Three Tier Model for Preventing

Academic, Mental Health, Behavior Problems

Virginia W. BerningerUniversity of Washington

Director, Multidisciplinary Learning Disabilities

Research Center, Literacy Trek Longitudinal Study, and

The Write Stuff Intervention Project,

and School Psychology Internship Program

vwb@u.washington.edu

CASP March 4, 2005

Riverside, CA

Greetings from UW School Psychology Program, Seattle, WA

Acknowledgements

NICHD RO1 25858NICHD P50 33812Graduate Students in School Psychology Co-Investigators at the University of

Washington and External ConsultantsHarcourt (norming research measures)

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

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

Today’s 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

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?

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

Other 3-Tier Models

Health: Universal (prevention), Secondary,

and Tertiary

Education: Core Curriculum in General

Education, Supplementary

Instruction in General Education,

Special Education

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

Tier 1 Screening

Step 1: Assess Reading and Writing SkillsAdminister 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.

Tier 1 Screening

Step 2: Research-Supported Process AssessmentFor 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.

Tier 1 Treatment

Step 3: Go directly to treatment!Linked to the process weaknessLinked to research-supported instructional

component for teaching reading or writing

Tier 1 Test Battery

Real Word Reading and Pseudoword Reading: Accuracy: WRMT-R, WJ-III, WIAT IIRate: TOWRE Word and Phonemic Efficiency

Phonological Coding/Awareness: CTOPP elision, PAL Syllables and Phonemes

Orthographic Coding/Awareness: PAL Receptive CodingRapid Automatic Naming--Letters: Wolf & Denckla, PAL

single letters and letter clustersRapid Automatic Letter Writing: PAL Alphabet Writing Note: Other standardized measures for the same processes

can be substituted.

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/.

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

Four games played to develop syllable segmentation skills:

Find the Hidden Is ant hidden in can’t? 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 don’t say it with den, say it with ter.

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/.

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

because

PAL 2001 Assessment Orthographic Coding

because

PAL 2001 Assessment Orthographic Coding

because

PAL 2001 Assessment Orthographic Coding

became

PAL 2001 Assessment Orthographic Coding

because

PAL 2001 Assessment Orthographic Coding

o

PAL 2001 Assessment Orthographic Coding

because

PAL 2001 Assessment Orthographic Coding

a

PAL 2001 Assessment Orthographic Coding

because

PAL 2001 Assessment Orthographic Coding

ua

PAL 2001 Assessment Orthographic Coding

because

PAL 2001 Assessment Orthographic Coding

au

PAL 1998a Orthographic Lessons (pp. 192)

Show written word (on chalk board, overhead, or written list at student’s 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.

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 word—so 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).

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

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.

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 D’Nealian.

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.

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

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.

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).

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

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

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@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.

Tier 1 Contribution to Bridging General-Special Education Gap

Prevents learning problems in general education Will be emphasized in the reauthorization of

IDEARequires partnerships among school

psychologists, speech and language specialists, special education teachers AND general education teachers

Contributes to educational evolution (optimizing learning of all students)

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.

Preventing Behavior Problems through Teacher Consultation

1. Visit Dr. Sylvia Rosenfield’s website on statewide school consultation model.

www.icteams.umd.edu

2. and Dr. Carol Lidz’s website for dynamic assessment

www.dynamicassessment.com

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.

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 Respect—due 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.

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@u.washington.edu

Contact Dan Lovitt (dlovitt@u.washington.edu) and request paper on “Emotional Coaching in the Classroom”

Facilitating School Success through Enhancing Teacher-Student Relationships

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

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.

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.

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)

Research into Practice within C3

Kindergartener with severe behavior problems is retained—teacher 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

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.

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.

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

PAL Lesson Set 6. Second Grade ReadingPAL Lesson Set 7. Third Grade Spelling and

ComposingPAL Lesson Set 8. Third Grade Handwriting,

Spelling, and ComposingPAL Lesson Set 9. Second Grade ReadingPAL Lesson Set 10. Fourth Grade Handwriting,

Spelling, and Composing

Research on Tier 3 Interventions Also Transformed into Lessons

PAL Lesson Set 11. Dyslexia Reading Treatment I

PAL Lesson Set 12. Dyslexia ReadingTreatment 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

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 MEASURES=A 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)