Prevent-Teach-Reinforce (PTR): An Evidence-Based Functional Behavior Assessment/Behavior Intervention

ProcessRO S E I O VA N N O N E , P H . D. , B C B A - D

I O VA N N O N E @ U S F. E D U

8 1 3 - 9 7 4 - 1 6 9 6

The contents of this training were developed under grant H324P04003 from the Department of Education

Agenda§Overview PTR

§PTR Process◦ Step 1-Teaming/goal setting/progress monitoring◦ Step 2 Functional assessment◦ Step 3a-Behavior intervention plan◦ Step 3b-Coaching/Fidelity◦ Step 4-Monitoring and making data-based decisions

Objectives§Participants will:

◦ Describe the 4-step PTR FBA process◦ Identify the critical components that enhance the success PTR◦ Demonstrate implementation of PTR with case studies

Prevent-Teach-ReinforceA COMPREHENSIVE FBA/BIP MODEL TESTED IN TYPICAL SCHOOLS

What is Prevent-Teach-Reinforce (PTR)?§Research project funded by U.S. Department of Education, Institute of Education Sciences

◦ University of South Florida ◦ Three central Florida school districts

◦ University of Colorado, Denver◦ Two Colorado school districts

§Purposes:◦ Answer the call for rigorous research◦ Evaluate effectiveness of PTR vs. �services as usual� using randomized controlled trial◦ Evaluate effectiveness of �standardized � approach

§Aims of the model◦ Make available tools that are parsimonious-easy for team/teachers to use◦ Use language that is not technical-easy to understand terms◦ Use a collaborative approach-not an expert model◦ Have consensual team-based processes built within each step◦ Provides ongoing support to teacher/team for implementation and making data-based decisions

Where is PTR in a Multi-tiered System of Supports (MTSS)?

PTR ModelStep 1-identify,

define, and prioritize behaviors

Step 1-Develop and use a daily progress monitoring system

Step 2-Analyze the problem by

conducting an FBA on each target

problem behavior

Step 2-Develop a hypothesis from

synthesized information

Step 3-Select and develop a multi-

component intervention plan

linked to the hypothesis

Step 3-Coach the teacher to

implement the plan and measure

fidelity

Step 4-Within 3 weeks, examine

the progress monitoring data and fidelity data

and make next-step decisions

Student-Centered Team• Facilitator

• Members who know student

• Member who know school/district

Research Support for PTR

Participants in PTR RCT◦

§245 students enrolled—randomly assigned to treatment or comparison§K-8th grade§General and Special Education

◦ All cognitive levels◦ All disabilities

§Teacher-nominated top externalizers◦ Systematic Screening for Behavior Disorders (SSBD)

§Behavioral difficulties◦ Duration– minimum 6 months◦ Frequency— minimum of 1 time per week◦ Intensity– disruption to the learning environment

Student Demographics by Primary DisabilityDisability N Percent

Autism 25 9.8Developmental Delay 5 2.0Emotional Disturbance 38 14.9Intellectual Disability 28 11.0Multiple Disabilities 4 1.6OHI (not ADD/ADHD) 1 .4OHI (ADD/ADHD) 8 3.1Specific Learning Disability 20 7.8Speech/Language Disability 10 3.9Visual Impairment 2 .8General Education 99 38.8TOTAL 245

Student DescriptionGrade Level

K12345678

N345353413016783

%13.921.621.616.712.26.52.93.31.2

Lunch StatusRegularFree/Reduced

77150

31.461.2

GenderFemaleMale

45200

18.481.6

Student Outcomes§Students receiving PTR, compared to students who received services as usual, significantly improved (p < .001)

◦ Their social skills and problem behaviors (measured by the Social Skills Rating Scale-SSRS)

◦ Their academic engaged time (AET) as measured by direct observations during 15 minute independent work time routine

§Effect sizes were moderate (as predicted-given that the comparison group were still getting some sort of ”treatment”)

Teacher Outcomes§Fidelity

◦ Majority of teachers achieved .80

§Social Validity◦ Modified Teacher Acceptability Rating Form (TARF; Reimers & Wacker,

1988)—15 items◦ 5-point Likert Scale◦ 124 teachers◦ Overall—4.16 (.52)

◦ Willingness to carry out plan—4.80 (0.42)◦ Like the procedures—4.46 (0.64

Other Research

Research in PTR§Two randomized controlled trials

◦ Original for kindergarten through grade 8 (5 years to ~ 14 years of age)◦ Young children (3 years to 6 years of age)

§Several single subject studies◦ General education◦ Autism◦ Child care settings◦ Families◦ High school students with emotional disorders

Research Outcomes§RCT-Students receiving PTR significantly improved social skills, problem behaviors and academic engagement compared to those who received services as usual (SAU)

§Single subject—multiple baseline designs showed PTR improved the dependent variable in all studies

§Teachers implemented the interventions with high (e.g., 80% or greater) fidelity

§Teachers found PTR to be socially valid

The PTR Process

PTR Team§Teaming: A collaborative process

§Suggestions—3 levels of knowledge represented:

◦ Members

◦ Person with knowledge of student (e.g., Classroom teacher, instructional assistant, parent)

◦ Facilitator—Someone with knowledge of functional assessment, behavioral principles (PTR facilitator/coach, school-based consultant)

◦ Someone with knowledge of context (e.g., administrator or designee)

§Determine relevant team members

◦ Can take many formats

◦ Most effective when:

◦ One or two key people assigned to a school are PTR facilitators/coaches

◦ The facilitator guides student-centered teams through the PTR process

Collaboration Activity

Questions to Consider in Forming Teams and Identifying Facilitators§What is the current skill level of facilitating FBA/BIPs in your school(s)?

§If your school/district does not have enough individuals with FBA/BIP skills, do you have key people in your district who could provide training including practice-based coaching?

§Who would be key people in your school(s) who could be trained as PTR facilitators?

◦ Characteristics to consider when selecting individual(s):◦ In a flexible position that allows him/her to support others (for example, it may be hard for a

teacher to be a facilitator unless his/her position is one that does not require 100% of time in a classroom

◦ Has significant behavioral training background or has extensive experience in applying behavioral principles

◦ Has experience collaborating with others◦ Has excellent interpersonal skills◦ Is respected by other professionals in school building/district

Step 1-Goal SettingIDENTIFY THE PROBLEM

Step 1: Goal Setting§Purpose:

◦ Identify behaviors of greatest concern to the team and possible replacement behaviors (teach)

◦ Prioritize and operationalize behaviors targeted for intervention◦ Develop teacher friendly baseline data collection system

Collaborative Process§NOT facilitator telling the team the behaviors to target

§INSTEAD facilitator guides the team to consensus on behaviors to be targeted

Facilitator

Team member

Team member

Team member

Team member

Case Study 1§Mike

◦ 9-year-old male◦ ESE Classification: Autism◦ Placement: Self-contained, autism classroom with 6 students ◦ Nonverbal: Uses signs, Dynamite, pictures to communicate ◦ Team: Teacher and two aides, PTR Consultant

Mike’s Team-Goal SettingBEHAVIORS TO DECREASE

Target Behavior:

• Screaming• Hitting

• Getting out of seat• Bossing peers

Operational Definition:

• Loud, high pitched noise heard outside the classroom

• Touching peers or adults with open hand, fist, foot, or

object while screaming

BEHAVIORS TO INCREASE

Target Behavior:

• Transition from preferred to non-preferred activities

• Express frustration using his communication

• Ask for a break or attention

• Initiate peer interactions using communication

Operational Definition:

• Moving to non-preferred activity and engaging in

communication at inside voice volume and pitch

• Use communication (voice output device, signs, pictures) to

request a break or attention

Case Study 2-Jeff§ General Education

§ Retained second grader

§ Class had 19 students

§ Team included two co-teachers ◦ both with their own second grade classrooms

Jeff’s BehaviorsBEHAVIORS TO DECREASETarget Behavior:• Disruptive behaviors

• Negative comments

Operational Definition:• Tapping pencil, making loud comments without raising

hand, tapping person seated near him, getting out of seat to sharpen pencil without permission.

BEHAVIORS TO INCREASE

Target Behavior:• On-task behavior

• Independent work completion

• Interact with peers at appropriate times

Operational Definition:• Actively participating in group instruction by raising hand to

speak and looking at teacher; during independent work, keeping pencil moving on paper in a way that gets task completed, letting neighbors work, raising hand to ask for help

• (this is part of on-task behavior-was measured by %age of assignments completed)

Step 1: Progress Monitoring System§Individualized Behavior Rating Scale Tool – IBRST

◦ Direct Behavior Rating (DBR)—Hybrid assessment combining features of systematic direct observations and rating scales

◦ Efficient and feasible for teacher use◦ Provides data for decisions◦ Prioritized and defined behaviors measured◦ Requires minimum of 1 appropriate and 1 inappropriate behavior

Components of IBRST§Scale—5 point foundation

◦ Can be flexible and add or subtract Likert scale points◦ Can be creative and use columns/rows for different time periods/people,

etc.

§Key—Vital for teacher ◦ Definition of behavior◦ Directions—over what time period of day will they be rating the behavior?

What do each of the anchor points represent as perceptual estimates?

§Practice◦ After setting up, ask teacher to rate student�s behavior from earlier in the

day or previous day◦ Adjust if necessary

Defining BehaviorsNONEXAMPLES

Grabs

Hits

EXAMPLES

•Grabs clothing of peers by pinching and bunching fabric with his fist

•Hits peers and adults on their bodies by slapping with hand (moderate intensity), pinching flesh with fingers (leaves mark), punching by making a fist with hand and making contact with peer/adult bodies

Case Study 1- Mike: Behavior Rating Scale Behavior

Screaming 9+ times7-8 times5-6 times3-4 times0-2 times

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Hitting 8+ times6-7 times4-5 times2-3 times0-1 times

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Expressing Frustration

40%+30-40%20-30%10-20%0-10%

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Transition to Non-preferred

Whimper or squealLouder than indoor voice

Outdoor play voiceLouder than outdoor play

Ear penetrating

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IBRST—Key for MikeScreaming: Loud, high-pitched noise heard outside the classroom. Rate your perception of Mike’s screaming episodes over the entire day. 5 = Terrible day; 4 = Typical bad day; 3 = So-So day; 2 = Good day; 1 = Fantastic day.

Hitting: Touching peers or adults with open hand, fist, foot, or object while screaming. Rate your perception of Mike’s hitting episodes over the entire day. 5 = Terrible day; 4 = Typical bad day; 3 = So-So day; 2 = Good day; 1 = Fantastic day.

Expressing frustration: Using communication (voice output device, signs, pictures) to request a break or attention. Rate your perception of the percentage of opportunities Mike used appropriate communication 5 = Fantastic day; 4 = Good day; 3 = So-so day; 2 = Typical bad day; 1 = Terrible day

Transition to non-preferred: Moving to non-preferred activity and engaging in communication at inside voice volume and pitch. Rate your perception of the overall intensity of Mike’s transitioning behaviors. 5 = Fantastic day; 4 = Good day; 3 = So-so day; 2 = Typical bad day; 1 = Terrible day

IBRST Inter-rater Reliability (Iovannone, Greebaum, Wang, Kincaid, & Dunlap, 2014)§Kappa coefficients of:◦ Problem Behavior 1 (n = 105): .82◦ Problem Behavior 2 (n = 90) : .77◦ Appropriate Behavior 1 (n = 103): .65◦ Appropriate Behavior 2 (n = 56): .76

Agreement of IBRST and Direct Observation§In recent multiple baseline study,

◦ Problem Behavior-74% of ratings in exact agreement, 16% within one scaled score

◦ Appropriate Behavior-75% exact agreement, 14% within one scaled score.

§Cohen’s Kappa = 0.70 (p<0.001)

Barnes, Iovannone, Blair, Crosland, & Peshak-George, (in review).

Secondary Level Modifications§Teams with 3 or more members

◦ Select one team member who will be the primary interventionist◦ Behavior identification and IBRST development will be focused on that

person�s situation◦ Other team members provide input/support◦ If desired, other team members can record IBRST data in their settings—

rating descriptions can stay the same or minor modifications can be made◦ Each row of BRS can represent a different teacher OR◦ Each teacher can keep own IBRST

◦ Facilitator collects all IBRST ratings at specified times

Variations of the Individualized Behavior Rating Scale Tool (IBRST)

Activity—Step 1

Step 1 Activity Instructions§Activity Packet

§Watch the video of Paris

§In your team, identify one problem behavior

§With your team, agree upon an operational definition of the behavior

§Write it on the goal form under problem behavior

§What would you target as a replacement behavior?

§Define the behavior in measurable/observable terms

Paris§First grade student in general education

§Team included teacher, school psychologist, guidance counselor, and special education coordinator

§School was considering referring Paris for special education eligibility assessment due to behavior problems

Step 2: PTR Functional Behavior AssessmentANALYZE THE PROBLEM

Given 60 seconds, use 4 straight lines to connect all of the dots without lifting

your pen

Child

A box to think outside of:

Step 2: PTR Assessment (FBA)Problem Analysis

§PTR Assessment (FBA) ◦ Prevent: Antecedents/triggers of problem behavior◦ Teach: Function(s) of problem behavior, possible replacement behaviors◦ Reinforce: Consequences associated with problem behavior, possible

reinforcers

§Assessment checklist completed by each team member

§Facilitator summarizes input on Assessment Summary Table and develops draft hypothesis

§Team reaches consensus

§Facilitator has conducted at least ONE direct observation of student and context prior to this step

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Several Versions of PTR Assessment§Elementary Version (pp. 21-24)

§Secondary Version (pp. 25-29; 30-35)

§Student Version (pp. 36-41; 42-47)

Learned Functions of Behaviors§GET

◦ Obtain◦ Activities, people, tasks, tangibles, sensory, pain attenuation

§GET OUT OF◦ Escape/Avoid/Delay

◦ Activities, people, tasks, tangibles, sensory, pain

NAME THAT FUNCTION!

Are Power, Control, Jealousy, Revenge Functions?

IOVANNONE, ANDERSON, & SCOTT, 2013

Completing the PTR Assessment Organization Table

Step 2: Case Study – MikeAssessment Summary Table of Problem Behavior

Antecedent/Prevention Data Teach/Function Data

Consequences/ Reinforce Data

nNon-preferred tasksnReading, Math—when in a group

n Other students upset/madnTeacher attending to othersnTransition

nPreferred (one-one) tonon-preferred (group

reading/math)nChange in schedule

nDenied item, told no, or tofix something

nGain attentionnPeers, adults

nDelay

nAccess to items

nRedirectednReprimandednCalm/soothe

nPersonal spacenLater must

complete task

nLoss of or delay in reinforcement

Scre

amin

g, H

ittin

g

Step 2: Case Study – MikeAssessment Summary Table of Absence of Problem Behavior

Antecedent/ Prevention Data

Teach Data Reinforce Data

nIndependent worknOne-on-one

attentionnSpecials

nPeer interactionnGetting attentionnRaising handnSharing attentionnConversation skillsnTaking turnsnWaitingnSelf-managementnAsking for breaknExpressing emotions

nTreasure boxnMovienAttentionnHelping teachernGoing to media

centernGoing outsidenWalknFood

Abse

nce

of S

crea

min

g,

HItt

ing

Mike�s HypothesesWhen…. he will As a result…1. Mike is (a) asked to complete non-

preferred tasks in small groups (Reading, Math), (b) stop a preferred one-one activity or transition to a non-preferred group activity, or (c) fix an error,

2. When the teacher is attending to other students,

scream and hit.

scream and hit

Mike (a) delays the transition or non-preferred activity and (b) gets attention from teachers and peers

Mike gets attention from teachers and peers

1. Mike is (a) asked to complete non-preferred tasks in small groups (Reading, Math), (b) stop a preferred one-one activity or transition to a non-preferred group activity, or (c) fix an error.

2. When the teacher is attending to other students,

(a) express his frustration appropriately and (b) transition from preferred to non-preferred tasks

Ask for attention

Mike (a) delays the transition or non-preferred activity and (b) gets attention from teachers and peers

Mike gets attention from teachers and/or peers

Inap

prop

riate

App

ropr

iate

Jeff’s HypothesisWhen…. he will As a result…

Jeff is presented with demands to start non-preferred academic tasks, specifically independent writing,

Walk around the room, talk to and touch peers, put his head down, tap his pencil, and not initiate writing

He avoids/delays non-preferred tasks

Jeff is presented with demands to start non-preferred academic tasks, specifically independent writing

Be academically engaged and independently complete tasks within the time assigned

He avoids/delays non-preferred tasks

Inap

prop

riate

Appr

opria

te

Step 2 Activity: Paris

Step 2: Activity Instructions§ACTIVITY PACKET

§Review the PTR Assessment Summary for Paris

§Develop a problem behavior and appropriate behavior hypothesis

§Feel free to use the cheat sheet

§Be ready to share

Step 3: PTR Intervention PlanDEVELOPING AND IMPLEMENTING AN INTERVENTION

“The problem is not that people resist change, but they resist being changed.”MICHAEL KIM, FOUNDER AND CEO OF HABIT DESIGN

Behavior Intervention Plan Development: Essential Features§Behavior interventions selected by team from PTR Menu§Facilitator guides the team/teacher by using ABA principles to develop most effective intervention that matches the team/teacher context

§Team/teacher provides description on how interventions will look in classroom setting§Each intervention selected is described in detail by task-analyzing steps, providing scripts, describing adult behaviors, NOT student behaviors§After plan developed, time is scheduled to train the team/teacher the strategies prior to implementation

§Plans for training students and other relevant individuals§Support provided once plan is implemented

Replacement BehaviorsFunctional Equivalent vs. Alternative SkillFUNCTIONAL EQUIVALENT (EXAMPLES)

Escape functions◦ Ask for a break◦ Ask to wait◦ Ask to terminate

Access attention functions◦ Ask for attention◦ Ask for a pro-social comment

Access specific object or activity◦ Ask for an object◦ Ask for a specific activity

ALTERNATIVE SKILL (EXAMPLES)

Raise hand for help or answering questions/participation

Independently complete work

Appropriately transition from point a to point b

Be academically engaged

Initiate social interactions

Make appropriate social comments

Linking Interventions to HypothesisHYPOTHESIS COMPONENT

Antecedent-When Mike is asked to transition from preferred to non-preferred

Teach-Mike screams and hits

Reinforce/function-As a result, he gets to delay the transition and get adult/peer attention.

LINKING OF INTERVENTION

Antecedent/prevent intervention-which intervention will directly modify the transition so that it no longer triggers screaming and hitting?

Teach-what will Mike be taught to do instead of screaming and hitting in the transition situations?

Reinforce-how will Mike’s replacement behavior(s) be reinforced with, at a minimum, delay and attention?

Which One Will More Likely be Consistently Implemented?

Provide choices of where to sit Provide Choices: The teacher will provide Don with a choice immediately after assigning him independent work in class. Choice options are: (a) materials to use for assignment; choice of leadership activities; (b) where to sit; (c) who to do the assignment with

Steps for Provide Choices:

1. Immediately after giving the class the independent math assignment, go over to Don and present him with a choice option.

2. When presenting him with a choice, say �Don, where do you want to sit? X or X?�

3. After Don makes his choice, say, �Thanks for making a great choice�and release him to his choice.

BIP-Prevention Strategies BIP-Prevention StrategiesOR

Additional Considerations§When developing the behavior intervention plan, ask the team how they will do the following:

◦ Pre-teach the student the plan◦ Prompts they will need to use in the initial stages◦ Fading prompts

Prevent Strategies

Specific Strategy steps

Environmental Support

Mike�s visual schedule will be modified to detail the number of and type of activities he is to complete during non-preferred activities. For example, if math involves listening to a lesson, doing a hands-on activity, and completing a worksheet, his visual schedule will list each activity under math using either a picture of the type of activity or using numbers that correspond to a number on the worksheet.Environmental Support Steps:1. Each week, an adult will review Mike’s schedule and activities and

ensure that the visual schedule matches the activities.2. Before a non-preferred activity, the teacher will review the visual

schedule with Mike and the tasks he will do by reviewing the visual schedule and pointing to each task while describing it.

3. After reviewing the schedule, the teacher will ask Mike some questions to make sure he knows the order of activities.

4. The teacher will remind Mike that after he finishes each activity, he will put an X over it to show it is finished.

5. After Mike completes each activity, the teacher (initially) will prompt Mike to place an X over the activity on his schedule.

Mike�s Intervention Plan

Mike�s Intervention PlanPrevent Strategies

Specific Strategy steps

Curricular Modification

Mike will be given an easy, independent activity, such as a worksheet, to complete upon transitioning to a non-preferred activity or an activity that requires him to wait, such as group activities.Curricular modification steps:1. At the beginning of each week, the teacher will identify the

transitions that would be appropriate for the curricular modification strategy.

2. Immediately after the transition signal for the specified transitions, the teacher will say �Mike, how about doing this __ first before going to __?�

3. Wait for Mike to complete the activity. During this time, provide minimum attention (e.g., limited talking, eye contact)

4. At the end of the activity, prompt Mike to transition (if he does not transition) or prompt him to use his replacement behavior (I need to calm down). 78

Mike�s Intervention PlanTeach Strategies

Specific Steps

Replacement Behavior:

Appropriately express his need to calm down

Mike will be taught to use his augmentative communication device to express his need to calm down.Replacement Behavior Steps:1. An adult will program Mike’s device to say �I need to calm down.�2. A choice board will be built into the device by identifying 3-4 options from

which Mike can select as his activity to calm down and identifying buttons to represent those choices.

3. One minute before transitioning from a preferred to a non-preferred activity or at the end of a preferred activity (if the timer has not gone off), the teacher/adult will remind Mike to use his replacement behavior. �Remember, If you start to get mad when you go to X, you can tell us you need to calm down.�

4. At the first sign of Mike beginning his screaming behavior (initial squeal), redirect Mike to use his replacement behavior by prompting him (most-to-least hierarchy) while saying “What do you need?” For example, initially the teacher will use physical prompting (hand-over-hand) to guide Mike in telling the adults that he needs to calm down.

5. Once Mike communicates �I need to calm down�, present him with the choice board of calming strategies and ask him, �What do you want?�

6. As soon as he is calm, praise him by saying �thank you for telling us what you need to calm down.�.

7. Allow Mike to engage in his choice until he is calm for 1-min.8. If Mike does not return to his area, then start having a fun time in that area

with those students present

Reinforce Strategies

Specific Steps

Replacement Behavior:

Appropriately express his need to calm down

Whenever Mike �says�, �I need to calm down�, give him the choice board, praise him for using his communication, and release him to his choice.1. Immediately after Mike indicates he needs to calm down, ask him “What do you

want?” while showing the choices.2. Immediately after Mike makes his choice, say �Thank you for telling us what you

need.�3. Depending upon his choice, release him or provide him with the selection.4. When he makes his transition, praise him (with a warm tone) for returning to the

group; “thank you for coming over.”

Discontinue reinforcing problem behavior

Minimal attention will be provided to Mike when he is calming down and when he is starting to scream.Steps:1. As soon as Mike begins to show signs for screaming, the adult will immediately

prompt Mike to say he needs to calm down by presenting the device and saying “What do you need?”.

2. If necessary, provide physical or partial physical prompting to have Mike say what he needs.

3. Immediately after Mike says “I need to calm down”, present the choice board and ask him “What do you want?”.

4. Provide positive praise for Mike saying what he needs, “thank you for telling us what you need.”

5. Allow him to engage in his choice for one minute.

Mike�s Intervention Plan

Jeff: PTR Intervention Plan PreventPrevent Strategies

Description

Choice-Making Using a choice matrix, decide upon the choice that will be offered to Jeff each day with his writing assignment. The following choices will be rotated: (a) Within—writing tool to use (pen/pencil), color notebook paper, color of eraser, topic; (b) Who—peer for writing partner; (c) Where—Robin’s room, round table, desk; (d) When—part now, part later, whole task nowSteps:1.Right before giving the writing assignment to Jeff, decide upon the choice to be offered. 2.Once the choice is determined, present it to Jeff by saying, “What do you want to use for writing today? The pen or the pencil?”3.Praise Jeff for making the choice—”Thank you for making a choice.” and honor the choice

Jeff—Intervention Plan PreventPrevent Strategies

Description

Environmental Support

Visual Timer: Set a visual timer for the amount of time agreed upon with Jeff to complete the writing assignment.

Steps:1. At the beginning of the writing period and while reviewing Jeff’s

self-management writing chart for the day, and before providing Jeff a choice, either call Jeff to the teacher’s desk or go over to Jeff.

2. Discuss the goal for completing the writing assignment. Say, “I think you can complete the assignment in ___ minutes. What do you think?”

3. Set the timer by saying, “Jeff, let’s see if you can beat the timer. Today, you have ___ minutes (time from step 1) to complete the writing. Ready, set, go.”

Jeff— Teach Intervention PlanTeach Strategies

Description

Incompatible

Replacement

Behavior—

Academic

Engagement

Jeff will be taught how to remain engaged on a writing assignment.

Engagement is defined as: working on a task without disrupting

by raising hand to speak, keeping pencil upright, and letting

neighbors work

Steps:

1. Each day, divide Jeff’s writing task into 3 major sections—

starter, details, conclusion

2. Initially, tell Jeff that for each section completed, he earns a

“dot” that he should place in the envelope hanging at the side of

his desk.

3. Inform him that he can use the dots later to get out of work and

to get special rewards for himself and the rest of the class.

4. Each day after giving the writing assignment to Jeff, review his

self-management checklist/dot total sheet. Review each

section of the writing assignment (step 1), his goal (time for

completion), and the academic engaged behaviors.

5. On Monday, a weekly goal should be discussed and set.

6. Immediately after reviewing Jeff’s goals and expected

behaviors, provide him a choice and set the timer.

Jeff—Reinforce Intervention PlanReinforce Strategies

Description

Reinforce Pro-

academic

Replacement

Behavior—

Academic

Engagement

Jeff will be reinforced for academic engagement and meeting his daily goal

with allowable/earned escape represented by the dots. Jeff can use

his dots to get out of doing work/problems during independent work

times.

Steps:

1. At the end of the writing period or when Jeff completes his writing

(whichever event occurs first), review Jeff’s self-management

checklist.

2. For each behavior on the checklist, discuss with Jeff whether he

performed the activity. If yes, place a check in the box. If no, place

an “x” in the box. For each check, Jeff should be given a dot. When

reviewing, say, “Jeff, did you write a starter sentence?”… Did you

stay on task? Did you meet your goal?” When giving dots, say “Jeff,

how many checks do you have today? How many dots do you earn?”

3. Jeff uses dots by sticking it over a problem/question he doesn’t want

to do and showing the teacher when he uses a dot. He can escape

as long as he has dots in his envelope.

4. If Jeff uses a dot to get out of work, immediately say “You used a dot

to get out of ____. You earned it!”

5. If Jeff meets his weekly goal, he can go to his brother’s kindergarten

class and read a book to them.

Jeff—Reinforce Intervention PlanReinforce Strategies

Description

Group Contingency (Modified)

If Jeff meets his daily (time) goal for completing his writing assignment within the time agreed upon, the class earns a bonus letter toward the mystery reinforcer of the week. When Jeff earns the class this letter, the class provides attention to Jeff by thanking him and celebrating (clapping hands, saying “Yeah”.

Steps:1. After reviewing Jeff’s self-management sheet, ask him, “Did you

meet your goal today?”2. If yes, “You did meet your goal. Let’s tell the class they’ve

earned a letter for the mystery reinforcer.” 3. Tell the class, “Jeff met his goal today. We get another letter on

the board.”4. Prompt the class to thank Jeff (if they haven’t done so

spontaneously).5. If no, “You worked hard and tried. You’ll do it tomorrow!”

Jeff—Reinforce Intervention PlanReinforce Strategies

Description

Discontinue reinforcement of problem behavior

If Jeff gets disruptive (disengaged) during academic tasks, redirect him to his replacement behavior.

Steps:1. At the first sign of Jeff starting to get disengaged, calmly walk

over to Jeff and gesture to his self-management chart by pointing to it. Provide no or minimal verbal comments.

2. If Jeff continues to be disengaged, calmly redirect him to use one of his dots (if he has any) to escape. Say “Jeff, it looks as if you need to use one of your dots to get out of some work.”

3. If Jeff continues to be disengaged and doesn’t use one of his dots, walk over to his desk, pick out one of his dots out of his envelope, and say “It looks as if you need to use one of your dots to get out of some work. Where should I put the dot?”

4. Continue to use dots if Jeff continues to be disengaged.5. If all of the dots are used, calmly remind Jeff how he will earn

dots to get out of work.

Step 3 Activity: Paris Intervention Plan

Step 3 Paris: Activity Instructions§ACTIVITY PACKET

§Look at your hypothesis developed for Paris.

§Identify one or two prevent, teach, and reinforce strategies you might want to try with Paris

§One for each component (prevent/teach/reinforce)

§For the Teach strategy, make certain one behavior you are teaching is a replacement behavior.

§Develop the specific steps (task analysis) of the replacement behavior intervention for Paris

Coaching/Fidelity

Practice-Based Coaching (PBC)Used to support teachers implementation of evidence-based practices-specifically pre-school, early childhood teachersPractice-based coaching and collaborative partnerships-Cyclical processCoaching Cycle Components

◦ Establishing shared goals and action planning

◦ Engaged in focused observation◦ Reflecting and receiving feedback about

practices

Embedded instruction◦ Implementation of skills is within authentic

practices or job responsibilities

Behavior Skills Training (BST; Reid & Parsons, 1995)§Procedure built upon ABA principles

§Method for teaching new skills

§Four components

Tips on Coaching§Relationships

◦ Ask teacher for best way to communicate◦ Respond quickly to any communication from teacher or team member◦ Ask questions instead of telling what to do◦ Listen more, speak less◦ Help out◦ Provide positive feedback◦ Identify successes and use as starting point

Characteristics of Effective Coaches (Facilitators)(Anderson, Smith, Iovannone, 2017)§Provides meaningful performance feedback

◦ Guides groups and individuals to select and implement effective practices◦ Guides data-based decision-making◦ Provides positive, supportive, constructive feedback

◦ Best if reflective activities are provided◦ Teacher can be asked what went well and what was challenging for him/her◦ The challenging response can be used by the coach to support problem-solving

◦ Uses “feedback sandwich” method to provide performance feedback

1. Positive Feedback

2. Constructive Feedback

3. Positive Feedback

Feedback StrategiesStrategy Description Examples

Begin with one or more positive statements

It is fine to use general statements such as, “You did a great job today” but be sure to provide some specific examples.

“You did a great job gesturing to Rick and Lila (peers) that they should just ignore Monty’s rocking. That prompt was subtle enough that I don’t think Monty or anyone else even noticed but it really helped reassure Rick and Lila that they were doing the right thing.”

Ask for positive reflection

Either before or after you identify something positive, ask the teacher what he or she thinks went well. If the teacher focuses on how well the student is doing, try to prompt the teacher to identify something about their own implementation that was positive.

“In your view, what do you think is going well? Either overall or just in the time I watched today?”

“I agree that Monty did well responding to his friends today. I’m wondering how you felt about the way you supported Monty and his friends—what went well?”

Ask for reflection on areas for improvement

Often asking the teacher to identify what went less than perfectly is a great entry into corrective feedback, people often know exactly what was wrong.

“You said you did ‘okay’ using the token board, I think you did a fantastic job. Were there any aspects of your interactions with Luca during table work today that you didn’t think went so well or that you would want to do differently?”

Corrective feedback is specific

Identify exactly what occurred incorrectly and, when appropriate, why

“On the TIG you and I indicated that praise should occur when James gives a correct answer, how do you think that went today?” “Right, I noticed a couple of times when that happened and several more when it didn’t. There is a lot going on so it is hard to stay on top of the feedback for correct responses too but James seems to really respond well to your praise so I’m thinking that is something we should work on, what do you think?

Help the teacher identify strategies to improve

When appropriate, use collaborative problem-solving to improve performance. See the table below for strategies you could use to improve performance of one or more skills

“Maybe we can come up with a way to make it easier to remember to praise correct responses. For example, when I am here and if you want me to, I could use some gesture, like this (makes a thumbs up) to remind you to praise James. What do you think of that?”

Build fluency slowly

Don’t overwhelm the teacher with corrective feedback. Identify one or at most two things to work on at a time.

“You just identified five things that you could work on. There are probably always things we can improve but let’s pick just one or two things to focus on.”

End with positive feedback

Feedback should conclude with another positive observation

We spent a lot of time talking about how to ensure that the next teaching session goes better and that is important. I think it is important though that we also recognize how much went right. You know, I really liked how you kept your cool today, even when Brad was really angry. I know that can be really hard to do.

Teacher Coaching§Teacher and Staff Training

◦ Initial training with no students present ◦ 30 -90 minutes

◦ Model, Role Play, ◦ Q & A, Discussion

§Coaching/Fidelity Checklist (Handout Packet)◦ Used by PTR Consultant for training evaluation ◦ Evaluate teacher accuracy on each step prior to implementation with

student◦ Comfort and competence measured◦ Can also be used as fidelity measure after intervention is implemented

Mike: Coaching/FidelityInterventions Implemented Impact (1 = no

impact; 5 = great impact)

Environmental Support 1) Mini schedule of center & group available 2) Mini schedule reviewed prior to start of centers 3) Prompted Mike to cross off completed items

Y N NA Y N NA Y N NA

1 2 3 4 5

Replacement Behavior—Functional 1) Reminded Mike prior to transition from

preferred to non-preferred to use new behavior 2) Prompted Mike to use new behavior at first sign

of screaming (e.g., squeal)

Y N NA

Y N NA

1 2 3 4 5

Reinforce Replacement Behavior 1) Immediately provided positive comment to Mike

for using replacement behavior (within 15 s) 2) Released Mike to calming choice for at least 1-

minute 3) Provided positive comment in warm tone to

Mike immediately upon completing transition.

Y N NA

Y N NA

Y N NA

1 2 3 4 5

Jeff Coaching/Fidelity Plan

Step 3: Training/Fidelity ChecklistCase Study - Paris§Group Activity:

§Look at the task analysis for Paris� replacement behaviors◦ Select the core strategies you would include on a coaching/training and

fidelity measure

101

Paris� Fidelity Checklist

102

Teach Intervention Strategy Fidelity

Replacement Behavior: Y/N/NA

Step 3: Facilitation Tips§Teams can select interventions for homework or can select during team meeting

§Focus on one routine, class, subject for developing intervention

§Make sure the facilitator is asking guiding questions-allow the teacher to describe how the intervention will be in their classroom

§If meeting time is limited, break up strategies:◦ One meeting, focus on full development of Prevent, next meeting develop Teach/Reinforce

OR◦ First concentrate on Teach/Reinforce; next meeting develop Prevent.

§Use technology (video, Skype, Wiki, Facebook) to provide support to teachers

§Fidelity observations and coaching sessions should NEVER be used as teacher evaluation tools

◦ Fidelity and training are coaching supports◦ Trust is essential for coaching and fidelity to work as intended

Step 4: Progress Monitoring

Step 4: Evaluation Progress Monitoring§First progress monitoring meeting should be held within 3 weeks of plan implementation

◦ Ongoing progress monitoring meetings will be held, initially, every 3 weeks.◦ Time between meetings can lengthen as behaviors continue to improve

§Data-Based Problem-Solving◦ What is working? What is not working?◦ What changes need to be made?◦ Is more data needed? (additional data collection measures)

§Implementation Fidelity Data◦ Is the plan being implemented consistently and accurately?

§Student outcome data◦ Is the problem behavior decreasing? Is the replacement behavior increasing?

§Expanding the plan◦ Routines, times of day◦ Generalize across settings and/or staff

Steps for Evaluating Outcomes§Make sure you have both fidelity measures (self and/or observation scores) AND student outcomes (IBRST measures)

§Decision rules◦ What constitutes adequate fidelity? 80%, 70%, something else?

◦ What constitutes adequate student progress? (e.g., 3 or more consecutive ratings at or above goal line?)

Primary Decisions

§If Fidelity scores are inadequate, determine the reasons (intervention too difficult, not feasible, not described adequately….)

◦ Retrain/coach the teacher/implementer◦ Modify the interventions so that they are feasible, simpler◦ Select different interventions that match the hypothesis

§If student outcomes are in the right direction (decision contingent upon outcome trend)

◦ Maintain intervention◦ Modify intervention◦ Fade intervention components◦ Shape behavior outcomes to become closer approximations of desired

behavior◦ Expand the intervention (additional people, additional settings or routines)

Primary Decisions§If student outcomes are remaining flat or data are showing that behavior problems are increasing and fidelity scores are adequate:

◦ Intensify intervention◦ Modify intervention◦ Conduct another FBA if hypothesis is suspect, team has new data, or context

has changed◦ Conduct a functional analysis◦ Expand team to include other experts

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Jeff Data

Review PTR Process§Four-step team-based process §Teacher/team driven

§Standardized/manualized process§Every intervention plan includes 3 components

◦ Prevent◦ Teach◦ Reinforce

§Plans are task analyzed

§Active coaching support provided to teacher/team to implement interventions§Data-based decision used to make next-step decisions

PTR (and related) Publications§PTR Manuals

1. Dunlap, G., Iovannone, R., Kincaid, D., Wilson, K., Christiansen, K., Strain, P., & English, C., 2010. Prevent-Teach-Reinforce: The school-based model of individualized positive behavior support. Baltimore, MD: Paul H. Brookes. (Second edition coming soon)

2. Dunlap, G., Wilson, K., Strain, P., & Lee, J. K. (2013). Prevent-Teach-Reinforce for young children: The early childhood model of individualized positive behavior support. Baltimore, MD: Paul H. Brookes.

§Journal Articles1. Barnes, S., Iovannone, R., Blair, K. S. W., Crosland, K., & Peshak-George, H. (under review). An evaluation of the Prevent-Teach-

Reinforce model within a multi-tiered intervention system. Journal of Positive Behavior Interventions.

2. DeJager, B. W., & Filter, K. J. (2015). Effects of Prevent-Teach-Reinforce on academic engagement and disruptive behavior. Journal of Applied School Psychology, 31, 369-391.

3. Dunlap, G., Iovannone, R., Wilson, K., Kincaid, D., & Strain, P. (2010). Prevent-Teach-Reinforce: A standardized model of school-based intervention. Journal of Positive Behavior Interventions, 12, 9-22.

4. Dunlap, G., Lee, J. K., Joseph, J. D., & Strain, P. (2015). A model for increasing the fidelity and effectiveness of interventions for challenging behaviors: Prevent-Teach-Reinforce for young children. Infants & Young Children, 28, 3-17.

5. Iovannone, R., Anderson, C.M., & Scott, T. M., (2017). Understanding setting events: What they are and how to identify them. Beyond Behavior.

6. Iovannone, R., Anderson, C. M., & Scott, T. M. (2013). Power and control: Useful functions or explanatory fictions? Beyond Behavior, 22, 3-6.

7. Iovannone, R., Greenbaum, P., Wei, W., Kincaid, D., & Dunlap, G. (2014). Interrater agreement of the Individualized BehaviorRating Scale Tool. Assessment for Effective Intervention, 39, 195-207.

8. Iovannone, R., Greenbaum, P., Wei, W., Kincaid, D., Dunlap, G., & Strain, P. (2009). Randomized controlled trial of a tertiarybehavior intervention for students with problem behaviors: Preliminary outcomes. Journal of Emotional and Behavioral Disorders, 17, 213-225.

9. Kulikowski, L. L., Blair, K. S. C., Iovannone, R., & Crosland (2015). An evaluation of the Prevent-Teach-Reinforce (PTR) model in a community preschool classroom. Journal of Behavior Analysis and Supports, 2, 1-22.

10. Sears, K. M., Blair, K. S. C., Iovannone, R. & Crosland, K., (in press). Using the Prevent-Teach-Reinforce model with families of young children with ASD. Journal of Autism and Developmental Disabilities.

11. Strain, P. S., Wilson, K., & Dunlap, G. (2011). Prevent-Teach-Reinforce: Addressing problem behaviors of students with autism in general education classroom. Behavior Disorders, 36, 160-171.

Questions?