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12/14/2012
1
SANCTUARY & PBIS: HOW POSITIVE BEHAVIORAL
INTERVENTIONS SUPPORT THE
SANCTUARY MODEL
Glen Chernack, Ph.D.
Dale Langley, Psy.D.
RegineWong, Psy.D.
Presentation Objectives
1. Overview of the Orchard School
2. Comprehensive RTI/PBIS
Systems at Orchard School
3. Bridging Sanctuary & PBIS
4. Data Driven Decision Making
ORCHARD SCHOOL
OVERVIEW
The Orchard School-ANDRUS
• ANDRUS main campus in
Yonkers, NY
• Nationally recognized
special education school
• Day and Residential
students (Grades K-9)
• Individualized
Educational Plan (IEP):
basis of academic and
related services
• IEP classifications:
o Emotional Disability (84%)
o ASD/PDD (8%)
o OHI/ADHD (6%)
o Learning Disability (1%)
The Orchard School-ANDRUS
• Classroom ratio of 8:1:1
• Services provided:
o Individual & Group therapies
o Speech and Language
Therapy
o Occupational Therapy
o Physical Therapy
o Psychiatric services
(Residential students only)
Treatment Programs:
Residential Program
• Approx. 73 students
• Reside mostly in New York
State (also serve children
nationally via Interstate
Compact).
• Difficulty managing emotion
and behavior at home &
school.
• Consistent, structured,
supervised, & therapeutic
support; specialized
academic support.
Day Program
• Approx. 79 students
• Reside in Westchester, New
York City, and neighboring
counties.
• Social & emotional difficulties
prevent performing to fullest
academic potential.
• Therapeutic support &
specialized academic support.
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2
Referrals• School districts/Committee on Special
Education (CSE)
• Department of Social Services (DSS)
• Specialists in the field of trauma
Curriculum & Treatment• 12-month program
• New York State Curriculum
• Participate in New York State Assessments (unless Alternative Assessment)o 9th grade students: Algebra and Living Environment
Regents Examination
• Specialized Treatment modalities:o Sanctuary Model (certified in 2012)
o Play Therapy
o Trauma Focused Cognitive Behavioral Therapy (TF-CBT)
o Art Therapy
o Eye Movement Desensitization Reprocessing (EMDR)
o Body and Sensory regulation/integration
Discharge
• Average length of stay:
o 18 months to 2 years
• Goals:
o Return to parent/guardian home
o Educated in home school districts RTI/PBIS OVERVIEW
AT ORCHARD
SCHOOL
Response to
Intervention (RtI)
• Screening
o Proactively Identify Student
Needs
o Predict who may be at risk for
poor outcomes
• Progress Monitoring
o Assess performance
o Quantifies improvement
o Evaluates effectiveness
•Multi-level Prevention System
o 3 levels of intensity
o Allows for individualizability
• Data-Based Decision Making
o Data analysis informs
decision making
o Objective replaces subjective
For more information on RtI visit the National Center on Response to Intervention:
http://www.rti4success.org/
PBIS = RtI for BehaviorsIt’s a multi-layered Approach
Academic Systems
80-90% 80-90%
Intensive, Individual Interventions•Individual Students•Assessment-based•High Intensity
Intensive, Individual Interventions•Individual Students•Assessment-based•Intense, durable procedures
Targeted Group Interventions•Some students (at-risk)•High efficiency•Rapid response
Targeted Group Interventions•Some students (at-risk)•High efficiency•Rapid response
Universal Interventions•All students•Preventive, proactive
Universal Interventions•All settings, all students•Preventive, proactive
Behavioral Systems
15-17%
3-5%
15-17%
3-5%
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3
PBIS focuses on…
Materials modified from George Sugai & Rob Horner (10/7/08)
“School-Wide Positive Behavior Support: Overview”
Improving classroom & school climate
Decreasing reactive
management
Maximizing academic
achievement
Improving support for
students w/ EBD
Integratingacademic &
behavior initiatives
Brief Introduction of PBIS Model
P: Positive B: Behavioral I: Interventions & S: Supports
Key Point
• Provide behavioral interventions to meet the student where he or she is currently functioning
Basic Principles
• Behaviors, like academics, need to be taught
• Student should be informed & involved in the process
• Interventions are student, environment & time specific
• Use data to make decisions
Teaching Behaviors:
Ask Yourself, “How did I learn to…?”
Blow a bubble? Tie my shoes?
Memorize the multiplication table?
Drive a car?
or
Use public
transportation?
PBIS at The Orchard School
Tier 3: Intensive Problem-Solving
Example: Functional Behavior Assessment (FBA),
Behavior Intervention Plans (BIP), 1:1 Staffing
Tier 2: Targeted Problem-Solving
Example: CARE Program, Classroom Specific
Behavior Plans, Teacher Consultation
Tier 1: Universal Prevention & Early-
Stage Problem-Solving
Example: CHAMPS, B+ Program, Classroom
Observations
At Orchard School we are C.H.A.M.P.S.
We like that CHAMPS is…
– Specific & Predictable
• Clear, simple expectations
– Proactive
• Opportunity for practice & re-
teaching
– Positive
• 6:1 schedule of reinforcement
• Emphasis on Labeled Praise
– Evidence-based
• Provides data with which to make
informed decisions
•Conversation –o What voice level should a student use
during this class?
•Help –
o How can a student get help or
assistance in this class?
•Activity –o What is the activity for this class?
•Movement –o What level and type of movement is expected during this class?
•Participation –o How will the teacher know students are participating in this class?
o How will the teacher know students are not participating?
•Success –o If a student meets the basic expectations of CHAMPS, he or she will
experience success!
Example: CHAMPS Expectations for Reading Class
= During Reading we will use a Voice Level 0.
Other than the reader, no one should be talking.
= If you need help or have a question, please raise your hand & wait silently
for staff to come over to your desk.
= Today’s activity is reading Chapter 3.
= During this period, you are to remain seated with your feet on the floor.
If you need materials or need to use the restroom, please ask staff.
= I will know you are participating and earning Champs Bucks when you have
your book open on your desk and are tracking while your peers read aloud.
I will know you are not participating when you are out of your seat or
having side conversations.
= When we follow expectations, we are successful and earn Champs Bucks.
Let’s have a great class!
12/14/2012
4
EXPECTATIONS ARE BE SET FOR
ALL TYPES OF ACTIVITIES…
How CHAMPS works
• Teachers set CHAMPS expectations for each class.
• Students earn CHAMPS bucks for following expectations.
• Students use bucks to buy items at CHAMPS Store.
Tier 2 Interventions
• Supports 10-15% of students
• Assortment of immediate interventions
• Similar implementation across students
• Prevents worsening of problem behaviors
• Continuous data monitoring and systematic
decision making process
• Increased communication with students,
staff, and familiesHome
School
Student
Systematic Approach
Step 1:•Student Selection
Step 2:
•Assess & Enroll Students to Appropriate Interventions
Step 3:•Monitor Progress Data
Step 4:
•Evaluate Success & Modify Program
CARE Program at Orchard School Procedures
• Morning Check-in
o Positively greeted by coordinator and pick up CARE card
• Throughout Day
o Staff reinforces expectations
o Rate students on CARE card: what they earned based on
their behavior
• Afternoon Check-out
o Tally points; made goal?
• Home/Cottage Feedback
o Reinforce positives and encourage student to make goal
12/14/2012
5
0 = No
1 = Yes
Be
Safe
Be
Respectful
Be
Responsible
Teacher
Comments
- Keep hands,
feet, and objects
to self
- Stay in Program
- Use kind
words and
actions
- Ask
permission
- Follow
directions
- Work in class
Period 1 0 1 0 1 0 1
Period 2 0 1 0 1 0 1
Period 3 0 1 0 1 0 1
Period 4 0 1 0 1 0 1
Totals: ______ + ______ + ______
Points earned today: ______
Total points possible: __12___
Percentage Earned: ______%
Tier 3 Interventions
• Supports 5-8% of students: Student specific plan
• Identifies the FUNCTION of a particular behavior
• Functional behavioral assessment (FBA) identifies
the events that reliably predict and maintain
problem behavior.
• Continuous data monitoring and systematic
decision making process
• FBA is the basis of a behavior intervention plan
(BIP)
Functional Behavior Assessment
• Five Outcomes (O’Neill et al)
oA clear description of the problem behavior
o Identification of predictors or antecedents of
the behavior
o Identification of the consequences that
maintain the behavior
oDevelopment of a testable hypothesis
oCollection of direct observation data
FBA Data Sources
• Interviews:
o Teacher, student, clinician, family, and related
service providers
• Direct observations
• Team meetings
• Baseline data focuses on:
o Frequency, duration, location, latency, and
intensity
Behavior Intervention Plans
• Four Considerations (O’Neill et al)
oHow will staff & family support change
oPlan driven by functional assessment data
oConsistent with behavioral psychology principals (i.e., reinforcement, punishment, generalization, stimulus control)
oGood fit with the environment to optimize implementation
BRIDGING
SANCTUARY & PBIS
12/14/2012
6
What is the Sanctuary Model?
• Objective:
o Provides a cohesive context where healing from
psychological & social traumatic experience can
be addressed
• Organizational culture intervention
• Theory-based, trauma-informed, evidence-
supported
Seven Sanctuary Commitments
Nonviolence
Emotional Intelligence
Social Learning
Open Communication
Social Responsibility
Democracy
Growth & Change
Sanctuary Tool Kit
• Practices to support the creation of a trauma-
informed culture
Safety Plans
Red Flag Reviews
Team Meetings
Community Meetings
Treatment Planning Conferences
Psycho-education
Key Features
• Sanctuary Model
o Creating therapeutic communities based on trauma theory
o Focuses on impact of recurrent stress
• Sanctuary & PBIS
o Provides safety for both students and staff
o Fosters a shared language
o Organizes how we talk about treatment & interventions
o Frequent contact with team members, students, and families
o Focuses on growth and change
Challenges to Change
• Innovative practices do not fare well in old
organizational structures and systems.
• Organizational and system changes are
essential to successful use of innovations.
Fixsen, Blase, Horner & Sugai, 2008
Understanding the Context
• Behavior support is the redesign of
environments, not the redesign of the
student.
• PBIS, like Sanctuary, focuses on changing the
behavior of staff who will implement the
interventions.
o PBIS describes how we will intervene and work
with students academically, behaviorally, and
socially.
12/14/2012
7
Integrated Methods
for Bringing about Change
• Diffusion/Dissemination of information
• Training
• Policies and Funding
• Coaching staff in the intervention
environment
o All methods work to support one another, but
have limited impact separately
What Works: Emphasis on Coaching
Facilitation
• Focus on Efficiency in vivo
Modeling
• Constantly focusing on increasing individual capabilities
Prompting/reminding/pre-correcting
• More than ‘Cheerleading’, directive encouraging
Asking the ‘right’ questions
• Program evaluation (data driven)
Unique Challenges of School
Environment
• Very structured and tightly scheduled
• Frequent transitions
• Infrequent access to breaks or preferred
activities (gym, recess, computers, art).
• History of failure/learned helplessness
• Social pressures
• Multiple staff, inconsistent messages
• Sensory demands
Balancing Complimentary Systems
PBIS Sanctuary
TOOL KITSPBIS SANCTUARY MODEL
Clear, consistent expectations Psycho-education
Labeled Praise Safety Plans
Continuous availability
of reinforcementCommunity Meetings
Data-driven decision makingTreatment Planning
Conferences
3-Tiered System of Support
(universal, group, individual)Red Flag Meetings
Team Meetings Team Meetings
DATA DRIVEN
DECISION MAKING
12/14/2012
8
Why Data?• Feelings are SUBJECTIVE
o Subjective decision-making is
reactive & inconsistent
o Example:
• Tommy broke a window
today. I feel bad because I
know he’s going through so
much…
– Likely Consequence?
• Jimmy also broke a window
today. He’s a terror in the
classroom and constant
provokes others! I really can’t
stand him! He needs to be
suspended and learn that he
needs to listen to staff!!
– Likely Consequence?
• Data is OBJECTIVE
o Objective decision-making can
be proactive & planned
(consistent)
• Tommy broke a window
today. That makes a total of 3
broken windows this month.
Last year he was averaging 1
broken window per month.
– Conclusion?
• Jimmy broke a window today.
That makes a total of 2
broken windows this month.
Last year he was averaging 5
broken windows per month.
– Conclusion?
Results of Student Survey
Area: SELF
Graphs used with permission from Cynthia HeidOrchard School Student Survey (2012)
95 93 91
9 12 128 10 12
0
10
20
30
40
50
60
70
80
90
100
We talk about ways to control our
emotions
My school and class have clear
expectations about how we should treat
each other
We talk about the way our actions affect
others
Agree/Strongly Agree Not Sure Disagree/Strongly Disagree
How well Programs are Working at Orchard School
0
50
100
150
200
250
300
350
400
Total Incident Reports2010-2012
Comparing the 2011-12
and 2010-11 school
years…
• In 2010-11: 2466 incidents
• In 2011-12: 1382 incidents
• That represents a 44%decrease in negative and
aggressive behaviors.
• All 12 months saw a range of
between 18-59% reduction in
unwanted behaviors compared
to the previous year.
• We also experienced up to
78% reduction in TCI Restraints
during this time period.
0
50
100
150
200
250
300
350
400
Se
pte
mb
er
Oct
ob
er
No
ve
mb
er
De
cem
be
r
Jan
ua
ry
Fe
bru
ary
Ma
rch
Ap
ril
Ma
y
Jun
e
July
Au
gu
st
Total # of Incidents at OS
2010-2011 2011-2012
Big 5 Data:(Who, What, Where, When, How Often)
6
4 4
3 3 3 3 3 3
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
0
1
2
3
4
5
6
7
A B C D E F G H I J K L M N O P Q R X T U V W X Y Z
IR by Student
September 2012
Big 5 Data:(Who, What, Where, When, How Often)
19 19
15
8 8
4
3 3
2
0
2
4
6
8
10
12
14
16
18
20
Physical
Aggression to
Child
Physical
Aggression to
Staff
Out of Program Minor Injury Property
Aggression
Property
Damage
AWOL/Off
Campus
Verbal
Aggression
Towards Staff
FALSE Fire
Alarm
IR by Problem Behavior
September 2012
12/14/2012
9
Big 5 Data:(Who, What, Where, When, How Often)
10
7 7
6 6
4 4 4
3 3 3 3 3 3
2 2 2 2 2
0
2
4
6
8
10
12
IR by Location
September 2012
Big 5 Data:(Who, What, Where, When, How Often)
1 1
4
8
5
7
4
2
3
4
3
2
3 3
1
6
2 2 2
1
3
4
2
9
2
0
1
2
3
4
5
6
7
8
9
10
IR by Time
September 2012
Big 5 Data:(Who, What, Where, When, How Often)
6.696.95
8.74
5.76
6.25
5.44
6.86
7.56
8.24
7.45
4.404.23
5.60
7.23
6.21
0.00
1.00
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00
September October November December January February March April May June July August
Average IR per day
2011-2012 2012-2013
Using a Student Example…
How we utilize Sanctuary and PBIS to best meet
the needs of each student at the Orchard School.
Alexandria
Alexandria’s Data
Month # of Incidents Notes
July 2 •TPC on 7/24 with mother & clinician
August 1 •10th Birthday 8/11
September 4 •Moved from Ms. S’s class to Ms. W’s for
2012-13 year
October 2 •TPC on 10/13 with mother & clinician
November 1
December 2
0
20
40
60
80
100
CARE CardAverage:
87
Student Self-
Monitoring CARE
CardAverage:
94 87
Baseline
Average:
54
Alexandria’s CARE Card Progress
12/14/2012
10
Does Alexandria have 0 -
2 IRs for the month? Stay on Tier 1: CHAMPS
B+
Alexandria
placed on Tier 2
CARE:
Has Alexandria:
• Averaged 80%
over 4 wks on
CARE card?
• Had < 3 IR/mo?
Red Flag:
Held to
discuss
supports
needed & to
collect
baseline data
Student Self-
Monitoring:
Has Alexandria:
• Averaged 80%
compliance over 4
wks?
• Had < 3 IR/mo?
Green Flag Party:
Held to celebrate
Alexandria’s
success on the
CARE program.
KeyThe answer is YES
The answer is NO
Automatic Process
Therapeutic & Academic
Milieu
Safety
Plan
TPCs
SELF
Red Flag
Mtg
Another Student Example…
Ray
Ray’s Data
Month # of Incidents Notes
August 5 •Admitted 8/2
September 6
October 4
November 5 •TPC 11/20 with grandmother, teacher & clinician
December 3 •Christmas 12/25: Anniversary of mother’s death
January 3 •Med Change
February 1 •TPC 2/28 with grandmother, teacher & clinician
March 1
April 2
May 1•TPC 5/22 with grandmother, teacher & clinician
•Mother’s Day
June 1
Aimsweb Behavior Graph: Ray’s Behavior Intervention Plan
Aimsweb Behavior Graph: Ray faded 1:1
Does student have 0 - 2
IRs for the month?
(Reviewed at PBIS committee)
Stay on Tier 1: CHAMPS
B+
Student placed
on Tier 2 CARE:
Has student:
• Averaged 80%
over 4 wks on
CARE card?
• Had < 3 IR/mo?
Newly
admitted
studentAdmissions
Meeting:
Discuss
supports
needed &
collect
baseline data
Student Self-
Monitoring:
Has the student:
• Averaged 80%
compliance over 4
wks?
• Had < 3 IR/mo?
Green Flag Party:
Held to celebrate
student’s success
on the CARE
program.
Team Meets:
Discuss the
function of
student’s
negative
behavior
(i.e., FBA)?
Teacher
or Staff
referral Student placed on
Tier 3:
Create (or modify)
student’s BIP. Discuss
data at TPC.
Has student averaged
80% over 3 months? Stay on Tier 3:
FBA/BIP for
another quarter
Fade 1:1 staff:
Has student continued
to average 80% over 3
months?
KeyThe answer is YES
The answer is NO
Automatic Process
Therapeutic & Academic MilieuSafety
Plan
TPCs
SELF
Red
Flag
Mtg
12/14/2012
11
QUESTIONS?