Showing posts with label functional assessment. Show all posts
Showing posts with label functional assessment. Show all posts

Saturday, November 12, 2022

Teaching Students Needed Academic and Social-Emotional Skills: We Need to Sweat the Small Stuff

[CLICK HERE to read this Blog on the Project ACHIEVE Webpage]

Dear Colleagues,

Introduction

   Once again, I am writing this Blog while flying at 33,000 feet. . . this time traveling from Vancouver, British Columbia back to Little Rock, Arkansas (for about 10 hours until I fly to my next consultation in New Jersey).

   I spent a phenomenal week working with the school psychologists attending the British Columbia Association of School Psychologists’ Annual Conference. There, I guided some in-depth discussions regarding how to design and implement effective (a) school-wide Social-Emotional Learning/Positive Behavioral Support and (b) Multi-Tiered Academic and Behavioral Support systems, and how to differentiate among and address (c) student stress, anxiety, and trauma practically in the classroom as part of a multi-tiered process.

   As always, I benefitted as much from the experience as I think I contributed.

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   During our discussions, I emphasized a number of times the importance of “sweating the small stuff.”

   I “get” that the intent of the saying, “Don’t sweat the small stuff,” is to encourage us to look at the “big picture of Life,” to take a deep breath, and to not obsess over the small irritants that seem to occur daily.

   But in education and psychology, and especially when working with students who are academically struggling or demonstrating social, emotional, behavioral, or mental health challenges, we must drill way past the “big picture” into the details of why these struggles or challenges are occurring, so that we can link them to the how reflected in the specific services, supports, strategies, and interventions needed for change.

   In today’s message, I want to provide some school-related instructional or intervention examples of this theme to remind both educators and related services professionals that a focus on the “small stuff” is needed to generate the “big stuff” that maximizes students’ academic and social-emotional learning, mastery, proficiency, and independence.

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A Brief Medical Miracle Analogy

   Before focusing on education, let’s start this journey by using medicine—and its focus at times on the “building blocks of life” as a metaphor for the need to “go small.”

   Just this week, it was announced that doctors were able to successfully treat in utero an unborn child with a rare genetic condition called Infantile-onset Pompe.

   According to the Hospital’s Press Release:

Pompe disease is seen in less than 1 in 100,000 live births, and is caused by mutations in a gene that makes acid alpha-glucosidase, an enzyme that breaks down glycogen. Without it or with limited amounts, glycogen accumulates dangerously in the body. After delivery, treatment to replace the enzyme is available, but the disease still often results in very low muscle tone, ventilator dependency and death.

 

The disease is one of several rare lysosomal storage disorders that can severely damage major organs before birth. Babies born with Pompe typically have enlarged hearts and die within two years if untreated.

   Two medical miracles actually occurred here.

   First, doctors have the know-how to complete genetic testing on unborn children that reveals different life-threatening conditions early in their prenatal development.

   Second, in this case’s new medical breakthrough, doctors provided this baby the enzyme replacement therapy well before she was born.

   The child is now 16 months old, and she has hit virtually all of her developmental milestones—for example, crawling, walking, talking, eating—at the expected times. More significantly, her cardiac functioning is normal.

   According to the attending doctor:

“This work also continues to expand the number and type of rare genetic diseases that can be treated prenatally. As new treatments become available for children with genetic conditions, we are developing protocols to apply before birth. I think of this as another step in expanding the repertoire of fetal therapy to treat genetic diseases that, while individually rare, are a large percentage of congenital anomalies.”

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   The point here is that many areas of science and medicine “travel” at the cellular (or smaller) level.

   Indeed, we are now treating illnesses and conditions that affect us at the “big picture” level—impacting our day-to-day functioning, our quality of life. . . indeed, our life itself—because doctors and other scientists are able to modify minute, microscopic biochemical, genetic, or physiological structures, pathways, and interactions.

   Ultimately, in many professions, success occurs because they attend to and “sweat” the small stuff. There just are no other alternatives.

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Some “Small Stuff” Examples in Education

   Critically, the five “small stuff” examples below have all occurred during the last three weeks in some of the schools where I am consulting.

   Some of you may remember that I wrote the five-year U.S. Department of Education School Climate Transformation Grants that were awarded in 2019 to three different school district clusters in Oklahoma, Michigan, and New Jersey, respectively.

   As part of the Grant activities, I work on-site in these districts’ schools for up to 40 days per year—helping them design and implement effective multi-tiered academic and social-emotional learning/positive behavior support systems, using Project ACHIEVE’s (www.projectachieve.info) evidence-based model, from preschool through high school.

   Ultimately, to accomplish our student-centered goals, we need to get “small.” Here are five examples that we hope will motivate you to think “smaller” about some of your professional activities or interactions with your students, staff, or others in your workplace.

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Small Procedures

   When we are preparing to conduct a Case Conference on a specific struggling or challenging student involving the multi-disciplinary, school-level Multi-Tiered Services (or Student Services) Team, we always asked the student’s teacher(s) to complete the “First Things First.”

   This involves a set of activities where the teacher(s) supported by select MTSS Team members (a) complete a Student Record Review, (b) Interview parents and previous teachers (or interveners), (c) determine the current functional academic and social-emotional skill level of the student, (d) identify or discount critical medical (or related) conditions, and (e) do classroom observations so that others can see the depth and breadth of the problem.

   One of my schools recently prepared for and conducted an MTSS Team Case Conference that I observed so that I could provide feedback on their use of our data-based problem-solving process.

   The Case involved a Second Grader who was way behind academically (e.g., she was “reading” at the end of kindergarten level), who was still reversing many numbers and letters, and whose First Grade teacher had recommended retention—which the parents had rejected. The child had been in this school since kindergarten, and she was only receiving periodic academic intervention supports.

   Nonetheless, when the School Counselor interviewed the mother three days before the Case Conference, for the very first time, the parent shared that the child had had significant breathing difficulties at birth, that her developmental milestones (e.g., walking, talking, etc.) were very delayed, and that she had had occupational therapy services before starting kindergarten.

   Small procedures means that we break, here, the MTSS process into the specific steps needed to collect the initial background and historical information needed on every student for every case.

   Everyone around the MTSS table acknowledged that the developmental information above should have been common knowledge at least two years ago. Indeed, this was a case of a parent not knowing the importance of this information, coupled with no one at the school ever asking for it. This not a case of a parent withholding the information.

   The MTSS Team immediately initiated a referral for special education and accommodation services and supports that would include (a) the completion of cognitive, processing, and academic achievement assessments; (b) a complete social-developmental history with the parents; and (c) a neurological screening to determine other potential concerns in that area.

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Small Gestures

   In another one of my Grant districts within the last two weeks, we were reviewing the results of a school climate survey completed by all of the students in Grade 5 and above.

   The Superintendent was very concerned because, among a number of troubling outcomes, a large percent of the student body agreed or strongly agreed to a statement, “My teachers care about me and my peers.”

   Noting that even if this was a student misperception, something needed to be done.

   A discussion ensued that focused on (a) some questioning the validity of the results, and wanting to re-write some questions and re-survey the students; (b) some expressing frustration that the students were not recognizing what the staff was already doing for them—suggesting that they were ungrateful; (c) some saying that the results had to be from a small minority of students—completely missing that eliminating these students’ results would not appreciably change the data; and (d) some generating interventions to “fix” the problems.

   The Superintendent patiently waited for the discussion to subside and then she asked me for my reflections.

   I first told the group that we should not be responding or making changes to the survey just to make us feel better.

   I then briefly explained that this survey—just like a thermometer—was a screening tool. . . it was simply identifying some “hot” areas within the school that concerned the students.

   Moreover, even if we re-wrote specific survey items and re-surveyed the students, the results—just like a thermometer—would not likely or fully tell us why we were getting the “hot” results. And this “outcome” would occur after spending (wasting) a lot more time in re-writing, re-surveying, re-analyzing the data, and re-discussing “the problem.”

   In the end, I suggested that we “get small”. . . that we begin to connect with the students and show them that we care by setting up a series of focus groups to listen to their concerns, their analyses, and their suggestions.

   In this way, everyone would experience two wins. First, the win of demonstrating to the students that the staff care enough to listen to their voices, and to entertain their suggestions on how to improve the school’s climate for them.

   This would then pave the way for a second win. . . an improvement of the school’s climate that would result in greater student attendance, engagement, motivation, and—hopefully—learning.

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Small Goals

   Another one of my Grant schools has a period each day at the secondary level for either academic remediation or enrichment.

   Relative to the latter, the staff have struggled—for the last two years—to figure out how to maximize the benefits of this intervention time.

   In fact, the outcome data suggest that there have been minimal academic benefits to the students, and that the staff are pretty frustrated with the entire endeavor.

   For me, the core of the problem is that the school is (a) focusing on reading and then math intervention weeks for all students on a rotating basis; (b) the intervention groups are organized by students’ scores from a computerized academic screening and progress monitoring program; and (c) the students in the intervention groups seem to be constantly changing (as are the assignments to intervention teachers).

   Rather than focus on the flaws embedded in the processes above, I—again—suggested that the school “get small.”

   This entailed the following:

·       Identifying the specific and core-essential skills in reading and math that each student needed remediation in; 

·       Prioritizing—for each quarter of the school year—whether a student would focus on either reading or math during their intervention time; and

·       Mapping all of the students with different reading or math skill needs on a white board, and clustering the intervention groups so that each one would focus on a homogeneous set of skills, targeted intervention materials, evaluation approaches, and expected outcomes.

   Thus, “getting small” here meant focusing on a small set of skills to remediate, small student groups that would stay intact for at least nine weeks—with the same teacher, and small goals that had a high probability of being successfully attained.

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Small Behaviors

   While presenting at the British Columbia Association of School Psychologists’ Conference, I talked some about our Stop & Think Social Skills Program, and why social skills instruction needed to target specific, observable, and measurable skills.

   Yes. . . we got small.

   I first made the point that an effective Social-Emotional Learning (SEL) initiative or program would be unsuccessful—relative to students learning and demonstrating actual interpersonal interactions—if it focused only on behavioral constructs—for example, respect, responsibility, safety, caring, honesty, cooperation, altruism.

  Indeed, to attain any goal related to behavioral constructs, teachers would (a) have to determine what respectful behaviors, responsible behaviors, safe behaviors, caring behaviors, honest behaviors, cooperative behaviors, and altruistic behaviors they want students to demonstrate; and then (b) teach their students these skills using sound behavioral instruction practices.

   This then led to my second point.

   In order to get the desired student behavior outcomes, social skills need to be taught from preschool through high school, using a scaffolded scope and sequence taught across the school year, the instruction needs to focus on behaviorally teaching—not just talking—about desired goals and expectations, and the instruction needs to use the same behavioral strategies that are used when we teach sports teams, theatre groups, painters, or musicians their crafts.

   To be sure. . . getting small is not always easy, but it is always necessary.

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Small Steps

   Staying with the social skills theme above, within the past two weeks, I was doing demonstration Stop & Think Social Skill lessons in one of my Grant middle schools.

   In one 6th Grade classroom—organized by the school as a self-contained general education classroom because the students had a hard time transitioning to seven different periods and teachers during the school day—I taught the “Dealing with Teasing” skill.

   [Note that I had never worked with these students before. In addition, while I wanted to teach this skill to the students, another purpose for the demonstration was to model an effective social skills lesson for the classroom teacher.]

   When we got to the role play part of the lesson, I chose two willing students at random to come up in front of the class and role play a scene where one of them would “tease” the other, and he (in this case) would verbalize and then demonstrate one of the “good choice behaviors” embedded in the Dealing with Teasing skill script.

   I noticed that the student who was going to be teased in the role play was somewhat quiet and a bit awkward. At the same time, as I always stay with the students doing a role play—to guide them through the script and the skill (as needed), and to ensure that a “positive practice” of the skill occurs—I was confident that this “teachable moment” would be a successful one for him.

   In the end, I needed to provide a fair amount of guidance and “scripting” for this student, but he did a great job and really seemed to both embrace and understand the skill, its intent, and its importance. He also appeared to be very pleased with his performance.

   Later in the day, I met with the 6th Grade Teacher to debrief the training. It was at this point that she told me how proud she was of the roleplaying student because he is on the autism spectrum.

   I was actually really surprised because, while I noted his awkwardness, I did not pick up his developmental-behavioral challenge during our interactions earlier that day.

   So. . . the “small stuff” lesson here is that (a) teaching students social skill behaviors is a step-by-step process; (b) even some of the students who most need these skills (e.g., those on the spectrum) can learn them when the skill steps are broken down and systematically integrated; and that (c) virtually all students can learn when we “sweat the small stuff” as we build their skills toward “the large stuff.”

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Summary

   Educators consistently talk about the importance of evidence-based practices. This is complemented by discussions noting that evidence-based practices—in order to work—need to be implemented with fidelity. And yet, in order to attain fidelity, educators typically need to attend to and follow the specific implementation steps that (full circle, here) are the reasons that the practices in question are evidence-based.

   Said a different way:

In order to make big and meaningful academic and social, emotional, and behavioral gains with students in our classrooms and schools, we need to sweat the small details that make effective practices work.

   In this Blog, we shared five school-related instructional or intervention vignettes to demonstrate the importance of this theme, and to remind educators and related services professionals that a focus on the “small student stuff” is needed to generate, as above, the “big educational stuff.”

   The vignettes described actual situations that I have experienced over the past three weeks—many in one or more of the schools where I am helping to implement effective multi-tiered academic and social-emotional learning/positive behavior support systems as part of three different five-year U.S. Department of Education School Climate Transformation Grants.

   The five vignettes focused on five “small” areas: Small Procedures, Small Gestures, Small Goals, Small Behaviors, and Small Steps.

   We hope that this discussion will encourage educators to look at and evaluate their current practices with students, and ask two Questions:

·       Am I attaining the success I am having with students because I am “sweating the small stuff?”

·       Where I am not having my desired success with students—or where I know I could have greater success, is it because I am missing, ignoring, or not “sweating the small stuff?”

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   I hope that the reflections in this Blog are relevant and useful to you.

   In many ways, one of the reasons why I write these Blogs is that it gives me an opportunity to “Stop &  Think” about my work in the field, why I have been successful in specific cases, and how I could be more successful in others. This makes my future work more intentional, planful, and impactful.

   As always, if you and your colleagues would like to “get small” and reflect on your students, schools, or professional settings with me—please feel free to send me an email, and let’s set up a time to talk. I would be honored to assist.

Best,

Howie

[CLICK HERE to read this Blog on the Project ACHIEVE Webpage]

 

Saturday, April 30, 2022

Using Effective Practices to Screen and Validate Students’ Social, Emotional, and Behavioral Status (Part II)

 Finding, Sorting, Analyzing, and Synthesizing the (Right) Data

[CLICK HERE to read this Blog on the Project ACHIEVE Webpage]

Dear Colleagues,

Introduction

   Students across the country are demonstrating more social, emotional, and behavioral challenges the past two years than ever before.

   The problems are so significant that, this past October, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association formally declared our country’s child and adolescent mental health status “a national emergency.”

   Adding to the considerable Pandemic-related statistics, a JAMA Pediatrics study published just this week looked at the adolescent suicide rates (ages 10 to 19) in 14 states from 2015 to 2020 (which included Year 1 of the Pandemic).

   The results indicated that adolescent suicide in these states increased by 10% in 2020 compared with the average rate over the pre-Pandemic period from 2015 to 2019.

   There was some variability, however. For example, California, Georgia, Indiana, New Jersey, Oklahoma, and Virginia all saw statistically significant suicide increases, while Montana saw significant decreases.

   Concurrently, even more extensive social, emotional, behavioral, and mental health challenges have been well-documented over the past year for all school-aged students. . . beyond the suicide statistics above.

   The implications of these increases were discussed in Part I of this two-part Blog Series:

Schools Must Use Effective Practices to Screen and then Validate Students’ Mental Health Status (Part I)

YES: Teachers Should Help Screen Students for Social, Emotional, and Behavioral Challenges. . . NO: That’s NOT Where the Screening Process Ends

[CLICK HERE for Part I]

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   Part I addressed the implications that, because of the increase in students’ social-emotional challenges, many schools have re-invested in the informal and formal screening processes that help to identify these students—determining which ones need strategic or intensive multi-tiered services, supports, strategies, or interventions.

   The “thesis” of Part I was that, while general education teachers are an important “early warning” layer to the student screening process, they are only the beginning and not the end of the process.

   To this end, most of Part I described ten essential practices needed in an effective mental health screening-to-services process. The state goal of this process is to differentiate between (a) students having minor, moderate, or significant social, emotional, and behavioral challenges versus (b) students demonstrating concerns that are more momentary, transient, developmentally-expected, or situational in nature.

   Part I emphasized that this process also involves the use of (a) multiple assessment approaches or tools; (b) completed by multiple raters (including the student him or herself); and (c) that assess student behavior across multiple settings.

   In this Part II of this Blog series (below), we will describe the six ways to collect social, emotional, and behavioral student data in the most reliable and valid ways.

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How Do You Collect Screening-to-Service Information and Data?

    Across the screening-to-services continuum, there are many ways to collect important social, emotional, and behavioral (SEB) student data. Ultimately, to be useful and usable, these data must be reliable and valid (this is a required psychometric principle), and they need to identify and differentiate among specific, legitimate student concerns.

   The different ways to collect social, emotional, and behavioral screening data can be summarized in the acronym RIOTS: Review, Interview, Observe, Test, and Self-report. This acronym is operationalized below with a few specific examples of how to use them in the screening-to-service process.

(R) Review

   Every school has records, files, electronic spreadsheets, and other documents on every student in their Student Information (or Data Management) Systems or their physical file cabinets.

   There are (a) “official” records—like electronic or paper Cumulative Folders; (b) instructional folders— like work sample folders collected by teachers; (c) clinical files—like case notes written and kept by counselors or school psychologists when students are attending therapy groups or are being evaluated through the school’s pre-referral, multi-tiered services process; and (d) plan-related documents—like Academic or Behavioral Intervention, 504, and Individual Education Plans.

   At the beginning of any social, emotional, behavioral (SEB) screening-to-services process, the Multi-Tiered Services and Support (MTSS) Team (see below) should review these records to identify students who are, were receiving, or may have benefitted from SEB and/or mental health services. These records also document (a) the past psychoeducational status and progress of a student-of-concern; (b) administrators, teachers, and support staff of record; and (c) family, medical, developmental, or situational (e.g., school or district moves or transitions) information of note.

   All of this record-related information is potentially useful if the screening process transitions into a root cause analysis, and then service, support, and intervention activities.

   For some schools, all students’ electronic records (and status) are reviewed annually or (even better) when quarterly report cards or triannual interim academic assessments are completed. These reviews represent the school’s formal SEB (and academic) screening process.

   For other schools, these reviews are supplemented by teacher-completed SEB screeners (see Part I of this Blog series).

   Regardless, the Review of Student Records is an often-missed activity in the screening-to-service process. It sometimes is amazing what essential current and cumulative information is in these (especially electronic) records that can help teachers to more fully understand their students and students-of-concern.

   Indeed, in some cases, previous successful interventions for specific students are well-documented in their records. These past interventions are the same, current interventions that will help a student now to be successful... they simply were not communicated from one teacher to another, for example, from one school year to the next.

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(I) Interview

   Because the experiences with and perceptions of students may differ, when educators have “common” concerns about the social, emotional, and behavioral (SEB) status of different students, these concerns should be formally communicated to and recognized by a school’s MTSS Team for action.

   An important “next step” in the screening-to-service process involves interviews with the different educators (as well as, for example, previous teachers, intervention specialists, and parents/guardian) to (a) specifically and operationally clarify the concerns; (b) check the similarities and differences across different people’s student-related perceptions and experiences; and (c) begin the information-gathering process to help determine the root cause(s) of the problem(s).

   A significant gap here is that some schools do not have a duly constituted MTSS Team (consisting of the best academic and SEB assessment and intervention experts in or available to the school), and this Team often meets on a “case-by-case,” rather than a regularly-scheduled weekly or bimonthly, basis.

   In the absence of regularly-scheduled meetings, information on specific students-of-concern with SEB challenges may not reach the MTSS Team until the student is exhibiting significant or prolonged challenges. In the absence of a multi-disciplinary MTSS Team, the screening-to-service process may involve only selected professionals (typically, the administrator, counselor, and general education teacher(s) currently teaching the student-of-concern)... and this process may lack the important perspective of a missing multi-disciplinary professional.

   Moving on, there are many different ways to interview teachers, other educators, and parents/guardians. Depending on when the interview is occurring across the screening-to-service continuum, the interview may focus on (a) clarifying concerns, (b) gathering or eventually validating student background or current status information, (c) identifying hypotheses or validating these hypotheses to determine the root cause(s) of a student’s challenges, or (d) evaluating a staff member’s commitment and ability to implement strategic or intensive interventions.

   As such, interviews can be open-ended, semi-structured, or structured—the latter often based on an evidence-based diagnostic protocol that guides the interviewer through a decision-tree that results in the clarification, validation, and analysis of a specific student challenge.

   One of the more specialized interviews is the Social-Developmental History. This is typically completed with a student’s parents/guardians, and it results in information regarding the historical, familial, biological/ physiological/neurological, developmental, fine and gross motor, speech and language, and social-behavioral past and present of the student.

   The Social-Developmental History often provides an important baseline regarding the student-of-concern, and it can both generate and dismiss specific hypotheses about the root cause(s) of a student’s challenge(s).

   Other diagnostic interviews can screen for or analyze specific internalizing (e.g., anxiety or depression) or externalizing (e.g., anger or explosiveness) SEB or mental health conditions or circumstances.

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(O) Observe

   An independent and objective observation of a student-of-concern is an essential (early) part of the screening-to-service process. These observations should occur both in the settings where the challenges seem to exist, as well as settings that are not problematic or where the student is “successful.”

   These observations are particularly important both to validate concerns that may arise from a screening instrument or process, as well as to (a) identify any common triggers or sequences of the challenging behavior; and (b) determine if other students have the same challenges (but have not been referred), or are involved either as triggers or reinforcers of the student-of-concern’s challenging behavior.

   Observations also are important because teachers are often processing hundreds of micro-events in their classrooms at any point in time, and they may inadvertently miss important interactions involving the challenging student, his or her peers, or even the curriculum and instruction or classroom management process. Thus, having another set of “eyes and ears” for a time in the classroom can help to close any observational gaps.

   Given all of this, MTSS Team members should be trained and available to do classroom observations as needed across the screening-to-service timeframe. Collectively, the Team should develop reliable, valid, and systematic observational protocols and processes for the most commonly referred SEB student challenges. Moreover, the Team should develop consistent and valid ways to collect, combine, and analyze all observational data to maximize their contributions to the screening-to-service process.

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(T) Test

   Testing usually involves a student’s face-to-face (or virtual) response to specific structured SEB questions that are asked by a teacher, support educator, or (especially) related services professional (e.g., counselor, school psychologist, or social worker). The testing could involve a screening, SEB diagnostic or personality, or progress monitoring/evaluative assessment, respectfully. Thus, some of the testing will focus on a broad range of possible SEB challenges, and some will address more narrowly specific concerns (e.g., attention deficit hyperactivity, autism spectrum disorders, stress and trauma).

   As discussed in Blog Part I, any SEB or personality testing should be part of a broader MTSS Team process, and involve psychometrically-sound instruments that are part of a multi-instrument, multi-respondent, multi-setting, multiple-gated process.

   Critically, SEB testing should use tests, tools, inventories, surveys, or other instruments that (a) differentiate between students with SEB skill gaps and those with motivational problems; (b) assess students’ strengths and competencies, rather than just challenges or deficits; and (c) are administered in ways that minimize subjectivity, bias, and fatigue—the latter occurring, for example, when practitioners attempt to complete too many assessments with a student because of limited time.

   When different MTSS professionals complete different tests with the same student, the results should be integrated into a cohesive whole. That is, each professional should not write or report on their own, individual test results. Instead, all of the results should be interdependently synthesized and reconciled to reflect “the whole student” and his/her comprehensive SEB status.

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(S) Self-Report

   The social, emotional, and behavioral screening-to-services process should include opportunities where students can formally or informally discuss or “report” their own concerns, self-analyses, or needs for themselves. Self-report opportunities often are completed with a teacher during the screening process, or a mental health professional during the diagnostic or root cause analysis phase of the process.

   When a planned activity, Self-reports typically occur in the context of a screening or diagnostic (clinical) interview.

   Relative to screening, teachers should receive training (and, perhaps, supervision) in how to conduct a student interview so that the quality and objectivity of the information received is maximized. In addition, teachers need to learn how to avoid triggering undue student emotionality. . . thereby exacerbating or accelerating the student’s concerns.

   Relative to clinical interviews, mental health practitioners need to balance open-ended listening with questions that help students to share their major concerns, SEB reflections, and hypothesized reasons for the concerns. Like interviews, self-report protocols can be structured, semi-structured, or open-ended. Clinical interviews need to be age- and developmentally-appropriate, and students may be provided a sample of the interview questions ahead of time if strategically helpful.

   Another type of self-report involves social-emotional or behavior rating scales that are completed, typically, by teachers and/or parents. These scales have demonstrated internal reliability and external validity, and they often are normed using specific, representative student populations. This allows a teacher or parent self-report to be compared to a larger sample of students so that the severity or intensity of an individual student’s SEB challenge(s) can be quantified.

   Some self-report scales—for example, the Behavioral Assessment System for Children (the BASC)—have protocols that are independently completed by teachers, parents, and the student-of-concern him- or herself. By cross-walking the results of these three self-reports, there is more “confidence” in the existence of specific student concerns, and the self-report information can be used in follow-up interviews to get a more personal perspective of each individual’s (teachers, parents, and the student-of-concern) challenge-related perceptions or experiences.

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Summary

   One of the goals of this Blog Part II is to help educators and MTSS Team members recognize the many sources of information and data within the social, emotional, and behavioral screening-to-service process. In discussing this process, we have emphasized the importance of:

·       Using psychometrically-sound procedures and instruments that are part of a multi-instrument, multi-respondent, multi-setting, multiple-gated process; and 

·       Connecting SEB screening activities with diagnostic root cause analysis activities that then link to strategic or intensive services, supports, strategies, or interventions (as needed).

   We have also emphasized that schools do not necessarily need to conduct formal screenings using, for example, behavior ratings scales where every student in a school is assessed. If reliable and valid, teacher reports, cumulative record reviews, and other sources of information may be all that is needed for schools to successfully complete a sound screening process.

   Given the information and discussion in both Blog Parts I and II, it is recommended that districts and (their) schools:

·     Write (or update) their comprehensive Multi-Tiered Mental Health Needs Assessment, Screening, Implementation, and Evaluation Plan;

·     Recognize that the development, implementation, and evaluation of this Plan should involve the ongoing participation of the District’s mental health staff, as well as community-based mental health agency and service representatives; 

·     Include needed resources and the training of teachers, administrators, and related service professionals in the Plan; and 

·     Include “Case Study” practice, ongoing consultation and coaching, and periodic formative and summative evaluations of the process so that students in need are accurately identified and served in objective, data-based, and timely ways.

   All screening-to-service implementation processes should be overseen by each school’s Multi-Tiered Services (Child Study, or Student Assistance) Team which (a) includes the best trained academic and social, emotional, behavioral assessment and intervention specialists in or available to the school; and (b) meets on a regular basis to address the needs of students in the school who are exhibiting academic and/or behavioral challenges.

   In the end, this process should focus on the academic and social, emotional, and behavioral independence, self-management, progress, and proficiency of all students—especially those who are struggling or presenting with specific challenges.

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   I hope that the two Blogs in this Series resonate with you and motivate you to think—especially toward the end of this school year—about how you want to begin the next school year relative to effectively identifying and serving your students.

   We all have had many Pandemic-related experiences over the past two-plus years, and our students do not always have the awareness, insight, or resources to understand and address their social, emotional, or behavioral needs.

   As always, if I can help you in any of the areas discussed in this Series, I am always happy to provide a free one-hour consultation conference call to help clarify your needs and directions on behalf of your students and colleagues.

   I am currently completing a number of Needs Assessments and Resource Analyses for different school districts in the areas of (a) school improvement, (b) social-emotional learning/positive behavioral discipline and classroom management systems, and (c) multi-tiered (special education) services and supports.

   The results are a research-to-practice Action Plan and implementation blueprint that helps many districts to reach both their short-term and long-term student, staff, and school goals and outcomes.

   Please feel free to reach out if you would like to begin this process. . . or just throw some ideas around.

Best,

Howie

[CLICK HERE to read this Blog on the Project ACHIEVE Webpage]

Saturday, April 16, 2022

Schools Must Use Effective Practices to Screen and then Validate Students’ Mental Health Status (Part I)

YES: Teachers Should Help Screen Students for Social, Emotional, and Behavioral Challenges

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NO: That’s NOT Where the Screening Process Ends

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[CLICK HERE to read this Blog on the Project ACHIEVE Webpage]

Dear Colleagues,

Introduction

  For a variety of Pandemic and Not-Pandemic reasons, students across the country are demonstrating more social, emotional, and behavioral challenges this year than ever before.

   As such, teachers have—appropriately—needed to consciously integrate social, emotional, and behavioral training and discussion into many of their school days.

   Moreover, mental health professionals (counselors, school psychologists, and social workers) have needed to provide more strategic (Tier II) and intensive (Tier III) services to students in-need—including many more threat, suicide, self-injury, and other, related assessments.

   Finally, administrators have needed to balance their responses to an increasing number of office referrals—making the difficult differentiation between “discipline” problems and “social, emotional, or mental health” problems.

   Given this, states and districts have re-emphasized the importance of an informal and formal behavioral health screening continuum that—within a school—begins in the classroom with general education teachers.

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Training Teachers to be Mental Health Screeners

   This month, an Education Week article (April 4, 2022; “With Students in Turmoil, Teachers Train in Mental Health”) discussed how some states and districts are handling the increase in students’ social-emotional needs.

[CLICK HERE to Read the Original Article]

   The article highlights include the following:

·     Students are exhibiting more social, emotional, and behavioral upsets in school: increased childhood depression, anxiety, panic attacks, eating disorders, fights, and thoughts of suicide.

·     These upsets appear to be more pronounced for low-income students who concomitantly have/are experiencing additional stresses related to where and how they live.

·     The national shortage of counselors, school psychologists, and other mental health professionals has decreased the availability of school-based intervention and support—requiring community mental health referrals that parents and students sometimes ignore, and that also involve long waiting lines.

·     Some states and districts are using professional development funding to train teachers to identify the warning signs of students’ mental health problems and/or involvement in substance abuse. 

·     One course, “Youth Mental Health First Aid,” was highlighted in the article, but this course is not easy to access by individual educators. It is typically sponsored by school districts; it covers only a limited number of possible mental health challenges; and it does not provide individualized instruction for specific local or regional challenges, nor on-site consultation or coaching to facilitate implementation.

·     In California, which began offering the “Youth Mental Health First Aid” course in 2014, only 8,000 teachers, administrators, and school staff out of a possible 600,000 K-12 staff have been trained.

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   The implications here include:

·     Districts and schools need to write (or update their) comprehensive Multi-Tiered Mental Health Needs Assessment, Screening, Implementation, and Evaluation Plan.

·     This development, implementation, and evaluation of this Plan should involve the ongoing participation of the District’s mental health staff, as well as community-based mental health agency and service representatives.

·     The Plan should include resources and trainings like the “Youth Mental Health First Aid” course, but it should not be dependent on any single course to fully prepare teachers and other staff in this important area. 

·     Any social, emotional, or mental health professional development should include “Case Study” practice, ongoing consultation and coaching, and an explicit screening process so that students in need are accurately identified in objective, data-based, and timely ways. 

·     All of the implementation processes should be overseen by each school’s Multi-Tiered Services (Child Study, or Student Assistance) Team which (a) includes the best trained academic and social, emotional, behavioral assessment and intervention specialists in or available to the school; and (b) meets on a regular basis to address the needs of students in the school who are exhibiting academic and/or behavioral challenges.

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Ten Essential Practices in an Effective Mental Health Screening-to-Services Process

   A sound and effective mental health screening-to-services process is important to differentiate between (a) students having minor, moderate, or significant social, emotional, and behavioral challenges versus (b) students demonstrating concerns that are more momentary, transient, developmentally expected, or situational in nature.

   While general education teachers often are the first educators to identify student behavior that is concerning, an effective mental health screening-to-services process requires the use of what are called “multiple-gated steps.”

   This process also involves the use of (a) multiple assessment approaches or tools; (b) completed by multiple raters (including the student him or herself); and (c) that assess student behavior across multiple settings. As with any data-based process, it is important that the ratings, observations, and data are reliable, and that the results are valid.

   In Part I of this two-part Blog series, we will describe the ten essential practices to guide a school’s effective mental health screening-to-services process.

   In our next Part II, we will describe the six ways to collect social, emotional, and behavioral student data in the most reliable and valid ways.

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   The ten essential practices to guide a school’s effective mental health screening-to-services process include the following:

   Practice 1.  Multiple gating procedures need to be used during all social, emotional, and behavioral universal screening activities so that the screening results are based on (a) reliable and valid data that (b) factor in false-positive and false-negative student outcomes.

   Too many screening procedures go from screening to intervention—without considering whether the initially-derived results are accurate. Part of this process is determining if the screening procedures have “identified” students who actually do not have significant problems (i.e., “false-positive” results), or have not identified students who actually do have problems (i.e., “false-negative” results).

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   Practice 2.  After including false-negative and eliminating false-positive students, identified students (who have been “red-flagged” by a screening procedure) receive additional diagnostic or functional assessments to determine their strengths, weaknesses, social-emotional knowledge and skill gaps, and the underlying reasons for those gaps.

   When screening procedures do not exist or are not accurate, Practices 5 and 6 below should occur with all students who are demonstrating social, emotional, or behavioral concerns in any school setting. 

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   Practice 3.  When screening students for social, emotional, or behavioral challenges, the potential impact of a student’s academic status should be considered as part of the diagnostic or functional assessment. This “catches” students who are demonstrating behavioral problems due to academic frustration or skill deficits.

   While it may target ways to help students effectively control, decrease, or communicate their frustration, intervention plans here must address the root cause of the problem: remediating students’ academic deficiencies so that the sources of their frustration is moderated or eliminated.

   Part of the diagnostic assessment should also differentiate current problems that are Pandemic-specific or related, and problems that existed before the Pandemic began in early 2020.

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   Practice 4.  All students should be taught—from preschool through high school—social, emotional, and behavioral skills as an explicit part of the school’s formal Social-Emotional Learning/Positive Behavioral Support System. 

   These skills should be taught through an articulated, scaffolded, and systematic scope and sequence curriculum map—by general education teachers at the Tier I level—using methods grounded in social learning theory. The social, emotional, and behavioral skills taught should be applied to facilitate students’ academic engagement and self-management, and their ability to interact collaboratively and prosocially in cooperative and project-based learning groups.

   Many students with social-emotional challenges have never been systematically taught social skills. These skill deficits typically are not present when schools implement an effective Tier I social skills curriculum.

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   Practice 5.  Before conducting diagnostic or functional assessments (see Practice 2 above), comprehensive reviews of identified students’ cumulative and other records/history are conducted, along with (a) student observations; (b) interviews with parents/guardians and previous teachers/intervention specialists; (c) assessments investigating the presence of medical, drug, or other physiologically-based issues; and (d) evaluations of previous interventions.

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   Practice 6.  Diagnostic or functional assessments should evaluate students and their past and present instructional settings. These assessments evaluate the quality of past and present instruction, the integrity of past and present curricula, and interventions that have already been attempted. This helps determine whether a student’s difficulties are due to teacher/instruction, curricular, or student-specific factors (or a combination thereof).

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   Practice 7.  Diagnostic or functional assessments to determine why a student is not making progress or is exhibiting concerns should occur prior to any student-directed academic or social, emotional, or behavioral interventions.

   These assessments should occur as soon as students with apparent behavioral challenges are screened and recognized (that is, during Tier I). These assessments should not be delayed until Tier III (unless the student’s case is immediately escalated to that level).

   Said a different way: The goal of the screening-to-services multiple-gated process is to (a) accurately identify the students with significant social, emotional, or behavioral needs; (b) determine the depth, breadth, and root causes of their challenges; (c) link the assessment results to high probability of success services, supports, and interventions; and (d) reduce or eliminate the original challenges as soon, quickly, and efficiently as possible.

   When interventions are attempted prematurely and in the absence of the functional assessment (that some schools delay until Tier III), they typically have a low probability of success, and when they fail, they often exacerbate the problem and make it more resistant to change.

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   Practice 8.  Early intervention and early intervening services should be provided as soon as needed by students. Tier III intensive services should be provided as soon as needed by students.

   Students who are “failing” in Tier I, should not be required to receive (and fail in) Tier II services, in order to “qualify” to receive Tier III services or supports. If students who are struggling in the general education classroom need immediate Tier III services, supports, or interventions, they should immediately receive these through the multi-tiered, multiple-gated process.

   Multi-tiered service delivery should occur on a needs-based and intensity-driven basis.

   Critically, early intervention, Tier I services may include—based on the diagnostic or functional assessment results—the use of assistive supports, the remediation of specific social-emotional skill gaps, accommodations within the instructional setting and process, and curricular modifications as needed. 

   General education teachers and support staff need to be skilled in (a) the different strategies that may be needed within these service and support areas (i.e., remediation, accommodation, and modification), and (b) how to strategically choose these different strategies based on diagnostic or functional assessment results. A school’s mental health staff may need to directly consult with and coach general education teachers in these areas.

   Tier II and III services include strategic or intensive interventions (a) that are still implemented in a student’s general education classroom, and/or (b) that involve social, emotional, attributional, behavioral, or mental health interventions taught individually or in small groups that are then generalized to students’ 24/7 school and personal lives.

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   Practice 9.  When (Tier I, II, or III) interventions do not work, the diagnostic or functional assessment process should be reinitiated, and it should be determined whether (a) the student’s problem was identified accurately, or has changed; (b) the assessment results correctly determined the underlying reasons for the problem; (c) the correct instructional or intervention approaches were selected; (d) the correct instructional or intervention approaches were implemented with the integrity and intensity needed; and/or (e) the student needs additional, different, or reprioritized services, supports, strategies, or interventions.

   That is, it should not immediately be assumed—without validation—that the interventions should have worked, and did not work because the student has a more significant problem that will require more intensive and specialized services (although, based on data, that may be the case).

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   Practice 10.  The “tiers” in a school’s multi-tiered system of supports reflect the intensity of services, supports, strategies, or interventions needed by one or more students.

   The tiers are not defined by the percentage of students receiving specific intensities or services, nor do they reflect the organization (i.e., small group or individual), delivery setting or place, or expertise of the primary providers of those services.

   Instead, individual school’s Tier II and Tier III services and supports vary from school to school as they reflect the mental health and related services personnel, skills, expertise, and resources within each school.

   For example, if the schools in one district each have their own highly-skilled full-time counselor, school psychologist, and social worker, those schools will be able to provide some social, emotional, or behavioral services and supports at the Tier II level.

   If a different district has the same number of schools but only one school psychologist and one social worker for the entire district, the more strategic or intensive services and supports needed by their students may have to be delivered by a local community mental health agency—something most schools would classify as a “Tier III” service.

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Summary

   At this point, there is no debate that many more students are demonstrating social, emotional, behavioral, and/or mental health difficulties in our schools. . . for a variety of reasons.

   Given this, some districts and schools are training their general education teachers to recognize the “early warning indicators” of such difficulties, and others are being encouraged to formally screen all of their students for these difficulties—often by the authors, publishers, or companies that have developed on-line assessment programs.

   Unfortunately, for many schools this is the end of the process.

   That is, they are collecting their data, assuming it is accurate, and putting the “identified” students into, sometimes generic, intervention groups or categories that are either unnecessary or have limited prospects for success.

   Moreover, as they are using their screening strategies or programs to identify students in social-emotional need, they are not validating (a) whether the students actually have the challenges (false-positives); (b) they are missing students who legitimately have challenges (false-negatives); and (c) they are not completing root cause analyses or functional assessments to connect the reasons underlying the students’ challenges with high-probability-of-success strategic or intensive services, supports, or interventions.

   This Blog (Part I of a two-part series) discusses the screening-to-services multiple-gating process that all schools should be using to identify and serve students with social, emotional, behavioral, and mental health challenges. The discussion is framed in ten effective practices that will help schools to avoid faulty decisions, unethical practices, and interventions that may make some students’ challenges worse or more resistant to change.

   In the next Part II, we will describe the six ways to collect social, emotional, and behavioral student data in the most reliable, valid, and intervention-related ways.

   What we are suggesting is nothing less than what a good medical doctor, mechanic, or electrician does when providing sound services. While doctors certainly screen their patients for a variety of possible illnesses, it is only through a data-based functional assessment process that they both validate any illnesses or medical problems that emerge from the screening, and begin to link the problems to medical treatments and/or solutions.

   As a school psychologist who works in many schools across the country—often for up to forty days per year and five years at a time, I understand the increase, diversity, and intensity of the student-related social, emotional, behavioral, and mental health issues that schools are experiencing.

   But I also understand that some of the “quick fixes” that are being used—especially in the absence of the sound, multi-tiered practices discussed in this Blog—are doing a disservice to everyone. . . students, staff, schools, systems, and communities.

   Use your mental health professionals. . . . do your research. . . . develop your plans and processes. . . . and let’s get this right the first time!

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   As always, I appreciate everyone who reads this bi-monthly Blog and thinks about the issues or recommendations that we share.

   As the school year winds down and we evaluate our students’ progress this year and needs for next year, if I can help you in any way please reach out by looking at the resources on our Website: www.projectachieve.info), or by calling me for a free one-hour consultation conference call to clarify your needs and directions.

   I am currently completing a number of Needs Assessments and Resource Analyses for different school districts in the areas of (a) school improvement, (b) social-emotional learning/positive behavioral discipline and classroom management systems, and (c) multi-tiered (special education) services and supports.

   The results are a research-to-practice Action Plan and implementation blueprint that helps many districts to reach their student, staff, and school goals and outcomes for the next three to five years.

   Please feel free to reach out if you would like to begin this process.

Best,

Howie

[CLICK HERE to read this Blog on the Project ACHIEVE Webpage]