Differential Effects of a Direct Behavior Rating Intervention Based on Function of Problem Behavior

The purpose of this study was to investigate the effectiveness of a teacher-implemented tier two behavior intervention and differential effects based on function of student problem behavior. The participants were 36 public elementary school students who were nominated for additional behavior support beyond universal School-wide Positive Behavior Support. The intervention provided was Check-In/Check-Out, a tier two intervention using direct behavior ratings to increase structure and feedback to the student’s environment. Before and after implementation of the intervention, the authors assessed the students’ function of behavior, levels of problem behavior, prosocial behavior, and rate of behavioral incidents. A multivariate analysis of variance indicated significant effects for all students in prosocial behavior and behavioral incidents, but not problem behavior. An analysis of interaction effects indicated statistically significant differences in response to intervention based on function of problem behavior. Results are discussed in terms of considering function of problem behavior in selecting tier two interventions and implementing a three tier response to intervention model. The 2004 reauthorization of the Individuals with Disabilities Education Act (IDEIA, 2004) allows educational agencies to utilize a Response to Intervention (RTI) model for identifying students under the category of specific learning disability. In contrast to previous models of special education eligibility that relied on results of standardized measures of cognition and academic achievement, RTI relies on the continuous monitoring of student progress while providing multiple tiers of prevention and intervention. Although the majority of research and scholarly discussion has focused on utilizing RTI models for academic concerns, several researchers have proposed a similar model for social behavior problems (Eber, Sugai, Smith, & Scott, 2002; Fairbanks, Sugai, Guardino, & Lathrop, 2007; Gresham, 1991; Sugai, Horner et al., 2000). In the field, over five thousand schools across North America are implementing a three tier RTI model to support student social behavior (Horner, Sugai, Todd, & LewisPalmer, 2005). This is an author-produced, peer-reviewed version of this article. The final, definitive version of this document can be found online at Journal of Positive Behavior Interventions (doi: 10.1177/1098300708319127) published by SAGE. Copyright restrictions may apply. 2 McIntosh, Kauffman, Carter, Dickey, and Horner in Journal of Positive Behavior Interventions (2009) Although the specific components of RTI vary by implementation context, the RTI process generally includes the following: a) screening all students to identify who may benefit from additional support, b) implementing evidencebased interventions, c) providing a continuum of intervention through multiple tiers of intensity (i.e., primary, secondary, and tertiary), d) continuously monitoring all student progress, and e) examining student progress data to make special education eligibility decisions (Fuchs, Mock, Morgan, & Young, 2003; Gresham, VanDerHeyden, & Witt, 2005). RTI is commonly implemented through a three tier model of support (e.g., H. M. Walker et al., 1996). Three tier models provide a proactive continuum of support, in place for all students in a school (O'Shaughnessy, Lane, Gresham, & Beebe-Frankenberger, 2003; Simmons et al., 2002; Sugai, Horner, & Gresham, 2002; Vaughn, LinanThompson, & Hickman, 2003). Three tier RTI models focus not only on the remediation of academic and behavioral problems, but also on prevention. Thus, a continuum of behavior support ranges from universal strategies to prevent the occurrence of problems for all students in the school, to highly structured, individualized interventions for students who display severe skill deficits. Walker and colleagues advanced a three tier continuum of behavior support based on an established public health model delineating primary, secondary, and tertiary prevention (Simeonsson, 1994). Following this logic, school personnel implement a proactive, universal system for all students. This tier one (primary prevention) system is intended to provide adequate support for 80 to 85% of the school population. A tier two (secondary prevention) system is put in place to support students who are at risk for developing more serious problem behaviors, and do not respond to the universal system alone. This is typically successful for 10 to 15% of the school population. Finally, a highly individualized tier three (tertiary prevention) system is implemented for students who display the most serious problem behavior, and do not respond to either tier one or tier two interventions. This is typically needed for 3 to 5% of the student population. Decision rules to move students up and down tiers is based on need for support, which is determined by continuous monitoring of student progress. Students will continue to move up the tiers until an intervention is effective. If the student requires a resource intensive program that includes specially-designed instruction (i.e., tier three), s/he may qualify for special education services. An example of an evidence-based three tier RTI model for social behavior is School-wide Positive Behavior Support (SWPBS; Colvin, Kame'enui, & Sugai, 1993; Horner et al., 2005; Sugai, Horner et al., 2000). The SWPBS approach involves selecting and implementing evidence-based interventions at each tier and using school-wide and individual data to provide and improve support for students. Fairbanks and colleagues (2007) examined a SWPBS three tier RTI approach in an elementary school. School personnel implemented a tier one school-wide and classroom management intervention (universal SWPBS) for all students, and identified students who did not respond to the universal intervention through office discipline referrals and teacher referral. These students were provided with a tier two, Check-In/Check-Out direct behavior rating intervention (Crone, Horner, & Hawken, 2003; Filter et al., 2007; Hawken, McLeod, & Rawlings, 2007). Students at tier two were monitored through daily points earned and direct observation. Those who did not respond to the tier two intervention were then provided with a tier three intervention, individualized function-based support (Crone & Horner, 2003). Tier Two Interventions Within the three tier RTI model, tier two interventions have received less research scrutiny than tier one or three interventions. This level of support is intended for students who need more support than the universal system but may not require an intensive individualized intervention. Tier two interventions share a number of critical features. Typically these are ongoing programs for students that have a moderate number of students receiving services at a given time. The support is provided similarly for all students—this makes the interventions cost-effective and efficient for individual school personnel to implement (March & Horner, 2002). To be efficient in delivery, these interventions should be readily available for referred students, require little assessment prior to implementation, require few additional resources, and take no more than 10 minutes per day of classroom teacher time (Crone et al., 2003). In addition, the intervention must be cost effective, so that it can support multiple students with few resources. Examples of tier two behavior interventions include direct behavior rating intervention systems (such as Check-In/Check-Out), social skills training, anger management programs, and homework clubs (Hawken & Horner, 2003). This is an author-produced, peer-reviewed version of this article. The final, definitive version of this document can be found online at Journal of Positive Behavior Interventions (doi: 10.1177/1098300708319127) published by SAGE. Copyright restrictions may apply. 3 McIntosh, Kauffman, Carter, Dickey, and Horner in Journal of Positive Behavior Interventions (2009) Current Concerns Regarding Tier Two Interventions A tier two intervention represents a precarious balance between the other tiers. For tier one, the question is simple: is the student responding to an evidence-based, fully implemented universal intervention? If the answer is no, the student moves up the tiers. For tier three, it is also relatively straightforward–is the student responding to the individualized intervention? If the answer is no, additional assessment and modification of the plan may be indicated. Because tier two lies between these tiers, the question is more complex. The initial question of response to intervention is the same, but if the answer is no, there exists a further question: is the lack of response due to an insufficient intensity of intervention (i.e., the student requires a tier three intervention) or a poor match to the student’s needs (i.e., the student requires a different tier two intervention)? Answering this question incorrectly could lead to an improper special education eligibility decision or the delay of needed intensive services (Fuchs et al., 2003). Several pressing concerns about the three tier model have not been addressed in the current research literature. For example, it is unknown whether tier two interventions should be modified to the individual student’s needs before moving up to the tier three level of support. Modifications could provide students with efficient support in the least restrictive environment, but adding an additional step to RTI may also stall the provision of needed services. In addition, it is unknown whether just one tier two intervention is sufficient for the entire school, or if multiple options are necessary. One particularly important dimension of behavior to consider in this debate is function of problem behavior (McIntosh, Horner, Chard, Dickey, & Braun, in press). Decades of research supports the use of functional behavior assessment