November 29, 2007
Identifying and Supporting Students At Risk for Emotional and Behavioral Disorders Within Multi-Level Models
By Lane, Kathleen Lynne
Abstract Three-tiered models have been embraced by many schools to prevent and respond to antisocial behavior. However, many of these three-tiered models are incomplete or underdeveloped. Specifically, little attention has been devoted to studying how to (a) systematically identify students who require more focused secondary interventions and (b) build empirically-validated approaches to meet the behavioral and academic needs of students with or at risk for EBD. This paper provides two illustrations, one at the elementary level and a second at the middle school level, of how to address this void in the literature.Between 2 and 20% of the school age population demonstrate behavior patterns indicative of emotional and behavioral disorders (EBD; Walker, Ramsey, & Gresham, 2004). Students with EBD have externalizing and internalizing behavior patterns that, by definition, impede social, behavioral, and academic progress and create challenges for society as a whole. In the school environment, their lack of decorum and limited social skills often demand teachers' attention, interfere with the instruction, lead to impaired social relationships, and negatively influence the educational experiences of all students in the classroom. Further, students with EBD have poorer attendance, are more likely to be retained in grade, and have higher school drop out rates than any other disability category (Wagner & Davis, 2006). Beyond the school setting, students with EBD are characterized by high rates of unemployment and under-employment; negative employment experiences; impaired personal relationships; and a greater need for mental health services (Bullis & Yovanoff, 2006; Walker, Ramsey, & Gresham, 2004; Zigmond, 2006). These pejorative outcomes pose tremendous costs, financially and otherwise, to families and society as a whole (Kauffman, 2005; Quinn & Poirier, 2004), with the most extreme consequences exemplified in the recent school shootings that occurred in Colorado, Missouri, and Wisconsin during this past year. It is imperative that schools and society take heed and address the multiple needs of students with and at risk for EBD - particularly during the early elementary years when behaviors are more amenable to intervention efforts (Bullis & Walker, 1994; Kazdin, 1987).
Social and Behavioral Domains
Historically, social skills and behavioral deficits (e.g., impaired social skills; aggression and coercion; noncompliance; anxiety and depression) typical of these students have most often captured attention from the teaching and research communities (Coie & Jacobs, 1993; Walker, Irvin, Noell, & Singer, 1992). Consequently, the field has developed clear descriptions of these youngsters' student-teacher interaction patterns (Shores, Jack, Gunter, Ellis, DeBriere, & Wehby, 1993); psychometrically sound assessment tools such as the Social Skills Rating System (SSRS; Gresham & Elliott, 1990), the Child Behavior Checklist (Achenbach, 1991), the Walker- McConnell Scale of Social Competence and School Adjustment (Walker & McConnell, 1995), and the Behavioral and Emotional Rating Scale (BERS; Epstein & Sharma, 1998); and validated systematic screening tools such as the Systematic Screening for Behavior Disorders (SSBD; Walker & Severson, 1992), the Student Risk Screening Scale (SRSS; Drummond, 1994), and the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997).
During this time, teacher preparation programs focused predominantly on social and behavioral competencies by addressing topics such as classroom management, social skills instruction, conflict resolution, and anger management (Lane, Gresham, & O'Shaughnessy, 2002). While these competencies are essential, instruction in strategies for teaching core academic skills (e.g., reading, writing, and mathematics) is important as well. Yet, academic competencies were tangential in most programs as evidenced by the scope and sequence of most university level text books. With the exception of the Wallace and Kauffman's (1986) text, Teaching Students with Learning and Behavior Problems (3rd ed.), university level texts designed to prepare teachers to work with students with EBD dedicated little attention to academic instruction.
This lack of focus on academics may be due to a number of factors such as (a) the misconception that students must learn to behave appropriately before instruction can occur (Lane et al., 2002), (b) the misconception that behavior and instruction are separate entities (Kauffman, Mostert, Trent, & Hallahan, 2002), and/or (c) the debate as to potential causal relationships between academic underachievement and externalizing behavior patterns across the grade span (Hinshaw, 1992; Petras et al., 2004). Yet, regardless of the explanation, it is essential that attention be devoted to identifying the most effective, efficient methods of providing instruction to students with or at risk for EBD (Lane, 2004). Fortunately, attention has recently shifted to meeting the academic needs of students with EBD.
The academic deficits of students with EBD are well established. Students receiving special education services under the label of emotional disturbance (ED, Individuals with Disabilities Education Act, 2004) exhibit significant academic deficits in reading, writing, and mathematics relative to their general education peers (Greenbaum et al., 1996; Landrum, Tankersley, & Kauffman, 2003; Mattison, Spitznagel, & Felix, 1998; Reid, Gonzalez, Nordness, Trout, & Epstein, 2004; Scruggs & Mastroprieri, 1986; Trout, Nordness, Pierce, & Epstein, 2003; Wagner & Davis, 2006). Recent investigations also suggest that students receiving special education services under the ED label have greater academic deficits than students with other disabilities (Zigmond, 2006). At best, these deficits appear to either remain stable (Anderson, Kutash, & Duchnowski, 2001; Mattison, Hooper, & Glassberg, 2002; Reid et al.) or, at worst, deteriorate over time (Nelson, Benner, Lane, & Smith, 2004).
Academic interventions and tutoring interventions conducted to date provide a sound foundation from which to continue this line of inquiry. Most of the interventions have been conducted in the area of reading (Lane, Barton-Arwood, Rogers, & Robertson, in press), which is encouraging given that reading is a seminal skill that holds the key to all other forms of knowledge. Yet, the database is still sparse with even less inquiry in the area of mathematics (Lane, 2004) and even fewer investigations in writing (Lane, 2004; Lane, Barton-Arwood et al., in press; Tindal & Crawford, 2002). The scarcity of treatment outcome studies to improve the writing skills of students with EBD is especially alarming given that writing is the primary means by which students demonstrate their knowledge (Graham, 2005), particularly as they progress through school.
Collectively, this body of literature-although an important beginning-suffers some core limitations. For example, these studies are characterized by: (a) few studies at the secondary level; (b) a strong focus on base skills (e.g., decoding, mathematical facts, spelling), with limited attention to higher level skills (e.g., reading comprehension, problem solving, and composition); (c) designs that lack core components such as social validity, treatment integrity, and generalization and maintenance; (d) narrowly defined or limited number of outcome measures; (e) incomplete information regarding the intervention (e.g., absence of dosage); and (f ) few replications (Lane, 2004). Thus, while strides have been made in learning how to address the academic needs of students with EBD, there is work to be accomplished.
Moving Forward: A Focus on Screening and Academic Support
Clearly, the needs of students with EBD are many and the consequences of not adequately meeting these needs are deleterious. Given that many students with EBD (2-20%) will not go to receive special education services under the Individuals with Disabilities Education Improvement Act (IDEIA, 2004), with less than 1% of the school age population being served under the emotionally disturbed category, we need to be prepared to support students with EBD within the general education setting (Walker et al., 2004). Therefore, it is necessary to identify the most effective, efficient methods for instructing students who demonstrate clear behavioral and academic deficits that impede their educational progress.
In recent years, the research and teaching communities have shifted the focus towards the school as an agent of change with the use of three-tiered models of positive behavior support (PBS) in an effort to meet the multiple needs of students with and at risk for learning and behavior problems (PBS; Horner & Sugai, 2000; Lewis & Sugai, 1999). This model originated in the mental health field and, after being revised to include new language and ideas, is now applied in educational settings across the K-12 grade span (Lane, in press). Rather than just preventing problem behaviors from occurring, PBS focuses on teaching appropriate, functional skills and providing students with opportunities to practice and receive reinforcement for using these skills. This is accomplished within a three-tiered system comprised of primary, secondary, and tertiary levels of prevention. All students participate in primary prevention supports, such as school-wide social skills programs, with a goal of preventing harm from occurring. Approximately 80% of the student body is expected to respond favorably to this level. Students who are nonresponsive to the primary prevention program are identified and placed in secondary prevention programs. secondary prevention efforts focus on reversing harm (Walker & Severson, 2002). Often these programs are small group interventions for students with common acquisition or performance deficits (e.g., conflict resolution, anger management). Approximately 10-15% of the student body is likely to require secondary prevention. Students with multiple risk factors and those who are nonresponsive to secondary prevention programs are identified for tertiary prevention efforts. Tertiary prevention efforts focus on reducing risk. Examples include function-based interventions and mental health services (Lane, Umbreit, & Beebe-Frankenberger, 1999). Approximately 5-7% of the student body is apt to need tertiary prevention (Horner & Sugai, 2000).
Thus, PBS programs are data driven models containing proactive components focusing on prevention (primary prevention) and reactive components focusing on remediation (secondary and tertiary). School- wide data are used to identify students for each level of prevention.
In terms of students with behavioral challenges, PBS models provide graduated support as warranted to (a) prevent the development of behavioral problems that may lead to EBD and (b) support students with EBD by implementing targeted interventions at the secondary and tertiary levels (Lane, in press). Carefully designed PBS programs are able to address the full range of learning and behavioral needs in a scientific, feasible manner. Given that learning and behavioral competencies (and deficits) interact to influence school performance, it is essential to apply prevention models that recognize this transactional relationship (Lane & Wehby, 2002).
However, at present many of these three-tiered models are incomplete or underdeveloped. For example, with a few exceptions (Cheney, Blum, & Walker, 2004; Lane, Wehby, Menzies, Doukas, Munton, & Gregg, 2003; Lane, Wehby, Menzies, Gregg, Doukas, & Munton, 2002; Walker, Cheney, Stage, & Blum, 2005), little attention has been devoted to studying how to (a) systematically identify students who require more focused secondary interventions and (b) build empirically-validated approaches to meet the behavioral and academic needs of students with or at risk for EBD.
In this paper, I illustrate two methods of addressing this void: one at the elementary school level and a second at the middle school level. In both illustrations, the primary prevention models were designed based on teacher expectations for student decorum (Kerr & Zigmond, 1986; Lane, Pierson, & Givner, 2004; Walker & Rankin, 1983) and implemented with support from university personnel. Systemic screening procedures were employed and extant school-wide data collected to monitor outcomes associated with the primary plan and to identify students at risk for EBD who had specific academic concerns. Next, secondary interventions with an academic emphasis were constructed, one using single case methodology and one using group design methodology, to enhance academic outcomes for students at risk for EBD at the elementary level (Lane, Harris, Graham, Weisenbach, Brindle, & Morphy, in press) and explore the relationship between academic underachievement and problem behavior at the middle school level (Lane, Robertson, & Lambert, in preparation).
Screening and Targeted Support at Elementary Level: An Illustration
While targeted interventions (e.g., secondary and tertiary prevention programs) are important for students with and at risk for EBD at all ages, they are particularly important at the early elementary level. It is during this window of opportunity that such efforts are most likely to be successful in preventing the development of EBD (Kazdin, 1993). Yet, as mentioned above, limited research exists regarding how to intervene academically with students with EBD. This absence is particularly salient in the area of writing. To date, only a few studies have explored the efficacy and feasibility of writing instruction with students with or at risk for EBD (Glomb & West, 1990; Mason & Shriner, in press; Rumsey & Ballard, 1985). This void is a concern given that writing is an essential skill. Namely, writing is a key process by which one acquires, organizes, and disseminates information (Bangert-Drowns, Hurley, & Wilkinson, 2004; Graham, 2005). Further, writing can serve as an important vehicle for communication, reflection, and expression, the latter of which is associated with psychological and physiological benefits (Graham, 2006; Smyth, 1998).
Despite the importance of writing, numerous students fail to demonstrate competence in writing, with only 25% of students in the National Assessment of Education Progress identified as competent writers (Persky, Daane, & Jin, 2003). Similar deficits are noted for students with EBD as well, as evidenced by considerable writing deficits across the K-12 grade span (Nelson et al., 2004). Thus, the need for sound writing instruction is essential, particularly for students with and at risk for EBD.
One instructional model that has met with demonstrated success with students with learning disabilities (e.g., Graham & Harris, 1989) and those with poor writing skills (Harris, Graham, & Mason, 2006) is Self-Regulated Strategy Development (SRSD; Harris & Graham, 1996). SRSD instruction is a supplemental model with three goals. First, students learn a specific composing process inclusive of planning and drafting. Second, students learn self-regulatory procedures necessary to apply the acquired writing strategy and regulate their behavior during the writing process. Some of these features include goal setting, self-monitoring, self-instruction, and self-reinforcement. Third, SRSD fosters core components of motivation which include self-efficacy and effort.
Recently this strategy has been successful with students with EBD as evidenced by strong improvements in writing quality; completeness and length of responses; and the number of story elements contained (Adkins, 2005; Graham, Harris, & Mason, 2005; Harris et al., 2006; Mason & Shriner, in press). In addition, evidence of generalization to other genres was present (Adkins, 2005). Yet, these studies were conducted outside of a PBS model. Given that schools are attempting to meet students' multiple needs within the context of multitiered models of support, it is important to study the feasibility and effectiveness of interventions imbedded in the PBS model.
Lane and colleagues (in press) extended this line of inquiry in a rural, inclusive elementary school in middle Tennessee by (a) exploring the effectiveness and feasibility of a targeted writing intervention implemented as part of an existing PBS model and (b) determining the effectiveness of SRSD research with a new group of students - those at risk for EBD who also have writing deficits. In this study, school-wide data collected as part of regular school practices were used to identify second-grade students with behavioral and writing concerns. The school collected a number of measures to monitor students' academic and behavioral progress. For example, academic progress was measured using state achievement tests, district administered and standardized writing prompts (Test of Oral Written Language-3, TOWL-3; Hammil & Larsen, 1996), Individual Assessment Inventory in multiple content areas (Measures of Academic Progress, 2006), and STAR Reading Assessment (Renaissance Learning, 2006). Behavioral performance was assessed using office discipline data which were monitored using the School- wide Information System (SWIS (c); May et al., 2000), attendance data, and two behavioral screeners: the Systematic Screening for Behavior Disorders (SSBD; Walker & Severson,1992) and the Student Risk Screening Scale (SRSS; Drummond, 1994). The behavior screeners were administered at three time points: 6 weeks into the school year, prior to winter break, and again at year end.
Screening: Participation Selection
For this study, the following screening procedures were used to identify students with behavior and writing concerns. A behavioral concern was operationally defined as scoring as moderate (4-8) or high (9-21) risk for antisocial behavior on the SRSS or exceeding normative criteria on stage two of the SSBD for either internalizing or externalizing behavior patterns. A writing concern was operationally defined as scoring at or below the 25th percentile on the TOWL-3 (see Lane et al., in press for a detailed discussion of instrument descriptions and screening procedures).
Eleven students were identified as meeting the inclusion criteria of which parental consent was secured for 8 students. However, one student moved during baseline and another did not complete the intervention prior to year end. Thus, 6 students (5 boys and 1 girl) completed the study. Only one student, the girl, had an internalizing behavior disorder.
Intervention Logistics and Outcomes
After securing teacher and parent consent as well as child assent, instruction was delivered to students by three graduate students in education who received 10 hours of training in SRSD procedures. Each instructor met with students individually 3-4 days per week for 30 minutes. The strategy was taught to mastery, with students taking between 13-15 instructional sessions to meet criterion. Instruction occurred outside of the classrooms in quiet locations (e.g., cafeteria, back hallways). The SRSD instructional model includes six stages: Develop Background Knowledge, Discuss It, Model It, Memorize It, Support It, and Independent Performance. Students participated in one or more session of instruction for each stage, with the actual number of days dependent upon their rate of progress. The instructors taught students a general planning strategy, POW: Pick my idea (i.e., pick an initial writing topic), Organize my notes (i.e., organize ideas using a graphic organizer), and Write and say more (i.e., continue to polish and refine the writing plan). Then, to help students with the "Organize my notes" component of POW, they were taught a genre-specific strategy to help them formulate their ideas and make notes for each part in their story. This was accomplished with another mnemonic, WWW, What = 2, How = 2, which prompted students to ask these questions: Who is the main character? When does the story take place? Where does the story take place? What does the main character do or want to do; what do other characters do? What happens when the main character tries to do it; what happens with other characters? How does the story end? and How does the main character feel; how do other characters feel?
Positive reinforcement was tied to the school's primary prevention plan by clarifying the behavioral expectations at the onset of the lesson and letting students know that they would receive a PBS ticket upon lesson completion if they met one or more of the four expectations delineated on the ticket (e.g., respect; responsibility; honesty and fairness; and working cooperatively with others).
A multiple baseline across participants design with multiple probes during baseline was used to evaluate outcomes (Kennedy, 2005). The six students were randomly assigned to one of three legs, with the baseline phase consisting of regular school practices. Fidelity data were collected for 42% of the instructional sessions by the project director. Findings revealed that the intervention was implemented with 100% fidelity for all but one student whose fidelity was 94.44%. To monitor student progress, students completed writing probes in which they viewed a line drawing illustration and then wrote a story based on the illustration. Each writing probe was scored for the number of story elements included, quality of the prompt, and length. Post-intervention probes were administered immediately after the SRSD intervention was concluded. Maintenance probes were administered approximately 6 weeks after intervention completion for the first three students and at 3, 2, and 1 weeks following intervention completion for the remaining three students due to time constraints associated with the end of the year.
Findings revealed a functional relation between completion of the SRSD program and improved writing skills as measured by story length, completeness (number of elements) and quality. Story length increased substantially with individual increases ranging from 1.5 to 7 fold between baseline and post-intervention phases. Further, all students' mean element scores ranged from 6 to 7 during post- intervention, with limited variability. Finally, the quality of writing probes increased with mean levels ranging form 5 to 6 following intervention completion. Gains were sustained into the maintenance phases. Further, teachers and students rated the intervention favorably, with the intervention actually exceeding the initial expectations of some participants. (see Lane et al., in press for complete intervention procedures and results).
Considerations for Future Research at the Elementary Level
In the current study, we offer one method of (a) identifying students with co-occurring behavioral and writing concerns using a systematic screening procedure developed from existing schoolwide data and (b) implementing a scientifically rigorous investigation within the context of the three-tiered model of support using single case methodology (Horner, Carr, Halle, McGee, Odom, & Wolery, 2005). Moving forward, we encourage additional screening methods to identify students for targeted intervention. For example, in the current study an alternative method of identifying students could have included district-administered writing prompts and office discipline referral data. second, future studies could be designed to include other outcome measures to examine the extent to which collateral effects were evident on other writing genres (e.g., personal narrative; Harris et al., 2006) and academic engagement during classroom-based writing activities. Previous SRSD investigations with second-grade students who were poor writers found collateral effects on personal narrative writing (Harris et al., 2006). Similarly, some reading interventions conducted with students at risk for EBD found that in addition to improved reading skills, students demonstrated decreased disruptive behavior and improved academic engagement (Lane et al., 2001; Lane et al., 2002). Additional investigation is needed to determine the complete outcomes associated with SRSD instruction implemented as a targeted intervention within a three-tiered model of support. Further, research is also needed to explore the feasibility and effectiveness of conducting secondary interventions with an academic emphasis at the secondary level.
Screening and Targeted Support at the Middle School Level: An Illustration
Screening and targeted support in middle and high schools is also important, but even more challenging due to factors such as increased school size, scheduling complexities, increased curricular demands, and the transitivity of the school day (Isakson & Jarvis, 1999). While marty schools collect a range of data such as disciplinary referrals, grade point averages, and attendance data, few schools implement systematic behavior screenings (e.g., Strength and Difficulties Questionnaire; Goodman, 1997). Further, seldom are these data used to identify students for targeted interventions. To date, we identified only four studies that used school-wide data to identify students requiring targeted interventions due to academic and/or behavioral concerns (Cheney, Blum, & Walker, 2004; Lane et al., 2003; Lane et al., 2002; Walker, Cheney, Stage, & Blum, 2005). Two studies (Cheney, Blum, & Walker, 2004; Walker, Cheney, Stage, & Blum, 2005) used the Systematic Screening for Behavior Disorders (Walker & Severson, 1992); whereas, the other two used data from the Student Risk Screening Scale (SRSS; Drummond, 1994) to identify students who were nonresponsive to primary prevention efforts (Lane et al., 2003; Lane et al., 2002). However, all studies were conducted at the elementary level.
Additional inquiry is needed to (a) identify scientifically valid, yet feasible methods of using school-wide data to identify middle and high school students who require more intensive levels of prevention and (b) determine how to focus intervention efforts for students who demonstrate academic and behavioral concerns. As previously discussed, descriptive research suggests that students with EBD have a number of deficits: poor conflict resolution skills; high levels of aggression and noncompliance; poor study skills; and subaverage academic performance (Lane, Wehby, Little, & Cooley, 2005; Mattison, Hooper, & Glassberg, 2002; Nelson et al., 2004; Reid et al, 2004; Walker et al., 2005). Thus, questions arise regarding how to focus intervention efforts.
During the last three decades the field has debated the hypothetical causal models exploring the relationship between academic and behavioral problems posing questions such as: Does academic underachievement lead to problem behavior? Do impaired behavioral patterns lead to academic underachievement? Is there a transactional relationship between these domains? Or are other variables (e.g., hyperactivity-inattention-impulsivity or low cognitive abilities) mediating academic and behavioral performance levels? (Berger, Yule, & Rutter, 1975; Hinshaw, 1992; Lane, 2004; Lynam, 1996; Rapport, Scanlan, & Denney, 1999; Richards, Symons, Greene, & Szuszkrewiz, 1995; Trout et al., 2003).
Yet, the majority of treatment outcome studies exploring these relationships have been conducted with elementary age students (Allyon & Roberts, 1974; Coie & Krehbiel, 1984; Lane, O'Shaughnessey, Lambros, Gresham, & Beebe-Frankenberger, 2001; Lane et al., 2002; Nelson, Stage, Epstein, & Pierce, 2005; Wehby, FaIk, Barton-Arwood, Lane, & Cooley, 2003). Furthermore, collective outcomes do not allow definitive conclusions to be drawn regarding the hypothetical models posed.
To date, only two such studies have been conducted at the middle school level, both of which were implemented in isolation from a multi-tiered model of support. Scott and Shearer-Lingo (2002) examined outcomes associated with a repeated readings intervention with three middle school students with EBD. Results revealed increases in oral reading fluency and task engagement. Spencer, Scruggs, and Mastropieri (2003) examined outcomes associated with a paragraph summary strategy using peer tutoring with middle school students with EBD attending an alternative school. Results of this cross-over design suggest improvements in quizzes, multiple choice tests, and task engagement.
Moving forward, it is important to clarify the relationship between academic underachievement and problem behavior across the developmental continuum. It is unlikely that one model will hold true at all developmental levels (Bullis & Walker, 1994). We contend that it is important to look at this relationship at the middle school level, when competencies in study skills and conflict resolution skills become more essential to (a) meeting task demands at the middle school level which include long-term assignments, demonstrating knowledge on comprehensive tests, and acquiring information from texts and (b) negotiating the numerous interpersonal interactions with peer groups and multiple teachers. Study Overview
Lane and colleagues (in preparation) attempted to address two key voids in the literature by conducting a study that (a) used schoolwide data to identify middle school students with academic and behavioral concerns who required secondary prevention efforts and (b) examined the utility of an academic and behavioral intervention relative to controls for these students. Specifically, this study compared the efficacy of a study skills and conflict resolution skills intervention relative to regular school practices for middle school students identified for participation using school-wide data.
In this study, school-wide data collected as part of regular school practices were used to identify rising seventh- and eighth- grade students with academic and behavioral concerns (operational definitions to follow). This rural, inclusive middle school collected a range of measures to monitor students' academic and behavioral progress. For example, grade point averages and course failures were monitored to assess students' academic progress. Office discipline referral data, which were monitored using SWIS (May et al., 2000) and two behavioral screeners, the Student Risk Screening Scale (SRSS; Drummond, 1994) and the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997), were collected to monitor students' behavioral progress. As was the case with the elementary level, behavior screeners were administered at three time points: 6 weeks into the school year, prior to winter break, and again at year end.
Screening: Participation Selection
The PBS team members and the project director analyzed the fourth quarter data to identify returning students, hereafter referred to as rising seventh and eighth graders, who continued to have academic and behavioral concerns at year end, despite participation in the primary prevention plan. An academic concern was operationally defined as having a GPA = />
Seventy four students (25 rising seventh graders, 49 rising eighth graders) were identified at year end and randomly assigned to one of three conditions: study skills (n = 25), conflict resolution skills (n = 24), or regular school practices (n = 25, a focus group), using stratified random sampling procedures. These interventions were scheduled to take place separate from this research project during the first quarter of the following year.
At the beginning of the following year, 68 students were still enrolled in the school and began the secondary prevention program as planned in August 2005. The other 6 students had moved out of the district, were placed in alternative learning centers, or changed to home schooling. Parental consent and student assent were requested for the students who were still present at the onset of the year to participate in an evaluation of this intervention. However, many parents did not respond. Consequently, although all 68 students participated in the intervention, data were collected and analyzed only for the 45 students for whom parental consent and student assent were secured: study skills n = 13; conflict resolution, n = 15; and control, n = 17.
Intervention Logistics and Outcomes
Students assigned to these conditions were placed into an elective grade-level course to receive instruction. The seventh- and eighthgrade study skills conditions were taught by two certified general education teachers; whereas the two conflict resolution skills conditions were led by school counselors. Students in the regular school practices were placed in "focus" elective classes (control group), taught by certified general education teachers. All classes were taught daily during the first quarter.
Students in the study skills groups received explicit instruction in strategies that have been used successfully with adolescents with learning and behavior problems to help them acquire and demonstrate knowledge (Bos & Vaughn, 2002; Descher et al., 2001; Ellis & Lentz, 1996). Strategies for acquiring knowledge for text, class discussion, and teacher-led instruction included note-taking (e.g., Cornell, Two Column; Faber, Morris, & Lieberman, 2000; Roberts, 1999) and graphic organizers (KWL, SQ3R, and POSSE; Bryant, 1998; Englert & Mariage, 1990,1991; McCormick & Cooper, 1991; Ogle, 1989). Strategies for demonstrating knowledge on tests, homework, and projects included organization skills such as goal setting (Miller & Kelley, 1994; Raskind, Goldberg, Higgins, & Herman, 1999), test- taking skills, and writing skills such as planning and editing (Bos & Vaughn; Rekruk, 1996; Sabornie & deBettencourt, 1997). A curriculum overview is available from the author.
Students in the conflict resolution groups received explicit instruction using the Productive Conflict Resolution Program (PCRP; School Mediation Project, 1998). Content included instruction in: understanding conflict, cooperation, conflict styles, valuing diversity, listening skills, expression skills, problem-solving, forgiveness, and reconciliation.
Students randomly assigned to the control condition received regular school practices which included placement in a "focus" classes. During this time, students were allowed to work on homework and ask some questions; yet, there was no formal instruction.
Students in the study skills and conflict resolution skills condition were taught on a daily basis over a 9 week period. During each 50 min instructional block, the lesson was taught during the first 30 min of class, followed by 20 min of applied practice. A total of 31 lessons were taught yielding 15.5 intervention hours. Treatment fidelity was assessed from teacher and RA perspectives, with respective scores of 98.82% and 92.11% for the study skills group and 73.72% and 69.32% for the conflict resolution skills group. Thus, fidelity was considerably lower for the conflict resolution skills group.
Student outcome measures included: near transfer [knowledge of study skills and knowledge of conflict resolution skills (Lane, 2004) and far transfer [Study Skills Habits (SHI, Jones & Slate, 1990), Conflict Resolution Style (ConflictTalk; Kimsey & Fuller, 2003), and Problem Behavior (Gresham & Elliott, 1990)]. These data were analyzed with a longitudinal random coefficients analysis (Littell, Milliken, Stroup, Wolfinger, & Schabenger, 2006) applied to three repeated measurements: pre-intervention, post- intervention, and maintenance (approximately 8 weeks following intervention completion). A total of five models were constructed for these outcomes to determine how students progressed on the five variables stated above.
Results revealed significant and comparable improvements in students' knowledge of study skills for students in both intervention groups, relative to regular school practices. However, students' absolute levels of knowledge still remained low, with mean scores less than 70%. Further, there were significant changes in students' study habits. Namely, students in the conflict resolution skills group exhibiting strong decreases (-4.53 at each data collection point) relative to control conditions and students in the study skills groups demonstrated strong increases (5.69 points at each time point) relative to students in the conflict resolution skills groups.
Social validity ratings indicated that students in the three intervention groups held similar views prior to intervention onset. However, following intervention completion, students in the conflict resolution skills groups reported significantly lower post- intervention social validity scores than students in the study skills or control conditions. Teachers of the study skills group rated the intervention far more socially valid at intervention onset as compared to the counselors who taught the conflict resolution skills group. This pattern was consistent following intervention completion, with post-intervention scores decreasing for both intervention groups. (see Lane et al., [in preparation] for complete intervention procedures and results).
Considerations for Future Research at the secondary Level
In this study, we illustrate one method of (a) identifying middle school students with co-occurring behavioral and academic concerns by applying specific inclusion criteria to the school-wide data collected to monitor overall intervention outcomes and (b) implementing scientifically rigorous investigations within the context of the threetiered model of support using group design methodology (Gersten et al., 2005). Results of this study suggest that the intervention did not produce all of the desired effects. Despite improvements in students' knowledge of study skills, the final level of performance was still far below mastery. Further, although study habits improved for students in the study skills group relative to students in the conflict resolution skills group, their scores did not improve significantly relative to students in the control condition.
Future investigations should consider (a) extending the intervention length to enhance intervention dosage; (b) reconceptualizing the curriculum to focus on more intensive instruction fewer skills and strategies to facilitate mastery; and (c) incorporating team teaching techniques with teachers and counselors. Namely, given the low level of fidelity for the conflict resolution skills, future studies should also consider the possibility of having teachers and counselors team teach in the conflict resolution skills group. Both of the counselors expressed concerns that they did not have requisite skills to manage the behaviors exhibited by many of the students in their respective classes. However, a similar study conducted by Robertson and Lane (in review) suggested that teachers did not feel they had the skills necessary to respond to some of the issues revealed by students in the conflict resolution skills groups. One solution may be to capitalize on both sets of skills (instruction and counseling) via team teaching. Overall, this study can be considered methodologically, but not pragmatically, successful (Institute for Education Sciences, 2005). However, this study has the ability to inform future treatment-outcome studies by (a) illustrating one method of using data-based procedures for identifying students in need of targeted interventions and (b) demonstrating how to conduct scientifically rigorous, group-design investigations at the secondary level of prevention.
As we look to the future, I am encouraged by some of the recent mandates and legislative acts that have place increased attention to (a) the prevention of antisocial behavior in general and (b) the importance of positive behavior supports to provide both prevention and remediation efforts. For example, Title IV of the Improving America's Schools Act of 1994, the Safe and Drug-Free Schools and Communities Act (1994) prompted state and local education agencies to design drug and violence prevention plans (Turnbull et al., 2002). The White House issued a call for schools to become nonviolent, safe environments (Kern & Manz, 2004). The Surgeon General, in the Surgeon General's Report on Youth Violence (2001), took a stance against school violence calling for the use of evidenced-based practices to dismantle antisocial networks by increasing academic success, establishing positive school climates, and adopting a primary prevention model (Satcher, 2001). Further, language in the reauthorization of IDEA (2004) requested "incentives for whole-school approaches, scientifically-based early reading programs, positive behavior interventions and supports, and early intervening services to reduce the need to label children as disabled in order to address the learning and behavioral needs of such children."
Many schools have embraced three-tiered models in an effort to respond to concerns of violent and antisocial behavior and addressed the mandates listed above (Horner & Sugai, 2000). It is encouraging to witness this shift away from reactive, punitive models of schoolwide discipline and towards more proactive models that provide for both prevention and remediation efforts (Lane, Robertson, & Graham-Bailey, 2006). Now is the time to refine these three-tiered models of support by building upon the contributions and advancements made during the last 30 years. Specifically, I advocate for (a) the application and continued development of systematic screenings and (b) scientifically rigorous, responsible inquiry of targeted interventions, implemented in the context of three tiered models of support.
Thanks in large part to the contribution of Hill Walker and colleagues, cost effective, feasible, and valid screening tools are available for use at the elementary level. Examples include the Early Screening Project (ESP; Walker, Severson, & Feil, 1995), Systematic Screening for Behavior Disorders (SSBD; Walker & Severson, 1992), the Student Risk Screening Scale (Drummond, 1994), and the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997). Yet, there are two primary limitations surrounding screening tools.
First, the availability of screening tools for use at the middle and high school levels is sparse. While there is one systematic screening tool, the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997), available for use in middle and high schools, this instrument is often criticized by teachers on our projects for its length. Absent are more feasible, practical tools. Future research is warranted to develop psychometrically-sound, yet practical tools for use in the upper grades. In doing so, such measures would need to take into account features of the middle and high school settings. For example, given that teachers have less than 1 hour with each student, it may be necessary to develop screeners that involve ratings from more than one teacher to establish convergent validity.
Second, despite the availability of screening tools at the elementary level, they are often not integrated into regular school practices at the elementary level and, instead, teacher judgment is the sole gate keeper for targeted support (Lane et al., 2007). A number of explanations have been offered to explain this lack of implementation, some of which include lack of resources, knowledge, and expertise; concerns surrounding the issue of labeling; and trepidations about how to support identified students (Kauffman, 1999; Lane et al., 2002; Walker et al., 2004). It is important that we help practitioners identify and address these concerns and, subsequently, integrate screenings across the K-12 grade span.
Moving forward, I recommend that researchers and practitioners collaborate to (a) develop psychometrically-sound, feasible screeners for use at the middle and high school levels; (b) institutionalize the use of validated screening tools in conjunction with other data collected at the school site to identify students with common areas of concern; and (c) provide identified students with the appropriate secondary prevention program. Further, in addition to establishing explicit criteria for entry into targeted supports, it is equally important to develop exit criteria to determine when the goals have been met to ensure that additional support is provided only as long as needed.
In terms of academic interventions, I am encouraged by the increased attention devoted to meeting the academic needs of students with and at risk for EBD (Lane, 2004; Mooney, Denny, & Gunter, 2004; Reid et al., 2004; Trout et al., 2003). As we continue to develop this line of inquiry, I encourage researchers and practitioners to use secondary interventions as a forum for (a) identifying how best to support students with EBD academically and (b) elucidating the relationship between academic underachievement and problem behavior (Hinshaw, 1992; Petras et al., 2004). This can be accomplished via both single case and group design methodology that adhere to core quality indicators recommended for determining evidenced-based practices (see Gersten et al., 2005; Horner et al., 2005). Then, once we have identified the most efficient, effective strategies to employ, we can help schools build their capacity to sustain these validated intervention practices.
Embedding studies into existing three-tiered models offers a number of benefits. First, by building in screening procedures at the primary level, we can ensure that all students are considered for possible supports and that multiple sources of data are used to identify students with common, co-occurring deficits (e.g., high risk for antisocial behavior and low reading performance). This approach enables schools to move away from teacher judgment in isolation when identifying students for secondary supports.
Second, once the number of students identified for a given secondary support is determined, we can employ rigorous scientific standards to (a) determine how best to focus intervention efforts (study skills vs. conflict resolution skills) and (b) student outcomes associated with a given program (e.g., SRSD writing instruction). When designing such studies, I encourage people to attend to the core quality indicators posed for single case (Horner et al., 2005) and experimental group designs (Gersten et al., 2005) that provide specific standards for describing participants and settings; defining dependent variables; describing intervention and comparison conditions; establishing internal and external validity; and evaluating social validity; and utilizing data analysis techniques appropriate to the given research questions. Also, I encourage researchers and journal editors to remember that success is not always defined by "what works," but also by "what does not work." While the ideal study is one which methodological and pragmatic success are achieved (Institute for Educational Sciences [IES], 2005), it is possible for methodologically successful studies that lack pragmatic success to also inform the field. A methodologically successful study was defined by IES as a study that "rigorously evaluated the impact of a clearly specified intervention on relevant student outcomes under clearly described conditions using an appropriate research design" (p. 43). A pragmatically successful study was defined by IES as a study in which "rigorous evaluation determined that the intervention has a net positive impact on student outcomes in relation to the program or practice to which it is being compared" (p. 43). If a methodologically successful study suggests that a given intervention strategy does not have a net positive impact on a given outcome relative to the comparison condition, that too is important information that (a) warrants dissemination and (b) has the potential to inform practice so that valuable instructional time is not lost on invalid practices.
Third, by conducting our inquiry within existing PBS models, we can better document baseline or comparison conditions. Adequate description of the baseline or comparison conditions is imperative for accurately evaluating the effects of an intervention, drawing generalizations regarding treatment outcomes, and allowing for replication studies (Lane, Wolery, Reichow, & Rogers, 2006). Strong PBS programs will collect treatment fidelity data to determine the degree to which the primary prevention program is in place as designed (Lane et al., 2006). This information, in conjunction with thorough descriptions of the regular school practices, can be used to analyze intervention outcomes of the secondary intervention efforts. For example, it may be that students respond more favorably to secondary interventions if they are in classes in which the primary plan is implemented with high levels of fidelity. Finally, once we have completed development studies, such as those funded through IES's Goal Area 2 competition, to determine the extent to which an intervention is evidence-based, we can then focus on building capacity at the school site to sustain implementation of these practices (IES: Goal Area 3). In other words, by conducting progressive research investigations within the context of this model, we can develop the knowledge base and enhance schools' abilities to implement and sustain evidenced-based practices in this model once university support and grant funding is completed. Bear, Wolf, and Risely (1987) indicated that the goal of all intervention research is meaningful, lasting change. To that I would add a goal of responsible inquiry in which we leave our school sites - the playing field for our inquiry - better than we found them, able to sustain evidence-based practices. One step in this direction is to strengthen existing three-tired models of support via (a) the application and continued development of systematic screenings and (b) scientifically rigorous, responsive inquiry of targeted interventions to inform practice.
In sum, this paper offers my thoughts on how we can advance the current implementation of three-tiered PBS models to better support students with and at risk for EBD. Please know that in no way to do I view this as an exhaustive list of recommendations. It is with great respect that I look back over the last 30 years at those who have dedicated their lives to improving the lives of students with EBD. As I look forward, I am hopeful. Never before has the general public and governing bodies been more interested in the prevention of school violence and antisocial behavior. The violence we have witnessed in the last several years, while beyond tragic, has placed us in a unique position to have the resources and interest necessary to continue our inquiry in the prevention of new cases of EBD and remediation of existing cases. Given the advances in screening, assessments, and intervention efforts during the past 30 years coupled with the tremendous potential evident in the individuals entering the field as teachers and researchers, it is with eager anticipation that I look forward to the next 30 years.
I am grateful to Robert Rutherford for the opportunity to be the keynote speaker at TECBD's 30th annual conference. In addition, I extend my thanks to the gentle giants who trained me and shaped my thinking; my students and research team for being so dedicated and supportive; the teachers and student with whom we work for inspiring me to want to learn more; and my family for giving me the time.
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