Current Status and Future Directions of School Based Interventions
Frank Gresham (School Psychology Review, 2004)A study guide
(1 Pt. ea unless noted otherwise).
1. How do school administrators typically view the cause of students’ behavior problems and what impact does this have on interventions used in the schools?School administrators often view students' behavioral problems as stemming from factors outside the school and therefore do not view schools as proactive agents in the process of prevention and/or behavior change, as a result, schools often utilize interventions that are either patently ineffective or, in some cases, harmful. (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
2. Effective interventions typically employ what kinds of strategies?
Effective behavioral interventions employ strategies and procedures that prevent behavior problems as compared to those that rely on aversive consequences to punish or otherwise deter problem behaviors (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
3. Briefly describe the basic assumptions/approaches of the four broad categories of behavioral interventions. (4 pts)
A. Applied behavior analysis. ABA describes the functional relationship between
antecedents, behaviors, and consequences. According to Gresham (2001), ABA uses “functional behavioral assessment methods to target antecedent and consequent events” and determines “the function that problem behavior serves for an individual in a specific situation”.B. Social learning theory (Social cognitive theory). Social learning theory, according to Gresham, is based on “the notion of reciprocal determinism that describes the role an individual's behavior has on changing the environment and vice-versa”. In other words, social learning theory “utilizes the concept of vicarious learning and the role of cognitive mediational processes in determining which environmental events are attended to, retained, and subsequently performed when an individual is exposed to modeling stimuli”.
C. Cognitive behavior therapy (CBT). CBT main goal is to change “maladaptive cognitions that, in turn, lead to changes in behavior” uses techniques such as “self-instruction, selfevaluation, correction of maladaptive selftalk, and problem solving”.
D. Neobehavioristic S-R models. Neobehavioristic S-R models are based on “features of classical (respondent) conditioning and avoidance learning in which maladaptive responses are conditioned to stimuli in the environment” (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
4. When compared to traditional psychotherapy models, how do behaviorally-based models measure up empirically?
Interventions based on either applied behavior analysis, behavior therapy, or cognitive behavior therapy methods have been shown to be superior to other child or adolescent psychotherapy methods (e.g., psychodynamic or humanistic methods) (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
5. Differentiate between “efficacy” and “effectiveness”.
According to Oxford dictionary, efficacy is “the ability to produce a desired or intended result” and effectiveness is “the degree to which something is successful in producing a desired result” (Oxford Dictionary). According to Gresham, efficacy refers to randomized ,controlled and systematic evaluation of interventions under tight experimental conditions with the clinical trial being the prototypical example. Effectiveness, on the other hand, focuses on the application and generalizability of intervention methods in "real world" settings. ) (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
6. What implications does this (# 5) have for the translation of research into practice?
It is possible for an intervention to have efficacy evidence but not effectiveness evidence due to the fact that efficacy research emphasizes internal validity (controlled conditions with specific populations) and effectiveness research emphasizes external validity (generalizability of findings to other population under less-controlled conditions) (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
7. In considering intervention choices, Gresham cites a medical analogy by Walker (2004).what is the meaning of this analogy?
The meaning of the analogy by Walker (2004) citied by Gresham is that “intervention or instructional practices in schools are based, in part, on the fact that many educators have not been trained in empirically supported intervention or instructional methods and/or they simply may be invested in philosophical or theoretical approaches that are at odds with more effective intervention strategies” (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).Note: Gresham was the first person (in school psychology) to describe “RTI”, long before it became popular – see Gresham (1991) in the References section of the article. 8. In the section “Matching Intensity of Intervention to Problem Severity”, Gresham essentially describes a generic RTI modeldescribe (don’t just list) each “level” in that model, and differentiate among the varying levels of behavioral intervention in each. (6 pts)
RTI model of intervention is composed of three levels of intervention intensity: universal interventions, selected interventions, and targeted/intensive interventions.
Universal intervention. These intervention is designed to target and affect all students and are delivered in the same manner and under the same conditions.
Selected intervention. Selected interventions represent a class of interventions that focuses on the nonresponders to universal interventions that comprise about 5-10% of the school population.
Targeted/Intensive intervention. The most intense level of intervention focuses on students that are the most recalcitrant to change and who exhibit chronic academic and/or behavioral difficulties (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
9. Gresham goes on to describe RTI more in dept in the section “Response to Intervention as a Basis for Selecting Interventions”. Using this section, describe how RTI works. (3 pts.)An RTI model uses a student's lack of response to an evidence-based intervention that is implemented with integrity as the basis for intensifying, modifying, or changing an intervention. RTI is based on the notion of discrepancy between pre- £ind postintervention levels of performance. RTI is also consistent with a problem-solving model of intervention in which 330 Status and Future of Behavioral Interventions problems are defined as a discrepancy between current and expected levels of performance. Any intervention that does not produce a discrepancy between preintervention and postintervention levels of performance should be modified or intensified in an RTI problem solving model (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
10. What are the advantages of RTI? Briefly describe each. (6 pts)
The most compelling reason for using this approach is that it provides immediate assistance to students who are having difficulties with behavioral or academic challenges. A common complaint of so-called "refer-test-place" models of service delivery is that they operate on prescribed timelines, require an avalanche of paperwork, and often take several months to determine eligibility for special education (Gresham, VanDerHeyden, & Witt, 2004; Reschly & Ysseldyke, 2002). In an RTI model, there is no need to wait for a student's difficulties to become more severe before effective intervention services are delivered (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
11. One of these advantages (in # 10) is treatment validity. Describe the most salient characteristics of treatment validity. (2 pts)
Treatment validity refers to the degree to which an assessment procedure informs or contributes to beneficial outcomes for individuals. Treatment validity contains the idea of incremental validity because it requires assessments to improve prediction above and beyond existing procedures. Treatment validity also includes principles of utility and cost benefit analysis that is commonly used in the personnel selection literature. Finally, treatment validity involves notion of evidential basis for test interpretation and use, specifically as it relates to construct validity, relevance/utility, and social consequences (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
Note: Gresham was also the first (in school psychology) to address the issue of “treatment integrity” - see Gresham (1989), of the reference section of the article.
12. To what does the term “treatment integrity” refer, and on what does TI focus? (2 pts)
Treatment integrity, sometimes called treatment fidelity, refers to the degree to which intervention is implemented as planned or intended. Treatment integrity focuses on the accuracy and consistency with which interventions are delivered in schools and/or classrooms (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
13. Why is treatment integrity an issue in school settings?
Treatment integrity an issue in school settings because Research suggests that the integrity of many treatments is either not monitored or systematically assessed (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
14. The degree to which treatments/interventions are implemented as intended is determined by what factors? (3 pts)
The degree to which treatments/interventions are implemented as intended is determined by the following factors: the complexity of the intervention the time required to implement the intervention the materials and resources required to implement the treatment correctly and the perceived and actual effectiveness of the intervention (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
15. Briefly describe the process/assumptions of the Heartland Model of RTI. (5 pts)
The Heartland AEA model (Heartland Area Education Agency, 2002) is a multiple-gating, problem-solving process based on five premises or assumptions:
1. The intensity of intervention (and therefore the costs) is matched to the degree of a student's responsiveness to that intervention.
2. Progression through various levels of intervention is based on inadequate or unacceptable response to interventions that have been implemented with integrity.
3. Decisions concerning movement through levels of intervention intensity are based on continuous progress monitoring of data collected from multiple sources.
4. As a student progresses through different intensity levels of the intervention, an increasing body of data is collected to inform decision making.
5. Special education and subsequent IEP determinations are considered only after the student shows inadequate or inappropriate responsiveness to intervention at earlier levels of intervention intensity (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
16. Differentiate between a functional behavior assessment and a functional behavior analysis. (2 pts)
Functional assessment includes a broad range of direct and indirect assessment procedures (e.g., historical records, functional assessment interviews, rating scales, and descriptive behavioral observations) that are used to formulate hypotheses about behavioral function. Functional analysis involves the experimental manipulation of antecedent and consequent events in a highly controlled analogue setting to systematically assess the controlling function of behavior (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
17. What was point of the study of the JABA meta-analytic articles done by Gresham, McIntyre, et a. (2014)?
Point of study of the JABA meta-analytic articles done by Gresham, McIntyre, et a. (2014) were whether interventions matched to the operant function of behavior are more effective than studies not reporting the use of FBA procedures (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).18. What did Gresham, McIntyre, et al. (2004) and Didden, Duker & Korzilius (1997) find?
Gresham, McIntyre, et al. (2004) and Didden, Duker & Korzilius (1997) found that interventions based on FBA information were no more effective than interventions not reporting FBA information to design interventions. Using percentage of nonoverlapping data points (PND) and effect size estimates, interventions that were not matched to the operant function of behavior produced the largest effect size and the second largest PND. Interventions that were based on experimental functional analysis showed smaller effect sizes than interventions based on descriptive FBA using both PND and effect size estimates (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
19. What did Didden, Duker and Korzilius (1997) find in their meta-analysis, and how do these findings compare to comprehensive reviews of the similar literature? (2 pts.)Didden, Duker, and Korzilius (1997) conducted a meta-analysis of 482 studies of problem behaviors of persons with mental retardation. Using PND as an index of effect size, these authors reported that interventions matched to behavioral function only increased the PND effect size by 8% in a regression analysis. Other reviews have also noted the relatively small effects of FBA-based interventions relative to non-FBA-based interventions (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
20. As a result of this literature and its implications, what are the FBA recommendations made by Braden & Kratochwill (1997)? (3 pts) Braden and Kratochwill (1997) suggested that prescribed interventions that are not based on FBA information should be considered when: assessment costs exceed treatment costs, consequences of delaying treatment are minimal, and no link between behavioral function and treatment selection has been demonstrated ” (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
21. What is the best predictor of behavioral consultation outcomes?
The best predictor of consultation outcomes is the adequacy or inadequacy of problem identification (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
22. What are meant by “social validity” (Wolf, 1978) and “habilitative validity”(Hawkins, 1991)? How are they different, according to Hawkins? (3 pts)
Wolf (1978) suggested that the social significance of behavior could be determined by how treatment consumers value that behavior. That is, the goals of behavioral interventions should have social validity interventions. Hawkins (1991) argued that target behaviors should be selected on the basis of a habilitative validity criterion. That is, the goals, interventions procedures, and outcomes in school-based interventions should teach or promote behaviors that allow for adaptation or successful functioning in school settings. Hawkins (1991) maintained that the term social validity is misleading because it involves only consumer satisfaction (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
23. Social validity has implications for teacher consultation. What are the issues here? (2 pts)Teachers often do not value behavioral interventions delivered in a consultation model because the treatment procedures are often unrealistic, onerous, and time-consuming; the target behaviors selected often are not the most relevant or important for the teacher; and the outcomes produced by behavioral interventions are not educationally or clinically important. For example, teachers and administrators probably would more highly value decreases in major disruptive behaviors that disrupt the classroom ecology and challenge the teacher's authority than increases in on-task behavior and work completion (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
24. Gresham and Lopez (1996) make several recommendations for socially validating behavioral interventions in schools – summarize these. (5 pts.)
Gresham and Lopez (1996) first recommendation is about school psychologists, who use developmental norms to make decisions regarding the appropriateness of intervention outcomes. For example, normative data exist for a variety of behaviors such as social skills, internalizing and externalizing behaviors and academic achievement. Normative information can be used to specify acceptable and unacceptable levels of performance subsequent to a behavioral intervention. For example, interventions bringing problem behavior into normative ranges may be used to judge the effectiveness of a behavioral intervention. Second recommendation is to use relevant judges to socially validate behavioral interventions. Direct consumers of those interventions such as teachers and parents will validate the majority of behavioral interventions. However, indirect consumers may also assist in the social validation process. Third recommendation is about behavioral interventions that can be socially validated by systematically using archival data that are available for all students in schools (Gresham 2004, Current Status and Future Directions of School-Based Behavioral Interventions).
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Bill Matthew
References
Effectiveness. Oxford Dictionary. Language Matters. Retrieved from
http://www.oxforddictionaries.com/definition/english/effectiveness
Efficacy. Oxford Dictionary. Language Matters. Retrieved from:
http://www.oxforddictionaries.com/definition/english/efficacy
Gresham, F.M (2004). Current Status and Future Directions of School-Based
Behavioral Interventions. University of Califomia'Riverside. School Psychology
Review, 2004, Volume 33, No. 3, pp. 326-343
