1. The Role of Intensive Support within School-wide PBIS Rob Horner University of Oregon

2. Main Messages  Applied Behavior Analysis is a compelling and effective technology for assessing and changing behavior.  In combination with medical and organizational variables we can use behavior analysis to both change behavior and improve quality of life.  Getting behavior analysis implemented with (a) fidelity, (b) breadth, and (c) sustainability remains a major challenge.  Hill Walker’s multi-tiered prevention model, Dean Fixsen’s implementation logic, and George Sugai’s integration of practices into an implementation “framework” are worthy of consideration.

3. Goals  Define core features of a “Three-Tiered” Framework for intervention  Emphasize the core role of intensive supports within the three- tiered prevention framework  Propose elements of a research agenda for enhancing implementation of function-based behavior support Three CE Questions summarized in last slide

4. Three-tiered approach  Hill Walker’s introduction of multi-tiered prevention, drawn from community mental health. (Walker et. al,1996)  Primary prevention  Evidence-based, efficient, all  Secondary prevention  Standardized, targeted, some  Tertiary prevention  Individualized, intensive, few

5. School-wide Positive Behavioral Interventions and Supports (PBIS)  Build a continuum of supports that begins with the whole school and extends to intensive, wraparound support for individual students and their families.  Implement effective practices with the systems needed for high fidelity and sustainability

6. What is School-wide Positive Behavior Intervention and Support?  School-wide PBIS is:  A framework for establishing the social culture and intensive, individual behavioral supports needed for a school to be an effective learning environment for all students.  Evidence-based features of SWPBIS  Prevention  Define and teach positive social expectations  Acknowledge positive behavior  Arrange consistent consequences for problem behavior  On-going collection and use of data for decision-making  Continuum of intensive, individual intervention supports.  Implementation of the systems that support effective practices

7. Bradshaw, C.P., Koth, C.W., Thornton, L.A., & Leaf, P.J. (2009). Altering school climate through school-wide Positive Behavioral Interventions and Supports: Findings from a group-randomized effectiveness trial. Prevention Science, 10(2), 100-115 Bradshaw, C.P., Koth, C.W., Bevans, K.B., Ialongo, N., & Leaf, P.J. (2008). The impact of school- wide Positive Behavioral Interventions and Supports (PBIS) on the organizational health of elementary schools. School Psychology Quarterly, 23(4), 462-473. Bradshaw, C. P., Mitchell, M. M., & Leaf, P. J. (2010). Examining the effects of School-Wide Positive Behavioral Interventions and Supports on student outcomes: Results from a randomized controlled effectiveness trial in elementary schools. Journal of Positive Behavior Interventions, 12, 133-148. Bradshaw, C.P., Reinke, W. M., Brown, L. D., Bevans, K.B., & Leaf, P.J. (2008). Implementation of school-wide Positive Behavioral Interventions and Supports (PBIS) in elementary schools: Observations from a randomized trial. Education & Treatment of Children, 31, 1-26. Horner, R., Sugai, G., Smolkowski, K., Eber, L., Nakasato, J., Todd, A., & Esperanza, J., (2009). A randomized, wait-list controlled effectiveness trial assessing school-wide positive behavior support in elementary schools. Journal of Positive Behavior Interventions, 11, 133-145. Horner, R. H., Sugai, G., & Anderson, C. M. (2010). Examining the evidence base for school-wide positive behavior support. Focus on Exceptionality, 42(8), 1-14. Randomized Controlled Trials Examining PBIS Reduced major disciplinary infractions Improvements in academic achievement Enhanced perception of organizational health & safety Improved school climate Reductions in teacher’s reports of bullying behavior

8. The Effects of School-wide PBS within a Randomized Control Effectiveness Trial Rob Horner, George Sugai, Keith Smolkowski, Lucille Eber, Jean Nakasato, Anne Todd, Jody Esperansa OSEP TA Center on Positive Behavior Support www.pbis.org In press in the Journal of Positive Behavior Intervention

9. Randomized Controlled Trial (Preliminary Findings)  Assessment Time Period  GroupT 1T 2T 3  Treatment(N = 30)OXOO  Control/Delay (N = 30)OOXO  (T = time (by year), O = observation, X = implementation of SWPBS training)

10. Results: With training by regular state trainers, schools are able to implement SWPBS to criterion. Random coefficients analysis: p <.0001; d = 1.78 Initial Training Delay Training **

11. Results: Perceived Social Risk Factors decreased when SWPBS was implemented with fidelity. Random coefficients analysis p =.0154; d = -.86 * *

12. Results: The percentage of 3 rd graders meeting the state reading standard increased with SWPBS implementation N.S. p =.032; d =.58 **

13. Schools adopting SWPBIS by year 14,325 Schools Adopting School-wide PBIS 14,325 Schools Adopting School-wide PBIS

14. Schools use SWPBIS (Feb, 2011) 11 states with over 500 schools 3 states with over 1000 schools 11 states with over 500 schools 3 states with over 1000 schools Illinois Texas Florida

15. Extension of Walker’s Logic to School-Wide PBIS  Primary Prevention: Tier I  Define, teach, monitor, reward behavioral expectations  Consistent continuum of consequences  Data collected and used for decision-making  Secondary Prevention: Tier II  First Step to Success  Check-in/ Check-out  Check and Connect  Tertiary Prevention: Tier III  Function-based support  Wraparound Tertiary Supports: High Intensity Applied Behavior Analysis with medical, behavioral, educational, community mental health Primary Prevention is the foundation for effective and sustained implementation of more intensive behavior support ** Eber ** Dishion & Fosco Analysis of “weak and non- responders”

16. The Effectiveness of Intervention Strategies Based on Functional Behavioral Assessment. Kimberly L. Ingram, Teri Lewis-Palmer and George Sugai University of Oregon,

18. Making Function-based Support more Accessible  Practices with Systems  Team  Time  Data Structure  Team Composition  Bennazi et al.,

19. The Role of Behavior Specialists in the Development of Function- based Behavior Support Plans Benazzi, L., Horner, R., & Good, R. University of Oregon

20. Three knowledge areas needed for a behavior support plan Behavior Support Plan Knowledge about The Student Knowledge about The Setting Knowledge about Behavioral Theory

21. Results: Technical Adequacy Mean Expert Rating (6-18) * Team alone plans were statistically different from plans that included behavior specialist. *Team + Specialist and Specialist Alone were not statistically significantly different.

22. Results: Contextual Fit Mean Team Rating (0-100) * Specialist Alone plans were statistically different from plans that included team members. * Team Alone and Team + Specialist plans were not statistically significantly different

23. Results: Mean Team Rank Team Preference (1-3) (inverse) * Specialist Alone plans statistically different from plans that included team members. * Team Alone and Team + Specialist plans were not statistically significantly different

24. Making Function-based Support more Accessible  Functional Behavioral Assessment as a common practice in schools  Sheldon Loman  Kathleen Strickland-Cohen  Providing the data systems to match behavioral technology  Individual Student Information System  Measure fidelity as well as impact

25. An Examination of the Efficacy of a Practical Functional Behavioral Assessment Training Model for Personnel in Schools Sheldon Loman, Ph.D. Portland State University and Robert H. Horner, Ph.D. University of Oregon 2011

26. Practical FBA Basic FBA: Single Response Class: Behaviors and Maintaining Functions are Easily Defined and Identified Complex FBA: Single or Multiple Response Classes: Behaviors and Maintaining Functions Vary, and are not Easily Defined and/or Identified

27. Study Design  Teach Practical FBA to 12 typical school personnel  Document their mastery of content  Typical School Personnel Conduct FBA with typical students under typical conditions  Functional Analysis conducted to test the accuracy of the Practical FBA.

28. Comparison of Summary Statements Generated from Interviews  9 out of 10 of the summary statements hypothesized by the FACTS interviews with teachers were confirmed via direct observation  10 out of 10 FBA Summary Statements based on FACTS + Direct Observation were confirmed via Functional Analysis. Results: Phase 3

29. Implementation and ABA  We know more about what to do, than about how to get what we know in place.  Organizational behavior analysis, and Implementation Science need to become more dominant elements in our research agenda.

30. © Fixsen & Blase, 2008 Performance Assessment (Fidelity) Coaching Training Selection Systems Intervention Facilitative Administration Decision Support Data System Integrated & Compensatory Competency Drivers Organization Drivers Leadership AdaptiveTechnical Successful Student Outcomes Program/Initiative/Framework (e.g. RtI)

31. Main Messages  Intensive Applied Behavior Analysis is an integral part of SWPBIS  We know more about what Intensive Support looks like than we do about how to get it in place in typical school and community settings. ----------------------------------------------------------------------------  Implementation of School-wide Systems (policy, team operating procedures, data systems, school-wide expectations) will enhance the implementation and impact of high intensity supports.  The construct of “function-based support” needs to be applied to all three tiers of intervention supports.  Need for more systematic analysis of “weak and non-responders”  Typical school personnel are able to conduct “basic” FBA  Teams will use FBA information well only if they have a member who is knowledgeable about behavioral theory.  Achieving the policy goal of making schools more effective with a wider range of students will require making ABA more accessible across the educational system.

32. Toward a Functional Research Agenda  Document necessary and sufficient conditions for implementing technically competent behavior analysis in applied settings.  Assess the effects of organizational systems on the quality of behavior analysis implementation… at all three tiers?  Assess if conducting “basic” FBAs improves the efficiency of effective behavior analysis implementation?  Use analysis of weak and non-responders to guide enhancements in standard behavior analysis procedures?

33. Behavior Support Elements Problem Behavior Functional Beh. Assessment Content of Support Plan Fidelity of Implementation Impact on Behavior and Lifestyle *Team *Specialist *Hypothesis statement *Competing Behavior Analysis *Contextual Fit *Implementation Plan *Technical Adequacy

34. Summary  What Tiers of Support within SWPBIS?  Primary Prevention, Secondary Prevention, Tertiary Prevention  What competencies needed on a team building BSP?  Knowledge about (a) Setting, (b) Individual, (c)Behavioral Theory  Measures needed in assessment of Intensive Support?  Outcome/Impact measures of student behavior  Fidelity measures of quality of implementation