WI PBIS Conference – August 19, 2015 – Session D3
Beyond ODRs: Identifying & Supporting Students
with Internalizing Behaviors through Universal
Screening Procedures
Lucille Eber
Midwest PBIS Network & National PBIS TA Center
lucille.eber@midwestpbis.org
http://midwestpbis.org
Nic Dibble
Wisconsin Department of Public Instruction
nic.dibble@dpi.wi.gov
http://sspw.dpi.wi.gov/
Content for this Session
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•
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Rationale & Context
Universal Screening Process, Tools
A quick District Example
What to do After Universal Screening
• Intervention Selection Process (EBPs)
• Tier 2/3 Screeners & Guidelines
Mental Health & School Age Children
One out of ten children between the ages of 8-15, experiences an emotional
disorder that has a major impact on daily functioning
 ADHD and mood disorders (e.g., depression) are most commonly-occurring disorders
% of Children and youth ages 815
Prevalence Estimates Grouped by Disorder
(N=3,042)
14
12
10
8
6
4
2
0
13.1
11.3
8.6 7.8
2.1 1.7
ADHD (all
forms)
Source: Merikangas et al., 2010
Conduct
Disorder
3.7 2.9
0.7 0.4
Anxiety
Disorder
Disorder without impairment
Mood
Disorder
Any disorder
Disorder with severe impairment
Mental Health & School Age Children
 Students at-risk for internalizing disorders (e.g.
children demonstrating overly shy, anxious, ’down’
behaviors) typically fly under the radar
 A Johns Hopkins University study found that averageperforming students with internalizing behaviors received
support via special education, or mental health services at
lower rates than underperforming students with
externalizing (e.g., ‘acting out’) behaviors
 Source: Bradshaw, Buckley, & Lalongo, 2008
Mental health and school age children
Internalizers are underserved by special education & mental health systems
Service Usage Rates
85
% of Children Receiving Service
90
75
80
65
70
60
50
40
Internalizers
40
Externalizers
30
20
10
0
Special Education
Source: Bradshaw, Buckley, & Ialongo, 2008
Mental Health
Mental Health & School Age Children
 Youth who are the victims of bullying
and who lack adequate peer
supports are vulnerable to mood &
anxiety disorders
Source: Deater-Deckard, 2001; Hawker & Boulton, 2000
Mental Health & School Age Children
 “Depressive disorders are
consistently the most prevalent
disorders among adolescent
suicide victims.”
Source: Gould, Greenberg, Velting, & Shaffer, 2003
Mental Health & School Age Children
 “Without early intervention, children who
routinely engage in aggressive, coercive
actions, are likely to develop more
serious anti-social patterns of behaviors
that are resistant to intervention.”
Source: Walker, Ramsey, & Gresham, 2004
Universal Screening Defined
 “Universal screening is the systematic
assessment of all children within a given class,
grade, school building, or school district, on
academic and/or social-emotional indicators
that the school personnel and community have
agreed are important.”
 Source: Ikeda, Neessen, & Witt, 2009
Purpose of Universal Screening for
Behavior
 Universal screening for behavior is integral to
the Response to Intervention (RtI) model
 Emphasis on prevention
 (similar to annual vision/hearing screenings)
 Use an evidence-based instrument to identify:
• Risk factors for emotional/behavioral difficulties
• Social-emotional strengths & needs
Benefits of Universal Screening for
Behavior
 Universal screening for behavior is more effective than
reliance on office discipline referrals (ODRs) for
identifying students with risk factors for internalizing
(e.g., depression, overly shy, withdrawn, anxiety)
behaviors
 ODRs are typically measures of non-compliant, acting-out
behaviors
 Teachers tend to under-refer internalizers
Sources: Walker, Cheney, Stage, & Blum, 2005; Walker et al., 2010
Universal Screening for Behavior
% of students identified in grades
screened
USDOE Tertiary Demo Project Universal Screening
Results in IL Schools: 2007-11
12.0%
9.4%
10.0%
9.6%
8.9%
8.0%
6.0%
4.0%
5.6%
5.8%
5.1%
3.5%
6.3%
3.8% 3.8% 3.8%
2.7%
2.0%
0.0%
Externalizers
Internalizers
2007-08: N=18 schools
2008-09: N=30 schools
2009-10: N=45 schools
2010-11: N=61 schools
Total
Context for Screening
 Universal screening for social/emotional needs is
similar to annual vision/hearing screenings)
 Why do we do it? If we find students who need
support as early as possible, we can prevent a
negative impact on their academic achievement
Universal Screening Readiness
Checklist
 Select process & tool that is best fit for your
district
 Identify resources & logistics
 Identify resources for supporting students identified via screening (in-school
& community-based)
 Foundational Tier 2 interventions: CICO, SAIGs, Simple function-based problem-solving
 Create a timeline for executing screening process including frequency of
screening (e.g., once, or multiple times per year?)
 Develop budget for materials, staff, etc.
 Create administration materials (e.g., power point to share process with staff,
parents & community members, consent forms, teacher checklists)
 Schedule dates for screening(s) & meetings to share school-wide results
Universal Screening Process
 Can be a single or a multi-gate process for
implementing universal screening for behavior
 Efficient:
 Takes approximately one hour, maximum, per classroom
to complete process
 Fair:
 All students receive consideration for additional supports
 Reduces bias by using evidence-based instrument
containing consistent, criteria to identify students
Multiple Gating Procedure
(Adapted from Walker & Severson, 1992)
Gate 1
Teachers Rank Order
then Select Top 3 Students
on Each Dimension
(Externalizing & Internalizing)
Pass Gate 1
Gate 2
Teachers Rate Top 3 Students in
Each Dimension (Externalizing &
Internalizing) using evidencebased instrument (i.e., SDQ,
SSBD, BASC-2/BESS)
Pass Gate 2
Tier 2
Intervention
Examples of Externalizing
Behaviors
 Displaying aggression
toward objects or
persons
 Arguing
 Being out of seat
 Not complying with
teacher instructions or
directives
Source: Walker and Severson, 1992
Examples of Internalizing
Behaviors
 Not talking with
other children
 Being shy
 Timid and/or
unassertive
 Avoiding or
withdrawing from
social situations
 Not standing up for
one’s self
Source: Walker and Severson, 1992
Screening process: Multi-Gate Example
 The school’s universal screening coordinator will pass out
a timeline & teacher ranking sheet at the end of a
faculty meeting & presentation
 Teacher’s complete the ranking form PRIOR to the
assigned date for universal screening
 Review description of externalizing behaviors, then list up
to 10 students in your class who demonstrate these types of
behaviors
 Repeat process for internalizing behaviors
 Rank order the top three externalizers, then rank the top
three internalizers
 May have a total of up to six students nominated at the end of the
process
Screening Process: Multi-Gate Example
Teacher Rank Ordering for Universal Behavioral Screening: Externalizers
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•
•
•
•
•
•
Property destruction (e.g., damaging books, desks, other school property)
Repeatedly quarrels with peers/adults
Coercion of others (e.g., bullying behaviors includes physical actions and verbal threats)
Regularly does not follow school/classroom rules
Consistent refusal to follow teacher’s directions
Frequently blurts out/speaks in class without permission
Often moves around the classroom/hallways without permission
Spreads rumors with the intention to harm others
Stealing
STEP ONE
Externalizers: Students
regularly displaying at least ONE
of the listed behaviors
STEP TWO
Externalizers: Top three
students regularly displaying
at least ONE of the
listed behaviors
ID #
Race/ethnicity
Screening Process: Multi-Gate Example
Teacher Rank Ordering for Universal Behavioral Screening: Internalizers
•
•
•
•
•
Anxious, nervous (e.g., nailbiting, easily startled)
Introverted (e.g., often seen alone)
Rarely/doesn’t speaks to peers
Overly sensitive (e.g., cries easily, has difficulty standing up to others)
Bullied by other students
STEP ONE
Internalizers: Students
regularly displaying at least
ONE
of the listed behaviors
STEP TWO
Internalizers: Top
three students
Regularly
displaying at least
ONE
Of the listed
behaviors
ID#
Race/ethnicity
Universal Screening Process
 Teachers are guided through online
administration of the selected checklist
(i.e. SSBD, SDQ, etc.)
 Results are immediately available to the
Tier 2 team
Universal Screening Process
 Parents of nominated students, who meet the
screening criteria, are contacted in writing to
request permission for their child’s participation in
a simple, secondary intervention (e.g., checkin/check-out)
 The universal screening coordinator will inform
teachers of students who are participating in
interventions
 Teachers will also receive progress monitoring
data
Universal Screening Readiness
Checklist
 Select an evidence-based screening
instrument
Use The Standards for Educational and Psychological
Testing or resources from other professional
organization resources (e.g., National Association for
School Psychologists) as guidelines for selecting an
appropriate screener
Reminder
 Screeners are NOT recommended as a diagnostic
tool for eligibility for special education services
 The screening process WILL NOT replace the
current procedures for special education
evaluation or any other identification for support
process
Universal Screening Readiness
Checklist
 Data
Develop data collection & progress monitoring
system
Determine systematic process for using results to
inform interventions
Plan for sharing screening & progress monitoring
results with staff & families
Examples of Universal Screening Instruments
Screener
Basic Info
Systematic Screening for Behavior Disorders
(SSBD; Walker & Severson, 1990)
http://store.cambiumlearning.com
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•
Walker, H. M., Severson, H. H., Feil, E.G.
(2014). Systematic Screening for Behavioral
Disorders (2nd ed.). Eugene, OR: Pacific
Northwest Publishing.
•
•
BASC-2/BESS (Kamphaus & Reynolds, 2007)
http://www.pearsonassessments.com
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•
Well-validated (Endorsed in 1990 by
the Program Effectiveness Panel of
the U.S. Department of Education)
Efficient (Screening process can be
completed within 45 minutes to 1
hour)
Most effective instrument for
identifying internalizers (Lane et al.,
2009)
Meets AERA/APA instrument
selection criteria
•
Measures behaviors associated with
internalizing & externalizing problem
behaviors & academic competence
Meets AERA/APA instrument
selection criteria
Incorporates three validity measures
to rule out response bias
Utilizes large (N= 12,350 children &
youth), nationally-representative
sample
Web-based screening capacity
available via AIMSewb
• Online access via AIMSweb:
Additional $1.00 per student for
subscribers and $4.00 per student for
non-subscribers)
• Computer software $600
(Manual= $ 131.49; includes
reproducible screening forms)
Systematic Screener for
Behavior Disorders
Walker, H. M., Severson, H. H., Feil, E.G.
(2014). Systematic Screening for
Behavioral Disorders (2nd ed.). Eugene, OR:
Pacific Northwest Publishing.
Examples of Evidence-based Screening Instruments
Screener
Strengths & Difficulties Questionnaire (SDQ;
Goodman, 2001)
http://www.sdqinfo.org
Basic Info
• Measures internalizing/externalizing
behaviors (although skewed more towards
externalizing behaviors)
• Free
• Option of completing pencil & paper, or
online version
• Can be scored online
• Technically sound: Large, representative
normative group
Student Risk Screening Scale (SRSS;
Drummond, 1993)
• Measures internalizing/externalizing
behaviors
• Free
• Quick to administer (less than 5 minutes
per student; 15 minutes for entire class,
depending upon number of students)
• Easy to understand & interpret score
results
• Technically-adequate
• Being revised by Kathleen Lane et al
Social Skills Improvement System (SSIS;
Gresham & Elliott, 2008)
http://psychcorp.pearsonassessments.com/
pai/ca/cahome.htm
• Measures problem behaviors, social &
academic competence
• Computer & web-based (AIMSweb)
administration & scoring available
A N. IL District Implementation Example
(shared at an IL Conference in 2012)
 26 Elementary and Jr. High Buildings Implementing all
3 Tiers of PBIS
 4 Cohorts 2011-12SY (6 Cohorts for 2012-13SY)
 8 buildings implementing Tiers 1, 2, & 3
 9 will begin implementing Tier 3 during 201213SY
 17 buildings implementing Tiers 1 &2
 11 will begin implementing Tier2 during 201213SY
Universal Screening
History 2010-2012
 2010-11SY
 4 Buildings from Cohort 1 participated in screening
 2 Elementary (Kindergarten-Sixth Grade)
 2 Jr. High (Seventh-Eighth Grade)
 2011-12 SY
 8 Buildings from Cohort 1 and 2 participated in screening
 4 Elementary (Kindergarten-Sixth Grade)
 4 Jr. High (Seventh-Eighth Grade)
 2012-13SY
 16 Buildings from Cohort 1-4 planning to participate
 11 Elementary
 5 Jr. High Buildings
Preparing for Screening
Year 1-Pilot
 Screening Window: October – November 2010
 District Admin & External Coach Responsibilities (Sept-Oct)
 External Coaches attended Universal Screening Facilitator training
 Tier 2 Coaches identified as Screening Facilitators
 Presented Universal Screening to Superintendent, Board Cabinet, District
Leadership Team & Building Administrators
 Developed Parent Information/Consent Letter
 Prepared protocols for Facilitators
 Identify and Train Screening Facilitators (Oct)
 Cohort 1 buildings for Pilot
 Implementing PBIS at least 2 years
 CICO implemented with fidelity for 1 full year
 Elementary Facilitator Training:
 Time Lines
 SSBD Facilitator Training-Process
 Jr. High Facilitator Training:
 Time Lines
 BASC-2/BESS Facilitator Training-Process
Preparing for Screening
Year 1-Pilot (con’t)

Facilitator Responsibilities (Oct-December)
 Review and follow timeline
 Facilitator timeline
 Teacher timeline
 CICO up & running since mid-September
 Increase in students participating as result of screener
 Changes to support internalizing students identified via screener
• CICO Parent letter
 Schedule screening dates with administrator
 20-30 min. overview
 1.5 hr. administration
 Wednesday Staff Development (Elementary & Jr. High)
 Grade Level Meeting (Jr. High)
 Present screening overview & administration with External Coach
 1 building presented without External Coach
 Prepare screening protocols for scoring
 SSBD: Facilitators scored using excel spread sheet
 BASC-2: PBIS scored
 Review results with administrator & staff
Universal Screening Tools
SSBD: Overview
 Overview
 1st-6th Staff attend a 20min presentation that includes rationale for screening
 District Support
 Parent Letter
 Review externalizing & internalizing behaviors
 Teacher timeline & ranking form
 Teachers given timeline for preparation & completion of screener
 Teachers provided ranking forms for Internalizers & Externalizers with descriptors
 Given 2 weeks to identify Top 10 Internalizers & Top 10 Externalizers from class roster
 Review Administration
 Supplies
• Pen/Pencil
• Student roster with identifying information (DOB, Race/Ethnicity, ID, etc.)
• Ranking forms with Top 3 Internalizers & Externalizers identified
 Expectations
•
•
•
•
Limit talking during administration to protect student information
Complete all forms (incomplete forms returned)
Come prepared
Ask questions prior to ensure the students who need support get it
Preparing for Screening
Year 2
 Screening Window: October – November 2011
 District Admin & External Coach Responsibilities (Aug-Sept)
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
Notified Tier 2 Coaches about Screening Facilitator training
Provided Facilitator training with PBIS Tier 2 TAC
Building Administrators informed of screening window
Modified Parent Information/Consent Letter
 Informed consent
 Screener part of support students receive at Tier 2
 Identify and Train Screening Facilitators (Sept)
 Cohort 1 and 2 buildings conduct screening
 Implementing PBIS at least 2 years
 CICO implemented with fidelity for 1 full year
 Elementary Facilitator Training:
 Time Lines
 SSBD Facilitator Training
 Jr. High Facilitator Training:
 Time Lines
 BASC-2/BESS Facilitator Training
Preparing for Screening
Year 2 (con’t)

Facilitator Responsibilities (Sept-December)
 Review and follow timeline
 Facilitator & Teacher timeline
 “Jump-start” Time Line
 CICO up and running since mid-September
 Increase in students participating as result of screener
 Changes to support internalizing students identified via screener
• CICO Parent letter
• DPR cards
 Schedule screening dates with administrator
 20-30 min. overview
 1-1.5 hr. administration
 Present overview & screening administration with External Coach to staff
 5 buildings presented without assistance from External Coach
 Prepare screening protocols for use for staff & scoring
 SSBD: Facilitators copied/labeled protocols & scored on-site
 BASC-2: Facilitators labeled protocols & PBIS scored off-site
 Review results with administrator & staff
Universal Screening
Parent Letter
October 2011
Dear Parent/Guardian,
As you know, ___________ school has been implementing Positive Behavior Intervention and Supports
(PBIS) which is a proactive approach to establishing the behavioral supports and social culture needed for
all students in a school to achieve social, emotional, and academic success.
Our school was selected to be a replication site by the Illinois PBIS organization, which provides us with
training and support as we work to continually improve ways to support our children and families. As part
of being a replication site this year, we will be utilizing an assessment tool for teachers that will help
identify students who may be having minor challenges in school, such as following rules and expectations,
or making friends. Our goal in using this teacher assessment tool is to identify which children may need
some assistance before minor challenges become big problems.
Over the next few weeks, your child’s classroom teacher will review the class roster and identify students
who currently may be having problems or difficulties in school. We will contact the parents of children who
have been selected by their classroom teacher to participate in a simple intervention focused on
supporting the child in a proactive and positive manner.
Please feel free to contact me at ________ if you have any questions.
Sincerely,
Principal
Universal Screening
Elementary Facilitator “Jump Start” List
Universal Screener To Do Checklist (ELEMENTARY)
Schedule Date with Administrator, External Coach, & PBIS TAC
__Staff Overview 20 to 30 min during STAFF DEVELOPMENT
__Screening Administration (Schedule no sooner than 2 weeks after
Overview- 1 to 1.5 hours during STAFF DEVELOPMENT
__Review and Mail Parent Letter (at least 2 weeks prior to screening date)
Prep for Overview
___Copy Teacher timeline to be given at/during overview (1 per teacher)
___Reserve meeting place with projector to view power point
___Review power point
Prep for Screening Administration
___Reserve meeting place with projector and place for teachers to
complete protocol
___Find place to keep protocols locked-up until input into excel spread sheet (keep protocols locked up until end of
school year then shred)
___Extra Pens or Pencils (just in-case some teachers forget)
___Prep protocols (Identifying information Label is attached to white copy to be sent by External Coach
week of October 11)
__Copy 3 of each per teacher (Green for Internalizers and Blue for Externalizers).
___Review power point
SSBD: Administration
 Administration
 Two weeks prior(following overview)
 Parent Letter mailed home
 Staff attend overview
 Facilitators prepare protocols
 One week prior
 Staff sent reminder email (no less than 2 days prior)
 Facilitators & External Coaches make final arrangements
 Day of Administration





Present brief overview of process
Review externalizing & internalizing behaviors
Review expectations
Facilitators collect & check forms for accuracy & completion
Facilitators lock completed forms in designated area until scoring
date
SD54 Screening Results - Elementary
Students Identified as % of Enrollment
10.00%
9.00%
8.00%
7.00%
6.00%
5.00%
4.00%
3.00%
2.00%
1.00%
0.00%
Year 1
Year 2
Internalizers
4.87%
5.08%
Externalizers
4.16%
2.71%
Total
9.03%
7.79%
BASC-2/BESS
 BASC-2/BESS uses T-scores to communicate results
relative to the average (mean=50)
 Identifiers & percentile ranks are provided for ease of
interpretation
 Normal risk level: T-score range 10-60
 Elevated risk level: T-score range 61-70
 Extremely Elevated risk level: T-score range ≥ 71
IL-PBIS Network, Sept 2010
Universal Screening Tools
BASC-2: Overview
 Overview
 Jr. High Teaching Staff attend a 20min presentation that includes rationale for
screening
 District Support
 Parent Letter
 Review externalizing and internalizing behaviors
 Teacher timeline and ranking form
 Teachers given timeline for preparation and completion of screener
 Teachers provided ranking forms for Internalizers and Externalizers with descriptors
 Given 2 weeks to identify Top 10 Internalizers and Top 10 Externalizers from class roster
 Review Administration
 Supplies
• #2 Pencil(s)
• Student roster with identifying information (DOB, Race/Ethnicity, ID, etc.)
• Ranking forms with Top 3 Internalizers and Externalizers identified
 Expectations
•
•
•
•
Limit talking during administration to protect student information
Complete all forms (incomplete forms returned)
Come prepared
Ask questions prior to ensure the students who need support get it
Universal Screening Tools
BASC-2: Administration
 Administration
 Two weeks prior(following overview)




Parent Letter mailed home
Staff attend overview
Facilitators label protocols
Facilitators attend grade level team meetings to provide support
 One week prior
 Staff sent reminder email (no less than 2 days prior)
 Facilitators and External Coaches make final arrangements
 Day of Administration






Present brief overview of process
Review externalizing & internalizing behaviors
Review expectations
Facilitators collect & check forms for accuracy & completion
Facilitators lock completed forms in designated area until picked up for scoring
External coaches make arrangements to deliver protocols to PBIS TAC
SD54 Screening Results - Jr. High
Students Identified as % of Enrollment
10.00%
9.00%
8.00%
7.00%
6.00%
5.00%
4.00%
3.00%
2.00%
1.00%
0.00%
Year 1
Year 2
Internalizers
2.95%
2.50%
Externalizers
5.49%
6.84%
Total
8.44%
9.34%
Universal Screener Roadblocks
(Year 1)

Scheduling screening window after start of school year




Delay in students receiving support once identified




Building unprepared for increase in students participating in CICO
Not enough staff to open new CICO stations
More externalizers identified than internalizers
Delay in scoring & identifying students (Jr. High)



Assessment schedule (MAP, ISSET) overlapping
Staff Development schedule difficult to change
Created scheduling conflicts for External Coaches
Staff refusing to “bubble-in” identifying information on scantron
Scoring done off-site
Staff support limited due to lack of knowledge about internalizers


“I don’t have any students to screen”
“Why are we calling out these students when they already have low self-esteem”
Universal Screener Successes
(Year 2)
 Scheduling screening window earlier allowed
for flexibility with External Coaches and/or
PBIS TAC to support teams
 Facilitators who participated Year 1 had
the option conduct Screening Overview &
Administration without outside support
 Increased number of students identified & given Tier 2
support sooner
 Increased staff support due to knowledge & experience
from Year1
 Number of Internalizers identified in Year 2 increased
25% in Elementary buildings & by 50% in Jr. High buildings
What to do After Screening?
SD54 Tier 2 Interventions
 CICO
 DPR card same for all students
 Check-In and Out with same staff member
 Parents notified of participation through calls and/or letter
 SAIG
 Pro Social
 Problem Solving
 Academic
 Check N Connect
 Used when student may need more than generic check-in
 Used when student needs change of check-in station or change of staff
 FBA/BIP
 Problem solving team identifies need for more support
 Utilize SAIG groups to teach skills to support replacement behavior
A Multi-Tiered System of Support for Behavior
Tier 1/Universal
School-Wide Assessment
School-Wide Prevention Systems
ODRs, credits
Attendance,
Tardies, Grades,
DIBELS, etc.
Tier 2/
Secondary
Check-in/ Checkout (CICO)
Social/Academic
Instructional Groups (SAIG)
Daily Progress
Report (DPR)
(Behavior and
Academic Goals)
Competing Behavior
Pathway, Functional
Assessment Interview,
Scatter Plots, etc.
SIMEO Tools:
HSC-T, RD-T, EI-T
Tier 3/
Tertiary
Group Intervention with
Individualized Feature
(e.g. Mentoring)
Brief Functional Behavior Assessment/
Behavior Intervention Planning (FBA/BIP)
Complex or Multiple-domain FBA/BIP
Wraparound / RENEW
Selection Process
 The intervention selected should be an
intervention that addresses the presenting
problem
 Selection of an intervention that matches the
presenting problem
 Considerations
 Developmental level
 Expertise of the provider
 Culturally appropriate
Example: Coping Cat at Rundlett
Middle School
 Enrollment: 1,010
 6th, 7th, & 8th Grade
 Race/Ethnicity:
 White: 85.8%
 Black: 5.6%
 Asian: 5.9%
Example (cont.)
Spring 2014: Identified Need
 A small (15) group of students who were asking to go to the office on a daily
basis or were frequently absent
 Most behaviors were internalizing: anxiety, withdrawal, avoidance of others
 These were students who performed academically, not special education
eligible
 School psychologist researched small group interventions for these students
 Found Coping Cat
Coping CAT is a Cognitive Behavioral Intervention
that helps students recognize & analyze feeling related
to stress & develop strategies to cope with stress
provoking situations. It is an 8 week, group intervention
that meets on a weekly basis for 45 minutes.
Modified Coping Cat
Coping Cat small groups (6 students) are co-facilitated by a Community Mental
Health Counselor and an RMS counselor. Student responsibilities include
participating in weekly group sessions, completing homework assignments (using
coping strategies) & self-monitoring progress.
Teacher responsibilities include prompting students to use their coping strategies
& a willingness to participate in professional development regarding stress
management &/or anxiety. Coping Cat instructor responsibilities include
implementing the Coping Cat curriculum with fidelity & monitoring student
progress with students & teachers.
Pre-post measure: Screen for Child Anxiety Related Disorders (SCARED).
Birmaher, Khetarpal, Cully, Brent, & McKenzie,1995.
Resource: Recorded webinar
Installing ISF-Local Experiences Integrating SOC & Education
A review of the core components of the ISF and experiences from SOC/Education efforts in New Hampshire.
https://theinstitute.adobeconnect.com/p5sh4fur2al/
MH Screening for Students Who Continue to Struggle
Following Tier 2 Interventions
 Why use screening tools at
Tiers 2 & 3?
 Parent Consent
 Protection of Pupil Rights
Amendment
 Guidance from case law
 Descriptions of evidencebased, behavioral health
screening tools (most available
at no cost)
 Strategies to improve access
to mental health services
Tier 1/Universal
School-Wide Assessment
School-Wide Prevention Systems
Tier 2/
Secondary
Tier 3/
Tertiary
Why Use Screening Tools at Tiers 2 & 3?
 May lead to better recommendations
 Evidence-base
 Supplements clinical judgment
 More information to make decisions
 Helps when sharing concerns with families
 Boosts credibility of referral with community
MH
Disclaimers
 MH screening is not assessment –
no medical diagnosis
 Prerequisites for use
 Competence
 Profession
 Individual
 Professional development & preparation
 Remember – Screening is not an
intervention
 Critical to have strong relationship with
community MH systems
Protection of Pupil Rights
Amendment (PPRA)
“LEAs must provide parents & eligible students
effective notice of their rights under PPRA. The notice
must explain that an LEA is required to obtain prior
written consent from parents before students are
required to submit to a survey that concerns one or
more of the 8 protected areas listed above, if the
survey is funded in whole or in part by Department
funds.”
USDE Annual Notice about FERPA & PPRA – March 2011
http://www2.ed.gov/policy/gen/guid/fpco/pdf/pprasuper.pdf
Legal Considerations: PPRA
 Schools must …
 Notify parents & offer opportunity to inspect
instrument prior to administration
 Obtain consent prior to screening
 Parents may …
 Choose to give or deny permission
 Note: parents may withdraw consent at any time
 File a complaint with USED
PPRA & Consent
 Critical question: Is student participation
required?
 If YES, Active Consent from parents
required
 If NO, Passive Consent from parents OK
Lessons from Court Cases
 Merricken v. Cressman, 364 F.Supp. 913 (1973)
 Fields v. Palmdale School District, 427 F.3d
1197 (9th Cir. 2005)
 C.N. v. Ridgewood Board of Education, 430
F.3d 159 (3rd Cir. 2005)
 Rhoades v. Penn-Harris-Madison School
Corporation, 574 F.Supp.2d 888 (2008)
Lessons from Court Cases
 Passive consent should be as informed as
active consent
 Information provided to parents must be complete
to allow them to make an informed decision
 Do not send one-sided “recruitment” letters
 Make sure parents may see screening tools in
advance
 Use multiple methods to inform parent to
increase chances they will learn about the
activity
Lessons from Court Cases
 Consent for 1 activity does not imply consent for a
follow-up activity
 Just because a parent consents to a screening activity does not
mean consent is given for other services
 Document students’ assent to participate in activities
 Students must be fully informed, as well
 Do not disclose information to a colleague, unless the
person really has a “legitimate educational interest”
 Does the person need this information to do her/his job?
Screening Tools Shared Today
1. Pediatric Symptom Checklist
2. Global Appraiser of Individual Needs – Short
Screener
3. Children’s Anxiety Scale
4. Depression Scale for Children
5. Columbia Depression Scale
6. Child & Parent Reports of Post-traumatic
Symptoms
7. Trauma Symptom Checklists for Children &
Young Children
Pediatric Symptom Checklist
 Checklist for to identify cognitive, emotional,
& behavioral problems
 Ages 4-16 years
 35-items, self-administered
 Parallel child & parent versions
 Youth checklist for 11 – 16 years
 Parent Checklist for children ages 4 – 16 years
Pediatric Symptom Checklist
 Available in 16 languages
 Extensive information available at PSC
Website maintained by Massachusetts
General Hospital
http://www2.massgeneral.org/allpsych/psc/psc_home.htm
Global Appraiser of Individual Needs –
Short Screener
 Cooperative effort of DPI & DHS
 For use with adolescents
 Covers AOD, externalizing & internalizing disorders,
attention deficits & criminal behavior
 Designed for self- or staff-administration with paper
& pen, computer, or on the web
 Can be administered by pupil services professionals following
webcast training
 3 - 5 minutes to administer
 Provides a measure of change
 Spanish version available
Global Appraiser of Individual
Needs – Short Screener
 GAIN-SS home page
http://sspw.dpi.wi.gov/sspw_pupilsvcsgainss





Webcast
Access to electronic tool
Manual
Consent forms
Treatment directories
 Call Student Services/Prevention & Wellness Team
for password – (608) 266-0963
Spence Children’s Anxiety Scale
 Scale is designed to parallel 6 domains of
anxiety from DSM






Generalized anxiety
Panic/agoraphobia
Social phobia
Separation anxiety
Obsessive/compulsive disorder
Physical injury fears
Spence Children’s Anxiety Scale
 School-age & preschool children
 3 Versions that are parallel
 Children
 Parent for child
 Parent for pre-school child
 Pre-school scale asks about traumatic events
 Self-administered
 44 items + narrative response
Spence Children’s Anxiety Scale
 Available in 16 languages
 Extensive information about the SCAS is
available at
http://www.scaswebsite.com/
Center for Epidemiological Studies
Depression Scale for Children
 Best evidence with females 6-18 years &
male adolescents 12-18 years
 20-items self-report
 Questions focus on feelings over past
week
Center for Epidemiological Studies
Depression Scale for Children
 Tool & instructions for use are available at
http://www.brightfutures.org/mentalhealth/pdf
/professionals/bridges/ces_dc.pdf.
Columbia Depression Scale
 Screens for depression & suicide
 Questions focus on feelings & behaviors
over the past 4 weeks
 Ages 11 & up
 Parallel student & parent instruments
 22-item self-report
 Provides level of risk and % of youth who
score within each risk range
Columbia Depression Scale
 Copyright by Columbia Teen Screen
 Free with permission from authors
 Prudence Fisher fisherp@nyspi.columbia.edu
 Copy available at
http://lphi.org/CMSuploads/ColumbiaDepression-Scale-64716.pdf
Child Report of Post-traumatic Symptoms
Parent Report of Post-traumatic Symptoms
 Ages 7-17
 Brief (5 min), self-report, 26 items
 Asks about symptoms over the past week
 Can be used to measure change over time
 Parallel child/youth & parent forms
 Available in 7 languages
http://www.nctsn.org/content/child-report-posttraumatic-symptoms
Trauma Symptom Checklist for Children
Trauma Symptom Checklist for Young Children
 TSCC for ages 8-17
 54 items, 15-20 minutes, self-report
http://www4.parinc.com/Products/Product.aspx?ProductI
D=TSCC
 TSCCYC for ages 3-7
 90 items, parent/caregiver report
http://www4.parinc.com/Products/Product.aspx?ProductI
D=TSCYC
 Parents & caregivers complete parallel tool for
ages 8-12
 English & Spanish
More information
More information about these & other behavioral
health screening tools at
http://sspw.dpi.wi.gov/sspw_mhbehavioraltools
Improving Access to Mental Health
Services
 Identify & proactively contact area MH/AOD
assessment professionals
 Learn referral procedures
 Obtain their release forms
 Learn assessment professionals’ expertise
 Mental health
 AOD
 Gauge willingness to participate in ongoing
communication following assessment
Improving Access to Mental Health
Services
 Recruit community mental health professional
to serve on school mental health team
 Designate as a “local school district official”
 Explore possibility of community mental health
agency opening school branch office
 DHS Memo can be found at
https://www.dhs.wisconsin.gov/dqa/memos/13020.pdf
Improving Access to Mental Health
Services
Wisconsin Mental Health & Substance Abuse
Services Directories
 AOD
http://www.dhs.wisconsin.gov/guide/aoda.htm
 Mental health
http://www.dhs.wisconsin.gov/guide/find/mental-health.htm
What are Parents’ Concerns?
 Assessment around mental health may raise
these thoughts in parents
 This is no big deal. My kid’s just a “drama
queen.”
 Is she saying my child needs medication?
 He thinks I’m a bad parent.
 This is my fault. Why didn’t I prevent this?
 I can’t let anybody know about this.
 Stigma & shame associated with mental
illness
Improving Access to Mental Health
Services
 Tailor referrals to individual student & family
circumstances
 Check emergency medical card for insurance
provider
 Research coverage with family
 Provide specific name(s) & contact info
 Offer to make call for appointment
Improving Access to Mental Health
Services
 Tailor referrals to individual student & family
circumstances
 Communicate level of urgency to community
assessment professional
 Share results of screening tool (with parent consent)
 Prepare family & student for next steps
 Ask family to sign release form for ongoing
communication & coordination
 Check in with family to determine follow through
& re-engage, if necessary
Insurance
 DHSS issued final rule 11/08/13
establishing parity for MH & AOD services
 Changes in BadgerCare & Affordable
Care Act
http://dhs.wisconsin.gov/badgercareplus/
Behavioral Health Info for Schools




Child & adolescent mental health information
Checklists for preliminary screening
Screening tools & rating scales
Mental health in the classroom




Educational evaluations
School-based interventions
Creating a safe school climate
SEL curriculum
 Medications
 Research studies
Massachusetts General Hospital Child Psychiatry Program
http://www2.massgeneral.org/schoolpsychiatry/for_educators.asp
Resources
Lane, K. L., Menzies, H. M, Oakes, W. P., & Kalberg,
J. R. (2012). Systematic screenings of behavior to
support instruction: From preschool to high school.
New York, NY: Guilford Press.
Oakes, W. P., Lane, K. L., Cox, M., & Messenger, M.
(2014). Logistics of behavior screenings: How and
why do we conduct behavior screenings at our
school? Preventing School Failure, 58, 159-170, DOI:
10.1080/1045988X.2014.895572
Systematic Screening for Behavior to Support
Instruction: An Overview
Kathleen Lynne Lane, Ph.D., BCBA-D
PBIS
ISF Webinars
Topic
Exploring the ISF for Integrating SOC & Education
Lucille Eber, Midwest PBIS Network, Susan Barrett, Sheppard Pratt Health Systems, &
Kelly Perales, Community Care Behavioral Health
Recording Link
https://theinstitute.ad
obeconnect.com/p7nt
om23s1p/
An introduction to the Interconnected System Framework (ISF) for efficiently
integrating mental health/SOC in schools featuring lessons learned from
Pennsylvania’s implementation experiences.
Installing ISF-Local Experiences Integrating SOC & Education
Susan Barrett, Sheppard Pratt Health Systems
A review of the core components of the ISF and experiences from SOC/Education
efforts in New Hampshire including strategies for work force development, focus for
ISF focused leadership teams, and ensuring use of data and evidence-based practices.
Installing ISF: The Role of School & Community-based Clinicians
Lucille Eber, Midwest PBIS Network; Susan Barrett, Mid-Atlantic PBIS Network; Mark
Weist, University of South Carolina; Ali Hearn & Sheri Luecking, Midwest PBIS
Network; Sharon Stephan & Nancy Lever, University of Maryland
An overview of the changing-role of clinicians within multi-tiered systems of
behavioral health in schools.
https://theinstitute.ad
obeconnect.com/p5sh
4fur2al/
https://theinstitute.ad
obeconnect.com/p23
wjt2fphd/
OSEP Technical Assistance Center
on PBIS 2015 Leadership Forum
PBIS: Integrated Multi-Tiered
Framework for Educational
Success
This two-day forum for school, state,
district and regional Leadership Teams
and other professionals has been
designed to increase the effectiveness of
PBIS implementation.
Sessions are organized by strands that
support initial through advanced
implementation in elementary, middle,
and high schools as well as juvenile
justice facilities:
PBIS Foundations
Classroom Applications
Tier 2 Systems & Practices
Tier 3 Systems & Practices
Aligning Systems
Juvenile Justice
Mental Health Integration
Equity
Applied Evaluation
Special Topics
Featuring sessions specifically designed for our Mental
Health, Juvenile Justice, and Family/Community
Partners!
Visit the Upcoming Events page at www.pbis.org for more information
Donald Stephens Convention Center - Rosemont, IL
SAVE THE DATE
October 22-23, 2015