Transcript Document

Wraparound as a Tier 3 Intervention for
Students with Significant
Emotional/Behavioral Challenges
Northern CA PBIS Symposium
November 18, 2013
Lucille Eber, Illinois PBIS Network
www.pbisillinois.org
[email protected]
SCHOOL-WIDE
POSITIVE BEHAVIOR
SUPPORT
~5%
~15%
Primary Prevention:
School-/ClassroomWide Systems for
All Students,
Staff, & Settings
~80% of Students
Tertiary Prevention:
Specialized
Individualized
Systems for Students
with High-Risk Behavior
Secondary Prevention:
Specialized Group
Systems for Students
with At-Risk Behavior
Layering Supports
 As students start with tier 2 interventions and may
not be successful, layering additional interventions is
important
 A student could be in CICO, in SAIG, have a FBA/BIP
and also be involved in wrap.
 OR, students could start with wrap, then the
team/school would make sure the student had access
to lower level interventions as a part of the wrap
plan
 Tier 3 wrap student action plan builds on lower level
interventions as a part of the comprehensive
wraparound plan
We Know the Practices that Work…
• Proactive, strength-based; “set kids up” to experience
success
• High rates of consistent, supported instruction;
teach/practice/reinforce
• Predictable and consistent environments
• Know unique “why?” for each student/problem
• Contextual fit: Strategic use of natural supports, and
settings
• Careful monitoring of data over time with ongoing
revisions to guide incremental improvements in quality
of life
The System Features Needed to Support
he Effective Practices…
• A Team unique to each individual child &
family
– Blend the family/natural supports with the school
representatives who know the child best
• A defined Meeting Process
– Meet frequently and use data
– Develop, implement, review range of interventions
• Facilitator Role
– Bringing team together
– Blending perspectives; guiding consensus
– Systematic use of data (strengths and needs)
What is Wraparound?
•
Wraparound is a process for
developing family-centered teams
and plans that are strength and
needs based
 (not deficit based)
 across multiple settings and life
domains.
A Growing Evidence Base
See Bruns and Suter, (2010) largest analysis of wrap research.
Key points include:
• Investment in wraparound is backed by controlled research.
In 2003, there were 3 controlled studies published, in 2010,
there are 12 scientifically controlled and over 36 overall
outcomes studies, more being published monthly.
• Research is showing an association between system,
organizational, team fidelity to good outcomes with families.
•
The wraparound-based RENEW process showing
significant outcomes for older, transition-aged youth with or
at-risk of EBD.
Individualized Comprehensive
Teams/Plans
 Who?
 Youth with multiple needs across home, school,
community
 Youth with multiple life domain needs
 The adults in youth’s life are not effectively
 engaged in comprehensive planning
 (i.e. adults not getting along very well)
 What?
 The development of a very unique,
individualized, strength-based team & plan
with the youth family that is designed to
improve quality of life as defined by the
youth/family.
Individualized, Comprehensive
Teams/Plans
What Do Tertiary Plans include?
Supports and interventions across multiple life domains and
settings (i.e. behavior support plans, academic interventions,
basic living supports, multi-agency strategies, family supports,
community supports, etc.)
What’s Different?
Natural supports and unique strengths are emphasized in
team and plan development. Youth/family access, voice,
ownership are critical features. Plans include supports for
adults/family, as well as youth.
10 Principles of Wraparound
1. Family Voice and
Choice
2. Team-Based
3. Natural Supports
4. Collaboration
5. Community-Based
•
6. Culturally-Competent
7. Individualized
8. Strengths-Based
9. Unconditional Care
10. Outcome-Based
NWI standardized the 10 principles in 2004
2008–Revised persistent to unconditional
10
Life Domain Areas to Consider
•
•
•
•
•
Physical
Needs/Living
Situation
Family/Attachment
Safety
Socialization
Cultural/Spiritual
•
•
•
•
Emotional/Psychol
ogical
Health
Educational/Vocati
onal
Legal
Four Phases of Wraparound
Implementation
I.
Team Development
- Get people ready to be a team
- Complete strengths/needs chats (baseline data)
II.
Initial Plan Development
- Hold initial planning meetings (integrate data)
- Develop a team “culture” (use data to establish voice)
III.
Plan Implementation & Refinement
- Hold team meetings to review plans (ongoing data
collection and use)
- Modify, adapt & adjust team plan (based on data)
IV. Plan Completion & Transition
- Define good enough (Data-based decision-making)
- “Unwrap”
Implementing Wraparound:
Key Elements Needed for Success
• Engaging students, families & teachers
• Team development & team ownership
• Ensuring student/family/teacher voice
 Getting to real (big) needs
• Effective interventions
 Serious use of strengths
 Natural supports
 Focus on needs vs. services
• Monitoring progress & sustaining
• System support buy-in
What’s New in Wraparound?
• Skill set specificity
• Focus on intervention design/effectiveness
• Integration with school-wide PBS
• Phases to guide implementation/supervision
• Data-based decision-making
• Integrity/fidelity assessment (WIT)
• Tools to guide teams:
– Home School Community
– Education Information Tool
Data-Based Decision-Making
and Wraparound
Can wraparound teams use data-based
decision-making to prioritize needs,
design strategies, & monitor progress of
the child/family team?
 more efficient teams, meetings, and plans?
 less reactive (emotion-based) actions?
 more strategic actions?
 more effective outcomes?
 longer-term commitment to maintain success?
Data-Based Decision-Making
and Wraparound
Can wraparound teams use data-based
decision-making to prioritize needs,
design strategies, & monitor progress of
the child/family team?
 more efficient teams, meetings, and plans?
 less reactive (emotion-based) actions?
 more strategic actions?
 more effective outcomes?
 longer-term commitment to maintain success?
Wraparound Skill Sets
1. Identifying “big” needs (quality of life indicators)
•
“Student needs to feel others respect him”
2. Establish voice/ownership
3. Reframe blame
4. Recognize/prevent teams’ becoming
immobilized by “setting events”
5. Getting to interventions that actually work
6. Integrate data-based decision-making into
complex process (home-schoolcommunity)
Good needs-based
interventions will:
• Change the environment around the
situation rather than waiting for the person
with the unmet need to do the changing
• Help build skills for the youth and the
youth’s supporters (family, teachers,
neighbors, kin, etc.)
• Access existing resources when there is fit,
avoid existing resources when there is not
Patricia Miles, 2002
Needs & Wraparound
• Focus on the “why” of a need not the “how”
– Needs to feel competent with academic tasks rather than he
needs to complete his assignments
• Use descriptive terms
– To learn, To know, To experience, To feel, To see, To have, To
be
• Deal with the “big” stuff
– Families/youth deserve to know their teams are dealing with their
larger challenges
• More than one way to meet it
– Unlike a goal (John will come to school every day)
• Improves quality of life (as defined by family, youth)
Adapted from P.Miles,2004
Services & Needs are Different
Service
• Defines the action
• Three levels
 Existing service
 Intervention
 Support
• Frequent changes
based on new
information
Need
• Defines why do the
action
• Unifying concept that
cuts across all three
levels of service
• Changes infrequently
until reports indicate
“met need”
P.Miles, 2004
“Needs” Talk in Team Meetings
• When a team member disguises a
service as a need, i.e.
– He needs a special education placement or
– The family needs counseling
• Ask the team member:
– What do you hope will be accomplished
through this?
– Why do you think this is important to the
person?
– How will you know when it’s been effective?
Examples of Needs Statements:
• The student needs to feel adults and peers
respect him.
• The student needs to feel happy about
being at school.
• The parent needs to know her son is
getting a fair shake at school.
• The student needs to be reassured that he
can complete the work.
Andy
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•
•
•
6th grade student
Behavior difficulties and academic failure
GPA 1.25 (2nd quarter)
6 ODRs (1st two quarters)
15 Out-of-School Suspensions (safety)
Family support needs –history of mobility
with plan to move at the end current
school year. Student moved nine times
since first grade
Why move to Phase I wraparound instead of an
FBA around one problem behavior?
– Discussing problem behaviors would not have
motivated family to participate on team.
– Probably not the first time schools have
approached family in this manner (“let’s talk
about behavior”)
– Bigger needs to work on to improve quality of
life for youth and family
– Open-ended conversation and use of wrap
data tools helped engage family
Andy
The team developed a mission
statement:
“Andy will be happy and confident in
school”
Using Data to Keep the Team Moving
“Celebrate Success of current plan”
Andy
Andy
• Andy was happy at school and his
mother was pleased with the help that
the wrap team provided. Teachers were
pleased with the change in Andy.
• Data is used to then identify “next
steps”.
Using Data to Keep the Team Moving
“Identify Ongoing Needs & Next Steps”
Andy
The check and connect
intervention and other
strategies helped Andy feel
better about being at his
school.
The team identified unmet
“needs”. The data is used
to engage the team to
continue working on a
plan.
Educational Information Tool
Andy
• The family expressed that
for the first time in their
son’s school experience,
they felt supported and
optimistic. Andy’s mother
wants him to continue at
this school.
• Andy’s team will help
develop a plan that
supports his
independence from
adults.
6
3rd/4th
Qtr.
0
1.25
15
23
2.30
0
6
1st/2nd
Qtr.
ODR
s
GPA
OSS
Tardy
Setting Event Challenges
• Setting events that seems outside of
the “control” of the school may
frustrate intervention efforts.
Effective Interventions:
Getting to the Setting Event
If you are doing wraparound
and effectively engage the
family, you are more likely to
(eventually) get to strategies
that address the setting event.
“Ben’s Story…
• “Ben” started CICO in September of 2009. He
was automatically entered into the intervention
when he met the building criteria of having two,
level two office discipline referrals.
• Behaviors of concern included: disobeying
directions, talking out, disrupting others learning,
off task, hitting other students, arguing with
teacher and students, name calling, cursing to
peers and adults.
• He averaged a 78% after 6 weeks.
And Then…
• A reverse request was given to the teacher
where she was asked to identify the next
secondary intervention (continued CICO, SAIG,
CICO with individual features or mentoring).
• The teacher chose for Ben to receive a mentor.
• His mentor was chosen from the community
partnership ‘G’ elementary has with a local
church.
Moving Forward
• In December, Ben began asking his mother
if he could be admitted to the hospital so he
“could get better”. He was experiencing
anger, thoughts of hurting himself and he
was physically aggressive with classmates
and peers. He was verbalizing “I can’t
control himself.”
• Ben had three prior psychiatric
hospitalizations (before coming to ‘G’
Elementary).
Challenges Ben and Family
Were Facing Included…
• Single parent family; mom working evenings
and overnights.
• No contact with biological father and no
consistent male role models.
• ADHD diagnoses; inconsistent use of
prescribed medication.
• Limited involvement in community &
neighborhood
• Limited social relationships at school & home
• Stress of moving to different homes.
Child and Family Strengths
• Ben’s Strengths identified in the first meeting included:
– “Ben”: Smart, good at math, reading, writing and playing video
games
– Mom: Very organized
– He’s creative and enjoys drawing cartoons
– Teacher: writing and math;
• Family Strengths:
– Mom consistently takes “Ben” to his mental health appointments.
– This might include getting the city bus for an hour ride, attending
an hour appointment, waiting another 30 minutes for the bus and
then riding home and then bringing him to school.
– Mom is an active participant at the school, follows
through with suggestions.
Wrap process
builds on lower tiered interventions
 At the first team meeting family agreed to:
 Continue CICO
 Continue mentoring
 Continue MH services
 Improved communication with Mental Health
 FBA to be completed (home and school)
 Family YMCA (schedule present at LANS for
funding)
Other Data…
Questionnaire: SIMEO 2010-Home,
School, Community Tool
Questionnaire: SIMEO 2010-Home,
School, Community Tool
Questionnaire: SIMEO 2010-Home,
School, Community Tool
Rehabilitation,
Empowerment, Natural
Supports, Education
and Work {RENEW}
J. Malloy and colleagues at UNH
• Developed in 1996 as the model for a 3-year RSAfunded employment model demonstration project for
youth with “SED”
• Focus is on community-based, self-determined services
and supports
• Promising results for youth who typically have very poor
post-school outcomes (Bullis & Cheney; Eber, Nelson & Miles,
1997; Cheney, Malloy & Hagner, 1998)
RENEW Overview
RENEW (Rehabilitation, Empowerment, Natural
Supports, Education and Work) is an application
of wraparound
• Reflects key principles: person-centered,
community and strengths-based, natural
supports
• Focused on student, versus parent
engagement (e.g., student-centered teams,
student-developed interests)
RENEW Features
1. Self-determination through Personal Futures
Planning
2. Individualized Team Development and
Wraparound
3. Individualized Education Programming
4. Individualized School-to-Career Planning
5. Naturally Supported Employment
6. Mentoring
7. Sustainable and Positive Social Connections
The RENEW MAPS
• History
• Who You Are Today
• Strengths & Accomplishments
• People
• What Works and Doesn’t Work (Preferences)
• Dreams
• Fears, Concerns, Barriers
• The Goals
• Next Steps
• Essential Next Steps and Follow Up (Action Plan)
Mapping
Futures Planning Maps uses flip chart
paper & markers, a power point projected
on a wall, or a Smart board and should
include:
• Both words and graphics that represent
the student and their story
• A focal point where everyone on the
team can see the Maps being created
K’s History
• K. was expelled from school in the 9th grade
due to behavioral issues at school
• K. attended Alternative Program for remainder
of 9th grade and freshman year.
• K. started the RENEW process during 2nd
semester of her sophomore year.
• The RENEW process was used to support K.
as she began to transition back to WHS,
attending 2 periods at WHS and attending the
Alternative Program for the remainder of the
day.
K’s Maps: Strengths and
Accomplishments
K’s Maps : Dreams
K’s Maps: Fears, Barriers and
Concerns
K’s Maps: Goals
K’s Action Plan
Goal: Learn more about Cosmotology School
Action Steps:
Reading Teacher will contact friend to set up question & answer
K’s Action Plan
Goal: To Be More Outgoing
Action Steps:
Start going out more with friends
Leave the house/neighborhood
more often
Join Clubs
Be part of a group
Keyanna’s Action Plan
Goal: Graduate Early
Action Steps:
Talk to Guidance Counselor to do a credit analysis to see if it is possible
K’s Action Plan
Goal: Identifying Colleges
Action Steps:
Start researching online
Decide on a program Cosmo or SW
Go to CLC for a visit over the summer
Go to College section of the library to find out about visits and to do more research
Keyanna’s Action Plan
Goal: Get a Job/ Open Savings Account
Action Steps:
Look for jobs online
Call Six Flags when once you turn 16
Look for a new job once Six Flags job ends
Interview at the Mall
Keyanna’s Action Plan
Goals: Get Better Grades
Action Steps:
Ask for help from O Plus Teachers
Study more
See if more work can be done from home
Make-up Math homework
Go to tutoring at church
PE papers for making up days missed
K. Today
•
•
•
•
•
•
90% Attendance Rate 2nd quarter
0 ODRs 2nd quarter
3.0 GPA
Student Council Member
Applied to be a student mentor
Student facilitator for a Freshman Girls
Group
• Employed at a local in-home daycare
SCHOOL-WIDE
POSITIVE BEHAVIOR
INTERVENTIONS and
SUPPORT
5%
15%
Primary Prevention:
School-/ClassroomWide Systems for
All Students,
Staff, & Settings
80% of Students
Tertiary Prevention:
Specialized
Individualized
Systems for Students
with High-Risk Behavior
Secondary Prevention:
Specialized Group
Systems for Students
with At-Risk Behavior
How
may
these meetings
bethan
different
How is
Wraparound
Different
other
than typical
meetings?
Meetings
Schoolsschool
Have with
Families?
Family voice and choice
Rely on the families natural supports
High frequency meetings
Continually checking to see how things are going
through use of data
 Considering cultural competency: do the family and
student feel accepted in the school and community




Positive
Behavior
Support
Social Competence &
Academic Achievement
OUTCOMES
Supporting
Decision
Making
Supporting
Staff Behavior
Adapted from “What is a
systems Approach in schoolwide PBS?”OSEP Technical
Assistance on Positive
Behavioral Interventions and
Supports. Accessed at
http://www.Pbis.org/schoolwid
e.htm
‫٭‬
PRACTICES
Supporting
Student Behavior
Resources
• www.pbisillinois.org
• www.pbis.org
• http://www.nwi.pdx.edu/