Conducting Behavioral and Social-Emotional Assessments in MTSS

Screen to Intervene

Nathaniel von der Embse, Katie Eklund, Stephen Kilgus

• Publisher: Routledge
• Year: 2022
• ISBN:
  9781000513660
• Edition: 1
• Topic: Education
• Subtopic: Behavioural Management

Conducting Behavioral and Social-Emotional Assessments in MTSS: Screen to Intervene offers effective assessment strategies for improving mental and behavioral health decision-making within multi-tiered systems of support. Accessible to school psychologists, behavior analysts, PBIS team leaders, and other school-based professionals, this applied book features evidence-based practices and case study examples to show how assessment data can drive prevention and intervention services, particularly at Tiers 1 and 2. Specific tools and recommendations for universal screening, problem analysis, and progress monitoring procedures offer a fresh, real-world approach to data-driven implementation of supports across schools.

1 Introduction to Integrated Mental and Behavioral Health Services within MTSS

DOI: 10.4324/9780429355790-1

The mission of schools is to “promote student achievement and preparation for global competitiveness by fostering educational excellence and ensuring equal access” (US Department of Education, 2020). While the focus on academic performance has always been central to this goal, increasingly, education systems recognize that academic success does not always equate to school success (Kilgus et al., 2017). There are numerous facilitators and inhibitors of academic growth, including social-emotional and behavioral (SEB) skill development (DiPerna, 2006). The success of these goals is dependent mainly on the provision of multi-tiered systems of support (MTSS) matching service delivery to student need. Although much progress has been made in the adoption of MTSS frameworks for academic supports and, to a somewhat lesser degree, positive behavioral interventions, the integration of social-emotional services has lagged (McIntosh et al., 2017). This is particularly problematic given the rise of student social-emotional, behavioral, and mental health needs (Russo et al., 2018).

What are Social-Emotional and Behavioral Needs?

Throughout this book, we use the term social-emotional and behavioral (SEB) needs. This terminology was chosen (1) to align with an outcome-driven approach and verbiage that is used by and familiar to most educators (Auerbach et al., 2019), (2) for consistency with the language used by the US Department of Education and federal legislation such as the Every Student Succeeds Act (2015), and (3) to reflect a modern conceptualization of complete mental health to include both psychological problems as well as strengths and assets (Suldo et al., 2016). The terms SEB and needs (rather than “problems”) encompasses a student with internalizing (e.g., withdrawal) or externalizing (e.g., aggression) concerns while also recognizing SEB wellbeing indicators and competencies such as adaptability and gratitude (Suldo & Romer, 2016). Conversely, the term “mental health” is often used to describe mental health problems with a focus on symptoms of psychopathology and may not incorporate strengths and competencies (Xie, 2013). Focusing only on individuals with indicators of problem behaviors may ignore those students who may lack critical resilience factors necessary for school success (Suldo et al., 2016). This is especially salient for education systems seeking to meet the needs of all children.

The School as a Primary Service Provider

Recent estimates have suggested that over 20% of school-aged children will exhibit the signs or symptoms of significant SEB needs (Edelman, 2006; Merikangas et al., 2010). Recent events, such as the COVID-19 pandemic, have brought these needs into greater focus as many schools have experienced vast increases in student needs (Golberstein et al., 2020). Schools have now emerged to become the de facto provider of student mental health (or SEB) services (Bruhn et al., 2014). Indeed, schools are a natural setting to facilitate cost-effective prevention efforts, which are essential considering that over half of adult mental and behavioral health problems first originate before 18 (Belfer, 2008). Schools are universally accessible to all children; many children do not have access to outside or private mental health care providers due to high cost, lack of private insurance, and limited availability (Graaf & Snowden, 2020). Despite the natural advantages of this setting, many schools lack the infrastructure to address student SEB needs systematically.

As consistent with historical practices and prior legislation, schools have traditionally been reactive to student needs, particularly in the SEB domains. For example, previous legislation (i.e., Education for All Handicapped Children, 1975, PL 94–142) required schools to initiate an evaluation to determine the need for special education services based upon a record of academic difficulty. Often this resulted in schools waiting for children to fail before initiating service delivery. Legislation gradually shifted practices towards preventative services such as Child Find mandates from the Individuals with Disabilities Education Act (2004) requiring school districts to identify and evaluate all children with a suspected disability. Around the same time, prevention science took hold in the public health sector, as seen in nationwide efforts to reduce smoking and promote vaccination. The maturation of the prevention science field was significant for education and, in turn, meeting the needs of students with SEB concerns, ultimately leading to further development and refinement of modern MTSS frameworks (Herman et al., 2012). The positive psychology movement has led to significant advancements in understanding complete mental health to include not only a focus on reducing psychopathology but also on promoting wellbeing (Suldo et al., 2016). More recently, the US government has made substantial investments of over $200 million to support school-based mental health programs such as Project AWARE and School Climate Transformation grants. These resources have been directly linked to increased prioritization of prevention efforts, specifically focusing on improving the psychological wellbeing of students. The confluence of these factors has resulted in the focus on SEB supports in schools as the right solution to the right problem during the right time (Kingdon & Stano, 1984).

Despite these resources and scientific advancements, there remain significant needs toward building the necessary school capacity to maintain services once external grants have ended. Additionally, continuing to develop evidence-based interventions and decision-making processes should be a priority. As will be described later, MTSS has a substantive evidence-base for integrated academic and behavioral intervention and shows promise as an essential foundation to incorporate SEB supports. Critical to the success of these systems is a robust data-informed decision-making process that promotes early identification of students in need and an efficient matching to needed intervention. A primary focus of this book will be to describe the critical features of such a system, as used within an MTSS framework.

Multi-Tiered Systems of Support and the Integration of Social-Emotional Supports

MTSS is an educational service delivery framework that provides high-quality, individualized instruction and intervention for all students through evidence-based practices and differentiated support (Stoiber, 2014). This scaffolded system is built on the foundations of prevention and early intervention, as opposed to older, more traditional school service delivery models that are more reactive in nature. MTSS service delivery is an effective way to provide structure and secure the best outcomes for every student based on their academic and behavioral needs. Within the MTSS framework, there are three tiers incorporating screening, assessment, intervention, and progress monitoring, allowing schools to maximize their resources while adequately addressing student concerns and challenges by intensifying supports from one Tier to the next based on student needs.

The MTSS framework can be visualized as a triangle, with Tier 1 as the bottom level, Tier 2 as the middle level, and Tier 3 as the pointed top level (Figure 1.1). Tier 1 is universal, meaning that all students receive this level of core instruction, exposure to evidence-based curricula, and behavioral support. Approximately 80–85% of students should be responsive to Tier 1 supports. The remaining 15% of the student population that has been unresponsive or not successful after Tier 1 instruction would then move into the second, more intensive Tier 2 level. Students would receive supplemental instruction through small-group interventions. Lastly, about 5% of students who have been unresponsive to Tier 1 and Tier 2 supports would receive even more intensive, individualized intervention in small-group or one-on-one settings in Tier 3. Movement between the tiers is fluid. Students may need to transition from Tier 1 up to Tier 2 for more intensive supports or from Tier 3 down to Tier 2 if the data indicates that less intensive intervention may be just as effective. Importantly, and as described throughout this book, tiers are a service, not a place. In other words, schools define tiers within an MTSS framework based on the type and intensity of intervention supports. Moreover, there is a continuum of supports within tiers, including variability in service intensity, resource allocation, and personnel responsible for delivering the intervention all within the same tier.

Figure 1.1 Model for the identification of teachers requiring additional support given high base rates of risk within their classroom.

Assessment, data collection, and progress monitoring are integral to this process. Data are used to guide decision-making and determine the level of support that each student needs to optimize outcomes. Indeed, to successfully establish an MTSS framework within a school system, there needs to be high-quality general instruction, functional and informative assessment practices, data-based decision-making to inform intervention, and progress monitoring to determine effectiveness and treatment fidelity. In Chapter 2, we introduce a novel assessment model designed to enhance the data-informed decision-making process within and between tiers of service. Several multi-tiered models can be categorized as MTSS frameworks. These models can be implemented separately or integrated to prevent and address academic and behavioral problems. For example, Response to Intervention (RtI) is a model typically applied in the domain of academics. At the same time, Positive Behavioral Interventions and Supports (PBIS) is a system that is usually employed in the domain of student behavior.

MTSS for Academics

The RtI model originated as an alternative means to refer and classify students for special education. The model has since been incorporated within the Individuals with Disabilities Education Act (20 USC §1400, 2004). In the years following its conceptualization, RtI has evolved into a practical, evidence-based approach for assessing and providing academic supports to all students, not only those who may require evaluation for special services. Indeed, the RtI model can be utilized in schools, districts, and states as an impetus for widespread educational change by providing educators with the research-based tools to ensure that all students receive the level of instruction that will be effective for them (Stoiber, 2014).

Significantly, each level of the RtI process depends on evidence-based data collection and assessment practices to accurately identify students, monitor their progress, and connect them to appropriate interventions. This problem-solving model has been applied across subjects and school contexts to support students in reading and literacy skills, mathematics, writing, and other academic areas.

Furthermore, the RtI model provides support to students, but it can also provide structure and reinforce foundational teaching skills for educators. Through the MTSS framework, teachers can be trained to provide high-quality instruction and classroom management at Tier 1 (Simonsen et al., 2014). Additionally, MTSS/RtI can be applied to identify teachers who need further support in implementing interventions at Tiers 2 and 3, thereby leading to even better outcomes for students (Simonsen et al., 2014). The RtI model can be applied within academics to provide necessary assistance to both students and teachers, resulting in a more effective educational system for everyone.

MTSS for Behavior

While the RtI model has traditionally been associated with acade...