2012 AWARD WINNER STATEMENTS
The need for consideration of functional assessment data to inform Tier 2 decisions
By Stephen P. Kilgus
Within common multitiered frameworks of behavioral service delivery (e.g., positive behavior interventions and supports), the purpose of Tier 2 targeted supports is to provide increased structure and feedback to students for whom universal systems and practices are insufficient in preventing problem behavior (Filter, McKenna, Benedict, & Horner, 2007). Tier 2 behavioral supports are likely to be appropriate for students displaying behavior that is disruptive to their own or others’ learning (Anderson & Borgmeier, 2010). They are not likely to effectively address dangerous or intense behavior, which will normally require application of individualized Tier 3 supports capable of quickly minimizing harm. The strength of a Tier 2 intervention is predicated upon its effectiveness, as well as its possession of multiple critical features related to its adoption, sustainability and fidelity of implementation. Various authors have proposed lists of these features (e.g., Anderson & Borgmeier, 2009; Hawken, Adolphson, MacLeod, & Schumann, 2009; McIntosh, Campbell, Carter, & Dickey, 2009), each of which may be placed into one of three broad feature categories.
First, it is desirable that Tier 2 interventions be general, in that they should be a standardized protocol, suitable for simultaneous use across multiple students and settings without need for much adaptation (Campbell & Anderson, 2011; Hawken et al., 2009; March & Horner, 2002; McIntosh et al., 2009). Second, sustainable Tier 2 supports should be efficient. Efficiency may be considered a multifaceted concept. For instance, an efficient Tier 2 intervention is cost effective, in that its implementation requires relatively minimal resources available to educators at no or low cost (Anderson & Borgmeier, 2010). It is also minimally disruptive to the instructional ecology, requiring little advanced assessment, teacher training and interventionist time and effort (Filter et al., 2007; McIntosh et al., 2009).
Finally, a sustainable Tier 2 intervention should also be an effective means by which to decrease disruptive nondangerous behavior, and increase prosocial behavior and academic engagement (Sugai & Horner, 2006). Research supports the effectiveness of several comprehensive Tier 2 supports, including check-in/check-out (CICO; Campbell & Anderson, 2008; Fairbanks, Sugai, Guardino, & Lathrop, 2007; Hawken, MacLeod, & Rawlings, 2007; Hawken & Horner, 2003; McIntosh et al., 2009; March & Horner, 2002), and First Step to Success (Golly, Sprague, Walker, Beard, & Gorham, 2000; Walker, Golly, McLane, & Kimmich, 2005). As it is common for schools to only adopt one or two standardized Tier 2 interventions (Sanetti & Simonsen, 2011), it is necessary that these strategies be effective for a diverse sample of students unresponsive to universal supports. For example, a system of one or two Tier 2 supports (e.g., CICO and social skills instruction) should support students of various ages and backgrounds evidencing a range of problematic behaviors across numerous settings. With that said, it is acknowledged that Tier 2 interventions will not be successful for all students, including those displaying highly problematic behavior. Recognition of this inevitably establishes the need for schools to adopt systems that support the creation of individualized behavior support plans at Tier 3. In contrast, Tier 2 supports should be successful for students displaying non-intense problem behavior, regardless of the function of that behavior. That is, it could be argued that it is unacceptable for the effectiveness of a school’s collective system of Tier 2 supports to be moderated by the function of behavior. If a school has adopted two Tier 2 interventions, it is required that together both interventions address behavior maintained by each of the four common functions. Additional information regarding this requirement is presented below.
Function as a moderator
A fundamental tenet of behaviorism is that all behavior is functional, and is therefore maintained by the consequences that follow it, including access to attention (from peers and adults), access to tangibles and activities, escape from aversive stimuli, and sensory stimulation. It is hypothesized that each behavior a student displays is an attempt to access one or more of these consequences. As such, manipulating how and when these consequences are provided may provide a means to decrease problem behavior and increase appropriate replacement behavior. Such approaches, which have been broadly referred to as function-based interventions, have repeatedly shown to be superior to non-function-based alternatives (Filter & Horner, 2009), wherein no attention is paid to whether the manipulated contingencies were those that maintained problem behavior and suppressed appropriate behavior. Although research indicative of the superiority of function-based interventions is plentiful at Tier 3, less empirical evidence has been collected at Tier 2. Yet, a recent line of studies has documented the influence of function on Tier 2 intervention effectiveness. For example, March and Horner (2002) found that although CICO was effective for 80.0% and 62.5% of students whose behavior was maintained by adult and peer attention, respectively, yet it was effective for only 27.3% of students with behavior maintained by escape from academic demands. Through multivariate analysis, McIntosh et al. (2009) identified a statistically significant interaction between function and CICO. Although application of the intervention resulted in statistically significant improvements in prosocial behavior, problem behavior, and office discipline referrals for students displaying attention-maintained behavior, no such improvements were noted for students with escape-maintained behavior.
Similar findings have been documented across several other investigations, thus supporting the moderating influence of function on the effectiveness of multiple Tier 2 interventions (Campbell & Anderson, 2011; Carter & Horner, 2007, 2009; Hawken, O’Neill, & MacLeod, 2011; Lane, Capizzi, Fisher, & Parks Ennis, 2012). Although results have varied, a relatively consistent finding pertains to the limited influence of these interventions on escape-maintained behavior. Recognition of this limitation has resulted in a series of studies, which have indicated that both CICO and First Step to Success effectively remediated escape-maintained behavior when supplemented by functionally relevant strategies (Campbell & Anderson, 2008; Carter & Horner, 2007, 2009; Fairbanks et al., 2007; March & Horner, 2002).
At first glance, results of these studies appear to support the foundation of the three-tier model, with Tier 2 interventions being insufficient for some students, thus requiring schools to implement individualized and intensive Tier 3 function-based supports to support them. Yet, the reader is cautioned against such a simplistic interpretation. As is commonly known, the Individuals with Disabilities Education Improvement Act’s (2004) requires schools to provide each student with a disability an education in the least restrictive environment (LRE). It could reasonably be argued that this requirement extends to all operations within a multi-tiered framework. Specifically, it is desirable that all students, regardless of disability status, should receive the least intensive and restrictive, yet still effective supports. When appropriate, it is preferable to provide at-risk students with Tier 2 supports, as Tier 3 supports (whether provided through general or special education services) are likely to be more restrictive, costly, and time-consuming. If data suggest a Tier 2 intervention is ineffective, educators should first document that the intervention was relevant to the function of the student’s behavior. If the intervention was not functionally relevant, it could be argued that the educators have not made a sufficient attempt to provide the student with appropriate supports in the LRE. A defensible course of action would therefore be to attempt an alternative Tier 2 intervention prior to consideration of Tier 3 supports. An even more defensible approach would have been to assess the function of the student’s problem behavior in advance of intervention implementation, and to use this information in assigning the student to functionally relevant Tier 2 supports. Such assessment procedures are necessary to fulfill the promise of multitiered frameworks as service delivery models supporting the rapid application of evidence-based interventions matched to student needs.
In sum, although it is considered acceptable for a school’s system of Tier 2 interventions to not necessarily support students displaying highly intense behaviors, it is considered unacceptable for this system to not support students displaying nonintense behaviors because said behaviors are maintained by certain functions. Rather than being referred for more intensive and restrictive supports, this latter group of students should be provided with interventions relevant to the function of their problem behavior at Tier 2. Unfortunately, the ability to do so is limited by the absence of research regarding (a) efficient and technically adequate functional assessment procedures, and (b) Tier 2 interventions relevant to escape-maintained behavior.
Implications for practitioners
Overall, it is clear functional assessment data is needed to support Tier 2 practices (Hawken et al., 2007, 2011). Yet, the direct methods and procedures that comprise fully scaled functional behavior assessments tend to be costly in terms of required time and effort. As such, it is recommended that educators support Tier 2 through the use of more indirect and efficient functional assessment methods that require less behavioral expertise, including rating scales, checklists and interviews (Hawken et al., 2008, 2011). Several of such methods have been examined within the literature, including the Motivation Assessment Scale (MAS; Durand & Crimmins, 1988), Functional Assessment Checklist: Teachers and Staff (FACTS; March et al., 2000), and Functional Analysis Screening Tool (FAST; Iwata & DeLeon, 1995). Unfortunately, the evidence supporting these methods is largely disappointing (McIntosh, Borgmeier, et al., 2008; Zaja, Moore, van Ingen, & Rojahn, 2011). Yet, the FACTS tool has a history of use at Tier 2 and is supported by the strongest psychometric evidence of the available options (McIntosh, Borgmeier, et al., 2008). Its use may therefore be considered defensible when informing low stakes decisions, such as Tier 2 intervention assignment. Future research is necessary to further investigate FACTS technical adequacy, and to support development of alternative functional assessment methods that may offer increased technical adequacy and efficiency.
It is also recommended that practitioners be prepared to supplement standardized Tier 2 supports (e.g., CICO), as necessary, for students demonstrating escape-maintained behavior. Specifically, practitioners should consider incorporating one or more efficient evidence-based and functionally relevant strategies known to either reduce the likelihood of escape-maintained problem behavior (e.g., curriculum revision, task modification) or increase the likelihood of future appropriate replacement behavior (e.g., break cards, momentary breaks; Lane et al., 2012; McIntosh, Brown, & Borgmeier, 2008; McIntosh et al., 2009). (Please see Geiger et al. (2010) for additional information regarding escape-maintained interventions.) Future research is necessary to examine whether such interventions may be formally incorporated into standardized Tier 2 protocols, thus eliminating the need for the idiosyncratic provision of supplementary function-based supports (Fairbanks et al., 2007), and enhancing the overall efficiency and generality of Tier 2 procedures.
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Sanetti, L.M.H., & Simonsen, B. (2011). Positive behavioral supports. In M.A. Bray, & T.J. Kehle, The Oxford handbook of school psychology (pp. 647-665). New York, NY: Oxford.
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Zaja, R.H., Moore, L., van Ingen, D.J., & Rojahn, J. (2011). Psychometric comparison of the functional assessment instruments QABF, FACT, and FAST for self-injurious, stereotypic and aggressive/destructive behaviour. Journal of Applied Research in Intellectual Disabilities, 24, 18-28.
Dr. Kilgus’ dissertation entitled “Diagnostic Accuracy of Direct Behavior Rating as a Screener of Elementary School Students”, reports the results of an investigation of the diagnostic accuracy and concurrent validity of the Direct Behavior Rating Single Item Scale (DBR-SIS) as a universal behavior screening instrument. The work conducted by Dr. Kilgus involved the integration of an applied study with advanced quantitative methodology. He recruited classroom teachers and then used receiver operating characteristic curve (ROC) curve analyses to identify cut scores on each DBR scales as well as the use of multiple DBR-SIS to improve accuracy. His findings have important implications for the advancement of behavior screening measures used to identify at-risk students in schools. Dr. Kilgus completed his work in School Psychology at the University of Connecticut with his academic advisor, Dr. Sandra M. Chafouleas.
Stephen P. Kilgus, PhD
East Carolina University
Department of Psychology
104 Rawl Building
Greenville, NC 27858