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Scaling UpScaling UpEvidence-based Evidence-based Practices Practices
Dean Fixsen, Karen Blase,Rob Horner, and George Sugai
Current ChallengesCurrent ChallengesEffective practices exist for literacy, social behavior and safety
Traditional TA approaches (dissemination and compliance) are insufficient
Methods are available to reliably produce benefits to students statewide
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
CurrentlyCurrently
EBPs now are boutique operations
◦Now have convincing demonstrations that EBPs can work in the real world
◦This is encouraging, but EBPs are not used on a sustainable scale sufficient to solve social problems
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
FutureFutureStart with the end in mindWhat will it take to:
◦make statewide use of education innovations
◦that produce increasingly effective outcomes
◦for the next 50 years?
ProblemProblem Most States already have
attempted to implement a variety of these science-based practices
Some attempts achieve their purposes, but others fall short
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Key Issues Key Issues Four big issues have emerged:
◦ Select what to scale up
◦ Determine how to implement new education practices so they actually produce the intended benefits to students (effective)
◦ Define how to scale up effective practices so they are available to all students who could benefit from them (effective, accessible)
◦ Define how to align system structures and functions to fully support scale up efforts as part of “education as usual” (effective, accessible, sustainable)
When is a “practice” ready for TA When is a “practice” ready for TA InvestmentInvestmentDefining a “practice”
◦ A “practice” is a procedure, or set of procedures, designed for use in a specific context, by individuals with certain skills/features, to produce specific outcomes for specific individuals.
Operationally defined proceduresTarget population/ ContextImplementer CharacteristicsDefined outcomes
The scope/size of a practice The scope/size of a practice mattersmattersPractices can be small, medium or
large in scope◦Time delay◦Functional behavioral assessment◦First Step to Success
Scale up practices only when they are bundled to a level where they have impact on a core social outcome.
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
When is a “practice” ready for TA When is a “practice” ready for TA InvestmentInvestment
Wisdom from: Karin Guldbrandsson H. Gotham Dean Fixsen and Karen Blase George Sugai Bruce Joyce and Beverly Showers
Eight Features of a “practice” that make it “ready for implementation” investment
When is a “practice” ready for TA When is a “practice” ready for TA InvestmentInvestment
Substantive impact on highly valued outcome.
Practice is comprehensive enough that it addresses a highly valued outcome (not just a piece)
There is a perceived need for the outcome Effect is dramatic (both in relative and absolute
terms)
The practice is defined with precision The practice can be described with operational
precision and substance. What is the “it”
Compatibility with existing practices
When is a “practice” ready for TA When is a “practice” ready for TA InvestmentInvestment
Evidence-based Experimental documentation of
relationship between practiced and impact published in peer-reviewed journal. (Effect Size of at least .50)
Emerging Promising Evidence-based
Efficiency Minimal additional resources to perform
new practice Minimal additional resources to transition
to new practice
When is a “practice” ready for TA When is a “practice” ready for TA InvestmentInvestmentSocial Validity
The people required to behave differently are comfortable with the new behavior(s) they are being asked to perform
Documentation of effectiveness trials
Adaptability The practice can be adapted to “fit” different
contexts The challenge of being precise and manualized
versus being flexible and adaptive (be clear about core).
Generalizability The practice is effective across the array of
contexts normally encountered.
ValuedOutcomes
Practice Implementation
Identifying& Modifying
Practices
Efficiency
EffectivenessPriority
Continuous Regeneration
Continuous
Measurement
Data-BasedProb.
Solving
Capacity
Building
What “packaging features” What “packaging features” are necessary for successful are necessary for successful adoption?adoption?Materials for exploration and awareness
What is the need, what is the practice, what is the documented link between the practice and valued outcome?
Materials for Installation and Initial Implementation
Materials for teaching people to master the new practice
Protocol for implementation
What “package features” What “package features” are necessary for are necessary for successful adoption?successful adoption?Evaluation tools
Is practice being implemented with fidelity
Is practice producing valued outcome
Are training segments producing implementation of core elements of “practice”
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Research Measures
Annual Self-Assessment Measures
Progress Monitoring Measures
Universal Tier of SWPBS
-School-wide Evaluation Tool (SET)
-Self-Assessment Survey (SAS)-Benchmarks of Quality (BoQ)
-Team Implementation Checklist (TIC)
Secondary and Tertiary Tiers of SWPBS
-Individual Student School-wide Evaluation Tool (I-SSET)
-Benchmarks of Advanced Tiers (BAT)
(To be developed)
Overall Summary of Implementation
-Implementation Phases Inventory (IPI)-Phases of Implementation (POI)
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Activity Activity Task Analysis Who When
1. Establish Commitment
Administrator Top 3 goal 80% of faculty Three year timeline
a.
b.
c.
d.
e.
2. Establish TeamRepresentativeAdministratorEffective team operating proceduresAudit of teams/initiatives
a.
b.
c.
d.
e.
Evaluation Guided Action Planning
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Key IssuesKey IssuesInterventions that are and remain
effective through several generations of teachers, principals, superintendents, and State and national leaders
Implementation supports that are and remain effective through several generations of trainers, coaches, evaluators, administrators, and State leaders
Teaching–Family Teaching–Family ReplicationsReplications
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
0
100
200
300
400
500
600
700
800
900
≤1972 1974 1976 1978 1980 1982
0
50
100
150
200
250
300
CumulativeCouples
CumulativeHomes
Fixsen, Blase, Timbers, & Wolf (2001)
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Follow Through ProgramsFollow Through Programs
Figure 1: This figure shows the average effects of nine Follow Through models on measures of basic skills (word knowledge, spelling, language, and math computation), cognitive-conceptual skills (reading comprehension, math concepts, and math problem solving) and self-concept. This figure is adapted from Engelmann, S. and Carnine, D. (1982), Theory of Instruction:
Principles and applications. New York: Irvington Press.
School AdoptingSchool-wide Positive Behavior Support
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Insufficient MethodsInsufficient MethodsExcellent experimental evidence for what does not work
Diffusion/dissemination of information by itself does not lead to successful implementation (research literature, mailings, promulgation of practice guidelines)
Training alone, no matter how well done, does not lead to successful implementation
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Insufficient MethodsInsufficient MethodsExcellent experimental evidence for what does not work
Implementation by laws/ compliance by itself does not work
Implementation by “following the money” by itself does not work
Implementation without changing supporting roles and functions does not work Paul Nutt (2002). Why Decisions Fail
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Sobering Sobering ObservationObservation
"All organizations [and systems] are designed, intentionally or unwittingly, to achieve precisely the results they get." R. Spencer Darling
Business Expert
Rise in Incidence of Autism
Reduction in Incidence of Mental Retardation
and Learning Disabilities
The Oregon Department of Education has released graduation rates for all public high schools.
Nearly one-third of all high school students don't receive a diploma after four years of study.
by Betsy Hammond,
The Oregonian Monday June 29, 2009,
Sobering ObservationsSobering ObservationsInnovative practices do not fare well in old organizational structures and systems
Organizational and system changes are essential to successful implementation◦Expect it◦Plan for it
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Build on local strengths, context and accomplishments
Implement 1-3 evidence-based practices at a sustainable scale of social importance.
Document value of implementation to achieve valued student outcomes
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Benefits to focusing on Benefits to focusing on Scaling ImplementationScaling Implementation
Benefits to focusing on Benefits to focusing on Scaling ImplementationScaling Implementation
Develop capacity of your State to implement any evidence-based practice with fidelity and good outcomes
De-silo implementation of evidence-based practices, innovations, legislative mandates in the State
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Scale UpScale UpTo scale up interventions we must first scale up implementation capacity
Building implementation capacity is essential to maximizing the use of EBPs and other innovations
Large scale, real time change© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Academic Systems Behavioral Systems
1-5% 1-5%
5-10% 5-10%
Intensive, Individual Interventions•Individual Students•Assessment-based•High Intensity•Of longer duration
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
80-90% 80-90%Universal Interventions•All students•Preventive, proactive
Universal Interventions•All settings, all students•Preventive, proactive
Multi-tier Model
Attention, Effort,
Precision
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Capacity DevelopmentCapacity Development
State Management Team
State Transformation Team
Regional Implementation Teams
State Management
Group
State Transformation
Team
Regional Implementation
Team
N = 50 – 200 Schools
Regional Implementation
Team
N = 50 – 200 Schools
Regional Implementation
Team
N = 50 – 200 Schools
Regional Implementation
Team
N = 50 – 200 Schools
IMPLEMENTATION CAPACITY FOR
SCALING UP EBPs
SIS
EP
Su
pp
ort
& 2
FT
E
State Management
Group
First Regional Implementation
TeamN = 9 Staff
Po
licy En
abled
P
ractice (PE
P)
Pra
ctic
e In
form
ed
Po
licy
(P
IP)
Sys
tem
C
han
ge
SIS
EP
Su
pp
ort
& 2
FT
E
ContextContext
Many initiatives to improve educationInitiatives too often conflicting and/or
competing
Early Intervention
Literacy
Math
Wraparound
Positive Behavior SupportFamily Support
Response to Intervention
Applied Behavior Analysis
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Using RTI to Align Using RTI to Align SystemsSystems
Literacy
Wraparound
Math
Family Support
Behavior Support
AL
IGN
ME
NT
Early Intervention
Res
po
nse
to
In
terv
enti
on
/Pre
ven
tio
n
Student Outcomes
Primary Prevention
Universal Screening
Multi-tiered
Support
Early Interventio
n
Progress Monitoring
Systems to support
practices
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Implementation TeamImplementation Team
A group that knows the innovation very well (formal and practice knowledge)
A group that knows how to implement that innovation with fidelity and good effect
A group that accumulates data & experiential knowledge -- more effective and efficient over time (information economics, K. Arrow)
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Implementation TeamImplementation Team
Implementation Team
Prepare Communities
Prepare schools faculty, staff
Work with Researchers
Assure Implementation
Prepare Districts Assure Student Benefits
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Capacity DevelopmentCapacity Development
Start with too many overqualified people
“Generation 1” RIT members become: ◦Generation 2 expanded RIT members
◦Generation 3 State Transformation Team leaders
◦Generation 4 State and federal officials
State Management
Group
State Transformation
Team2 FTE & Others
Regional Implementation
Team
N = 50 – 200 Schools
Regional Implementation
Team
N = 50 – 200 Schools
Regional Implementation
Team
N = 50 – 200 Schools
Regional Implementation
Team
N = 50 – 200 Schools
IMPLEMENTATION CAPACITY FOR
SCALING UP EBPs
[Phase 2]
SIS
EP
Su
pp
ort
Intensive Development
Saturation
State Capacity Development
0
2
4
6
8
10
12
14
16
1 2 3 4 5 6 7 8 9 10 11 12
Years
Reg
iona
l Im
pl. T
eam
s RITs
STTs
Intensive Development
Saturation44/51
Coaching DefinedCoaching DefinedCoaching is the active and iterative
delivery of: ◦ (a) prompts that increase successful
behavior, and ◦ (b) corrections that decrease unsuccessful
behavior.
◦ Coaching is done by someone with credibility and experience with the target skill(s)
◦ Coaching is done on-site, in real time ◦ Coaching is done after initial training◦ Coaching is done repeatedly (e.g. monthly)◦ Coaching intensity is adjusted to need
Outcomes of CoachingOutcomes of CoachingFluency with trained skillsAdaptation of trained concepts/skills
to local contexts and challenges And new challenges that arise
Rapid redirection from miss-applications
Increased fidelity of overall implementation
Improved sustainability Most often due to ability to increase
coaching intensity at critical points in time.
Training Outcomes Related to Training Components
Training Outcomes
Training Components
Knowledge of Content
Skill Implementation
ClassroomApplication
Presentation/ Lecture
PlusDemonstration
Plus Practice
Plus Coaching/ Admin SupportData Feedback
10% 5% 0%
30% 20% 0%
60% 60% 5%
95% 95% 95%
Joyce & Showers, 2002
Coaching Coaching within SWPBS within SWPBS ImplementationImplementation
Context:◦9600 schools implementing SWPBS
nationallyDefining the Role
Internal vs External
Selecting CoachesTraining and support for coachesAssessing Impact
Rehearsal and CoachingRehearsal and CoachingAfter initial training, a majority of
participants (211 of 213) demonstrated poor implementation. Decision-makers should pair training prior to implementation with on-going rehearsal and performance feedback (coaching)◦Test et al 2008
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
0
1
2
3
4
5
6
7
Sep Oct Nov Dec Jan Feb Mar Apr May
Avg. Refe
rrals
per
Day
05-06 06-07
Example of the Impact of Coaching on Student Outcomes:Example of the Impact of Coaching on Student Outcomes:Average Major Discipline Referrals per Day per MonthAverage Major Discipline Referrals per Day per Month
Coach Coach returns from returns from
leaveleave
Leadership Team
FundingVisibility Political
Support
Training Coaching Evaluation
Local Demonstration Schools
Active Coordination
BehavioralExpertise
““Even if you’re on the right track, you’ll get Even if you’re on the right track, you’ll get run over if you just sit there” run over if you just sit there”
- Will Rogers - Will Rogers