Three Tier Model for Preventing Academic, Mental Health, Behavior Problems

1
Three Tier Model for PreventingAcademic,
Mental Health, Behavior Problems

• Virginia W. Berninger
• University of Washington
• Director, Multidisciplinary Learning Disabilities
  
• Research Center, Literacy Trek Longitudinal
  Study, and
• The Write Stuff Intervention Project,
• and School Psychology Internship Program
• vwb_at_u.washington.edu
• CASP March 4, 2005
• Riverside, CA

2
Greetings from UW School Psychology Program,
Seattle, WA
3
Acknowledgements

• NICHD RO1 25858
• NICHD P50 33812
• Graduate Students in School Psychology
• Co-Investigators at the University of Washington
  and External Consultants
• Harcourt (norming research measures)

4
Research Evidence

• Based on longitudinal study 1984-85 of beginning
  reading
• Based on NICHD-funded cross-sectional research of
  writing and reading 1989-92
• Based on NICHD-funded longitudinal and
  instructional research on writing and
  writing-reading connections 1992-2006

5
Research Evidence

• Based on NICHD-funded Multidisciplinary
  Research on Learning Disabilities Links between
  Biology and Schools 1995-2005
• School-based prevention and clinic-based
  treatment
• Teacher training
• Family genetics
• Brain imaging

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Todays Presentation

• Implementing a Three-Tier Model of
  Assessment-Intervention Links
• The purpose of assessment is to plan and
  introduce intervention to directly improve
  academic learning (treatment validity), which
  indirectly improves mental health and behavior,
• especially if coupled with C3

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Questions to Ponder

1. Would Larry P against California have happened if
   schools were using diagnostic instruments
   validated for prevention and treatment validity
   coupled with C3?
2. Are tests (particularly IQ tests) the culprit?
   Or, is the problem practitioners lack of
   scientific knowledge of individual differences in
   learners relevant to academic learning and of
   effective instructional practices?
3. Are educational practices that do not promote
   caring, connecting with children and their
   families and communities, and communicating
   effectively with children and their families at
   the heart of school failure and school drop out?

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UW Three-Tier Model for Psychologists

• Tier 1 Screen for Early Reading and Writing
  Intervention
• Tier 2 Assess and Modify Curriculum and
  Instruction to Increase Number of Students
  Meeting State Standards and Passing High Stakes
  Tests
• Tier 3 Differential Diagnosis, Treatment
  Planning and Implementation, and Brain and
  Behavioral Progress Evaluation for Treating
  Persisting Reading and Writing Problems

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Other 3-Tier Models

• Health Universal (prevention), Secondary,
• and Tertiary
• Education Core Curriculum in General
• Education, Supplementary
• Instruction in General
  Education,
• Special Education

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Validating Tests on Basis of Using Them to Bring
about Student Change

• Psychometric Properties Necessary
• Reliability
• Concurrent and Construct Validity
• Psychometric Properties Not Sufficient--Links to
  Instruction Also Necessary
• Treatment Validity

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Tier 1 Screening

• Step 1 Assess Reading and Writing Skills
• Administer standardized tests of real word and
  pseudoword and passage oral reading accuracy
  (grades 1 and 2) and rate (grades 2 and 3),
  handwriting (grades 1 to 3) , and spelling
  (grades 2 and 3).
• If rate low, give accuracy measures too.

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Tier 1 Screening

• Step 2 Research-Supported Process Assessment
• For students below mean on real word or
  pseudoword reading or spelling, assess
  phonological coding/awareness,
• orthographic coding/awareness, rapid
  automatic naming, and rapid automatic letter
  writing (grades 1, 2, 3).
• For students below mean on handwriting,
  administer orthographic coding and finger sense.
  

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Tier 1 Treatment

• Step 3 Go directly to treatment!
• Linked to the process weakness
• Linked to research-supported instructional
  component for teaching reading or writing

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Tier 1 Test Battery

• Real Word Reading and Pseudoword Reading
• Accuracy WRMT-R, WJ-III, WIAT II
• Rate TOWRE Word and Phonemic Efficiency
• Phonological Coding/Awareness CTOPP elision,
  PAL Syllables and Phonemes
• Orthographic Coding/Awareness PAL Receptive
  Coding
• Rapid Automatic Naming--Letters Wolf Denckla,
  PAL single letters and letter clusters
• Rapid Automatic Letter Writing PAL Alphabet
  Writing
• Note Other standardized measures for the same
  processes can be substituted.

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PAL 2001 Phonological Assessment

• Rhyming Analysis (odd one out of three)
• tell lake well
• Generation hat
• Syllable Segmentation
• Say Jabberwocky
  without er.
• Phoneme Segmentation Identifying
  remaining
• sounds when
• all but one phoneme
  is omitted. Say
• jabber
  without /abber/.
• a single phoneme is
  deleted. Say
• jabber
  without /j/.

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PAL 1998a Phonological Lessons(pp. 196-219)

• Four games played to develop syllable
  segmentation skills
• Find the Hidden Is ant hidden in cant? in
  Andy?
• Say the Missing Say carelessly. Now say
  lessly. What is missing?
• Say the Word Without Say friendliness. Now say
  it without ness.
• Substitute Say garden. Now dont say it with
  den, say it with ter.

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PAL 1998a Phonological Lessons (pp. 196-219)

• Four games played to develop phoneme
  segmentation skills
• Find the Hidden Does the word begin with /m/ as
  in mother? make? time?
• Say the Missing Sat mice. Now say ice. What is
  missing?
• Say the Word Without Say wave. Now say it
  without /w/.
• Substitute Say sad. Now say it with /h/ instead
  of /s/.

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PAL 2001 Assessment of (Receptive Orthographic
Coding) (STM/WM)

• because

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PAL 2001 Assessment Orthographic Coding

• because

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PAL 2001 Assessment Orthographic Coding

• because

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PAL 2001 Assessment Orthographic Coding

• became

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PAL 2001 Assessment Orthographic Coding

• because

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PAL 2001 Assessment Orthographic Coding

• o

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PAL 2001 Assessment Orthographic Coding

• because

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PAL 2001 Assessment Orthographic Coding

• a

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PAL 2001 Assessment Orthographic Coding

• because

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PAL 2001 Assessment Orthographic Coding

• ua

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PAL 2001 Assessment Orthographic Coding

• because

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PAL 2001 Assessment Orthographic Coding

• au

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PAL 1998a Orthographic Lessons (pp. 192)

• Show written word (on chalk board, overhead, or
  written list at students desk) from the reading
  or spelling curriculum briefly (about 1 second)
  with this instruction while sweeping finger under
  the word in left to right direction Look
  carefully at each letter in this word.
• Then cover the word with a card and ask the
  children to spell the word or write a designated
  letter or letter group (orally taking turns or
  everyone writing independently).
• Then uncover the word and play one of the games
  on the next slide.

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PAL 1998a Orthographic Lessons (pp. 192)

• 1. Direct children to look carefully at this
  written word
  breakfast2. Cover word for about 1 second.3a.
  Whole Word Game Now spell what you saw (do not
  name the wordso children have to rely on memory
  for all the letters in the word).
  breakfast3b. Letter in a Word Game Now name
  (or write) the first letter in the word (then the
  last letter). b, t3c. Letter Groups/Clusters in
  a Word Game Now name (or write) the first two
  letters (br), the last two words (st), the third
  and fourth letters (ea).

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PAL 2001 Rapid Automatic Letter Naming (RAN)
(mouth)

• Name the letters as accurately and quickly as
  you can without making a mistake. Go in order
  starting here. When you finish one row go onto
  the next row and keep going until you finish the
  last row.
• b h n d o t a r th oa
  br nd

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PAL 2001 Assessing Rapid Automatic Letter Writing
(hand)

• Print the letters of the alphabet in order as
  accurately and quickly as you can without making
  a mistake. Use manuscript not cursive writing.

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PAL 1998b Handwriting Lessons for Treating Slow
RAN and Letter Writing

• Each lesson consists of 4 pages of letter models
  and space to practice each of 26 letters once and
  lined paper with composition topic to compose for
  5 minutes. Each lesson can be used up to three
  times.
• 24 lessons in ball and stick lower case
  manuscript letter and 24 lessons in lower case
  manuscript DNealian.

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PAL 1998b Handwriting Lessons

• Instructions Study the numbered arrow
  cues in ____(name letter). Cover ____(name
  letter). (Start with 1 sec delay between covering
  and writing letter and increase.) Now
  write_____(name letter). Compare_____(name
  letter) to the model letter. If your ____(name
  letter) looks different from the model letter,
  fix it so it looks the same.
• Instructional Adaptation Ask children to name
  letters as they write them.

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Teach for Transfer to Composing

• Important Instructional Design Features
• Only practice each letter once in a lesson
  (avoids habituation)
• Always compose for 5 minutes and share with peers

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PAL 1998a Alphabet Retrieval Game (pp. 193) for
Improving Automatic Retrieval

• Name or Write the letter that comes after these
  letters a, s, w, g, m. Name or Write the
  letter that comes before these letters u, r, t,
  l, i.24 sets of five after and five before items
  to use in the context of a writing lesson aimed
  at all levels of language.

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Processes Assessed, Learned, and Taught within
Functional Systems

• Reading and Writing are Functional Systems
  (Luria, 1970) that draw on multiple processes
  (some shared and some unique) to achieve a
  variety of goals.
• . Implement process treatment in lessons
  teaching all the necessary processes close in
  time and coordinate their timing to achieve
  fluency and high-level, meaning goals (Berninger
  Abbott, 2003).

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Translating Tier 1 Research into Lessons
Teachers Can Use

• PAL Research-Supported Reading and Writing
  Lessons
• (Harcourt/PsychCorp, 2003)
• I. Reading
• Lesson Set 1 Alphabet Principle ?
  Monosyllabic
• Words ? Reading
  stories
• Lesson Set 2 Alphabet Principle ?
  Polysyllabic
• Words ? Reading
  and Summarizing
• stories

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Translating Tier 1 Research into Lessons
Teachers Can Use

• PAL Research-Supported Reading and Writing
  Lessons
• (Harcourt/PsychCorp, 2003)
• II. Writing
• Lesson Set 3 Alphabet Principle ? Copying
  Words
• Words ? Composing
• Lesson Set 4 Alphabet Principle ? Spelling
  Monosyllabic
• Words? Composing
  with High
• Frequency
  Grade-Appropriate Words
• Lesson Set 5 Alphabet Principle ? Spelling
  Polysyllabic
• Words? Composing
  with Teacher Generated Topics

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Reading More about theThree Tier Model

• Berninger, V., Stage, S., Smith, D.,
  Hildebrand, D. (2001). Assessment for reading
  and writing intervention A 3-tier model for
  prevention and intervention. In J. Andrews, H.,
  D.Saklofske, H. Janzen (Eds.). Ability,
  achievement, and behavior assessment. A
  practical handbook (pp. 195-223). New York
  Academic Press. sstage_at_u.washington.edu for
  additional publications about problem solving
  consultation.
• Berninger, V. (2002). Best practices in
  reading, writing, and math assessment-intervention
  links A systems approach for schools,
  classrooms, and individuals. In A. Thomas J.
  Grimes (Eds.) Best Practices in School
  Psychology IV. Vol 1 (pp. 851-865). Bethesda,
  MD National Association of School
  Psychologists.

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Tier 1 Contribution to Bridging General-Special
Education Gap

• Prevents learning problems in general education
• Will be emphasized in the reauthorization of IDEA
• Requires partnerships among school psychologists,
  speech and language specialists, special
  education teachers AND general education teachers
• Contributes to educational evolution (optimizing
  learning of all students)

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Preventing Mental Health Problems through
Academic Instruction

• Current treatment research uses usual
  treatment as the control. Counseling did not
  lead to added gains beyond academic instruction.
• Weiss, B., Catron, T., Harris, V., Phung, T.
  (1999). The effectiveness of traditional child
  psychotherapy. Journal of Consulting and
  Clinical Psychology, 67, 82-94.

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Preventing Behavior Problems through Teacher
Consultation

• 1. Visit Dr. Sylvia Rosenfields website on
  statewide school consultation model.
• www.icteams.umd.edu
• 2. and Dr. Carol Lidzs website for dynamic
  assessment
• www.dynamicassessment.com

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Preventing Mental Health Problems through
Research-Supported Social Skills Training

• Committee For Children
• www.cfchildren.org Phone Number
  800-634-4449.
• Second Step
• Grossman, D.C., Neckerman, H.J., Koepsell, T.D.,
  Liu, P.Y., Asher, K.N. Beland, K., Frey, K.S.
  Rivara, F.P.  (1997).  The effectiveness of a
  violence prevention curriculum among children in
  elementary school.  Journal of the American
  Medical Association, 277, 1605-1611.
• Frey, K. S., Nolen, S. B., VanSchoiak-Edstrom,
  L., Hirschstein, M. (2005). Evaluating a
  school-based social competence program Linking
  behavior, goals and beliefs. Journal of Applied
  Developmental Psychology, 26, 171 200.

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Preventing Mental Health Problems through
Research-Supported Social Skills Training

• Committee For Children
• www.cfchildren.org Phone Number
  800-634-4449.
• Van Schoiack, L., Frey, K. S., Beland, K.
  (2002). Changing adolescents' attitudes about
  relational and physical aggression An early
  evaluation of a school-based intervention. School
  Psychology Review, 31, 201-216.
• Steps to Respectdue out in the May Issue.
• Frey, K. S., Hirschstein, M. K., Snell, J. L.,
  Edstrom, L. V., MacKenzie, E. P. Broderick, C.
  (in press). Reducing playground bullying and
  supporting beliefs An experimental trial of the
  Steps to Respect program. Developmental
  Psychology.

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Preventing Mental Health Problems through
Research-Supported Mental Health Prevention

• Contact Dr. Carolyn Webster Stratton for
  research-supported strategies for parents and
  schools to use with conduct disordered children.
  cws_at_u.washington.edu
• Contact Dan Lovitt (dlovitt_at_u.washington.edu) and
  request paper on Emotional Coaching in the
  Classroom

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Facilitating School Success through Enhancing
Teacher-Student Relationships

• Read Pianta, R. (1999). Enhancing Relationships
  between Children and Teachers. Washington, D.C.
  American Psychological Association.

54
School Psychologists as Miracle Workers

• The Los Angeles Unified School District (LAUSD)
  Partnership between School Psychologists and
  General Education Teachers
• Dr. Alnita Dunn, Psychology Services Coordinator
  in LAUSD, headed the effort.
• Participating school psychologists included
  Debby Barth Carrera, Rosalie Bell, Ph.D., Debbie
  Bloom, Patricia Burrows, Ruben Carranza, June
  Durr, Christina Harrell, Erin Holman, Chris
  Mealy-Ures, Nicole Mock, AnneMarie Serrano,
  Christine Toleson, Tiana Thorpe, Reymundo
  Verastigui, and Didi Watts) and the teachers at
  the participating schools (24th St. School, 96th
  St. School, 116th St. School, Fernangeles,
  Fletcher Dr., Hoover St., Hyde Park Blvd.,
  Kittridge St., Los Angeles Elementary School,
  Murchison St., Pio Pico, Russell, Sierra Park,
  Westminster Ave., and Woodcrest.

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Further Information on School Psychology
Partnerships

1. Berninger, V., Dunn, A., Lin, S.., Shimada, S.
   (2004). School Evolution Scientist-Practitioner
   Educators Creating Optimal Learning Environments
   for ALL Students. Journal of Learning
   Disabilities, 37, 500-508.
2. Berninger, V. , Dunn, A., Alper, T. (2004).
   Integrated models for branching assessment,
   instructional assessment, and profile assessment.
   In A. Prifitera, D. Saklofske, L. Weiss, E.
   Rolfhus (Eds.), WISC-IV Clinical use and
   interpretation (pp. 151-185). San Diego, CA
   Academic Press.
3. Articles by Dunn in CASP newsletter.

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School Psychologists as Miracle Workers

• UW School Psychology Interns 2004-2005
• Care, Connect, and Communicate C3
• and then implement research-supported instruction
• Proof in principle (stories of school psychology
  interns)

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Research into Practice within C3

• Kindergartener with severe behavior problems is
  retainedteacher wants the child in special
  education
• School psychology intern has read NASP position
  paper on retention, assesses child using
  research-supported tests, pinpoints cognitive
  strengths and specific literacy weaknesses

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Research into Practice within C3

• School has not contacted parent who does not have
  phone. School psychology intern visits home and
  invites mom to school, does active listening
  about the family situation, and assists mom in
  obtaining services through Catholic Charities.
• School psychology intern uses consultation skills
  to convince the kindergarten and first grade
  teacher to allow the student to visit the first
  grade classroom for reading instruction and to
  receive supplementary, research-supported
  instruction to work on weaknesses in
  literacy-related processes.

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Research into Practice within C3

• Evidence-based Outcomes
• Mom is now in recovery from addiction to
  prescription drugs child is visiting with
  divorced dad.
• Child remained successfully in 1st grade and at
  the end of the year was achieving above the
  national population mean in all reading and
  writing skills.

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Research on Tier 2 Interventions (to Meet
Standards) Also Transformed into Lessons

• PAL Lesson Set 6. Second Grade Reading
• PAL Lesson Set 7. Third Grade Spelling and
• Composing
• PAL Lesson Set 8. Third Grade Handwriting,
• Spelling, and Composing
• PAL Lesson Set 9. Second Grade Reading
• PAL Lesson Set 10. Fourth Grade Handwriting,
• Spelling, and Composing

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Research on Tier 3 Interventions Also Transformed
into Lessons

• PAL Lesson Set 11. Dyslexia Reading
  Treatment I
• PAL Lesson Set 12. Dyslexia Reading
• Treatment II
• PAL Lesson Set 13. Dyslexia Reading-Writing
• Treatment I
• PAL Lesson Set 14. Dyslexia Reading-Writing
• Treatment II
• PAL Lesson Set 15. Dyslexia ReadingTreatment III

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PAL (Process Assessment of the Learner)
Disseminates UW Research on Assessment and
Intervention

• Available from Harcourt/Psycorp
• 1998a PAL Intervention Guides for Reading and
  Writing
• 1998 b PAL Intervention Kit (with Handwriting
• Automaticity Lessons and
  Talking Letters)
• 2001 PAL Test Battery, WIAT II
• 2003 PAL Research-Supported Reading
• and Writing Lessons
• based on UW research but developed and normed on
  national sample by Harcourt.
• NOT A CURRICULUM OR TEST TO BE USED IN ISOLATION
  OF OTHER MEASURESA WAY OF MAKING AVAILABLE TO
  PRACTITIONERS RESEARCH-SUPPORTED ASSESSMENT AND
  INTERVENTION (BASED ON PEER REVIEWED RESEARCH AND
  THEN TRANSFERRED TO PUBLISHER WHO TRANSLATES THE
  RESEARCH FINDINGS INTO A PRODUCT)