A PROJECT OF SERESC Developing a Screening Process for Determining Young Children in Need of Targeted Supports 2015 Alaska RTI Conference January 25, 2015 Howard Muscott, Ed.D, Director NH Center for Effective Behavioral Interventions and Supports Bedford, NH www.nhcebis.seresc.net; 603-206-6891; hmuscott@seresc.net Outcomes A PROJECT OF SERESC 1. Understand how Tier 2 supports fit into the 3Tier PWPBIS as Response to Instruction Framework 2. Identify three pathways for determining risk; 3. Develop a form for gathering information from staff; 4. Develop behavioral indicators and cut scores; & 5. Understand how to use a normed systematic screening assessment. 6. To learn about how screening was successfully used to implement Tiered Interventions in Head Starts Agenda A PROJECT OF SERESC 1. Overview of PWPBIS 2. Features of Tier 2 3. Pathways for Determining Risk 4. Teacher Nomination 5. Behavioral Indicators 6. Normed Screening Tools and Procedures 7. Post Screening Processes 5 A Systemic Multi-tiered Approach A PROJECT OF SERESC “PBIS has allowed me to address problems early before they escalated and became a crisis. The shift from reactive to proactive has been one of the best changes I’ve seen in all my years of consulting in Head Start programs.” NH Head Start Mental Health Consultant Program-wide Positive Behavioral Interventions and Supports A PROJECT OF SERESC 6 Muscott, Mann & Pomerleau (2008) PWPBIS is a systematic framework for improving valued social, emotional, behavioral and learning outcomes for young children in early childhood education programs. PWPBIS uses a broad set of evidence-based systemic and individualized strategies to effectively prevent and respond to challenging problem behavior and collaborate with families. PWPBIS is a strategic approach in which collaborative teams use effective group processes and data-based decision-making to achieve desired outcomes. 7 Program-wide Positive Behavioral Interventions and Supports Systems Supporting Decision Making A PROJECT OF SERESC Supporting Staff Behavior SYSTEMS PRACTICES Supporting Student Behavior and Families DATA Program-wide Positive Behavior Supports in Early Childhood Education Programs Tertiary Intervention: Function-Based Support for Children with Persistent Challenges Primary Promotion: High Quality Early Education for All Children Individualized Strategies Social and Emotional Teaching Strategies Secondary Prevention: Explicit Instruction for Groups of Children at Risk Preventative Practices Building Positive Relationships with Children and Families Muscott, Mann & Pomerleau (2008) Adapted from the Center on the Social and Educational Foundations for Early Learning 8 A PROJECT OF SERESC 9 10 Tier 1: Primary Prevention in ECE A PROJECT OF SERESC Tier 1, primary prevention, is designed to address the whole population in the ECE program While applied to the entire preschool, the emphasis here is on reaching the approximately 80-90% of young children who do not have serious behavior problems or mental health needs The purpose of universal strategies is to maximize learning, deter problem behavior, and increase positive peer and adult interactions 11 Tier 1: Primary Prevention in ECE A PROJECT OF SERESC All children should receive sufficient density of positive feedback from their caregivers. All families should be positively engaged. Building Positive Relationships with Children and Families Sources: Shores, Gunter, & Jack, 1993; Brendekamp & Copple, 1997). 12 Tier 1: Primary Prevention in ECE A PROJECT OF SERESC 1. 2. 3. 4. 5. 6. 7. Maintain a predictable schedule Minimize and plan effective transitions Provide visual reminders of rules Teach appropriate behavior Use positive reinforcement to promote appropriate behavior Provide choices where appropriate, and Maximize child engagement to minimize problem behaviors. Preventative Practices Sources: Laus, Danko, Lawry, Strain, & Smith, 1999; Strain & Hemmeter (1999) A PROJECT OF SERESC Tier 2: Secondary Prevention in Early Childhood Education Tier 2, secondary prevention, is aimed at the roughly 5-10% of young children considered at risk for developing behavioral disorders or mental illness These students enter school with significant risk factors and are usually unresponsive to universal prevention strategies alone. The goal of secondary prevention is two-fold: To decrease opportunities in which high-risk behaviors might be fostered To establish effective and efficient prosocial repertoires that would increase their responsiveness to primary interventions 14 Tier 2: Secondary Prevention in ECE A PROJECT OF SERESC Explicit instruction in emotional literacy skills, controlling impulses and anger and friendship-making skills is provided to small groups of children. Research indicates that systematic efforts to promote children’s social competence can have both preventive and remedial effects. Social & Emotional Teaching Strategies Sources: Fox, Dunlap, Hemmeter, Joseph & Strain, 2003; Webster-Stratton & Reid (2004) 15 Tier 3: Tertiary Interventions A PROJECT OF SERESC Level 3, tertiary interventions, targets the 1-5% of young children who display persistent challenging symptoms or behaviors The goal of tertiary interventions is to reduce the frequency, intensity and complexity of a child's maladaptive behavior patterns and provide him/her with suitable, efficient and effective replacement behaviors that will compete with his/her more maladaptive ones. Tertiary interventions are individualized, assessment-based and designed to meet individual needs. 16 Tier 3: Tertiary Interventions A PROJECT OF SERESC Function-based interventions are developed through the process of functional assessment (FA) and behavior support plans (BSP). Functional assessment determines why the student exhibits challenging behavior. BSPs are most effective when developed by a team with family involvement. Individualized Strategies Sources: Blair, Umbreit, & Eck, 2000; Dunlap & Fox, 1999; Galensky, Miltenberger, Stricker, & Garlinghouse, 2001; Moes & Frea, 2000; Reeve & Carr, 2000). A PROJECT OF SERESC Steps for Addressing Children in Need of Tier 2 Supports Develop a process for screening/nomination of children who are not responding to Tier 1 behavior supports and may need additional supports What is Screening? Salvia & Ysseldyke (1988) A PROJECT OF SERESC Screening is an initial stage of assessment in which those who may evidence a particular problem are sorted out from among the general population. Individuals who perform poorly on screening measures as considered “atrisk.” Features of Good Universal Screening A PROJECT OF SERESC Accurate Cost efficient Acceptable Useful Why Universal Screening? A PROJECT OF SERESC To find children whose problems are not immediately obvious and identify problems with a high degree of accuracy Early identification leads to early intervention Preschools that implement Universal Screening select interventions based on results of the screening tools. This is effective and efficient. Universally Accepted Types of Screening in School A PROJECT OF SERESC Readiness Vision Why not? Hearing Behavior Dental A PROJECT OF SERESC Why Screen for Behavior Disorders? It’s Costly Not To! Indicators of problem behaviors are evident in preschoolers and elementary age students Internalizers are missed with other approaches Early intervention matters Schools are the only place where we have universal access Recommended by the President’s New Freedom Commission and Special Education Task Force, Surgeon General, Safe Schools/Healthy Students as an evidenced-based practice Minimizing Errors Effective Screening Programs A PROJECT OF SERESC A screening-identification program to be considered effective, it must insure acceptable levels of accuracy, cost efficiency, and consumer acceptance. Accuracy implies that the screening process provides reliable and valid information for the purposes of making decisions (Hartmann, Roper, & Bradford, 1979). Cost efficiency means that, relative to the outcomes produced or achieved, the system's implementation does not consume too much professional time. Acceptance implies that such a system would be adopted by professionals and used repeatedly over time. Screening for Behavior A PROJECT OF SERESC I’m Concerned About A Child What Should I Do? Activity 1: Current Supports A PROJECT OF SERESC Think: Identify your current process for getting help with a student for whom you have behavioral concerns (5 minutes) Pair Up: Discuss with colleagues next to you (5 minutes) Share Out: (5 minutes) Activation Pathways to Secondary Tier 2 Systems of Behavior Support Muscott & Mann (2010) A PROJECT OF SERESC Students Are Not Responding to Core Curriculum & Tier 1 Systems Universal Screening Using Normed Systematic Screening Assessments Universal Screening Using Local Benchmarks Behavioral Indicators (+ and -) Instances of Challenging Behavior, Attendance, Tardiness, Nurse Visits, etc. Teacher Nomination Parent Nomination Secondary Systems Activation through Team-based Decision Making Process Teacher Activation to Tier 2 Team A PROJECT OF SERESC Begins with completion of an activation form Form should be efficient and easy to complete It should include a reason for requesting supports It should include a quick data summary including behavioral and academic indicators It could include what has been tried Amount of information should match what’s necessary to make good decision about potential supports Consider what forms and information were used with Tier 1 teams Nomination Form Activity 2: Nomination Form A PROJECT OF SERESC Think: Review the example nomination form. Make suggested edits that might improve the form for use in your early childhood program. (10 minutes) Pair Up: Discuss with colleagues next to you (5 minutes) Share Out: (5 minutes) A PROJECT OF SERESC Early Identification: Behavioral Indicators and Cut Scores 1. Behavioral indicators of students at risk should be identified 2. Indicators should be practical and related to behavioral risk 3. Data indicators should be easy to collect or already available 4. Cut scores should be determined for time periods that are Isn’t Challenging Behavior Enough? A PROJECT OF SERESC Students Students with with externalizing internalizing problems? problems? A PROJECT OF SERESC Challenging Behaviors in Early Childhood Physical Aggression Verbal Aggression Self-injury Property Damage Disruption/Tantrum Non-compliance Social Withdrawal/Isolation 8. Inappropriate Language 9. Running Away 10. Unsafe Behaviors 1. 2. 3. 4. 5. 6. 7. 32 Defining Challenging Behaviors A PROJECT OF SERESC Physical Aggression – forceful physical actions directed towards adults/peers that may result in physical contact and injury (e.g., hitting, kicking, spitting, pinching, and throwing objects). Verbal Aggression – the use of threatening, offensive or intimidating words directed towards an adult/peer (e.g., screaming, name-calling, swearing/ profanity, use of threats). 33 Defining Challenging Behaviors A PROJECT OF SERESC Disruption/Tantrum – an outburst or action that prevents learning or interferes with teaching and persists despite an adult’s request to stop or attempt to provide support. Non-compliance – refusal to follow a reasonable request, direction or the established routine, which persists after multiple requests and a reasonable amount of time. Running away – the act of leaving a designated area of supervision or boundary of play without permission and without responding to the requests of an adult to return. A PROJECT OF SERESC Tier 2 Behavioral Indicators, Cut Scores and Benchmarking Periods for ECE Programs Indicator November 1 February 1 March 1 Instances of 3 or more Challenging Behavior 3 or more in this timeframe 3 or more this timeframe Nurse TLC Visits (Non-medical) 4 or more 4 in this timeframe 4 in this timeframe Absences 3 or more 3 in this timeframe 3 in this timeframe High Stress Event (Death in immediate family, divorce, domestic violence, 1 or more 1 in this timeframe 1 in this timeframe Behavioral Indicators within Timeframe A PROJECT OF SERESC Office Discipline Referrals (no minors) 08/01/2009-10/06/2009 Students: 20 Referrals: 25 Activity 3: Behavioral Indicators A PROJECT OF SERESC Think: 1. Determine a practical time period that aligns with your school calendar. 2. Identify/name 2-3 potential Tier II indicators on the chart. 3. For one indicator, determine the cut score for the initial time period.(10 minutes) Pair Up: Discuss with colleagues next to you. (5 minutes) Share Out: (5 minutes) A PROJECT OF SERESC Tier 2 Behavioral Indicators, Cut Scores and Benchmarking Periods for ECE Programs Indicator Date Date Date Date Features of an Evidence-based Screening Practice A PROJECT OF SERESC Good psychometric properties Reliability Validity Screening selects true positives and minimizes false negatives Multi-source and multi-method assessment and intervention are the most accurate and effective. Factors associated with long term outcomes Efficient to implement Low cost Intervention and services are targeted for the appropriate child 39 A PROJECT OF SERESC Scientifically Validated Early Childhood Assessments ASQ:SE Screening – Determining the Need for Additional Supports An easy-to-use, research-validated screening system that helps educators assess children’s social-emotional development Self-regulation, compliance, communication, adaptive functioning, autonomy, affect, and interactions with people With the results, professionals can quickly recognize young children at-risk for social or emotional difficulties, identify behaviors of concern to caregivers, and identify any need for further assessment or intervention. 41 A PROJECT OF SERESC Devereux Early Childhood Assessment Clinical (DECA-C) Ages 2-5 The DECA-C Protective Factor assesses both social- Scales (Initiative, emotional strengths Self-control, and (protective factors) Attachment) and behavioral Behavioral Concerns concerns. Scales (Attention During the past 4 Problems, weeks… Aggression, 62 Items Withdrawal/ 15-20 minutes Depression, Teacher and Parent Emotional Control Versions Problems). Implementation Procedures A PROJECT OF SERESC Systematic screenings are recommended twice a year in October and February/March In preschools, classroom teachers screen students in their class they have known for at least 30 school days Group administration at a faculty meeting or training is efficient – allow 1 ½ to 2 hours Activity 3: Scientifically Based Screening A PROJECT OF SERESC Pair Up: Discuss feasibility of using a systematic screening process with colleagues next to you. (10 minutes) Share Out: (5 minutes) Ready for School Success - NH A PROJECT OF SERESC New Hampshire Center for Effective Behavioral Interventions and Supports – Program-Wide Positive Behavioral Interventions and Supports (PW-PBIS) NH Head Start Programs: Southern NH Services, Inc. (Manchester & Nashua ) & Belknap-Merrimack (Laconia) Head Start Programs Support for RSS-NH is provided by the U. S. Department of Education Office of Safe and Drug-Free Schools, under the Foundations for Learning Grants Program READY FOR SCHOOL SUCCESS NEW HAMPSHIRE Ready for School Success – NH THE CHALLENGE A PROJECT OF SERESC Early childhood educators frequently encounter students who are at risk for school failure because they exhibit challenging behavior or lack the required social-emotional skills for school success. If not provided with high-quality, effective interventions, many of these students, particularly those with externalizing behaviors, continue onward to experience a negative developmental trajectory through their childhood, adolescent, and adult years. Despite the overall success of Head Start programs in providing early intervention services to students from lowincome households, providing students who are dually at risk with behavior challenges or social-emotional deficits and one or more additional risk associated with Head Start participation factors (e.g., family poverty, developmental delays) with adequate access to evidence-based interventions and supports has remained a major barrier for many young students and their families. Ready for School Success – NH OUTCOMES A PROJECT OF SERESC Improve school readiness of dually at-risk preschoolers attending the Southern New Hampshire Services, Inc. (SNHHS) and Community Action Program BelknapMerrimack Counties, Inc. Head Start (BMHS) programs Enhancing child and family access to a linguistically appropriate, culturally competent and sustainable multi-tier continuum of program and community-based social, emotional and behavioral supports (PWPBIS) Results in measurable gains in student’s emotional, behavioral, and social development A PROJECT OF SERESC Ready for School Success – NH SCREENING Ages and Stages Questionnaire: Social Emotional Development (ASQ-SE) Each fall, the students were screened for risk by both teachers and parents using the ASQ-SE Fall 2011 indicated 26% (66 of 257) of students at SNHS and 41% (23 of 56) of students at BMHS were screened at risk by either their teachers or parents. Parents generally rated their children as more at risk. For example at BMHS, three times as many children were rated at risk by their parents than their teachers. Ready for School Success – NH SUPPORTING Dually-At-RISK STUDENTS A PROJECT OF SERESC Dually at risk if (a) qualified for Head Start participation, as indicated by enrollment in one of the participating Head Start locations, and (b) fell within the at-risk range on the ASQ-SE. The project was very successful in providing additional services to students who were identified as at-risk 88% having received Tier II and/or Tier III interventions depending on need and response to interventions (Some parents refused services or supports). ASQ:SE Results Fall 2010 BM-HS DATA A PROJECT OF SERESC Total # Children Screened: 56 Total Typical Risk: 35 (62.5%) Total Elevated: 21 (37.5%) Elevated Teacher Scores: 6 (11%) Elevated Parent Scores: 15 (27%) Elevated in Both: 4 (7%) PW-PBIS Big Idea A PROJECT OF SERESC Data-based decision making requires commitment to a consistent and effective data collection and decision making process to attain positive child and program outcomes A PROJECT OF SERESC “Insanity is engaging in the same process over and over, and expecting different outcomes.” Albert Einstein Who should participate in Tier 2 Interventions? A PROJECT OF SERESC Universal Teaching strategies are geared toward the entire program, and apply to all classrooms Targeted Group Interventions are for children who are NOT responding to the universal system and require more support to be successful Includes children either from a classroom or across multiple classrooms that need additional social-emotional support Tier 2: Secondary Prevention in ECE Explicit instruction in emotional literacy skills, controlling impulses and anger and friendshipmaking skills is provided to small groups of children. Research indicates that systematic efforts to promote children’s social competence can have both preventive and remedial effects. Social & Emotional Teaching Strategies Sources: Fox, Dunlap, Hemmeter, Joseph & Strain, 2003; Webster-Stratton & Reid (2004) Create Process for Implementing Targeted Group Interventions A PROJECT OF SERESC Identify which children need TGI Identify the primary skill deficits Assign child to appropriate intervention based on his/her needs Identify who will implement the targeted group support Identify what to teach, where, when, & how READY FOR SCHOOL SUCCESS-NEW HAMPSHIRE 2011-12 BEHAVIOR SUPPORT CONTINUUM FOR DUALLY AT-RISK CHILDREN ATTENDING BELKNAP-MERRIMACK HEAD START AT LACONIA A PROJECT OF SERESC All Head Start Funded Children Screened within 45 Days by Teachers & Parents Ages & Stages Questionnaire: Social-Emotional (ASQE –SE) (n=59) Core Head Start Program & Monitor Progress N=20 Children Screened as Dually At Risk (29 of 59 = 49%) Children Without Elevated Teacher or Parent Ratings (30 of 59 = 51%) Ages & Stages Questionnaire: Social-Emotional (ASQE –SE) Children with Elevated Teacher Rating Only (n=4 = 7%) Children with Elevated Parent Rating Only (n=15 = 25%) Children with Elevated Teacher and Parent Ratings (n=10= 17%) Teacher Nominations without Elevated Ratings on Either (n=10 = 17%) All 39 Children Nominated for Social Skills Instruction (12 lessons) Receive Social Skills Instruction Complete Social Skills Instruction DECA Completed Incident Data Collected Dually At Risk Children Reassessed After Social Skills Instruction Ages & Stages Questionnaire: Social-Emotional (ASQE –SE) – Teacher Rating Only Improved; Did Not Improve Teacher Rating of Skill Improvement Significantly Improved; Partially Improved; Did Not Improve Creative Curriculum Significantly Improved; Did Not Improve Parents of Dually At Risk Children Nominated for Parent Skills Group (once per week for six weeks) attend and complete Parent Skills Group Parents of Dually At Risk Children for Who Complete Parent Skills Group Assess Skills/Dispositions with Pre-Post Self-Assessment Parent Stress Inventory Parents Rate Their Child Ages & Stages Questionnaire: Social-Emotional (ASQE –SE) Dually At Risk Children Who Did Not Respond Nominated for Big Bs Card __ Begin Big B Program Daily in May Monitor Progress 56 RSS-NH Tiered Interventions A PROJECT OF SERESC Tier 1 Core Instruction at Head Starts Tier 2 Continuum Social Skills Group Instruction Teacher Check Connect and Expect Parent Education Classes Tier 3 Individualized Behavior Plans 57 RSS-NH: Social Skills Instruction Adapted from Center on Social Emotional Foundations for Early Learning A PROJECT OF SERESC One time per week group 30 minutes 4-6 children 12 lessons in 2011-12 Samples 1 )I was so mad! Goal: To increase emotional literacy; learn to express feelings in healthy ways, to increase problem solving 2) How am I feeling? Goal: To increase emotional literacy and to help children begin to understand the mind body connection, increase empathy 3) What could you do to help? Goal: To increase problem solving skills, develop theory of mind and sense of altruism, and increase personal responsibility 4) What might happen? Goal: To increase understanding of cause and effect; and problem solving 5) Stop light/ solutions kit. Goal: To teach and practice problems solving steps. Problem Solving Steps ? 1. What is my problem? 2. Think, think, think of some solutions 3. What would happen if…? Would it be safe? Would it be fair? How would everyone feel? 4. Give it a try! Frustrated Sad Frustrated Embarrassed Mad Learning Self Control Recognizing that anger can interfere with problem solving Learning how to recognize anger in oneself and others Learning how to calm down Understanding appropriate ways to express anger Turtle Technique Recognize that you “Think” Stop. feel angry. Go into shell. Take 3 deep breathes. And think calm, coping thoughts. Come out of shell when calm and think of a solution. 62 Teacher Check, Connect and Expect Mann and Muscott (2007); Adapted from Cheney (2006) A PROJECT OF SERESC Teacher Check, Connect and Expect is an efficient, early, & systematic response for students not responding to primary prevention systems of behavior support. Occurs prior to implementing more sophisticated & less efficient secondary supports. TCCE is a procedure in which classroom teachers provide higher rates of feedback & attention to ‘atrisk’ students for exhibiting expected classroom behaviors linked to school-wide expectations TCCE allows for a systematic monitoring of student behavior using data-based decision-making. Teacher Check, Connect & Expect Mann and Muscott (2007) Offers an immediate and low effort approach whereby teachers: greet child at the beginning of the day review their behavior on a daily chart based on classroom schedule & established expectations provide feedback and encouragement at each checkpoint & the end of the day The Potential Benefits of Involvement in TCCE 1. Provides increased positive teacher-child contacts before relationship is damaged by repetitious conflict (builds relationship) 2. Provides increased reinforcement to the child for following expectations (builds self-esteem, self-worth) 3. Provides increased home-school communication and partnership (daily feedback to family) 4. Provides an early, effective and efficient response to emerging problem behavior before it becomes chronic and engrained Potential Benefits of Involvement in Teacher Check Connect Expect 5. Connects logically and easily to program- wide system of behavior support 6. Provides an efficient and measurable assessment of progress that helps determine if interventions are working 7. Provides information that may be useful for identification of predictors of behavior should more supports be needed. 8. Data can be entered in BIRCHIS™ Teacher:__________________ Name:_____________________ Classroom:_________________ Date:______________________ Be Safe I earned _______ Green Lights (Optional _______ of 28) Be Kind Be Careful with Our Things Make it Better Arrival Breakfast Circle Free Choice/Play Small Group Activities Outdoor Play Lunch Tomorrow is a new day. I will try again tomorrow. Updated 10-20-11 Name:_______________ I earned ____ Green Lights Today is:_____________ (Optional ____ of 7) A PROJECT OF SERESC Be Safe Wait Safely with Adult Sit Down & Buckle Up Stay in Seat Hands and Feet to Self Quiet Voice Wait for Bus to Stop Un-buckle Tomorrow is a new day. I will try again tomorrow. Updated 10-20-11 A PROJECT OF SERESC Ready for School Success – NH PARENT EDUCATION 38 participating parents attended 6-8 week parenting classes (70% or more of classes) Used the Center on the Social Emotional Foundations for Early Learning curriculum, an empirically validated, widely recognized program Focused on strengthening parenting competencies and fostering parents’ involvement in children’s school experiences in order to promote children’s academic, social, and emotional competencies and reduce conduct problems Ready for School Success – NH PARENT EDUCATION A PROJECT OF SERESC Care was taken to avoid time-related conflicts that might preclude attendance, such as scheduling the parent training during non-traditional hours to better accommodate working families’ schedules. Reimbursement was offered for transportation costs (e.g., taxi/bus fare or fuel consumption) to and from the group location. Language translation services during the skills group were offered to parents whose primary language was not English. Child-care services or reimbursement were offered to participating parents to cover the parenting skills group scheduled meeting time. A PROJECT OF SERESC Ready for School Success – NH Child GAINS 91.4% of the 47 students who were identified as at-risk by teacher ratings exhibited an improvement of 15% or greater on the ASQ-SE. Additionally, students who exhibited improvement typically exceeded the cut-off point of 15% by a wide margin, with an average improvement of 45.6% in 2010-11, and 57.1% in 2011-12. By the project’s end, 44.6% of students whose teacher ratings had indicated elevated risk now fell in the typical risk category Ready for School Success – NH CHILD GAINS A PROJECT OF SERESC Incident data on challenging behaviors was collected on 32 at-risk students from the two Head Starts during the winter and spring of school year 2011-12. Twelve students had no documentable behavioral incidents during the data collection period and as a result were considered successful. In addition 14 students reduced the number of behavioral incidents by at least 25%. All told, 26 of 32 students were successful in meeting the performance measure. A PROJECT OF SERESC Ready for School Success – NH PARENT GAINS Parent survey responses to the parenting class indicated high levels of satisfaction, with parents reporting increased confidence in their ability to build a positive relationship with their child, to figure out reasons their child acts as he or she does, and to have clear expectations and house rules. Parents also indicated that they were more likely to actively engage in teaching social skills and to use different strategies to promote positive behavior, and that they would be likely to recommend the training to other parents. A PROJECT OF SERESC Ready for School Success – NH PARENTAL STRESS Parenting Stress Index – Short Form (PSI-SF) Average decline in total parental stress in parents who participated in the training at Belknap-Merrimack Head Start Pre-test percentile ranking of 75.7% (average raw score, 90.5) Post-test percentile ranking of 53.1% (average raw score, 75.5). A PROJECT OF SERESC Ready for School Success – NH PARENT EDUCATION Participation in parent education programs was associated with improvements in student behavior and development. 8 children at SNHHS identified as at-risk on the ASQ-SE teacher rating scale and whose parents participated in the education programs Showed an average improvement of 26% in teacher ratings of social emotional development by the conclusion of the education program