partnership between the family and the teaching staff. They build a relationship.  Families have said that they have learned to like their child again! 9

Benefits: Improvements in Staff Morale, Confidence, and Teamwork  Staff satisfaction has increased.  Staff turnover has decreased.  Staff feel confident in their consistent use of PBS strategies.  Staff have more time to teach because they are better prepared for the children.  Staff work better as a team. 10

Benefits: Staff Empowerment  Staff are implementing the Teaching Pyramid with fidelity.  Staff are better able to track children’s challenging behavior and respond proactively.  Staff have hope!  The focus is on prevention instead of intervention. 11

Benefits: Child Outcomes  There are fewer referrals to external experts, we know what to do.  Children are improving in their social emotional competence over the program year.  Children are having fewer problems across the year.  Children are improving when they receive intensive behavioral interventions. 12

THE FOUNDATION OF THE PYRAMID Tier One 13

Tier 1 in Infant-Toddler Classrooms  Primary caregiving  Routines are individualized based on the needs of each child  Adults use routines to interact socially with infants and toddlers  Adults interact verbally with children mapping their activities and emotions  Adults respond to children’s signs of distress 14

Tier 1 in Infant Toddler Classrooms  Adults support interactions between toddlers  Adults redirect children who are engaging in challenging behaviors 15

The Pyramid Infant Toddler Observation System (TPITOS)  Importance of translating theory to practice  Measuring implementation  Using information for professional development  Structure of the TPITOS Classroom Design/Key Adult Variables Red Flags  Current status of TPITOS 16

17

18

19

20

THE IMPORTANCE OF UNIVERSAL SCREENING Finding children needing more than the foundation 21

Infant/Toddler S-E Screening  Child social-emotional development and functioning  Environmental support for child social-emotional behavior and development (center/classroom and home)  Key adult-child interaction behaviors that predict important child social-emotional outcomes 22

Social-Emotional Development & Functioning Ages and Stages Questionnaire- Social-Emotional (ASQ-SE; Bricker et al.) Caregiver report minutes to complete Provides a cut-off score for social-emotional concerns 23

General Environment Support of Social-Emotional Behavior & Functioning The Pyramid Infant Toddler Observation Scale (TPITOS) 14 Red Flags 24 Classroom design and behavior items Rated on a 4-point scale (exemplary practice to not observed) Home Observation for Measurement of the Environment (HOME IT; Caldwell & Bradley) 45 items completed during home interview 6 subscales related to the home environment (parent involvement presence of appropriate materials and opportunities) 24

Considerations for Selecting & Implementing Repeatable Brief Easy to use and score Inexpensive Reliable and valid Capable of telling programs: When there is a concern What intervention needs to zero in on Whether intervention is making a difference 25

Recognizing Infants & Toddlers Needing more than Universal Intervention 26

Externalizing Concerns  Severe tantrums Hitting, kicking, biting  Difficulty accepting guidance Screaming no, throwing toys and materials 27

Internalizing Concerns  Withdrawn  Unengaged with people or materials  Sad, anxious, irritable  Have a hard time being comforted 28

Dysregulation Concerns  Difficult to read signals Hard to recognize when they are happy or upset  Rapidly changing signals Move quickly & with little warning to unconsolable crying  Difficulty calming  Difficulty with routines Falling asleep, staying asleep Feeding 29

Screening Identification  Parent or teacher report (ASQ-SE)  HOME  TPITOS 30

GREATER FOCUS ON INDIVIDUALIZATION Tier Two 31

Tier 2 Intervention  Intervention becomes more individualized  Involves a closer look at teacher-child interaction in the classroom Focusing in on a child’s signals Looking at adult behaviors that foster positive child behavior Looking at adult behaviors that get in the way of supporting child positive behavior Identifying specific ways that teachers can respond to a child’s individual signals to: Support and build on positive signals Reduce stress in response to negative signals 32

Indicator of Parent-Child Interaction IPCI (Baggett, Carta, & Horn, 2003) Brief rating scale following observation of authentic interaction activities at home/center Adult behaviors that facilitate child social-emotional development Adult behaviors that interfere with child social- emotional development Child engagement Child distress 33

IPCI Use  Completed for children for whom Tier 1 concerns are identified ASQ-SE HOME Classroom Environment  Teacher-child interaction Classroom supervisor Lead teacher while observing assistant teacher-child interaction  Parent-child interaction in the center or home Completed by a home visitor (teacher, family advocate, social worker) 34

INTENSIVE INTERVENTION Tier Three 35

Who might need intensive intervention?  Children who are not showing progress in response to Tier 2 intervention.  Children whose development and behavior is identified as extremely off-track and teachers are unable to manage their behavior or support them without intensive supports. 36

Purpose of Tier 3  No change as a result of your prevention strategies and intervention strategies at the lower levels of the pyramid.  Behaviors escalate. 37

Tier 3  Team based process  Functional assessment  Individualized behavior support plan  Prevention strategies  Replacement skills  Adult responses to children’s behavior  Implemented across environments  Linked to services beyond the classroom as needed 38

CRITICAL ROLE OF FAMILIES IN THE INFANT- TODDLER PYRAMID 39

Role of Families in the Pyramid  Families are involved from the very beginning of the model.  If additional support is needed for a child, staff work directly with the family. We will go to their home or they can come to the center…family choice.  Training in Positive Behavior Support is available to families.  The family is considered the “expert” on the child. They play an important role in any planning process.  Families are taught to take Behavior Incident Reports.. Their observations are very valuable for planning. 40

Partnerships  Family support plans are an option.  Mental health partners are in the centers regularly to work with parents and staff on prevention strategies.  Mental health partners are available for consultation in the home, at the center or in their office…family choice.  The staff and the family are a team. We share results of our observations and compare our data.  We use specific praise with parents as well as children and each other. 41

We make it a point to celebrate small successes. 42

Summary and Conclusions  Some of the same features of the original Teaching Pyramid can be applied to programs serving infants and toddlers.  Strong foundation equals prevention.  We need to ensure fidelity of implementation of the foundation.  Families are a central feature of Infant-Toddler Teaching Pyramid.  Measures are available for carrying out universal screening to determine which children might need more intensive supports.  Measures for monitoring progress of children in their interaction with caregivers.  Successful implementation of the model will depend on the strong collaboration with community partners. 43