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Monday, November 4, 2013

Interventions that WORK

In education, multiple interventions such as retention, ability grouping, after-school programs and school wide reform programs have been attempted to improve educational outcomes. However, such interventions were not supported by rigorous evidence. As a result there has been no progress in raising elementary and secondary school achievement the past 30 years according to the National Assessment of Educational Progress. This lack of progress has occurred despite a 90% increase in spending per student for the same time period.

Since the enactment of the No Child Left Behind Act educators have been encouraged to use “scientifically-based research” to guide their decisions about which interventions to implement. The belief is that with the implementation of scientifically–based interventions there will be advances in the effectiveness of education in America. School psychologist play an important role in assisting school personnel with the implementation of interventions for students.

• What evidence based interventions have you seen being used in your practicum placements?
• What role does the school psychologist play in the implementation of these interventions?
• Do you feel that schools over, under or appropriately utilize school psychologists’ in the implementation of evidence based interventions?


There is a need for school psychologists to function as evidence-based practitioners who apply evaluation procedures in conjunction with intervention implementation. Unfortunately most research that's available does not address some of the most important issues being faced in real world educational settings. As raised in our midterm, there are a number of factors interfering with school psychologist’s ability to apply interventions. These factors vary in the degree to which they affect the ways interventions are selected and applied at the individual and systems level (Peacock, Ervin, Daly III, & Merrell, 2010). Evidence-based guidelines have been developed in order to educate school professionals with the purpose of promoting the implementation of effective practices. These guidelines were created to help professionals, in our case school psychologists, work through the process of "systematically finding, appraising, and using research findings as the basis for selecting and implementing interventions" (Peacock et al., 2010).

An intervention will not guarantee success. Intervention success does not simply rely on the effectiveness of the intervention but rather on the characteristics of the student or the district one is working with. Although we have learned the importance of research support in selecting interventions, it is evident every child has individual needs and what may be successful for one child may not be for another. An intervention that is based on a group's success may not necessarily produce success for an individual student.

The School Psychology Task Force on Evidence-Based Interventions has established four categories that will examine the evidence base to support an intervention. The four categories are as follows: scientific basis, key features, clinical utility aspects, and feasibility, and cost-effectiveness (Peacock et al., 2010). Do you believe these categories are sufficient in proving the effectiveness of an intervention? Which criteria do you think are most or least important?

Based on the four set of criteria, two interventions were mentioned in the chapter, parent-child interactions therapy (PCIT) and the Incredible Years series. PCIT focuses on direct interaction with the child and parent while the Incredible Years series includes child, parent, and teacher interaction. Although both are supported by a great deal of evidence, which would you recommend to a parent with a child experiencing behavioral concerns? What factors would guide your decision?

Some applications of behavior intervention methods discussed in the chapter were time-out (TO) and time-in (TI), task-based grounding (TBG), the classroom pass program, and home-school notes. All applications have shown successful outcomes and aid in the partnership between the school psychologist and parents. TO is commonly used by parents but if not implemented correctly, it will prove to be ineffective. TO will almost always require professional input (Peacock et al., 2010). TBG should encourage children to complete the tasks given by their parents rather than encourage inappropriate behavioral issues. The classroom pass allows children an escape option in an aversive situation which provides a sense of control while home-school notes facilitate communication between the home and school settings (Peacock et al., 2010).

• Of the previously mentioned applications, which do you think result in long lasting results?

• What are major disadvantages a parent and school psychologist may experience while attempting to implement such applications?

• As a future school psychologist, how would you recommend a specific at home intervention without offending parents?




References:

Coalition for Evidence-Based Policy (2002). Bringing evidence-driven progress to education: A recommended strategy for the U.S. Department of Education. http://www.excelgov.org/usermedia/images/uploads/PDFs/coalitionFinRpt.pdf

Coalition for Evidence-Based Policy. (2003). Identifying and implementing education practices supported by rigorous evidence: A user friendly guide. http://excelgov.org/usermedia/images/uploads/PDFs/User-Friendly_Guide_12.2.03.pdf

Peacock, G. G., Ervin, R. A., Dally III, E. J., Merrell, K. W. (2010). Practical handbook of school psychology: Effective practices for the 21st century. New York, NY: The Guilford Press.


This Blog was created by: Estela Lopez & Roseann Brizan

11 comments:

Florencia Torres said...

After speaking with the school psychologist, I learned that a new committee (I&RS) serving students was established at the middle school last year. The Instruction and Referral Services committee (I&RS) is composed by a school nurse, a teacher, a CST member, an administrator, and the guidance counselor. The structure of this framework resembles an RTI three tiered level model of intervention although the school psychologist is not involved at a system level. Students that fall below certain letter grades or those who don’t perform as desired on the state level tests (Tier 1 of intervention) are placed into “basic skills training” by their teachers. The I&RS (Tier 2) designs interventions for the students assigned to the basic skills training programs. The students that don’t respond to the I&RS interventions are referred to the CST (Tier 3) for individualized attention. The teachers monitor the students’ progress. The I&RS meetings designed to monitor the success of the intervention are not systematically scheduled. According to the district’s school psychologist, the interventions they use are not always scientifically based interventions and the data gathering process and consultation procedures are informal. The primary problem they present at carrying out the system-wide interventions is that teachers are not well trained and lose objectivity when gathering data or monitoring students’ progress. Some of teachers are resistant to change.
I don’t see the school psychologist having any differential role in the implementation of the interventions. They explained to me that implementation of interventions is a collaborative team effort. The only circumstances when the school psychologists plays a differential role is when counseling is provided. The school psychologist is the only member of the CTS and I&RS qualified to implement this type of intervention.
The school underutilize school psychologists in the implementation of evidence based interventions. I can think of a few reasons why this happens.
1-Training/ knowledge: Many practitioners don’t know or have not been given the tools to distinguish interventions supported by scientifically-rigorous evidence from those which are not. Also, they may not know how to function designing and implementing interventions at a 3-tiered level. Think of the school psychologists that have been practicing in the field for over 10 years. They weren’t trained under this “new framework”. Most likely, when we do our “externships” we won’t be practicing these types of interventions either because the schools are not implementing them. Therefore, we won’t be exposed to the ideal training of the school psychologist. Training influences our ability and competence to implement evidence-based interventions.
2-Define Responsibilities: Right now, all the members of the CST and I&RNS perform similar functions. Their roles overlap. One of the reasons why it is so difficult to implement scientifically based interventions it is because it doesn’t seem to be a specialized leader. If the school psychologists were to perform this role, the school psychologists need to be given the responsibility of designing and implementing scientifically-based interventions. After reading the article “Identifying and implementing education practices supported by rigorous evidence: A user friendly guide” I realize this is a job in itself. The school psychologist can’t do it all. Either case managing responsibilities need to be taken off their schedules or more school psychologist need to be hired to implement and perform scientifically based interventions.

Roseann Briza said...

I think Florencia brings up a good point when she stated that school psychologist who have been practicing for over ten years have not been trained under the "new framework" of implementing interventions at a three tiered level and therefore are not practicing under this model. This may inhibit future psychologist who are studying in states that do not mandate evidence based intervention from receiving practical training in this area. Practicing school psychologist who have not received formal training in evidence based approaches can consider receiving professional development to enhance their knowledge.
From my experience school psychologists are underutilized because many administrators are not fully aware of the knowledge and training that school psychologists bring into the schools. Educating the people who make the decisions, about the expertise that school psychologists bring to the table will be an important step towards appropriately utilizing psychologist in an evidence based approach within the local school districts. Once administration has insight to the skill set level of the school psychologist their role may be re-defined.

EstelaLopez said...
This comment has been removed by the author.
EstelaLopez said...

Florencia, it's great to hear that an intervention model is being implemented in that middle school. I began to feel as though all school psychologists were performing the function of case managers and not school psychologists. I'm aware that it truly depends on the needs of the district. The school psychologist I am shadowing is performing the job of a case manager and if done otherwise, she is not obeying the standards that were placed by the district. Although the school psychologist has gotten used to the traditional way of performing her job, she does recognize she is not being as effective as could be. It's upsetting the position school psychologists have been placed, especially when we are learning of "new" ways to help implement interventions. Roseann, you also made a great point. A change in mindset must begin with the administration in order for school psychologists to perform in a more effective way than they are today.

Olivia said...

I wanted to respond to Flor’s comment while also answering Estela’s and Roseann’s question regarding the 4 categories used to examine evidence-based interventions. I think Flor brings up a good point with regard to defining responsibilities and roles. I am currently doing my practicum at a school that is only for students placed out of district due to behavioral or emotional issues which prevent them from being successful in the public school setting. At this school there are about 55 students and for every 2 students there is a staff member. Additionally, they have 5 counselors, 2 of which are licensed school psychologists. This means that each counselor has approximately 10 students who come to them as needed to discuss their problems or difficulties. The team also meets with the students to discuss any disciplinary write-ups they receive from teachers so as to get the student’s opinion on what occurred and see if it can be rectified through communication before disciplinary action is taken. The school environment is tense to say the least, but it runs efficiently and some evidence-based interventions can be implemented on an individual basis. However, it is important to note that it runs this way because there is a very large staff with clearly defined roles and each part of this framework communicates with each other so all faculty members are aware of the problems of each and every one of the students. To illustrate, one teacher overheard a female student talking about initiating a fight after school with a fellow student and so she informed all staff members immediately and the two students who were supposedly going to fight, were brought in for counseling and, at the end of the day, escorted separately from the building. This works only because the 4th criterion (“feasibility and cost-effectiveness”) is met. Fortunately the school has enough funding to support a robust faculty but it is not just quantity over quality. The majority of the counseling team is young, driven, and familiar with new intervention techniques which they would implement if they saw it working for an individual. To conclude, I think it is necessary for each team member to have a clearly defined role and to have open communication consistently with all staff members who are in contact with their students. Without this level of functionality among the staff it would be unfeasible to implement any type of intervention, either individual or system-wide.

Rivca Zacharia said...

Reading the other posts, I understand that the culture and policies of a district will influence whether evidence based interventions will be applied. For example, the district that I am doing my practicum in is about to roll out a Social Skills program based on Jed Baker’s model. The 4 criteria were used in devising the program: scientific basis, key features, clinical utility aspects and feasibility and cost effectiveness. The program was requested by each of the 5 principals in the district based on an identified concern (Social Skills for their respective student body) and the CST is tasked with creating a program to meet the needs for each school and student level (elementary through high school). The principals and the school psychologists select the students who will participate in the 8 week program. Though the school psychologists have been provided with an overall framework for the program, each can tailor their own presentations as they feel will serve their respective students best.
Teachers, school administration and school psychologists have an open communication and a collaborative relationship in this school district. I have seen teachers initiate ABA, Classroom pass program and ongoing home-school notes communication with parents to work on specific student behavior and academic issues and coordinate with the school psychologist. These programs have proven successful for students and eliminated the need for a psycho-educational assessment in some cases.
It has a great deal to do with the funding the district receives for special education supports, the culture in the district for special education and the support from administration. In this particular district, the families are active and supportive and the school district is well funded therefore the schools are able to provide more services to the students with special needs from having one-to-one aides to teachers with extensive credentials (elementary special education teachers with doctorate degrees). The level and amount of professional development required by the director of special services for the district will influence how school psychologists regard their position. Do they work predominantly as case managers and perform assessments or do they have the opportunity to expand their skill set using evidence-based practices.

EstelaLopez said...

Olivia and Rivca both give excellent examples of what it is to be working with schools and districts who are well funded. A collaborative team effort is needed in order to function effectively. Feasibility and cost effectiveness is important when trying to implement new models. Rivca mentioned the collaborative communication amongst parents and educators in the district she is doing her practicum in. Unfortunately, the sad reality is that not all districts are well funded and not all parents are as involved as we would like. Home-school notes will not be as effective in districts who struggle this way. What can be suggested towards a struggling district in a low-income community where parents' involvement is lacking but needed in order to develop effective intervention models? Aside from the parental support, what can be done to have the administration on board and provide financial support? Do these districts simply adjust to the resources they are provided with and continue struggling? What do you all suggest?

Fabio Simao said...

The stark reality is that the limiting factor in the efficacy in any school psychologist’s arsenal comes down to the fourth indicator in evaluating evidence–based programs and interventions: feasibility and cost-effectiveness. Fidelity and integrity of the scientific method (i.e. scientific basics, key features, and clinical utility specifically) are rendered useless and irrelevant if they are not capable of being sustained and provided with the means to do such. Roseann alludes to what I feel is the most important factor in achieving this sustainability. That is, an administration that not only embraces but also promotes progressive evidence-based practices. I am a big proponent of visionary leadership; one that looks well beyond the microcosm of a school building. Yet this idealism is often countered by the argument – and perhaps the reality – that economics hamstrings principals and other officials, essentially restricting their ability to effect any change grounded in data-driven and empirically based practices. The lack of sufficient funds produces the lack of feasibility.

So the question remains, what can we as future psychologists do to change this insidious culture?
We must take a page from the very same problem solving model we utilize and focus on the variables we are capable of altering. That means we must seize harping on how economics dictate the circumstances we work under. True, the culture created by a cash strapped district can be quite restrictive in how we utilize our skills yet it is within our professional obligation to effect our own change. This is not done with sweeping, wholesale transformations. It is accomplished with persistence and simplistic micro changes. Ones that build ongoing trust between school psychologists, teachers, parents, and school administrators. Much like giving a child a bedtime or classroom pass to instill a sense of control, we must collaborate with teachers and allow them to be integral members in intervention decisions. This strategy provides them with a sense of control over the situation and in turn produces a motivation to sustain empirically based interventions. We have the opportunity to use our unique skill set to realize a “practitioner as researcher” approach, yet must be savvy enough to acquire the willing assistance of teachers, administrators, and parents alike to facilitate this goal. Lastly, it is imperative that we, as Flor mentioned, maintain a high degree of training and commit ourselves to lifelong learning and professional development. In the end, we must position ourselves to deliver the leadership that may not be forthcoming from an administration that is bound by factors beyond our control.

There is one last point I’d like to make. Many of us in class have shared their individual experiences in their practicum shadowing. By in large, what I’ve seen isn’t an adherence to a traditional medical model; rather it’s more of a concerted effort to shift towards a more proactive approach. We are, however, keenly aware of the disparity that still exists mainly between the affluence of the suburbs and the paucity of the inner cities. These tangible differences in economics and theoretical guiding principals can surely impact how a school psychologist conducts his/her job. We all have had differing degrees of experience in this realm within our shadow appointments. For instance, Lawrence’s experience at Weequahic High School in Newark surely differs from my own in Montclair. I purpose that we explore these differences in more detail in class. We have a great opportunity to utilize all of our shadow experiences to put a real face on the issues we easily attribute to largely impersonal concepts such as economic disparity. I say lets share these experiences in a way that illuminates what these differences are, why they may exist, and how we might eliminate them; not from a textbook driven approach but rather from the realities we are witnessing every week.

Rivca Zacharia said...

Fabio has raised great points and I agree that we can learn from each other’s experiences to see what is happening in the field so that we don’t each think that our experience is representative of the whole.
I believe that school psychologists serve as a bridge between the schools and the students and families in a unique role. This will enable them at times, and as needed, to work with obstacles of district funding and parent involvement. In most school districts, you have a fair representation of all socioeconomic strata’s. In each school district we will also find parents who are not able to be involved in their children’s education for a myriad of reasons, the end product is the same, the child needs to be supported. I believe this is important information for each of us to have regardless of where we do our practicum.
It becomes the responsibility of the school psychologist, the teacher, the school administration and relevant members of the CST to find solutions for the student be-it in the classroom, in recess, basic skills support, homework and follow-up the next day to identify cost effective supports that will translate to success in the student’s school day. It is important to communicate these programs in an on-going basis to the parents, it is their choice how they proceed with that information. There are times when the information has to be communicated in a foreign language or to more than one parent in the case of divorce.

Craig Barriale said...

I believe that everyone, as usual, has brought up some valuable points pertaining to the blog post, which was very well-written, by Estela and Roseann. I definitely agree with Fabio and Rivca that we can all learn a lot about our potential fields by sharing what we learn in our shadowing experiences. This course is definitely one of my favorites because we get to see what really goes on in the profession rather than just reading about it from a textbook. I also like Rivca's point about the school psychologist being the bridge between the schools and the students and families. I have definitely seen this bridge role take effect in my shadowing experience and also in my professional experience as a teacher. Sometimes there are issues that are going on that only the school psychologist can really take care of and handle when it comes to dealing with not only the students but the parents as well. Based on the readings, it seems as though there is a big push for more RTI in schools. Also based on the readings and our discussions it seems like that would great to use, but sometimes it just is not possible in certain districts. Additionally, I believe that school psychologists, students, and professors alike would all agree that evidence-based practices are wonderful to use in practice, but sometimes it just is not in the cards. That being said, I believe it is important for us, as students, to research various evidence-based practices that we can hopefully implement when we become school psychologists.

Lawrence said...

During my school practicum, I have seen an effective intervention take place. It is a school wide intervention that takes away the electronics from the students every morning to reduce antagonizing, instigation, and bullying that happens via internet and social media. I don't think school psychologist are over or under utilized, I think they are used appropriately for the children who needs them with the support of the child study team and the learning consultant. The school psychologist plays a huge role in implementing interventions because they are the ones who are dealing with the students with IEP's, social problems, behavioral problems, and academic problems; while having the responsibility of helping them achieve success despite their difficulties. Like Fabio mentioned, we all are going through different and unique experiences at our practicum sites that we all can gain and learn from. Each school is unique, and each school psychologist is different; so the intervention my school psychologist may pick or suggest will most likely be different from the interventions other school psychologists from other practicums would suggest, due to its level (high school middle school, or elementary school), resources, S.E.S, number of classified students, etc. In my particular practicum setting, the school psychologist does implement interventions on a singular level, but most of the interventions of the school are targeted to the entire student body for reasons that are specific and most helpful for my particular school building. Major disadvantages a parent and school psychologist may experience while attempting to implement interventions are lack of communication, lack of critical attention to details and instruction, and indifference. I feel these subtle missteps can be the reason that an intervention isn't working as planned. As a future school psychologist, I would recommend a specific at home intervention without offending the parents by having great communication with them, explaining how important their child's success is to me, and how imperative this in-home intervention is for his or her child's development. Once I fully explain the benefits of the intervention while keeping the lines of communication open, I feel they won't be offended with the intervention; just anxiously waiting the first signs of their child's improvement and future success.