Transcript Interconnected Systems Framework Part 1: Screening

Advancing Education
Effectiveness:
The Interconnected Systems
Framework (ISF) for PBIS and
School Mental Health
Northern CA PBIS Symposium
November 18, 2013
[email protected]
Content:
• Describe the features of an Interconnected
Systems Framework (ISF) for Integrating
Mental Health in Schools
• Describe efforts and resources from blended
efforts of National Centers to promote a
broader continuum of evidence-based
practices to support the mental health of all
students
• Describe emerging examples of ISF
Acknowledgements
•
•
•
•
•
•
•
Susan Barrett & Mark WeistJoanne Cashman- NASDSE(IDEA Partnership)
Rob Horner & George Sugai – National PBIS TA Center
SharonStephens & Nancy Lever-National Center for SMH
Jill Johnson-IL
Kelly Perales- PA
All the ISF Authors and participants
Some ‘Ah Ha’ moments…
• Why expect teachers/principals to switch to proactive
strength-based approach with the students deemed
“the worst” when practices not being used for others?
• Why ask them to build highly individualized plans
from scratch one student at a time?
• Was difficult because evidence-based behavioral
approaches were not being used…
Need for Change?
Special Education
Sea of Ineligibility
General Education
Bridging the Gap
Amount of Resources
Needed to Solve Problem
General +
Intensive
Resources
General +
Supplemental
Resources
General Resources
Intensity of Problem
Some “Big Picture” Challenges
• Low intensity, low fidelity interventions for
behavior/emotional needs
• Habitual use of restrictive settings (and poor
outcomes) for youth with disabilities
• High rate of undiagnosed MH problems
(stigma, lack of knowledge, etc)
• Changing the routines of ineffective practices
(systems) that are “familiar” to systems
Why Partnership Are Needed
• One in 5 youth have a MH “condition”
• About 70% of those get no treatment
• School is “defacto” MH provider
• JJ system is next level of system default
• Suicide is 4th leading cause of death among young adults
• Factors that impact mental health occur ‘round the clock’
• It is challenging for educators to address the factors beyond school
• It is challenging for community providers to address the factors in
school
• Potential partners must come together in a comprehensive system
BIG Idea…
• How Multi-tiered Systems of Support (MTSS)
can enhance mental health in schools
• Installing SMH through MTSS in Schools
• The Interconnected Systems Framework (ISF)
SMH +MTSS=ISF
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
ISF Monograph Development
June 2012 – September 2013
• Define the common goals of SMH and PBIS
• Discuss the advantages of interconnection
• Identify successful local efforts to implement
collaborative strategies and cross-initiative efforts
• Define the research, policy, and implementation
agendas to take us to the next action level
Positive Behavior Intervention and
Support (www.pbis.org)
Decision making framework to guide selection
and implementation of best practices for
improving academic and behavioral functioning
– Data based decision making
– Measurable outcomes
– Evidence-based practices
– Systems to support effective implementation
SMH and PBIS
Common Purpose
• Schools supporting/promoting MH of ALL
students
• Prevention, early access, interventions
commensurate with level of need (versus
labeling with no or poor follow-up)
• School personnel feel confident and
competent in identifying and intervening with
accuracy and effectiveness
Key Rationale
• PBIS and SMH systems are operating
separately
• Results in ad hoc, disorganized delivery of
SMH and contributes to lack of depth in
programs at Tiers 2 and 3 for PBIS
• By joining together synergies are unleashed
and the likelihood of achieving depth and
quality in programs at all three tiers is greatly
enhanced
Logic
Enhanced resources, staff and coordination of
ISF help to build systems at all tiers
Youth with challenging emotional/behavioral
problems are generally treated very poorly by
schools and other community agencies, and
the “usual” approaches do not work
Logic, cont.
• Effective academic performance promotes
student mental health and effective mental
health promotes student academic
performance. The same integration is
required in our systems
Development of ISF
• 2002-2007: Site Development with PBIS
Expansion (informal and independent)
• 2004: CoP focus on integration of PBIS and SMH
• 2009: First ISF White Paper
• 2009- 2013: Monthly calls with implementation
sites, national presentations (from sessions to
strands)
• 2010-2013: Grant Submissions
• June, 2012- September, 2013: ISF Monograph
Connections
and
Partnerships
• OSEP National PBIS Technical Assistance
Center (pbis.org)
• Center for School Mental Health
(csmh.umaryland.edu)
• NASDSE (ideapartnership.org)
• National COP for SBH (sharedwork.org)
Core Features of a Response to
Intervention (RtI) Approach
• Investment in prevention, screening and
early intervention for students not at
“benchmark”
• Multi-tiered intervention approach
• Use of progress monitoring and problemsolving process at all 3-tiers
Core Features of a Response to
Intervention (RtI) Approach
• Research-based practices and active use
of data for decision-making at all 3-tiers
• Use of progress monitoring and problemsolving process at all 3-tiers
ISF Defined
– ISF provides structure and process for education and
mental health systems to interact in most effective and
efficient way.
– ISF is guided by key stakeholders in education and
mental health system who have the authority to
reallocate resources, change role and function of staff,
and change policy.
– ISF applies strong interdisciplinary, cross-system
collaboration.
ISF Defined
– ISF uses the tiered prevention logic as the
overall organizer to develop an action plan.
– ISF involves cross system problem solving teams
that use data to decide which evidence based
practices to implement.
– ISF involves ongoing progress monitoring for
both fidelity and impact.
– ISF emphasizes active involvement by youth,
families, and other school and community
stakeholders.
Traditional
• Each school works
out their own plan
with Mental
Health (MH)
agency;
 Preferred
• District has a plan
for integrating MH
at all buildings
(based on
community data as
well as school data);
Traditional
• A MH counselor
is housed in a
school building 1
day a week to
“see” students;
 Preferred
• MH person
participates in
teams at all 3 tiers;
Traditional
• No data to
decide on or
monitor
interventions;
 Preferred
• MH person leads
group or individual
interventions based
on data;
Structure for Developing an ISF:
A District/Community leadership that includes families,
develops, supports and monitors a plan that includes:
– Community partners participating in all three levels of
systems teaming in schools: Universal, Secondary,
and Tertiary
– Team of SFC partners review data and design
interventions that are evidence-based and can be
progress monitored
– MH providers from both school and community
develop, facilitate, coordinate and monitor all
interventions through one structure
3-Tiered System of Support Necessary Conversations
Family and
community
Universal
Team
Plans SW &
Class-wide
supports
Universal
Support
Family and
community
Community
Secondary
Systems Team
Problem Solving
Team
Uses Process data;
determines overall
intervention
effectiveness
Standing team with
family; uses FBA/BIP
process for one youth
at a time
Tertiary
Systems Team
Uses Process data;
determines overall
intervention
effectiveness
CICO
Brief
SAIG
Group w.
individual
feature
Brief
FBA/BIP
Sept. 1, 2009
Family and
community
FBA/
BIP
Complex
FBA/BIP
WRAP
Interconnected Systems Framework
Tier I: Universal/Prevention for All
Coordinated Systems, Data, Practices for
Promoting Healthy Social and Emotional Development
for ALL Students
 School Improvement team gives priority to
social and emotional health
 Mental Health skill development for
students, staff/, families and communities
 Social Emotional Learning curricula for all
 Safe & caring learning environments
 Partnerships : school, home & community
 Decision making framework guides use of
and best practices that consider unique
strengths and challenges of each school
community
Interconnected Systems Framework
Tier 2: Early Intervention for Some
Coordinated Systems for Early Detection, Identification,
and Response to Mental Health Concerns
 Systems Planning Team coordinates referral
process, decision rules and progress monitors
 Array of services available
 Communication system: staff, families and
community
 Early identification of students at risk for
mental health concerns due to specific
risk factors
 Skill-building at the individual and groups
level as well as support groups
 Staff and Family training to support skill
development across settings
Interconnected Systems Framework
Tier 3: Intensive Interventions for Few
Individual Student and Family Supports
 Systems Planning team
coordinates decision
rules/referrals and progress
monitors
 Individual team developed to
support each student
 Individual plans have array of
interventions/services
 Plans can range from one to
multiple life domains
 System in place for each team
to monitor student progress
MH/PBIS: An Expanded Tier One
• Broader range of Data
– Opportunity to review community data and expand Tier 1
intervention options based on data
• Universal screening
– for social, emotional, and behavioral at-risk indicators
– for families who may request assistance for their children
• Teaching
– social skills with evidence-based curricula to all students
– appropriate emotional regulation and expression to all
students
– behavioral expectations to all students
School Data
 Community Data
Student and system level
• Academic (Benchmark,
GPA, Credit accrual etc)
•
•
•
•
Discipline
Attendance
Climate/Perception
Visits to Nurse,
Social Worker,
Counselor, etc
• Screening from one
view
• Community
Demographics
• Food Pantry Visits
• Protective and Risk
Factors
• Calls to crisis centers,
hospital visits
• Screening at multiple
views
MH/PBIS: An Expanded Tier Two
• Mapping of all existing interventions to ensure key
resources are aligned to ensure both efficiency and
effectiveness (“bully prevention”, “discipline”, “character
education”, “RtI behavior”, etc.)
• Groups co-facilitated by school staff and community
partner (example – guidance counselor and community
provider clinician)
• Opportunity to expand the continuum of interventions
based on data (i.e. trauma informed interventions)
• Out-reach to families for support/interventions
MH/PBIS: An Expanded Tier Three
• Quicker access to a richer continuum
ofcommunity-based supports for students and
families
• FBA/BIP and/or person-centered wraparound
plans completed together with school staff
and mental health provider for one concise
plan, rather than each ‘completing paperwork
to be filed’
A District Example
IL District U-46
at a Glance: 2012-2013
Enrollment:



Total school enrollment 40,570
54.8% Low Income
97 languages spoken in U-46 homes
Facilities:




40 Elementary Schools (PreK-6)
8 Middle Schools (7-8) + 1 Alternative Middle School
5 High Schools + 2 Alternative High Schools
2 Early Childhood Centers
Communities Served:


11 communities
3 counties (Cook, DuPage, Kane)
20 Community Partners
57 providers trained in PBIS/SAIG
Boys and Girls Club of Elgin*Centro de Informacion*
Community Crisis Center*Crossroads Kids Club*
Easter Seals*Elgin Police Department*
Family Service Association of Greater Elgin Area*Fox
Valley Pregnancy Center*Fox Valley Volunteer
Hospice*Girl Scouts of Northern Illinois*Hanover
Township Youth and Family Services*Kenneth
Young*Renz Center*Streamwood Behavioral
Healthcare System*Taylor Family YMCA*The
Y*WAYS*West Ridge Community Church*Youth
Leadership Academy
U-46 School and Community Alliance Work
Groups 2009-2012
Operations
Tier 2/3
High School Violence Prevention
Tier 2/3 Work Group Outcomes
 Creation of Guidelines for Schools and Agencies
Working Together
 Agency Partners are active members of Secondary
Systems Teams (9)
 Trained Agency Partners in Social Academic
Instructional Groups/DPR Data
 25 partners are sitting on teams and/or providing
SAIG in schools
 Use of the DPR (Daily Progress Report) for
progress-monitoring
G. Elementary Major ODRs per 100
Students
100
90.31
80
60
44.88
50.40
44.57
40
20
0
2009-10
2010-11
2011-12
Major ODRs per 100 students
2012-13
G. Elementary Students with 6+
ODRs
6.00%
5.00%
4.85%
4.00%
3.00%
2.00%
1.97%
1.79%
1.74%
2010-11
2011-12
2012-13
1.00%
0.00%
2009-10
Students with 6+ ODRs
CO Elementary OSS Events and
OSS Days
40
38
35
30
25
OSS Events
20
15
15
17
10
10
5
0
2009-10
2012-13
OSS Days
C-O Elementary Students with 6+
ODRs
1.20%
1.13%
1.00%
0.80%
0.60%
0.40%
0.19%
0.20%
0.00%
2009-10
2012-13
Students with 6+ ODRs
PBIS + Positive Youth Development
Key elements to the Youth Development
approach are the following:
 Youth are viewed as a valued and respected asset to society;
 Policies and programs focus on the evolving developmental needs
and tasks of adolescents, and involve youth as partners rather than
clients;
 Families, schools and communities are engaged in developing
environments that support youth;
 Adolescents are involved in activities that enhance their
competence, connections, character, confidence and contribution to
society;
 Adolescents are provided an opportunity to experiment in a safe
environment and to develop positive social values and norms; and
 Adolescents are engaged in activities that promote selfunderstanding, self-worth, and a sense of belonging and resiliency.
E. High School Example
Social Academic Instruction Groups
(SAIG)





Coordinated by EHS Counselor
Facilitated by Community Partner
Data: Feedback from Teachers and Students
Groups 6-8 weeks
Students grouped based on teacher feedback
and lack of response to CICO
 Agency partner is active member of secondary
systems team
Weekly Progress
Report:
Earn and Give Respect
(student will not talk back to
staff)
Hold Yourself Responsible
(Student will be on time to
class)
Safety First
(Student will wear ID around
neck)
I feel connected to my school
Pre-Test
Post-Test
Strongly Disagree
Disagree
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Neither Agree nor Disagree
Agree
Strongly Agree
Strongly Agree
0% 0%
22%
33%
45%
45%
11%
11%
11%
22%
I feel respected and important
while at school
Pre-Test
Post-Test
Strongly Disagree
Disagree
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Neither Agree nor Disagree
Agree
Strongly Agree
Strongly Agree
0% 0%
11%
11%
0%
33%
22%
22%
67%
34%
Next Steps for Alliance…





Increase Trauma focus at all three tiers
Directory of partners/agencies
Blend initiatives/coordinate across the district
Alternative to suspension expansion
Utilize exemplars in district as examples for
other schools
 Increase communication/visibility of Alliance
Closing thoughts………
Problem
•
Innovative practices do not fare well in old
organizational structures and systems
•
Organizational and system changes are
essential to successful use of innovations
– Expect it
– Plan for it
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
The Need to Be Plan-ful:
Implementation occurs in stages:
•
•
•
•
•
•
Exploration-Adoption
Installation
Initial Implementation
Full Implementation
Innovation
Sustainability
Fixsen, Naoom, Blase, Friedman, & Wallace, 2005
2 – 4 Years
Problem
• Students cannot benefit from
interventions they do not experience
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008
Ensuring Systems are Ready
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