Prevent-Teach-Reinforce
Model: A Tier 3 Behavior
Intervention Process
Rose Iovannone, Ph.D., BCBA-D
iovannone@usf.edu
Don Kincaid, Ed.D., BCBA
kincaid@usf.edu
The contents of this training were developed under grant H324P04003 from the Department of Education
Agenda
 AM




PTR Overview
Step 1—Teaming
Step 2—Goal Setting
Step 3—PTR Assessment
 PM





Step 4a—PTR Intervention Plan
Step 4b—Coaching/Fidelity
Step 5—Evaluation
Questions/Wrap-up
Next Steps
Objectives
 Participants will:
 Describe the 5-step PTR Tier 3 support model
 Identify the critical components that enhance the success
of Tier 3 supports
 Apply the principles of the PTR process to a case study
 Determine how the PTR process is applicable within their
setting
Tier 3 Function-Based Behavior
Interventions in Schools
 Current Issues






Absence of uniform policies & practices
Form versus a process
Expert driven versus collaborative effort
Occasionally contextual fit considered
Limited support/follow-up/training for teacher provided
Teachers may not be the personnel to facilitate FBAs in
schools
 Increased focus on school psychologists (Scott & Kamps,
2007) and other school-based behavioral consultants or
“coaches”
Prevent-teach-reinforce
The Model
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
Participants
 200+ students—100 treatment, 100 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
Prevent-Teach-Reinforce: PTR
 Intervention teams given manual and
assigned PTR consultant
 Five step process (aligned with problem
solving process):




Teaming
Goal Setting (Identification of Problem)
Functional Assessment (Problem Analysis)
Intervention (Intervention Implementation)
 Coaching and fidelity
 Evaluation (Monitoring and Evaluation of RtI)
PTR Preliminary Outcomes
Student Demographics by Primary Disability
Disability
Autism
N
Percent
25
9.8
Developmental Delay
5
2.0
Emotional Disturbance
38
14.9
Mental Retardation
28
11.0
Multiple Disabilities
4
1.6
OHI (not ADD/ADHD)
1
.4
OHI (ADD/ADHD)
8
3.1
Specific Learning Disability
20
7.8
Speech/Language Disability
10
3.9
2
.8
99
245
38.8
Visual Impairment
General Education
TOTAL
Student Description
Grade Level
K
1
2
3
4
5
6
7
8
N
34
53
53
41
30
16
7
8
3
%
13.9
21.6
21.6
16.7
12.2
6.5
2.9
3.3
1.2
77
150
31.4
61.2
45
200
18.4
81.6
Lunch Status
Regular
Free/Reduced
Gender
Female
Male
Outcomes
 Student Outcomes:
 Treatment and control group comparison resulted in
significant differences (p < .001; moderate effect sizes
(.44 to .55)
 Intervention students:
 Social Skills Rating System (SSRS): Problem Behavior
scores decreased
 SSRS: Social Skills scores increased
 Academic Engaged Time scores increased
Randomized Controlled Trial Results
AET
0.7
AET ratio
0.6
Treatment n =
126
0.5
Control n=98
0.4
0.3
p<..01
g = .51
0.2
0.1
0
Baseline
Post-test
Time Interval
Cross-Over Treatment Results
Social Skills
90
88
86
84
82
Social Skills
AET
80
60
78
76
Baseline
50
Post-test
40
30
AET
20
Problem Behavior
10
124
0
122
Baseline
120
118
Problem
Behavior
116
114
112
110
Baseline
Post-test
Post-test
Teacher Outcomes
 Fidelity



Majority of teachers achieved .80
Mean # coaching/training sessions = 3.5
Prevention higher than Teach and Reinforce
 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)
 Alliance


Teachers rated PTR consultants highly (4.80 mean)
Highest—trust, follow-through, collaborative
The PTR Process
Step 1: Teaming
 Teaming: A collaborative process
 Members
 Person with knowledge of student (e.g., Classroom teacher,
instructional assistant, parent)
 Someone with expertise in functional assessment, behavioral
principles (PTR consultant, school-based consultant)
 Someone with knowledge of context (e.g., administrator or
designee)
Step 1: Teaming
 Purpose:
 Evaluate strengths and weaknesses of team functioning
 Outline roles and responsibilities
 Determine a consensus-making process
Collaboration Activity
(page 2 Activity Packet)
Step 1: Teaming
 Forms for creating an effective cohesive team
 Classroom Team Survey (pg. 18 book; pg. 2-3 blank)
 Teacher Work-Style Survey (pg. 19 book; pg. 4 blank)
 Paraeducator Work-Style Survey (pg. 20 book; pg. 5
blank)
 PTR Work-Style Comparison Sheet (used by facilitator)
(pg. 21 book; pg. 6 blank)
 Purposes: To identify potential issues enhancing and
impeding effective intervention implementation
Step 1: Teaming Facilitation
Tips
 Avoid direct confrontation or “fixing” issues
 Purpose is for team to recognize potential issues that
enhance and inhibit problem solving process
 Less talk, more listening and facilitating
 Provide visual summary of results to each team
member
 Ask them to review the results and reflect
 Ask for their ideas, reactions, input
 Facilitate the discussion
Step 1: Teaming Case Study
 Mike
 9-year-old male
 ESE Classification: Autism
 Placement: Self-contained, autism classroom with 6
students (wide age range)
 Nonverbal: Uses signs, Dynamite, pictures to
communicate
 Team: Teacher and two aides, PTR Consultant
TEAMING ACTIVITY:
MIKE
ACTIVITY PACKET
pages 3-5
Step 1: Teaming Activity
Instructions
 Get with a “team”
 Review the work-style survey responses (page 3) and
the teaming survey (pages 4-5) from Mike’s team
 Identify potential issues that may impact how the team
functions
 Discuss how you would facilitate a discussion with the
team about the issues
Step 1: Discussion
 What do you need in order to facilitate Step 1?
 How will you use this step?
 What forms will you be using?
Step 2-Goal Setting
Identify the problem
What Determines Success?
 Analysis of outcomes of 800+ consultation cases
involving elementary students
 Problem identification = 43%
 Problem analysis & plan development = 31%
 Goal attainment occurred in 97% of cases in which a
plan was implemented
 “consultants successful in identifying problems were
almost invariably able to solve those problems”
Bergan & Tombari, 1976
Step 2: 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
 Targeted Areas:
 Problem behaviors
 Social skills
 Academic behaviors
Step 2: Goal Setting
(pg. 7-9 blank forms; pg. 38 book)
Behavior
Broad Goal
Social
Academic
Broad outcomes desired
(what is the overall goal to be achieved in each
category)?
Short-Term
Inappropriate behaviors preventing student from
Goal: Behavior achieving long-term goals
to Decrease
(current problem behaviors/deficits)
Short-Term
Skills to be taught to replace inappropriate behaviors
Goal: Behavior (skills to replace problem behaviors that will achieve
to Increase
broad goal)
Case Study—Step 2: Goal Setting
Increase
Decrease
Broad
Behavior
Social
Academic
Mike will communicate his Mike will interact with
wants and needs
peers appropriately
appropriately
Mike will comply with
non-preferred activities
and requests
Mike will decrease
screaming, hitting, and
getting out of his seat
Mike will decrease
hitting, screaming at,
and bossing his peers
Mike will decrease
screaming and hitting
Mike will ask for a break
or for attention when
needed
Mike will initiate peer
interactions using his
Dynamite
Mike will engage in nonpreferred activities and
communicate his
frustration using his
Dynamite or an
appropriate tone
Step 2: Data Collection System
Behavior Rating Scale – BRS (pg. 10 blank forms; pg. 39 book)
 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
Step 2: Behavior Rating Scale
(BRS)
 Behavior recorded at least once each day
 Specific time period/routine
 Whole day
 Combination of both
 Anchors –scale of 1-5
 Measure options:




Frequency
Duration
Intensity
Percentage of opportunities
BRS Guiding Questions
 In which routine(s) will you be rating the behavior?
 What would be the easiest way to track the behavior?
 How often it occurs?
 How long it lasts?
 How intense it is?
 What is your estimate of the behavior happening on a
typical day?
 Problem behavior = 4
 Appropriate behavior = 2
 What would the behavior look like on a great day?
 Problem behavior = 1
 Appropriate behavior = 5
Case Study - Mike: Operational
Definitions
 Problem behaviors
 Screaming—loud, high pitched noise heard outside the
classroom
 Hitting—anytime Mike touches peers or adults with an
open hand, fist, foot, or object while screaming or
protesting
 Replacement/Appropriate Behaviors
 Express frustration appropriately using Dynamite,
pictures, or signs to ask for a break or attention
 Transition to non-preferred activities: Moving to nonpreferred activity and engaging with appropriate verbal
expression
01/15
Case Study- Mike: Behavior Rating Scale
Behavior
Screaming
9+ times
7-8 times
5-6 times
3-4 times
0-2 times
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
Hitting
8+ times
6-7 times
4-5 times
2-3 times
0-1 times
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
Expressing
Frustration
40%+
30-40%
20-30%
10-20%
0-10%
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
Transition to
Non-preferred
Whimper or squeal
Louder than indoor voice
Outdoor play voice
Louder than outdoor play
Ear penetrating
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
BRS Psychometrics (Preliminary)
 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
 Iovannone, Greenbaum, Wei, Kincaid, & Dunlap (in
review)
Other Uses of BRS
 Systemic data tracking method for Tier 3
 Sample system created by:
 Cindy Anderson
 School district in Florida
Secondary Level Modifications
 Teams with 3 or more members
 Select one team member who will be the primary interventionist
 Behavior identification and BRS development will be focused
on that person’s situation
 Other team members provide input/support
 If desired, other team members can record BRS 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 BRS
 Consultant/coach collects all BRS ratings at specified times
Step 2a Activity:
Developing a
Behavior Rating Scale
(BRS)
Step 2: BRS Group Activity
• Setting up a Behavior Rating Scale
• One volunteer
• Identify a behavior of concern
• As a group, walk through the steps to set
up the scale
BRS Problem Behavior:
Group Activity
Behavior
Anchors
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
5
4
3
2
1
Activity—Step 2b
Activity Packet—Page 6
Step 2 Activity Instructions
 Watch the video of Paris
 Identify one problem behavior
 With your team, agree upon an operational definition of
the behavior
 Write it on the goal form, second row (decrease)
 What would you target as a replacement behavior?
 Clearly define the behavior and write it on the third row
(increase).
Activity (page 7 Activity Packet)
 In your teams, identify one student you know with
serious problem behaviors.
 As a team, identify one behavior you would like
decrease for this student
 Define it in clear, measurable terms
 Identify a behavior you would like to see increase that
may replace the problem behavior
 Define it in clear, measurable terms
Facilitation Tips
 Have team members submit the goal setting table as
homework
 Have a visual that summarizes all of the input
 Do not reword input—wait until meeting to have team
provide clarification
 If step is conducted during problem solving meeting, use
group processes to ensure all team members participate
 Use post-it notes or index cards and provide several to each
team member
 Use 2 minute thinking time, have team members write input on
notes/cards
 Use round robin to get input from all
Step 2: Discussion
 What do you need in order to facilitate Step 2?
 How will you implement this step?
Step 3:
Functional behavior
assessment
Analyze the Problem
Given 60 seconds, use 4 straight lines to
connect all of the dots without lifting
your pen (Page 8 Activities)
A box to think outside of:
Child
Step 3: PTR Functional
Assessment
 PTR Assessment (FBA) (pp. 56-61 book; 9-13 activity;
12-16 blank forms)
 Checklist format
 Prevent = antecedents
 Teach = function, possible replacements
 Reinforce = consequences, possible reinforcers
 One form completed for each problem behavior by each
team member
 Information leads to hypothesis
Step 3: Prevent Section (First 2
pages of Assessment)
 Read the questions
 Be prepared to discuss the questions in this section
Step 3: Activity (pages 9-10
Activity packet)
Practice using this section with regard to a student you
know.
Step 3: Teach Section
 Read and discuss the questions in this section
Step 3: Activity (Pages 11-12
Activity Packet)
Practice using the Teach section with regard to a student
you know.
Step 3: Reinforce Section
 Read and discuss the questions in this section
Step 3: Activity (Page 13 Activity
Packet)
Practice using the Reinforce section with regard to a
student you know.
Step 3: PTR Assessment Table
(pg. 18 blank forms, pg. 62 book)
 Used by consultant to summarize all information from
PTR Assessment
 Responses organized and categorized
 Information requiring clarification listed
 Draft hypotheses developed
 “Cheat sheet” (page 17 blank forms; page 16 Activity
Packet)
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
Step 3: Case Study – Mike
Assessment Summary Table of Problem Behavior
Prevention Data
Screaming, Hitting
Non-preferred task
Reading,
Math
 Other students upset/mad
Teacher attending to others
Transition
Preferred to
non-preferred
Change in schedule
Denied item, told no, or to
fix something
Teach Data
Gain attention
Reinforce Data
Redirected
Peers,
Reprimanded
adults
Calm/soothe
Delay
Personal space
Later must
complete task
Access to items
Loss of or delay in
reinforcement
Step 3: Case Study – Mike
Assessment of Appropriate Behavior
Prosocial
Prevention Data
Teach Data
Reinforce Data
Independent work
Peer interaction
Treasure box
One-on-one
Getting attention
Movie
attention
Specials
Raising hand
Attention
Sharing attention
Helping teacher
Conversation skills
Going to media
Taking turns
center
Going outside
Walk
Food
Waiting
Self-management
Asking for break
Expressing
emotions
Step 3: Developing the Hypothesis
When….
Student will…. As a result…
Inappropriate
Behavior
Appropriate
Behavior
 Prevention data = antecedents or triggers
 Teach data = replacement behavior and possible function
 Reinforce data = function and reinforcers
Step 3: Case Study – Mike Hypotheses
Appropriate
Inappropriate
When….
he will
As a result…
Mike is asked to complete nonscream and hit
preferred tasks (Reading, Math),
stop preferred activity or transition
to non-preferred activity, fix an
error, or when teacher is attending
to other students
Mike is able to
gain attention and
delay the
transition/activity
Mike is asked to complete nonpreferred task (Reading, Math),
stop preferred activity or transition
to non-preferred activity, fix an
error, or when teacher attending to
other students
express his
frustrations
appropriately
Mike is able to
delay the
transition/activity
complete the
assigned task
Mike is able to
gain attention
Facilitation Tips
 Team members complete for homework
 During meeting, use as an interview
 During meeting, give each team member 15 minutes to
complete. Give 15 minute break to allow time for
facilitator/coach to synthesize information in
Assessment Organization Table
 Secondary: May want to change forced choice options
to make appropriate for secondary environments
Step 3 Activity: Paris
Activity Packet Pages 14-15
Step 3: Activity Instructions
 Review the PTR Assessment Summary for Paris (on
page 14)
 Develop a problem behavior and appropriate behavior
hypothesis (use form on page 15)
 Feel free to use the cheat sheet (page 16)
 Be ready to share
Step 3: Activity (Page 17 Activity
Packet)
Practice using the PTR Assessment Organization Table to
organize your PTR Assessment information you
completed on the child you know and develop a draft
hypothesis.
Use the ‘cheat sheet’ on page 16 to assist.
Step 3: Discussion
 What do you need in order to facilitate Step 3?
 How will you implement this step?
Step 4: PTR Behavior
Intervention Plan
Implement Behavior Interventions
Step 4: Behavior Intervention Plan
 Team selects interventions from each component (P-TR) (pg. 19 blank forms; pg. 102 book; page 20 blank
forms secondary version)
 Detailed behavior plan developed (template pp. 23-24
blank forms; pp. 104-105 book)
 Consultant provides training and on-site assistance with
plan implementation
 Implementation fidelity evaluated
Step 4:
Using the Intervention Checklist
 Record each team member’s rank on the checklist (pp.
21-22 blank forms; pg. 103 book)
 Develop a list of preferred interventions




Mean of ratings
Interventions rank ordered #1
Number of people selecting specific intervention
*Be sure to make note of interventions ranked
highest/selected by teacher
Case Study: Tips on Linking
Interventions to Hypothesis
 Prior to selecting interventions, “guidelines” provided to
participants
 Prevention strategies should:
 Get Mike attention more often
 Modifying non-preferred tasks
 Changing what happens when he makes a mistake
 Signaling end of preferred activity
 Teach strategies should address:
 How to get attention/assistance
 How to get break/delay appropriately
 Reinforce strategies should:
 Give Mike attention/help
 Give Mike break/delay
Step 4: Intervention Checklist
Summary
 Discuss interventions selected by the team
 Team gains consensus on the interventions to be
implemented
 PTR consultant ensures interventions:
 Agree with hypothesis
 Can be done in the classroom
Step 4: Writing the Intervention
Plan
 Task analyze each step of the plan
 NOT— “give student choices”
 YES— Prior to the start of independent reading, tell the
student “we have 2 worksheets today” (show worksheets).
“Which worksheet would you like to do first?”
 If teachers do not know how to do it, they will not
implement the strategy.
Step 4: Case Study – Mike’s BIP
Prevent
Strategies
Environmental
Support
Specific Strategy steps
A wait card will be placed on Mike’s desk to assist him in
remembering to wait his turn.
1. Prior to group work, tell Mike, “Remember, when it is
someone else’s turn, you sit quietly and wait,” while pointing to his
card.
2. If Mike calls out, point to his visual to remind him what to do.
3. Use a verbal prompt if the point prompt does not work.
Mike’s Intervention Plan
Prevent
Strategies
Environmental
Support
Specific Strategy steps
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.
1. Prior to the start of the activity, Mike should review the visual
schedule.
2. As Mike completes an activity, he should X off the activity.
Mike’s Intervention Plan
Prevent
Strategies
Curricular
Modification
Specific Strategy steps
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
Teach
Strategies
Replacement
Behavior
Specific Strategy Steps
Mike will be taught to use his voice output device to
express his need to calm down.
Steps:
1.
2.
3.
4.
5.
6.
7.
Mike’s device will be programmed to say “I need to calm
down.”
Prior to transitioning to a non-preferred activity or at the end
of a preferred activity, say “If you start to get mad, you can
choose to calm down.”
As soon as Mike starts to get upset, prompt him to use his
device (hierarchy—hand-over-hand, gesture, verbal).
Once Mike communicates “I need to calm down”, present
him with the choice board of calming strategies and ask him,
“What do you want?”
As soon as he is calm, praise him (e.g., “You made a good
choice.”.
Allow Mike to engage in his choice until he is calm for 1minute.
If Mike does not want to leave his choice, then start
becoming animated with students in the non-preferred
activity.
Teach
Strategies
SelfManagement
Specific Strategy Steps
Mike will be taught to independently use his calming
strategies.
1. A tracking sheet with smiley faces and sad faces will be
given to Mike at the start of each day.
2. Role-play with Mike about when he needs to make the
choice to calm down.
3. Practice completing the tracking sheet.
4. Set and review the daily goal for using the calming
strategies.
5. Prompt Mike to complete the tracking sheet if needed
Reinforce
Strategies
Specific Strategy Steps
Replacement
Behavior
Anytime Mike “says” “I need to calm down”, his choice board
should be given.
1. Praise Mike for communicating (“thank you for telling me
what you need.”)
2. Provide his choice board.
3. Allow him to calm for 1 minute
4. Praise him as soon as he is quiet
5. Praise him for returning to the group
SelfManagement
Anytime Mike scores his behavior, attention should be given.
1.
2.
3.
4.
Waiting
When Mike marks his tracking sheet, praise him for
doing so.
At the end of the day, review the sheet with Mike.
Talk about the sad faces.
Provide his reward if his goal is met.
Mike will earn a skittle paired with attention if he waits. This
will be faded to an intermittent schedule.
Reinforce
Strategies
Specific Strategy Steps
Transition Mike will earn stars during Reading Centers if he
transitions and completes his work without screaming.
1.
2.
3.
4.
5.
A social story will be reviewed prior to Reading
Centers to remind Mike that he can earn a star if he
comes to centers and works.
At the end of each reading center, an adult will review
Mike’s behavior with him and ask him if he earned his
stars.
Provide his stars if earned.
During the teacher’s group, Mike can earn 2 stars: 1 for
transitioning to the group and 1 for working during
group.
Allow Mike to participate in his chosen activity if he
earned his stars.
Discuss PTR Intervention
Plan
 How is the PTR intervention plan and level of detail
different from current BIPs?
 How will the level of detail make a difference in
implementation and effectiveness?
Step 4 Activity: Paris
Intervention Plan
Activity Packet Page 18
Step 4 Paris: Activity Instructions
 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
TEACH replacement behavior intervention for Paris
(page 18).
Step 4: Coaching SupportTeacher Training on BIP
 Provide opportunity to practice the plan with the
teacher (team) without the students present (30-90
minutes)
 Role play, Q & A, Discuss
 Evaluate teacher accuracy on each step prior to
teacher implementing plan with student
 Coaching Checklist used by PTR for
training evaluation (pp. 25-26 blank forms;
pg. 106 book).
Task Analysis of Intervention
Discuss
Q&A
Verbal
Role-play
Observe
Feedback
Case Study: Sample Coaching
Checklist for Mike
PREVENT – Environmental Support
1. Mini schedule of group & center time available
2. Schedule reviewed prior to task
3. Schedule reviewed & items crossed off
TEACH – Replacement Behavior
1. Remind to use Dynamite prior to transition
2. Provided choice board and honored choice
REINFORCE –Replacement Behavior
1. Verbally or gesturally acknowledge ASAP
2. Allowed to cool off for 1-minute
TOTAL (# Yes/ # Total)
Fidelity Score ( .00 – 1.00)
Training
Review
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Step 4: In-Class Support
 Provide support to teacher in
implementation
 Be present on first day of
implementation
 Determine when to debrief
 Measure fidelity
 Discuss and modify if necessary
Step 4: Intervention Fidelity
 Measure teacher implementation of plan (pg. 107
book)
 PTR—Two fidelity measures
 Adherence—did they do it?
 What is the most important part of intervention to be
implemented to ensure intervention happens?
 Quality—did they do it correctly?
 What are all the parts that need to be implemented
completely and correctly?
Case Study: Fidelity
Interventions
Environmental Support
1) Mini schedule of center & group available
2) Mini schedule reviewed prior to start of
centers
3) Items crossed off as completed
Replacement Behavior—Functional
1) Reminded student to use DynaVox prior to
transition & when student engaged in
warning signs
Reinforce Replacement Behavior
1) Teacher immediately recognized student
for using DynaVox (within 15 s)
2) Choice board given
2) Choice honored
3) Allowed to calm down for at least 1-minute
Adherence
Quality
Mini schedule Mini schedule
present
present & reviewed
at least either prior to
or after activities
completed
Teacher
Teacher reminded
reminded
student prior to at
student prior
least 2 of 3
to transition
transitions & all
behavior
Choice given Teacher immediately
and honored (within 15 seconds)
recognized student
and allowed student
to calm down
Other Methods of
Collecting Fidelity
Teacher Fidelity SelfAssessments
 Daily Fidelity Self-Check (sample pg. 27 blank forms)
 Teacher has major steps of intervention
 Provides them with nonintrusive prompts
 Weekly Fidelity Self-Check (pg. 29 blank forms)
 Aligned with Behavior Rating Scale
 Can be used with Excel Spreadsheet
Activity 4b: Coaching/Fidelity
Pg. 19 Activity Packet
 Develop a fidelity measure for the replacement
behavior intervention your team developed for Paris
Step 4: Facilitation Tips
 Secondary—modify menu of interventions to include those appropriate for
middle/high school
 Teams can select interventions for homework or can select during team meeting
 Focus on one routine, class, subject for developing intervention
 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.
 Fidelity measurements can be done once or twice a week rather than daily
 One form can be used for training and fidelity
 Use technology (video, Skype, Wiki, Facebook) to provide support to teachers
Activity (page 24-25 Activity
Packet)
 Brainstorm ideas on possible prevent, teach, and
reinforce interventions that would be appropriate for
your student’s hypothesis
 Begin to task analyze the interventions
Step 4: Discussion
 What do you need in order to facilitate Step 4?
 How will you implement this step?
Step 5: Evaluation
 Is it working?
 BRS and/or other data measures
 Is it being implemented consistently and accurately?
 Fidelity ratings
 Are more data needed?
 Does the plan need to be modified or expanded?
 How can the team maintain the interventions?
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Step 5: Mike Evaluation
Screaming
Baseline
Intervention
4
Definition
Changed
3
2
1
Step 5: Evaluation
Hitting
Intervention
Baseline
5
Rating
4
3
2
1
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Rating
Step 5: Evaluation
Expression of Frustration
5
Baseline
Intervention
4
3
2
1
Step 5: Evaluation
Transition to Non-Preferred
Baseline
5
Rating
4
3
2
1
Intervention
Step 5: Evaluation
Mike Outcome Data
Measure
Baseline
Post-test
Change
SSRS-PB
123
112
-11
SSRS-SS
87
102
+15
AET
.34
.57
+23
Social Validity
(pp. 30-31 blank forms; pp. 120-121 book)
 Social validity—Acceptance and effectiveness of
intervention
 Highly correlated with intervention implementation and
maintenance
 Provides data on functionality of intervention’
 Can be a pre-post measure
Teacher-Consultant Alliance
(page 32 blank forms)
 Provides data on relationship between facilitator (e.g.,
school-based behavior consultant) and implementer of
interventions (e.g., teacher)
 Can be used as pre-post test measure
 Provides core behaviors valued in consultant/teacher
relationship
 High correlation with teacher willingness to implement
interventions
Step 5 Activity Instructions
 Review the graphs and outcome data for Paris (Pages
20-23 in activity packet)
 As a team, what decisions would you make?




Continue with intervention
Modify or change intervention
Gather more data
Other????
 Justify your responses.
Step 5: Facilitation Tips
 When fading interventions, do so systematically.
 Consider Multi-tiered System of Supports (access to Tiers 1
and 2)
 Make all decisions on data
 ALWAYS review fidelity data
 ALWAYS review BRS data (or other child outcomes)
 Have decision rules (e.g.,3 consecutive data points at or above
goal line, fidelity score necessary to consider adequate
implementation, etc.)
 Remind team this is a dynamic process and behavior is
never “fixed”.
Step 5: Discussion
 What do you need in order to facilitate Step 5?
 How will you implement this step?
 How will you use the BRS or other evaluation
measures to make data-based decisions?
Review PTR Process
 Five-step team-based process
 Teacher/team driven
 Prescriptive/manualized process
 Support provided to teacher/team to implement interventions
 Every intervention plan includes 3 components
 Prevent
 Teach
 Reinforce
 Plans are task analyzed
References

Manual
 Dunlap, G., Iovannone, R., English, C., Kincaid, D., Wilson, K., Christiansen, K., & Strain,
P. (2010). Prevent-Teach-Reinforce: A school-based model of individualized positive
behavior support. Baltimore:Paul H. Brookes

Journal articles
 Iovannone, R., Greenbaum, P., Wei, W., Kincaid, D., Dunlap, G., & Strain, P. (2009).



Randomized controlled trial of a tertiary behavior intervention for students with problem
behaviors: Preliminary outcomes. Journal of Emotional and Behavioral Disorders,17, 213225.
Dunlap, G., Iovannone, R., Wilson, K., Strain, P., & Kincaid, D. (2010). Prevent-TeachReinforce: A standardized model of school-based behavioral intervention. Journal of
Positive Behavior Interventions, 12, 9-22
Iovannone, R., Greenbaum, P., Wei, W., Kincaid, D., & Dunlap, G. (in review). Reliability of
the Individualized Behavior Rating Scale-Strategy for Teachers (IBRS-ST): A Progress
Monitoring Tool. Manuscript submitted for publication.
Next steps:
 Facilitating schools to scale up
 Training key school staff and team members to do process
Questions?