12/14/2012

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SANCTUARY & PBIS: HOW POSITIVE BEHAVIORAL

INTERVENTIONS SUPPORT THE

SANCTUARY MODEL

Glen Chernack, Ph.D.

Dale Langley, Psy.D.

RegineWong, Psy.D.

Presentation Objectives

1. Overview of the Orchard School

2. Comprehensive RTI/PBIS

Systems at Orchard School

3. Bridging Sanctuary & PBIS

4. Data Driven Decision Making

ORCHARD SCHOOL

OVERVIEW

The Orchard School-ANDRUS

• ANDRUS main campus in

Yonkers, NY

• Nationally recognized

special education school

• Day and Residential

students (Grades K-9)

• Individualized

Educational Plan (IEP):

basis of academic and

related services

• IEP classifications:

o Emotional Disability (84%)

o ASD/PDD (8%)

o OHI/ADHD (6%)

o Learning Disability (1%)

The Orchard School-ANDRUS

• Classroom ratio of 8:1:1

• Services provided:

o Individual & Group therapies

o Speech and Language

Therapy

o Occupational Therapy

o Physical Therapy

o Psychiatric services

(Residential students only)

Treatment Programs:

Residential Program

• Approx. 73 students

• Reside mostly in New York

State (also serve children

nationally via Interstate

Compact).

• Difficulty managing emotion

and behavior at home &

school.

• Consistent, structured,

supervised, & therapeutic

support; specialized

academic support.

Day Program

• Approx. 79 students

• Reside in Westchester, New

York City, and neighboring

counties.

• Social & emotional difficulties

prevent performing to fullest

academic potential.

• Therapeutic support &

specialized academic support.

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Referrals• School districts/Committee on Special

Education (CSE)

• Department of Social Services (DSS)

• Specialists in the field of trauma

Curriculum & Treatment• 12-month program

• New York State Curriculum

• Participate in New York State Assessments (unless Alternative Assessment)o 9th grade students: Algebra and Living Environment

Regents Examination

• Specialized Treatment modalities:o Sanctuary Model (certified in 2012)

o Play Therapy

o Trauma Focused Cognitive Behavioral Therapy (TF-CBT)

o Art Therapy

o Eye Movement Desensitization Reprocessing (EMDR)

o Body and Sensory regulation/integration

Discharge

• Average length of stay:

o 18 months to 2 years

• Goals:

o Return to parent/guardian home

o Educated in home school districts RTI/PBIS OVERVIEW

AT ORCHARD

SCHOOL

Response to

Intervention (RtI)

• Screening

o Proactively Identify Student

Needs

o Predict who may be at risk for

poor outcomes

• Progress Monitoring

o Assess performance

o Quantifies improvement

o Evaluates effectiveness

•Multi-level Prevention System

o 3 levels of intensity

o Allows for individualizability

• Data-Based Decision Making

o Data analysis informs

decision making

o Objective replaces subjective

For more information on RtI visit the National Center on Response to Intervention:

http://www.rti4success.org/

PBIS = RtI for BehaviorsIt’s a multi-layered Approach

Academic Systems

80-90% 80-90%

Intensive, Individual Interventions•Individual Students•Assessment-based•High Intensity

Intensive, Individual Interventions•Individual Students•Assessment-based•Intense, durable procedures

Targeted Group Interventions•Some students (at-risk)•High efficiency•Rapid response

Targeted Group Interventions•Some students (at-risk)•High efficiency•Rapid response

Universal Interventions•All students•Preventive, proactive

Universal Interventions•All settings, all students•Preventive, proactive

Behavioral Systems

15-17%

3-5%

15-17%

3-5%

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PBIS focuses on…

Materials modified from George Sugai & Rob Horner (10/7/08)

“School-Wide Positive Behavior Support: Overview”

Improving classroom & school climate

Decreasing reactive

management

Maximizing academic

achievement

Improving support for

students w/ EBD

Integratingacademic &

behavior initiatives

Brief Introduction of PBIS Model

P: Positive B: Behavioral I: Interventions & S: Supports

Key Point

• Provide behavioral interventions to meet the student where he or she is currently functioning

Basic Principles

• Behaviors, like academics, need to be taught

• Student should be informed & involved in the process

• Interventions are student, environment & time specific

• Use data to make decisions

Teaching Behaviors:

Ask Yourself, “How did I learn to…?”

Blow a bubble? Tie my shoes?

Memorize the multiplication table?

Drive a car?

or

Use public

transportation?

PBIS at The Orchard School

Tier 3: Intensive Problem-Solving

Example: Functional Behavior Assessment (FBA),

Behavior Intervention Plans (BIP), 1:1 Staffing

Tier 2: Targeted Problem-Solving

Example: CARE Program, Classroom Specific

Behavior Plans, Teacher Consultation

Tier 1: Universal Prevention & Early-

Stage Problem-Solving

Example: CHAMPS, B+ Program, Classroom

Observations

At Orchard School we are C.H.A.M.P.S.

We like that CHAMPS is…

– Specific & Predictable

• Clear, simple expectations

– Proactive

• Opportunity for practice & re-

teaching

– Positive

• 6:1 schedule of reinforcement

• Emphasis on Labeled Praise

– Evidence-based

• Provides data with which to make

informed decisions

•Conversation –o What voice level should a student use

during this class?

•Help –

o How can a student get help or

assistance in this class?

•Activity –o What is the activity for this class?

•Movement –o What level and type of movement is expected during this class?

•Participation –o How will the teacher know students are participating in this class?

o How will the teacher know students are not participating?

•Success –o If a student meets the basic expectations of CHAMPS, he or she will

experience success!

Example: CHAMPS Expectations for Reading Class

= During Reading we will use a Voice Level 0.

Other than the reader, no one should be talking.

= If you need help or have a question, please raise your hand & wait silently

for staff to come over to your desk.

= Today’s activity is reading Chapter 3.

= During this period, you are to remain seated with your feet on the floor.

If you need materials or need to use the restroom, please ask staff.

= I will know you are participating and earning Champs Bucks when you have

your book open on your desk and are tracking while your peers read aloud.

I will know you are not participating when you are out of your seat or

having side conversations.

= When we follow expectations, we are successful and earn Champs Bucks.

Let’s have a great class!

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EXPECTATIONS ARE BE SET FOR

ALL TYPES OF ACTIVITIES…

How CHAMPS works

• Teachers set CHAMPS expectations for each class.

• Students earn CHAMPS bucks for following expectations.

• Students use bucks to buy items at CHAMPS Store.

Tier 2 Interventions

• Supports 10-15% of students

• Assortment of immediate interventions

• Similar implementation across students

• Prevents worsening of problem behaviors

• Continuous data monitoring and systematic

decision making process

• Increased communication with students,

staff, and familiesHome

School

Student

Systematic Approach

Step 1:•Student Selection

Step 2:

•Assess & Enroll Students to Appropriate Interventions

Step 3:•Monitor Progress Data

Step 4:

•Evaluate Success & Modify Program

CARE Program at Orchard School Procedures

• Morning Check-in

o Positively greeted by coordinator and pick up CARE card

• Throughout Day

o Staff reinforces expectations

o Rate students on CARE card: what they earned based on

their behavior

• Afternoon Check-out

o Tally points; made goal?

• Home/Cottage Feedback

o Reinforce positives and encourage student to make goal

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5

0 = No

1 = Yes

Be

Safe

Be

Respectful

Be

Responsible

Teacher

Comments

- Keep hands,

feet, and objects

to self

- Stay in Program

- Use kind

words and

actions

- Ask

permission

- Follow

directions

- Work in class

Period 1 0 1 0 1 0 1

Period 2 0 1 0 1 0 1

Period 3 0 1 0 1 0 1

Period 4 0 1 0 1 0 1

Totals: ______ + ______ + ______

Points earned today: ______

Total points possible: __12___

Percentage Earned: ______%

Tier 3 Interventions

• Supports 5-8% of students: Student specific plan

• Identifies the FUNCTION of a particular behavior

• Functional behavioral assessment (FBA) identifies

the events that reliably predict and maintain

problem behavior.

• Continuous data monitoring and systematic

decision making process

• FBA is the basis of a behavior intervention plan

(BIP)

Functional Behavior Assessment

• Five Outcomes (O’Neill et al)

oA clear description of the problem behavior

o Identification of predictors or antecedents of

the behavior

o Identification of the consequences that

maintain the behavior

oDevelopment of a testable hypothesis

oCollection of direct observation data

FBA Data Sources

• Interviews:

o Teacher, student, clinician, family, and related

service providers

• Direct observations

• Team meetings

• Baseline data focuses on:

o Frequency, duration, location, latency, and

intensity

Behavior Intervention Plans

• Four Considerations (O’Neill et al)

oHow will staff & family support change

oPlan driven by functional assessment data

oConsistent with behavioral psychology principals (i.e., reinforcement, punishment, generalization, stimulus control)

oGood fit with the environment to optimize implementation

BRIDGING

SANCTUARY & PBIS

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What is the Sanctuary Model?

• Objective:

o Provides a cohesive context where healing from

psychological & social traumatic experience can

be addressed

• Organizational culture intervention

• Theory-based, trauma-informed, evidence-

supported

Seven Sanctuary Commitments

Nonviolence

Emotional Intelligence

Social Learning

Open Communication

Social Responsibility

Democracy

Growth & Change

Sanctuary Tool Kit

• Practices to support the creation of a trauma-

informed culture

Safety Plans

Red Flag Reviews

Team Meetings

Community Meetings

Treatment Planning Conferences

Psycho-education

Key Features

• Sanctuary Model

o Creating therapeutic communities based on trauma theory

o Focuses on impact of recurrent stress

• Sanctuary & PBIS

o Provides safety for both students and staff

o Fosters a shared language

o Organizes how we talk about treatment & interventions

o Frequent contact with team members, students, and families

o Focuses on growth and change

Challenges to Change

• Innovative practices do not fare well in old

organizational structures and systems.

• Organizational and system changes are

essential to successful use of innovations.

Fixsen, Blase, Horner & Sugai, 2008

Understanding the Context

• Behavior support is the redesign of

environments, not the redesign of the

student.

• PBIS, like Sanctuary, focuses on changing the

behavior of staff who will implement the

interventions.

o PBIS describes how we will intervene and work

with students academically, behaviorally, and

socially.

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Integrated Methods

for Bringing about Change

• Diffusion/Dissemination of information

• Training

• Policies and Funding

• Coaching staff in the intervention

environment

o All methods work to support one another, but

have limited impact separately

What Works: Emphasis on Coaching

Facilitation

• Focus on Efficiency in vivo

Modeling

• Constantly focusing on increasing individual capabilities

Prompting/reminding/pre-correcting

• More than ‘Cheerleading’, directive encouraging

Asking the ‘right’ questions

• Program evaluation (data driven)

Unique Challenges of School

Environment

• Very structured and tightly scheduled

• Frequent transitions

• Infrequent access to breaks or preferred

activities (gym, recess, computers, art).

• History of failure/learned helplessness

• Social pressures

• Multiple staff, inconsistent messages

• Sensory demands

Balancing Complimentary Systems

PBIS Sanctuary

TOOL KITSPBIS SANCTUARY MODEL

Clear, consistent expectations Psycho-education

Labeled Praise Safety Plans

Continuous availability

of reinforcementCommunity Meetings

Data-driven decision makingTreatment Planning

Conferences

3-Tiered System of Support

(universal, group, individual)Red Flag Meetings

Team Meetings Team Meetings

DATA DRIVEN

DECISION MAKING

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Why Data?• Feelings are SUBJECTIVE

o Subjective decision-making is

reactive & inconsistent

o Example:

• Tommy broke a window

today. I feel bad because I

know he’s going through so

much…

– Likely Consequence?

• Jimmy also broke a window

today. He’s a terror in the

classroom and constant

provokes others! I really can’t

stand him! He needs to be

suspended and learn that he

needs to listen to staff!!

– Likely Consequence?

• Data is OBJECTIVE

o Objective decision-making can

be proactive & planned

(consistent)

• Tommy broke a window

today. That makes a total of 3

broken windows this month.

Last year he was averaging 1

broken window per month.

– Conclusion?

• Jimmy broke a window today.

That makes a total of 2

broken windows this month.

Last year he was averaging 5

broken windows per month.

– Conclusion?

Results of Student Survey

Area: SELF

Graphs used with permission from Cynthia HeidOrchard School Student Survey (2012)

95 93 91

9 12 128 10 12

0

10

20

30

40

50

60

70

80

90

100

We talk about ways to control our

emotions

My school and class have clear

expectations about how we should treat

each other

We talk about the way our actions affect

others

Agree/Strongly Agree Not Sure Disagree/Strongly Disagree

How well Programs are Working at Orchard School

0

50

100

150

200

250

300

350

400

Total Incident Reports2010-2012

Comparing the 2011-12

and 2010-11 school

years…

• In 2010-11: 2466 incidents

• In 2011-12: 1382 incidents

• That represents a 44%decrease in negative and

aggressive behaviors.

• All 12 months saw a range of

between 18-59% reduction in

unwanted behaviors compared

to the previous year.

• We also experienced up to

78% reduction in TCI Restraints

during this time period.

0

50

100

150

200

250

300

350

400

Se

pte

mb

er

Oct

ob

er

No

ve

mb

er

De

cem

be

r

Jan

ua

ry

Fe

bru

ary

Ma

rch

Ap

ril

Ma

y

Jun

e

July

Au

gu

st

Total # of Incidents at OS

2010-2011 2011-2012

Big 5 Data:(Who, What, Where, When, How Often)

6

4 4

3 3 3 3 3 3

2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

0

1

2

3

4

5

6

7

A B C D E F G H I J K L M N O P Q R X T U V W X Y Z

IR by Student

September 2012

Big 5 Data:(Who, What, Where, When, How Often)

19 19

15

8 8

4

3 3

2

0

2

4

6

8

10

12

14

16

18

20

Physical

Aggression to

Child

Physical

Aggression to

Staff

Out of Program Minor Injury Property

Aggression

Property

Damage

AWOL/Off

Campus

Verbal

Aggression

Towards Staff

FALSE Fire

Alarm

IR by Problem Behavior

September 2012

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Big 5 Data:(Who, What, Where, When, How Often)

10

7 7

6 6

4 4 4

3 3 3 3 3 3

2 2 2 2 2

0

2

4

6

8

10

12

IR by Location

September 2012

Big 5 Data:(Who, What, Where, When, How Often)

1 1

4

8

5

7

4

2

3

4

3

2

3 3

1

6

2 2 2

1

3

4

2

9

2

0

1

2

3

4

5

6

7

8

9

10

IR by Time

September 2012

Big 5 Data:(Who, What, Where, When, How Often)

6.696.95

8.74

5.76

6.25

5.44

6.86

7.56

8.24

7.45

4.404.23

5.60

7.23

6.21

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00

10.00

September October November December January February March April May June July August

Average IR per day

2011-2012 2012-2013

Using a Student Example…

How we utilize Sanctuary and PBIS to best meet

the needs of each student at the Orchard School.

Alexandria

Alexandria’s Data

Month # of Incidents Notes

July 2 •TPC on 7/24 with mother & clinician

August 1 •10th Birthday 8/11

September 4 •Moved from Ms. S’s class to Ms. W’s for

2012-13 year

October 2 •TPC on 10/13 with mother & clinician

November 1

December 2

0

20

40

60

80

100

CARE CardAverage:

87

Student Self-

Monitoring CARE

CardAverage:

94 87

Baseline

Average:

54

Alexandria’s CARE Card Progress

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Does Alexandria have 0 -

2 IRs for the month? Stay on Tier 1: CHAMPS

B+

Alexandria

placed on Tier 2

CARE:

Has Alexandria:

• Averaged 80%

over 4 wks on

CARE card?

• Had < 3 IR/mo?

Red Flag:

Held to

discuss

supports

needed & to

collect

baseline data

Student Self-

Monitoring:

Has Alexandria:

• Averaged 80%

compliance over 4

wks?

• Had < 3 IR/mo?

Green Flag Party:

Held to celebrate

Alexandria’s

success on the

CARE program.

KeyThe answer is YES

The answer is NO

Automatic Process

Therapeutic & Academic

Milieu

Safety

Plan

TPCs

SELF

Red Flag

Mtg

Another Student Example…

Ray

Ray’s Data

Month # of Incidents Notes

August 5 •Admitted 8/2

September 6

October 4

November 5 •TPC 11/20 with grandmother, teacher & clinician

December 3 •Christmas 12/25: Anniversary of mother’s death

January 3 •Med Change

February 1 •TPC 2/28 with grandmother, teacher & clinician

March 1

April 2

May 1•TPC 5/22 with grandmother, teacher & clinician

•Mother’s Day

June 1

Aimsweb Behavior Graph: Ray’s Behavior Intervention Plan

Aimsweb Behavior Graph: Ray faded 1:1

Does student have 0 - 2

IRs for the month?

(Reviewed at PBIS committee)

Stay on Tier 1: CHAMPS

B+

Student placed

on Tier 2 CARE:

Has student:

• Averaged 80%

over 4 wks on

CARE card?

• Had < 3 IR/mo?

Newly

admitted

studentAdmissions

Meeting:

Discuss

supports

needed &

collect

baseline data

Student Self-

Monitoring:

Has the student:

• Averaged 80%

compliance over 4

wks?

• Had < 3 IR/mo?

Green Flag Party:

Held to celebrate

student’s success

on the CARE

program.

Team Meets:

Discuss the

function of

student’s

negative

behavior

(i.e., FBA)?

Teacher

or Staff

referral Student placed on

Tier 3:

Create (or modify)

student’s BIP. Discuss

data at TPC.

Has student averaged

80% over 3 months? Stay on Tier 3:

FBA/BIP for

another quarter

Fade 1:1 staff:

Has student continued

to average 80% over 3

months?

KeyThe answer is YES

The answer is NO

Automatic Process

Therapeutic & Academic MilieuSafety

Plan

TPCs

SELF

Red

Flag

Mtg

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11

QUESTIONS?