Three Tier Model for Preventing
Academic, Mental Health, Behavior Problems
Virginia W. Berninger
University of Washington
Director, Multidisciplinary Learning Disabilities
Research Center, Literacy Trek Longitudinal Study, and
The Write Stuff Intervention Project,
and School Psychology Internship Program
vwb@u.washington.edu
CASP March 4, 2005
Riverside, CA
Greetings from UW School Psychology Program,
Seattle, WA
Acknowledgements
NICHD RO1 25858
NICHD P50 33812
Graduate Students in School Psychology
Co-Investigators at the University of
Washington and External Consultants
Harcourt (norming research measures)
Research Evidence
Based on longitudinal study 1984-85 of
beginning reading
Based on NICHD-funded cross-sectional
research of writing and reading 1989-92
Based on NICHD-funded longitudinal and
instructional research on writing and
writing-reading connections 1992-2006
Research Evidence
Based on NICHD-funded Multidisciplinary
Research on Learning Disabilities: Links
between Biology and Schools 1995-2005
 School-based prevention and clinic-based
treatment
 Teacher training
 Family genetics
 Brain imaging
Today’s Presentation
Implementing a Three-Tier Model of
Assessment-Intervention Links:
The purpose of assessment is to plan and
introduce intervention to directly improve
academic learning (treatment validity),
which indirectly improves mental health
and behavior,
especially if coupled with C3
Questions to Ponder
1.
2.
3.
Would Larry P against California have happened if
schools were using diagnostic instruments validated for
prevention and treatment validity coupled with C3?
Are tests (particularly IQ tests) the culprit? Or, is the
problem practitioners’ lack of scientific knowledge of
individual differences in learners relevant to academic
learning and of effective instructional practices?
Are educational practices that do not promote caring,
connecting with children and their families and
communities, and communicating effectively with
children and their families at the heart of school failure
and school drop out?
UW Three-Tier Model
for Psychologists
Tier 1: Screen for Early Reading and Writing
Intervention
Tier 2: Assess and Modify Curriculum and
Instruction to Increase Number of Students
Meeting State Standards and Passing High Stakes
Tests
Tier 3: Differential Diagnosis, Treatment Planning
and Implementation, and Brain and Behavioral
Progress Evaluation for Treating Persisting
Reading and Writing Problems
Other 3-Tier Models
Health: Universal (prevention), Secondary,
and Tertiary
Education: Core Curriculum in General
Education, Supplementary
Instruction in General Education,
Special Education
Validating Tests on Basis of Using Them
to Bring about + Student Change
Psychometric Properties Necessary
• Reliability
• Concurrent and Construct Validity
Psychometric Properties Not Sufficient--Links
to Instruction Also Necessary
• Treatment Validity
Tier 1 Screening
Step 1: Assess Reading and Writing Skills
Administer standardized tests of real word
and pseudoword and passage oral reading
accuracy (grades 1 and 2) and rate (grades
2 and 3), handwriting (grades 1 to 3) , and
spelling (grades 2 and 3).
If rate low, give accuracy measures too.
Tier 1 Screening
Step 2: Research-Supported Process Assessment
 For students below mean on real word or
pseudoword reading or spelling, assess
phonological coding/awareness,
orthographic coding/awareness, rapid automatic
naming, and rapid automatic letter writing (grades
1, 2, 3).
 For students below mean on handwriting,
administer orthographic coding and finger sense.
Tier 1 Treatment
Step 3: Go directly to treatment!
Linked to the process weakness
Linked to research-supported instructional
component for teaching reading or writing
Tier 1 Test Battery
Real Word Reading and Pseudoword Reading:
Accuracy: WRMT-R, WJ-III, WIAT II
Rate: TOWRE Word and Phonemic Efficiency
Phonological Coding/Awareness: CTOPP elision, PAL
Syllables and Phonemes
Orthographic Coding/Awareness: PAL Receptive Coding
Rapid Automatic Naming--Letters: Wolf & Denckla, PAL
single letters and letter clusters
Rapid Automatic Letter Writing: PAL Alphabet Writing
Note: Other standardized measures for the same processes
can be substituted.
PAL 2001 Phonological Assessment
Rhyming: Analysis (odd one out of three)
tell lake well
Generation hat
Syllable Segmentation:
Say Jabberwocky without er.
Phoneme Segmentation: Identifying remaining
sounds when
all but one phoneme is omitted. Say
jabber without /abber/.
a single phoneme is deleted. Say
jabber without /j/.
PAL 1998a Phonological Lessons
(pp. 196-219)
Four games played to develop syllable
segmentation skills:
 Find the Hidden Is ant hidden in can’t? in
Andy?
 Say the Missing Say carelessly. Now say lessly.
What is missing?
 Say the Word Without Say friendliness. Now
say it without ness.
 Substitute Say garden. Now don’t say it with
den, say it with ter.
PAL 1998a Phonological Lessons
(pp. 196-219)
Four games played to develop phoneme
segmentation skills:
 Find the Hidden
Does the word begin with
/m/ as in mother? make? time?
 Say the Missing Sat mice. Now say ice. What is
missing?
 Say the Word Without Say wave. Now say it
without /w/.
 Substitute Say sad. Now say it with /h/ instead of
/s/.
PAL 2001 Assessment of
(Receptive Orthographic Coding) (STM/WM)
because
PAL 2001 Assessment
Orthographic Coding
because
PAL 2001 Assessment
Orthographic Coding
because
PAL 2001 Assessment
Orthographic Coding
became
PAL 2001 Assessment
Orthographic Coding
because
PAL 2001 Assessment
Orthographic Coding
o
PAL 2001 Assessment
Orthographic Coding
because
PAL 2001 Assessment
Orthographic Coding
a
PAL 2001 Assessment
Orthographic Coding
because
PAL 2001 Assessment
Orthographic Coding
ua
PAL 2001 Assessment
Orthographic Coding
because
PAL 2001 Assessment
Orthographic Coding
au
PAL 1998a Orthographic Lessons
(pp. 192)
 Show written word (on chalk board, overhead, or written
list at student’s desk) from the reading or spelling
curriculum briefly (about 1 second) with this instruction
while sweeping finger under the word in left to right
direction: “Look carefully at each letter in this word.”
 Then cover the word with a card and ask the children to
spell the word or write a designated letter or letter group
(orally taking turns or everyone writing independently).
 Then uncover the word and play one of the games on the
next slide.
PAL 1998a Orthographic Lessons
(pp. 192)
1. Direct children to look carefully at this written word:
breakfast
2. Cover word for about 1 second.
3a. Whole Word Game: Now spell what you saw (do not
name the word—so children have to rely on memory for all
the letters in the word).
breakfast
3b. Letter in a Word Game: Now name (or write) the
first letter in the word (then the last letter). b, t
3c. Letter Groups/Clusters in a Word Game: Now
name (or write) the first two letters (br), the last two words
(st), the third and fourth letters (ea).
PAL 2001 Rapid Automatic Letter
Naming (RAN) (mouth)
Name the letters as accurately and quickly as
you can without making a mistake. Go in
order starting here. When you finish one
row go onto the next row and keep going
until you finish the last row.
b h n d o t a r
th oa br nd
PAL 2001 Assessing Rapid
Automatic Letter Writing (hand)
Print the letters of the alphabet in
order as accurately and quickly as
you can without making a mistake.
Use manuscript not cursive
writing.
PAL 1998b Handwriting Lessons for
Treating Slow RAN and Letter Writing
• Each lesson consists of 4 pages of letter models
and space to practice each of 26 letters once and
lined paper with composition topic to compose for
5 minutes. Each lesson can be used up to three
times.
• 24 lessons in ball and stick lower case manuscript
letter and 24 lessons in lower case manuscript
D’Nealian.
PAL 1998b Handwriting Lessons
Instructions: “Study the numbered arrow cues in
____(name letter). Cover ____(name letter). (Start with 1
sec delay between covering and writing letter and
increase.) Now write_____(name letter).
Compare_____(name letter) to the model letter. If your
____(name letter) looks different from the model letter, fix
it so it looks the same. ”
Instructional Adaptation: Ask children to name letters as
they write them.
Teach for Transfer to Composing
Important Instructional Design Features:
Only practice each letter once in a lesson
(avoids habituation)
Always compose for 5 minutes and share
with peers
PAL 1998a Alphabet Retrieval Game (pp.
193) for Improving Automatic Retrieval
• Name or Write the letter that comes after
these letters: a, s, w, g, m.
Name or Write the letter that comes before
these letters: u, r, t, l, i.
24 sets of five after and five before items to
use in the context of a writing lesson aimed
at all levels of language.
Processes Assessed, Learned, and
Taught within Functional Systems
Reading and Writing are Functional Systems
(Luria, 1970) that draw on multiple processes
(some shared and some unique) to achieve a
variety of goals.
:. Implement process treatment in lessons teaching
all the necessary processes close in time and
coordinate their timing to achieve fluency and
high-level, meaning goals (Berninger & Abbott, 2003).
Translating Tier 1 Research
into Lessons Teachers Can Use
PAL Research-Supported Reading and Writing Lessons
(Harcourt/PsychCorp, 2003)
I. Reading
Lesson Set 1 Alphabet Principle  Monosyllabic
Words  Reading stories
Lesson Set 2 Alphabet Principle  Polysyllabic
Words  Reading and Summarizing
stories
Translating Tier 1 Research
into Lessons Teachers Can Use
PAL Research-Supported Reading and Writing Lessons
(Harcourt/PsychCorp, 2003)
II. Writing
Lesson Set 3 Alphabet Principle  Copying Words
Words  Composing
Lesson Set 4 Alphabet Principle  Spelling Monosyllabic
Words Composing with High
Frequency Grade-Appropriate Words
Lesson Set 5 Alphabet Principle  Spelling Polysyllabic
Words Composing with Teacher Generated Topics
Reading More about the
Three Tier Model
Berninger, V., Stage, S., Smith, D., & Hildebrand, D. (2001). Assessment
for reading and writing intervention: A 3-tier model for prevention and
intervention. In J. Andrews, H., D.Saklofske, & H. Janzen (Eds.).
Ability, achievement, and behavior assessment. A practical handbook
(pp. 195-223). New York: Academic Press. sstage@u.washington.edu
for additional publications about problem solving consultation.
Berninger, V. (2002). Best practices in reading, writing, and math
assessment-intervention links: A systems approach for schools,
classrooms, and individuals. In A. Thomas & J. Grimes (Eds.) Best
Practices in School Psychology IV. Vol 1 (pp. 851-865). Bethesda,
MD: National Association of School Psychologists.
Tier 1 Contribution to Bridging
General-Special Education Gap
 Prevents learning problems in general education
 Will be emphasized in the reauthorization of
IDEA
 Requires partnerships among school
psychologists, speech and language specialists,
special education teachers AND general education
teachers
 Contributes to educational evolution (optimizing
learning of all students)
Preventing Mental Health Problems
through Academic Instruction
Current treatment research uses usual treatment as
the control. Counseling did not lead to added
gains beyond academic instruction.
Weiss, B., Catron, T., Harris, V., & Phung, T.
(1999). The effectiveness of traditional child
psychotherapy. Journal of Consulting and
Clinical Psychology, 67, 82-94.
Preventing Behavior Problems
through Teacher Consultation
1. Visit Dr. Sylvia Rosenfield’s website on
statewide school consultation model.
www.icteams.umd.edu
2.
and Dr. Carol Lidz’s website for dynamic
assessment
www.dynamicassessment.com
Preventing Mental Health Problems through
Research-Supported Social Skills Training
Committee For Children
www.cfchildren.org Phone Number 800-634-4449.
• Second Step
• Grossman, D.C., Neckerman, H.J., Koepsell, T.D., Liu, P.Y., Asher,
K.N. Beland, K., Frey, K.S. & Rivara, F.P. (1997). The effectiveness
of a violence prevention curriculum among children in elementary
school. Journal of the American Medical Association, 277, 16051611.
• Frey, K. S., Nolen, S. B., VanSchoiak-Edstrom, L., & Hirschstein, M.
(2005). Evaluating a school-based social competence program:
Linking behavior, goals and beliefs. Journal of Applied Developmental
Psychology, 26, 171 – 200.
Preventing Mental Health Problems through
Research-Supported Social Skills Training
Committee For Children
www.cfchildren.org Phone Number 800-634-4449.
• Van Schoiack, L., Frey, K. S., & Beland, K. (2002).
Changing adolescents' attitudes about relational and
physical aggression: An early evaluation of a school-based
intervention. School Psychology Review, 31, 201-216.
• Steps to Respect—due out in the May Issue.
• Frey, K. S., Hirschstein, M. K., Snell, J. L., Edstrom, L. V.,
MacKenzie, E. P. & Broderick, C. (in press). Reducing
playground bullying and supporting beliefs: An
experimental trial of the Steps to Respect program.
Developmental Psychology.
Preventing Mental Health Problems through
Research-Supported Mental Health Prevention
Contact Dr. Carolyn Webster Stratton for
research-supported strategies for parents
and schools to use with conduct disordered
children. cws@u.washington.edu
Contact Dan Lovitt
(dlovitt@u.washington.edu) and request
paper on “Emotional Coaching in the
Classroom”
Facilitating School Success through
Enhancing Teacher-Student Relationships
Read Pianta, R. (1999). Enhancing
Relationships between Children and
Teachers. Washington, D.C. : American
Psychological Association.
School Psychologists
as Miracle Workers
The Los Angeles Unified School District (LAUSD) Partnership between
School Psychologists and General Education Teachers
Dr. Alnita Dunn, Psychology Services Coordinator in LAUSD, headed
the effort.
Participating school psychologists included: Debby Barth Carrera,
Rosalie Bell, Ph.D., Debbie Bloom, Patricia Burrows, Ruben
Carranza, June Durr, Christina Harrell, Erin Holman, Chris MealyUres, Nicole Mock, AnneMarie Serrano, Christine Toleson, Tiana
Thorpe, Reymundo Verastigui, and Didi Watts) and the teachers at the
participating schools (24th St. School, 96th St. School, 116th St.
School, Fernangeles, Fletcher Dr., Hoover St., Hyde Park Blvd.,
Kittridge St., Los Angeles Elementary School, Murchison St., Pio
Pico, Russell, Sierra Park, Westminster Ave., and Woodcrest.
Further Information on School
Psychology Partnerships
1.
2.
3.
Berninger, V., Dunn, A., Lin, S.., & Shimada, S. (2004).
School Evolution: Scientist-Practitioner Educators
Creating Optimal Learning Environments for ALL
Students. Journal of Learning Disabilities, 37, 500-508.
Berninger, V. , Dunn, A., & Alper, T. (2004). Integrated
models for branching assessment, instructional
assessment, and profile assessment. In A. Prifitera, D.
Saklofske, L. Weiss, & E. Rolfhus (Eds.), WISC-IV
Clinical use and interpretation (pp. 151-185). San
Diego, CA: Academic Press.
Articles by Dunn in CASP newsletter.
School Psychologists
as Miracle Workers
UW School Psychology Interns 2004-2005:
Care, Connect, and Communicate C3
and then implement research-supported
instruction
Proof in principle (stories of school
psychology interns)
Research into Practice within
3
C
Kindergartener with severe behavior problems
is retained—teacher wants the child in
special education
School psychology intern has read NASP
position paper on retention, assesses child
using research-supported tests, pinpoints
cognitive strengths and specific literacy
weaknesses
Research into Practice within
3
C
School has not contacted parent who does not have
phone. School psychology intern visits home and
invites mom to school, does “active” listening
about the family situation, and assists mom in
obtaining services through Catholic Charities.
School psychology intern uses consultation skills to
convince the kindergarten and first grade teacher
to allow the student to visit the first grade
classroom for reading instruction and to receive
supplementary, research-supported instruction to
work on weaknesses in literacy-related processes.
Research into Practice within
3
C
Evidence-based Outcomes:
Mom is now in recovery from addiction to
prescription drugs; child is visiting with
divorced dad.
Child remained successfully in 1st grade and
at the end of the year was achieving above
the national population mean in all reading
and writing skills.
Research on Tier 2 Interventions (to Meet
Standards) Also Transformed into Lessons
PAL Lesson Set 6.
PAL Lesson Set 7.
PAL Lesson Set 8.
PAL Lesson Set 9.
PAL Lesson Set 10.
Second Grade Reading
Third Grade Spelling and
Composing
Third Grade Handwriting,
Spelling, and Composing
Second Grade Reading
Fourth Grade Handwriting,
Spelling, and Composing
Research on Tier 3 Interventions
Also Transformed into Lessons
PAL Lesson Set 11.
PAL Lesson Set 12.
PAL Lesson Set 13.
PAL Lesson Set 14.
PAL Lesson Set 15.
Dyslexia Reading
Treatment I
Dyslexia Reading
Treatment II
Dyslexia Reading-Writing
Treatment I
Dyslexia Reading-Writing
Treatment II
Dyslexia ReadingTreatment III
PAL (Process Assessment of the Learner)
Disseminates UW Research on Assessment and Intervention
Available from Harcourt/Psycorp
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–
–
–
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1998a PAL Intervention Guides for Reading and Writing
1998 b PAL Intervention Kit (with Handwriting
Automaticity Lessons and Talking Letters)
2001 PAL Test Battery*, WIAT II
2003 PAL Research-Supported Reading
and Writing Lessons
*based on UW research but developed and normed on national sample by
Harcourt.
– NOT A CURRICULUM OR TEST TO BE USED IN ISOLATION OF
OTHER MEASURES=A WAY OF MAKING AVAILABLE TO
PRACTITIONERS RESEARCH-SUPPORTED ASSESSMENT AND
INTERVENTION (BASED ON PEER REVIEWED RESEARCH AND
THEN TRANSFERRED TO PUBLISHER WHO TRANSLATES THE
RESEARCH FINDINGS INTO A PRODUCT)