Empirically Supported Prevention and Intervention Strategies

Overview

This section provides structural essentials of a comprehensive systemic design for implementing proactive interventions and supports. Specifically, interventions that could be implemented using existing school resources are provided and specific commercially available or packaged interventions have not been included. Therefore, this section should not be viewed as an exhaustive list of effective interventions.

In this section, the critical features of empirically supported prevention and intervention strategies are described for each intervention tier. Specifically for each tier (Tier 1, Tier 2 and Tier 3), a narrative description of the strategies is provided in outline form.

Tier 1: Universal Schoolwide and Classwide Strategies

Tier 1 interventions are characterized by the fact that they are universal in design and provide differentiated instruction for all students. They are preventive and proactive in nature and require that actions be proactive, positive and preventive in nature; based on the use of empirically validated procedures; done in collaboration with community supports; based in a common approach to discipline and climate; culturally responsive; and cognizant of linguistic diversity, addressing the needs of ELLs and varieties of English. Implementation of Tier 1 strategies and interventions help to and maintain a positive school climate.

1. State, post and teach positively stated expectations.
   • Identify expectations that tell students what to do, rather than what not to do.
   • Post the expectations within classroom and relevant school settings.
   • Explicitly teach the expectations within the context of those school settings and classroom routines and provide practice in the natural context.
   • Actively supervise (i.e., move, scan and interact with) students in the natural context.
   • Remind or prompt students to follow expectations.
   • Consider implementing an evidence-based social skills curriculum that includes specific strategies for anger management, conflict resolution, etc. (e.g., programs reviewed by www.CASEL.org).
   • Create a win-win teacher-student exchange. Students should be provided a way out, or options other than negative choices or behaviors.
2. Select and implement instructional practices that maximize opportunities to respond and promote active student engagement in a variety of ways.
   • Use a variety of evidence-based strategies to increase opportunities to respond, including choral responding, response cards and guided notes.
   • Implement a variety of evidence-based instructional practices that increase active engagement, including direct instruction, class-wide peer tutoring and computer assisted instruction.
   • Provide a positive-based collaborative learning community that centers on rigor, relevance and relationship to support high school best practices that bring about an increase in success and performance.
3. Maximize structure and predictability in school and classroom environments.
   • Design the physical arrangement of the setting, including the physical layout and seating arrangements (e.g., preferential seating) to (a) maximize structure and (b) minimize crowding and distraction.
   • Develop and teach predictable routines (e.g., how to enter/exit the classroom, take care of personal needs, get materials and conduct small group activities).
   • Provide structure during transitions by (a) developing a transition routine, (b) teaching that routine to students, and (c) promoting students when there will be a transition or other change to their schedule.
   • Post all schedules/transitions and daily changes to minimize the impact of change.
4. Implement a variety of strategies to recognize and reinforce (i.e., increase) appropriate student behavior.
   • Students should be immediately recognized for demonstrating appropriate, expectation-following behavior using specific and contingent praise (i.e., specify the behavior being recognized).
   • In addition, consider implementing additional empirically validated strategies, including group contingencies or rewards, behavior contracts and/or token economies.
   • Create a schoolwide positive based support system.
5. Implement a variety of strategies to discourage and decrease inappropriate student behavior.
   • Respond to inappropriate behavior in a calm voice (low volume and intensity) and business-like manner (neutral/unemotional).
   • Provide a specific, brief and contingent error correction (e.g., "Behavior X was not respectful. Instead, please get my attention by doing Y) for minor behavioral incidents.
   • Consider additional empirically validated strategies to decrease inappropriate student behavior, including performance feedback, differential reinforcement, planned ignoring, response cost and time-out. Ensure that these procedures are implemented correctly and with fidelity (e.g., as described by Alberto and Troutman, 2009; Cooper, Heron and Heward, 2006) and implement the least restrictive procedure necessary.
   • Avoid reactive approaches to inappropriate behaviors such as punishment that fails to teach the student acceptable replacement behaviors and may reinforce the inappropriate behavior. Strategies and interventions must look beyond the misbehavior and explore the underlying causes of the misbehavior.
   • Use open communication within collaborative teams to individualize and address strategies to replace inappropriate behaviors.
6. Collect progress-monitoring data on social behavior and use those data to make decisions.
   • Collect data (e.g., office discipline referrals and behavior data collected by a teacher) to document the levels (frequency, rate, duration or latency) and intensity of students' social behavior.
   • Use data to make decisions about which students (a) benefit from Tier 1 strategies and interventions (i.e., students with moderate or increasing levels of disruptive behaviors
   • that do not present a danger to self or others), or (c) require Tier 3 strategies and interventions (i.e., students with high or increasing levels of disruptive behaviors and students with any level of problem behavior that presents a danger to self or others).

Tier 2: Interventions Included in Previous Tier and Targeted Group Strategies

Tier 2 interventions are typically implemented by a school-level team and they should be data driven. In other words, data should be used to make decisions about which students (a) require and benefit from a Tier 2 intervention, (b) require more intensive Tier 3 interventions or (c) have demonstrated success and are ready to return to Tier 1 interventions.

1. Small-group Social Skills Instruction
   • Social skills instruction should be developed to promote maintenance and generalization of skills across contexts.
   • Lesson plans should follow a model-lead-test format (i.e., systematic and direct instruction).
   • During and after lessons, provide opportunities to practice and receive feedback in the natural setting (when possible).
   • Include strategies to prompt or cue the skill in the natural setting. For example, create picture cues or written prompts for expected behaviors to post in the natural settings.
2. Check-in/Check-out (CICO) Interventions

   Implement a CICO intervention that prompts students to (a) check-in with a positive adult when they first arrive at school, (b) check-in with their teacher(s) at specified time interval throughout the day (e.g., at the end of scheduled activities or classes), (c) check-out with a positive adult and (d) check-in with their parent or guardian at home. (Note: there are many variations of this intervention.)

   Teach students, staff and parents the following procedures and implement them with fidelity:

   • During the morning check-in, an assigned adult greets the students, reminds them about the expectations for the day, makes sure they have the required materials and gives them a point sheet or daily behavior report card to carry throughout the day to recruit feedback from their teacher(s).
   • Throughout the day, each student gives his/her teacher(s) the point sheets and teachers provide (a) a rating of the extent to which each student demonstrated the expected behaviors and (b) brief verbal feedback (specific praise or error correction) about the student's performance during that period.
   • At the end of the day, the student returns to the same assigned adult who reviews their point sheet, determines if the student met his/her daily goal (i.e., earned the required number of points), provides a reward contingent on meeting the goal and gives the student a copy of the point sheet to take home.
   • At home, students share their point sheet with their parent(s) or guardian(s) who are asked to provide positive feedback or help the student problem solve for the next day, depending on the indicated level of performance.
   • Carefully monitor this intervention, use data to make decisions and provide students with an opportunity to transition to self-management (where they rate themselves) and/or to return to Tier 1 if successful.
3. Mentoring
   • Mentoring programs link students with adults from the community. Mentoring can take place in a variety of settings (e.g., school, community and recreation center) and include either structured or less structured activities (e.g., planned academic support, social interaction and recreation).
   • One example of a more intensive mentoring program that has demonstrated initial effectiveness is Big Brothers Big Sisters. Big Brothers Big Sisters pairs students with community members who share similar characteristics and interests. Mentoring consists of two types of activities: "site-based mentoring," which includes weekly visits a the child's school and "community-based mentoring," which involves the "Big" and "Little" engaging in preferred activities together in the community (e.g., sports and recreation).
4. School-related Group Counseling Interventions
   • Structured small-group activities focused on areas of concern (social skills groups, behavioral contracting and organizational support)

Tier 3: Interventions Included in Previous Tier and Individualized and Intensive Interventions

Tier 3 interventions are by their very nature more intensive and individualized. Students who are not making progress using Tier II interventions, need a much more structured, individualized and intensive intervention. According to the National Association of School Psychologists (NASP) these interventions are best implemented using the best practice of teaming and behavioral consultation. The interventions will be most successful when multiple, simultaneous causes are considered and linked to multiple interventions designed to treat the individual. The team should consider the following characteristics: cognitive, behavioral, health, peer, curriculum, teacher, classroom/school district, as well as, family /neighborhood/community and cultural and linguistic factors.

1. Assessment of the Function of Behavior(s) and Positive Support Planning
   • Assessing the function of student behavior(s) is a process of (a) identifying behaviors to target with intervention, (b) operationally defining each behavior, (c) collecting information via records reviews, inter views and observations to identify the context in which the behaviors occur (antecedents that trigger and consequences that maintain the behavior), and (d) determining the function that the behavior serves for the individual (positive or negative reinforcement). The outcome of such an assessment is a confirmed summary statement which specifies ABC and may be formatted as follows: Given _____ (antecedents), the student engages in _____ (behaviors) to _____ (get/obtain or escape/avoid) _____ (stimuli).
   • After conducting an assessment of the function of the behavior, an individualized, positive behavior support/BIP should be developed by (a) identifying an appropriate alternative behavior to replace the problem behavior and meet the same function, (b) devising a behavior support plan that describes the ways in which the environment is rearranged to make the replacement behavior more efficient, effective, relevant and durable than the problem behavior, (c) monitoring for fidelity of implementation and (d) taking data to guide the modification and eventual fading of the plan.
2. Individualized Student/family Supports Planned Through a Wraparound or Person-centered Process
   • Wraparound services for children with significant mental health issues are family and child-centered. They take place in a variety of settings and include behavior treatment or care planning. Progress in monitored with date, updated regularly and reevaluated every three months.
   • In Connecticut, the local systems of care incorporate a continuum of services for children with significant mental health issues, as well as provide a structure for communities to come together, to address systems in the children's behavioral health system.
   • Connecticut community collaboratives work together to coordinate services and advocate for children who have significant mental health issues and their families.
3. Counseling Interventions
   • Frequency and intensity of structured small-group activities focused on areas of concern (social skills groups, behavioral contracting and organizational support) may increase.
   • Conduct structured goal-oriented counseling sessions in systematic response to identified needs of groups of children. Themes include academic skill building, social skill development, career awareness, conflict resolution, family issues and making healthy choices.
   • Provide individual counseling in response to student requests.

Recap of Tier Strategies

Recap of Tier 1 Strategies

• State, post, and teach positively stated expectations.
• Select and implement instructional practices that maximize opportunities to respond to and promote active student engagement in a variety ways.
• Maximize structure and predictability in school and classroom environments.
• Implement a variety of strategies to recognize and reinforce (i.e., increase) appropriate student behavior.
• Implement a variety of strategies to discourage and decrease inappropriate student behavior.
• Collect progress-monitoring data on social behavior, and use those data to make decisions.

Recap of Tier 2 Strategies

• Small-group social skills Interventions.
• Mentoring.
• School-related group counseling interventions.
• Check-in/check-out interventions.

Recap of Tier 3 Strategies

• Assessment of the function of behavior.
• Individualized student/family supports.
• Individualized counseling interventions.
• Consultation/teaming.