May 2002 ABA Conference Poster Presentation

An Analysis of Referral Characteristics and Treatment Efficacy Associated with Statewide Behavioral Assistance Teams

James Fox, Cynthia Hales, Leia Blevins & Denise Plante
East Tennessee State University
&
John J. Wheeler, & Michael Mayton
Tennessee Technological University
 

 
Abstract:

The emergence of technical assistance teams in the area of positive behavior supports has been expansive in recent years given the 1997 Reauthorization of the Individuals with Disabilities Education Act.  This is due largely to the mandate that charged educators with the implementation of functional behavior assessment and the design of behavioral support plans to address challenging behavior.  This poster will be to provide data on the referral characteristics and treatment efficacy associated with a school-based technical assistance team model.  This model, known as the Make a Difference Project has been a statewide behavioral initiative funded through the Tennessee Department of Education for the past seven years.  Specifically, our presentation will describe data from two of these projects (East Tennessee State University and Tennessee Technological University).  Cumulatively these projects serve school systems within a total of 37 counties.  The aggregate data presented will be an evaluation of the characteristics of children and youth referred for services and data regarding treatment efficacy.  Finally, concerns related to the delivery of positive behavior supports through technical assistance teams will be discussed.

 

Rationale:

•Increased focus on functional behavior assessment (FBA) in school for students with challenging behaviors

Experimental data-base shows effectiveness population served, time demands for FBA & challenging behaviors targeted & varied intervention categories

BUT few existing large-scale evaluations of FBA under more naturalistic conditions

FBA judged not just by intervention effects but also by types of disabilities, target behaviors, efficiency of FBA, complexity of challenging behaviors

 

Purpose:

Report initial descriptive data set replicated across 2nd project 
 2 State funded projects in Tennessee

Establish data base for future comparisons with other similar project
-Number of referrals per year
-Types of disabilities of students referred 
-Number & types of target behaviors
-Waiting List Time and Time to Completion of FBA  
-Types of recommendations made for behavior intervention plan (BIP)  

 

Project Goals:
 

ETSU
Technical assistance to schools–  
-Conduct FBAs with students with disability & challenging behaviors referred to project–
-Train & consult with school system & building level FBA teams		 TTU
Consultation & Technical assistance
-positive behavior support
-schools, children & families
-Consultation, behavior assessment, intervention
-Professional development
-In-service training
-Lending library

 

Funding:

Tennessee State Department of Education
Both ETSU & TTU projects

Yearly

Since 1995

To provide technical assistance and training to schools and families in region
Students with disabilities and challenging behaviors

 

Project Staff:
 
ETSU

Director 
2 full time professional staff
    -Manager, Coordinator
1 graduate assistant
1 student worker
    -computer specialist & data  entry

TTU

Director
2 full time professional staff
    -Master’s level coordinators
1 Secretary
Doctoral students

 

Service Area:   
 ETSU  

-Rural Northeast TN
-Only 3 communities with 40,000+
-25% not have HS diploma
-–’96 per capita income $18,934 (vs. $24,436 nationally)
-8 county, 5 city/small town 		TTU

Upper Cumberland Region•
-22 counties•
-Rural, isolated areas
-Per capita income average ranges $10,157 – 16,000–
-Social problems
-•High rates of child abuse, domestic violence

 

Referral Process:

ETSU

-Teachers, principals refer student to SPED director•
       -Student must have SPED
         diagnosis & 1 or more   
         challenging behaviors–
-SPED director gets parent permission & refers to ETSU–
-ETSU staff evaluate referral appropriateness & prioritize–
-Case assigned by project manager–
-Staff contact referring source for initial interview

TTU

-Public awareness•
       -Meetings, brochure, newsletter–
-Receive referral–
-TTU initial contact with school/family–
-months, 6 months

 

FBA Process: 
ETSU

-Interview•
     -teacher, staff, parent, child•
-Define behaviors, settings, triggers, consequences–
--Behavior – Situation Rating Scales (MAS, PBQ)–
-Scatterplot 1 – 2 weeks
–Direct observations•
           -ABC, FADO
     -•Hypothesize function–
-1 or more Environmental Manipulations•
--To evaluate function–
---Write report, recommendations–
-ETSU staff, school personnel, parents develop BIP

TTU

-Formulate team of school personnel & TTU staff
-–Develop mutual goals & objectives per referral
-–Assist school-based team to implement best, effective
      -•FBA, design behavior support plan, implement interventions, follow along 2 weeks, 1 month, 3
-–Provide professional development to school personnel & families
      -•Positive behavior support
     -•Workshops, formal presentations
-–Collect satisfaction data from schools & families re: project services

 

FIGURE 1:

Referral Spikes around K&1, 4th, & middle school   

Most referrals range K – Middle School, drops off after 9th 

ETSU:

TTU:

 

FIGURE 2:

Mostly Males ETSU 13% steady increase in females

TTU more females than ETSU

ETSU:

TTU:

 

FIGURE 3:

High incidence disabilities most frequent diagnosis

ETSU most frequent LD, Speech& Language Delay, MR and OHI

TTU most frequent ED, Autism, & DD

ETSU:

TTU:

 

FIGURE 4:

Generally multiple TBs

ETSU  3-6 TBs TTU 1-4 TBs

ETSU:

TTU:

FIGURE 5:

Ave. 2 / Mo./ Fiscal Year

ETSU most in 3rd quarter (Jan. – Mar.), next 2nd quarter (Oct. – Dec.)

TTU most in 2nd quarter, nest 3rd quarter

ETSU:

TTU:

 

FIGURE 6:

3-5 weeks

ETSU median 27 days (0-276) TTU median 14 days (0-226)

ETSU:

TTU:

 

FIGURE 7:

2-3 months

ETSU median 60 days (3-332) TTU median 90 days (15-270)

ETSU:

TTU:

 

FIGURE 8:

Overall ETSU 38% Edu., 47% Beh. TTU 36% Edu., 43% Beh.

Percentage of Total (’01-’02) ETSU 58% Edu., 29% Beh. TTU 36% Edu., 42% Beh.

ETSU:

TTU:

 

Student Referral Results:

Increased referrals at typical transition points
Kindergarten/1st grade, 4th grade, & 7th grade

•Most referrals =  Preschool - elementary grades
–decreased after the 9th grade

Referrals mostly boys;
clear increase in girls in the ETSU project

Most frequent diagnoses = high incidence disabilities
ETSU more LD & Speech Language Delay; TTU more ED & Autism diagnoses

Referrals had multiple target behaviors
ETSU 3 – 6 TBs; TTU 1 – 4 TBs

 

FBA Process Results:

Mean rate of referrals = 2 per month

-–ETSU highest in 3rd quarter, TTU highest in 2nd
-–Both projects conducted multiple observations
-•ETSU mean of 5 ABCs, 4 FADOs per case
-•TTU mean of 2 ABCs and FADOs per case. 

Waiting List Time (referral to 1st interview)  
–-ETSU median wait = 27 days (range 0-276 days
-TTU median wait = 18 days (range 1 – 240).

Time to Complete FBA (1st interview to Recommendation)
-–Generally 2  - 3 months to completion
–-ETSU median was 60 days & TTU was 80 days

•Days of Actual contact during FBA (ETSU only)
–Median Contact was 11 days, range 4  - 23 days.

•Time to Complete FBA (1st interview to Recommendation)
-–Generally 2  - 3 months to completion
–-ETSU median was 60 days & TTU was 80 days

•Days of Actual contact during FBA (ETSU only)
–Median Contact was 11 days, range 4  - 23 days.

 

FBA Recommendation Results:

Recommendation Type relatively consistent across the projects–
-85% cases one or more behavior intervention recommendations -–70 - 80% cases one or more Educational Recommendations were made

•Total Recommendations written
-–Behavior Management = 45%
-–Educational Interventions = 37%
-–Educational recommendations (60%) exceeded Behavioral (30%)
-recommendations at ETSU in 01 – 02 year for the first time

 

Conclusions:

Referrals differed greatly from those with whom FBA
originally developed
–Need to change/adjust FBA procedures/instruments?

•Referral rates not constant but clustered 
–How identification & assessment resources are deployed

•Multiple observations, target behaviors.
–Require trained personnel with time & resources

• Extended time to complete FBA
–research to find most efficient & accurate methods
–change law & policy to reflect completion time

•FBA recommendation data
–further address relation of learning/instructional variables & challenging
behavior

 

Web Addresses:

ETSU “Make a Difference Project”
•http://makeadifference.etsu.edu

 

TTU “Make a Difference Project”•
http://plato.ess.tntech.edu/ci/difference.html