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Monday, November 4, 2013

Who are we leaving behind?

No Child Left Behind (NCLB) requires those working in education to use evidence-based interventions. Interventions that research has determined to be effective in an educational setting include: one-on-one tutoring by qualified tutors for at risk readers in grades 1-3; life-skills training for junior high students; reducing class size in grades K-3; instruction for early readers in phonemic awareness and phonics; and high-quality educational care and preschool for low-income children.
Further identification of evidence-based interventions and supports is ongoing. Educational institutions no longer wish to waste precious time trying various programs without scientific evidence behind them. Due to a slower than expected rise in achievement levels in public schools, the U.S. Department of Education is looking to advance evidence-based policy in its own department and the broader policy community. Therefore, evidence-based practices have emerged out of the NCLB mandates that have not only effected how the Department of Education approaches educational strategies but also how practitioners in the schools will manage intervention policies from a school-wide to classroom perspective.

In order to create effective evidence based curricula and interventions, children need to be tested to establish which approach is most effective. While education should strive to implement programs and interventions that have been shown to work over time, many are not in favor of children being tested multiple times -- pre-tests, post-tests and standardized tests -- in order to establish the statistical information needed. What is your opinion regarding the implementation of evidence-based interventions? The effect of multiple-testing scenarios with elementary age and older public education students?

One of the most critical functions a school psychologist performs is the selection of effective interventions. As school psychologists we must follow certain guidelines and criteria to examine research support of interventions before choosing the ones we will implement. There are four main categories which are recommended when examining the evidence base to support an intervention and determining if interventions are flexible and sensitive to realities of schools and school-based practice. These categories consist of scientific basics, key features, clinical utility, and feasibility and cost-effectiveness.

Scientific basics relates to the empirical/theoretical basis, general design qualities, and statistical treatment of the prevention or intervention under review. Key features relates to the internal and construct validity criteria. Clinical utility relates to external validity and how appropriate an intervention is for a person’s specific needs. Lastly, feasibility and cost-effectiveness relate to the simplicity and compliance of others to put an intervention into place, as well as budget related factors. As a school psychologist, do you think that meeting all four of these guidelines is necessary? Which of the guidelines do you find to be the most or least important and why?

There has been an increased emphasis on parent teacher partnerships in schools due to the significant relationship between home environment and school behavior. The school psychologist often takes on the role of a ‘broker” in these partnerships. Chapter 3 analyzes appropriate actions that a school psychologist must take and knowledge that he or she must possess in order to consult to parents. Consistent with this chapter, it is the duty of the school psychologist to educate parents on issues such as rule-governed behavior, child development, and child learning, and others.

It is up to the school psychologist to guide parents to perceive certain behaviors through the eyes of their child and in this way to understand why they do what they do and what can be done to change the behavior. The chapter talks about different treatment applications that parents typically practice such as time out and task-based grounding. It also mentions negative effects of punitive consequences that some parents use. A common example is a child running into the street when a car is approaching; the parent gets scared and as a result yells at the child. Many people believe that the parent is wrong for yelling at the child while others believe this method will in fact teach the child not to run into the street again. What do you think about punitive consequences? Are there ever situations when they are appropriate? As a school psychologist, what would you recommend the parent do instead of, or in addition to, punitive consequences?

Coalition for Evidence-Based Policy. (2002). Bringing evidence-driven progress to education: A recommended strategy for the U.S. Department of Education.

Coalition for Evidence-Based Policy. (2003). Identifying and implementing education practices supported by rigorous evidence: A user friendly guide.

Daly, E.J., Ervin, R.A., Merrell, K.W., & Peacock, G.G. (2010). Practical Handbook of School Psychology. New York, NY: The Guilford
Press.

This Blog was created by: Lisa Kleitsch, Rozanna Shindelman, and Keri Georgewitz

22 comments:

Sean Latino said...

I find that cost effectiveness and feasibility of implementing an evidence based theory within a school setting is most important. It is undeniable that an evidence based intervention will be reliable and valid. This intervention would not even be in practice I not already reliable having high construct validity and external validity and therefore I feel that the practical and professional school psychologist in the field should be more focused on applying interventions in cost efficient and effective manner. The focus within research for a school psychologist should be interpreting resources which teach how to integrate the interventions directly into their immediate school environment. Such considerations as budgets, resources, and ability of faculty must be assessed rather than scrutinizing and criticizing research regarding if a test “good enough” to use. Finding a valid test is easy, implementing a test to be valid is the hard part of the school psychologist’s job; the school psychologist must open up discussion with their colleagues and get the pertinent school administrators and teachers to agree to their intervention plans and then see that the intervention is being carried through properly and effectively on all levels. Without this step the child in need will never actually get the educational support they need. In conclusions I find the feasibility and cost effectiveness category of the four main categories which are recommended when examining the evidence base to support an intervention the most important component as it takes into account the practical utilitarian perspective of a school psychologist’s job.

Jessica Maneri said...

In regard to many people not being in favor of testing, or having a child tested multiple times, I think it would be difficult and unjust to eliminate testing. Standardized testing and evidence-based interventions go hand in hand, as it would be impossible for school psychologists, the CST, or teachers to make educated decisions for students without these two factors. While testing elementary age children may cause anxiety/nervousness in the child, there are techniques and strategies that the school psychologist/parents can held their younger children with to minimize these effects. I think it is important to weigh whether it matters more that the child struggle with situational anxiety/nervousness or struggle with learning disabilities that were never addressed or caught for the rest of their time in school, or only to be determined later on in their educational careers, keeping them from excelling for many years. As for older public education students, testing and evidence based practice is just as important, for many reasons. Not only is it important for being able to determine eligibility, it is important in the sense that a student may have outgrown a disability and is ready to be declassified. Testing allows school psychologists and CST to see concrete evidence on whether or not the interventions being implemented for each student are working to the students benefit. I do not agree, however, that educators should rely solely on testing, however I do believe it is one of the necessary factor in the sea of different strategies used.

Jessica Maneri said...

As a school psychologist in training, I think that meeting all four guidelines in examining research support of interventions is important. While I agree with Sean that cost-effectiveness and feasibility is an important guideline, I think that clinical utility is possibly more important to consider. It is true that if teachers, administrations, and CST members are reluctant to or refuse to implement intervention or cooperate with one another to deliver intervention, the child will never get the support they need, however I also think that when cost becomes the primary consideration it can cloud the minds of the service-providers/districts and can supersede other important criteria. The reason I think clinical utility is critical to consider is because clinical utility speaks to the acceptability of an intervention. Within this guideline, external validity is considered, which refers to the likelihood of generalizability of evidence-based practices. Just because an intervention illustrated efficacy in the research setting, it matters that the intervention remain effective when brought into actual context. It is also extremely important to be able to say whether or not your school, or your classroom, or your teachers/students are ready for certain interventions. Clinical utility allows school psychologists to question whether an evidence-based intervention will be applied effectively in their particular school, with particular students and teachers, in particular circumstance. This guideline allows CST and school psychologists to be specific in effectively treating the specific population in their school, based on linguistics, culture, ethnicities, etc.
Lastly, in regard to negative effects of punitive consequences, I think the use of this treatment depends on specific situations. In the example used by the blog discussion leaders, yelling at a child running into the street is an initial human reaction of fear. It also helps to grab the attention of the child and could help the child to become aware, so yes, I think there are situations where punitive consequences are appropriate. I think emotion sometimes helps children to understand that certain situations are taken seriously. Instead of or in addition to punitive consequences, the portion of the chapter that discusses TO (Time Out) is insightful to parents since it addresses TO from a professional standpoint, and reminds parents that the key to a successful time out without encouraging or increases negative behaviors is to ignore the child’s attempts to gain control of TO. I think ignoring a child’s attempt to act out forces the child to learn to re-group/helps them to gain a certain sense of self-awareness/manage their behaviors. I do however believe in the child being given a verbal explanation after the TO is over as to why the adult paid no attention, and then why the adult began to pay attention and allowed the child out of TO (address their bad behavior vs. their good behavior)

Giselle Batista said...

Jessica, I completely agree with what you are saying. I think that a baseline criteria needs to be established to determine whether implemented interventions are effective. If a based level criteria is not establish, we could implement all the services in the world, and know what direction were moving in. You also mentioned that test can be anxiety provoking. Throughout many of the courses I have learned that a little bit of anxiety isn't necessarily a bad thing. It keeps us on our feet and makes us care. However, if the anxiety is to an excaberated/impairing level, then this is something to address on a one-to-one basis. Each child should be treated as an individual, due to distinct needs.

In relation to what Sean noted, I think that the "intended role" of the school psychologist and the "actual role" of the school psychologist. It seems difficult to decipher and implement a plan that is always bound to work. With so many different students, parents, districts, etc., there is so much that may new modifications for it to be applicable for certain students. For evidenced based approaches to work for students, they need to fit their needs, using a multi-systemic approach.

Rachel schneider said...

I agree with Jess that it is important to use tests to target students who may have learning disabilities and are falling behind their peers. Tests give information on where the students are academically. I think testing could be beneficial but I also think testing has gone too far. Standardized tests are not used anymore just to asses students anymore but to determine how the teacher is doing. This causes many issues with the teachers trying to teach to the test. It becomes less about what the students are learning but if they know how to answer a question the right way. The school year now revolves around tests, students as young as kindergarten are learning how to answer questions by filling in bubbles. there needs to be a limit to standardized testing. From a test you may learn how well a student can take a test, and how well teachers can teach students of different ability levels to take tests but the results show nothing about the actual abilities of the student or teacher outside their testing abilities.

Sean Latino said...

Jess and Giselle I am glad you can see why I chose the cost effectiveness and feasibility as my main priority in choosing an intervention. I think that clinical Utility is extremely important too as it allows a CST and school psychologist to determine if the intervention is relevant to their immediate school system. I feel that maybe a hierarchy of these four main considerations must be developed in order to visualize and emphasize a chain of causation within the spheres of scientific basics, key features, clinical utility, and feasibility and cost-effectiveness. Perhaps putting feasibility and cost effectiveness as the first consideration in which you assess what is realistic for your school setting, then look at clinical utility in order to see which intervention is most effective and pertinent to your school setting, then the scientific basis to ensure that the intervention is valid and reliable following evidence based guidelines, and lastly key features since one can tailor an intervention to their specific needs therefore making key features malleable to your school setting is the best way to structure these considerations. Each consideration holds its own value and purpose but at the end of the day an intervention proving to have much clinical utility will be passed over if too expensive, too extensive, and calls for demands of implementation beyond the school psychologist’s administration, faculty, and economic resources. At the end of the day the school psychologist is a science practitioner who performs their craft within the economic boundaries of an organization, i.e. the school; hence, the school psychologist must be a realist when asking to implant his interventions into the environment he provides his scientific services to.

Rozanna said...

Sean and Jessica I think you both made good points regarding the intervention criteria. I think it is safe to say that every criteria serves its own purpose and is equally important for different reasons. Rachel, I like what you said about the current reason for testing. Does anyone think that a child can actually gain something from a standardized test or instruction on taking a standardized test and what do you think that would be? Also, does anyone think that some children are given unnecessary tests?

Keri said...

Sean, I can strongly relate to your viewpoint on cost-effectiveness and feasibility especially after the day I just spent at my placement. The school psychologist I observe is in the process of classifying a child with ADHD who is constantly acting out in class and disrupting his classmates. The school psychologist is currently in the midst of creating his first intervention he would like to implement with this child which is a rewards system for positive behaviors. Long story short, he was looking for velcro to create a system for the child. He searched the building from top to bottom looking for velcro and could not find any anywhere. He eventually became so frustrated he had an outburst saying how he doesn’t understand how he is supposed to do his job and create functional behavior plans if he isn’t even provided the materials to make them.
To top it all off, he specifically asked the teacher NOT to give this child the iPad (which she basically gives him as a last resort) and she did it anyway. This teacher begs and begs him to help her with this child. However, when he tells her what to do, she does not follow his instruction whatsoever. He has even considered getting the principle involved, but he knows he needs to handle this himself. So not only was he not able to create the system with the materials he needed, but the teacher wasn’t being compliant either. Therefore, the importance of budget and feasibility within staff members is extremely important when it comes to implementing an intervention. The other guidelines including scientific basics, key features and clinical utility were already being met, but his last step towards implementing this intervention kept hitting road blocks.

Alison said...

Wow Keri, what a perfect example of how the relationship between school psychologists and teachers is a key component to successful interventions. There is only so much the school psychologist can do on their end; even if they had all of the best research-based interventions and unlimited funding, if the teachers or aides or parents are not willing to implement those interventions or behavior plans they will be ineffective.

We all wrote papers about the discrepancy between ideal and actual practice of school psychology, and financial issues can have a great impact on causing that gap. As some of you said and evident from Keri's example, we have to be able to distinguish between the 'theoretically best' intervention, and the one that is feasible in the current situation.

In my practicum this week, a teacher for a pull-out resource 8th grade language arts class has been seeking out the school psychologist for months begging for advice on what to do with this class. She is constantly frustrated and upset and students are not making progress. She explained to the school psychologist yesterday that she will not implement any behavior plan, she said she 'is a teacher, not a behaviorist'.

So what should the school psychologist do? The students are suffering, the teacher's not happy and demanding that he solve the problem.



Danielle Territo said...

I believe punitive consequences can be effective depending on the situation. In the example given in this blog, yelling at the child for running into the street is a very common reaction. It could be an impulse reaction from fear, as Jessica explained above. Naturally parents will want to reprimand their child for this behavior because the consequences could be fatal, and they do not want to see their children getting hurt. Perhaps the delivery of the reaction could be changed from yelling to telling the child calmly, but at the same time the parents want their children to know the severity of consequences this specific behavior can produce, and using yelling or an angry tone of voice will associate fear of this particular behavior.

For other situations that do not involve a child’s safety, punitive consequences can be appropriate to help to reduce negative behaviors especially when parents are supported and trained by a school psychologist. The chapter gave examples such as Time-Out and Time-In, and Task Based Grounding. The effectiveness of these strategies will vary by the child and the intensity in which the consequences are given. If the desired outcomes are not achieved from using basic forms of these consequences, a parent should consult with a school psychologist about how the consequences can be manipulated to yield positive results in behavior.

Rozanna said...

Danielle you make a good point in rationalizing how punitive consequences can be effective. It is true that the consequence of running into the street could be fatal and therefore the parent needs to take appropriate action to ensure the child understands this behavior is unacceptable.

However, the chapter mentions that children can get used to yelling and therefore it may be needed regularly to get the child to do as the parent deems necessary.

Do you guys think that children get used to punitive consequences? Do you think this can effect them academically?

Alison said...

The book explains how punishment can be an escalatory process that in extreme cases, has to potential to lead to child abuse. Even if it does not escalate to physical abuse, when a parent consistently reprimands a child by yelling, the child becomes accustom to that yelling and it becomes less and less effective. The chapter explains how punitive tactics, when used often can lead to distress, fear, and retaliation.

From personal experience working in a classroom, I've seen the overwhelmingly powerful effects of simply ignoring negative behavior and praising positive behavior. We discussed this is class last week, and I know that several of you have seen the same results.

When working with parents as "problem-solving partners" I think it is important to explain different strategies and how well they work. In addition, alerting parents to some of the detrimental effects of punishing behavior may make them more likely to try an alternative method.

Rozanna said...

Thank you Alison, explaining child psychology to parents can definitely open their eyes to punishing methods they use. Some parents are just really unaware of their child's perspective and at the same time unaware of alternate methods they can use.

Do you think children who are abused at home, verbally or physically, are more or less likely to have behavioral issues in school?

Giselle Batista said...

as a number of you have mentioned, punitive techniques in redirecting behavior may not always prove to be effective. However, as the example proceed by Danielle, we are more prone to yell when caught up "in the moment". In a school district with a large amour of students and little resource, the teacher may be more likely to use momentary interventions in hopes to just the behavior at that moment. Therefore, it requires training an constant awareness when you strength/positive based approaches, such as praising the appropriate behavior and ignoring the undesired behavior.
Working in a therapeutic after-school problem with diagnosed children, we followed a CBT approach, and only acknowledged the positive(providing positive reinforcement) and ignored/redirected the negative. All being trained clinicians in the program, it was still difficult at time to not become overwhelmed and flustered when the students were out of control to some extend. Therefore, I can only image how difficult it would be for regular education teachers.
Alison mentioned how in the school she was working in benefitted from this approach. I wonder if the approach is trailered to certain age groups? Granted, focusing on the positive did work for the most part, however, at times the students were phased by the consequences to their actions.

Lisa Kleitsch said...

The practice of ignoring negative behaviors while praising positive ones is an effective behavioral tool. In my training as a Montessori teacher, we were taught that learning is a series of approximations, and that while the child is learning a new skill, you should be praising that child every step of the way. It is the same with wanting to redirect a negative behavior. Small steps are taken toward changing the behavior. As the child inches toward the goal behavior, you should be praising his or her effort and ignoring the child when he or she has exhibited the unwanted behavior. Naturally, this is the theory. I have often observed frustration on the part of the teacher and a large amount of frustration on the part of parents. Ignoring dangerous behaviors is certainly not okay. That needs to be addressed immediately. But as Giselle stated, it is difficult not to get overwhelmed and flustered.

It has been my experience that children who are abused at home, act out in school. As far as I understand it, school is a safe place where the child is free to express his or her feelings. I had a student who was witness to his parent’s abusive relationship. When he came to school, he acted out situations and used adult language that was not appropriate for a five year old. He would use curse words and say to other students that if he didn’t like what they were doing, he would slap them. Half way through the year, he mentioned to me in passing that he thought about hurting himself. At that point, the whole school got involved and a psychologist intervened to work with him and the family. So I think the behaviors are likely to show up in school.

Consequences for children need to be appropriate for their age. Parents don’t always know which consequence to administer. Usually, they’re too harsh or for too long a period of time. Yelling at a child crossing the street is not abuse or punishment. You are exhibiting fear. Yelling in a dangerous situation is an instinct; it comes from wanting to protect your child. It is important though to explain after why you yelled. It’s an opportunity to go over rules of crossing the street, etc. Depending on the child, you may need to hold his or her hand. But you don’t damage your child by yelling in this situation. It is abuse when it is consistent and long term. And as Alison mentioned, often there is an escalation in abuse when the only form of discipline is punitive.

Parents need appropriate tools and as school psychologists we need to be aware of the various programs available. One that I often recommended is called 1-2-3 Magic developed by Dr. Thomas Phelan. You’ve probably heard of it. It’s for younger children and it’s very simple. It is very helpful for those parents who need a structured approach on how to administer direct discipline and create positive relationships with their children at the same time.

udoka nwigwe said...

I agree with Jessica as far as not eliminating testing completely. This is an important service that school psychologists provide to their students. It allows them to determine if a child is need of academic support through special education services. The only downfall to testing is that, some school psychologist do not research or implement an evidence-based intervention after classifying the student. Just to put a child into special education services is not good enough. Evidence-based interventions are important and should be implemented, especially after a child is classified. It gives students who are in need of it a chance of succeeding academically and behaviorally. Each child responds differently to an intervention, however, it is up to the school psychologist to research and find the best intervention that will help their student succeed. Therefore, to keep testing without putting any intervention in place makes this practice ineffective. Evidence-based interventions are just as important as testing.

udoka nwigwe said...

Rozanna, children who are abused verbally and physically will tend to exhibit more behavior issues at school. The younger kids will tend to act out in an aggressive way toward their peers due to witnessing it at home. To them this is normal behavior, especially if it is being done everyday. Also, these students will seek negative attention at school because their parents fail to provide them with the appropriate attention at home. Behavior is learned and if a child is learning this at home, they will eventually bring this into school. Some times these students become the bullies at their schools, which is unfortunate.

Danielle Territo said...

Rozanna in response to your question regarding if children get used to punitive consequences, I think that they do depending on the child. For example, an older child whose parents regularly use task based grounding will know that they still have the freedom to take part in negative behaviors with only the consequence of not being able to do anything leisurely for a set time limit. Some children will only see this time limit as a road block, and when this road block has ended they will continue to take part in the negative behavior.

In my opinion, if children are not effected by punitive consequences at home, they are probably more likely to be defiant to punitive consequences in an academic setting. For them, they believe they can get away with anything with their own parents, so why would they listen to a teacher? It is essential that parents learn to use effective punitive consequences at home, and if possible with the help of a school psychologist.

Rozanna said...

I agree with you guys that children who are abused at home are more likely to act out in the school setting. I believe this goes back to them getting used to punitive consequences. Children who are abused at home hold on to so many emotions that when they are placed in an environment that supports individualism, such as a school, they are likely to let everything out and it does not always come out in the appropriate manner. Of course, as Danielle said this depends on the child. Some children will get shutdown by the abuse and internalize their feelings.

I worked at an outpatient substance abuse clinic over the summer. There was one girl who used drugs due to her anger issues. It turns out her mother lost custody of her at a young age because she lit her eyebrow on fire as a way to wake her up in the morning. This girl is only 14 years old but dealt with a lot of abuse from her parents both verbally and physically therefore it is no surprise to me that she is angry and acts out on a regular basis.

Keri said...

Udoka, I agree with your take on testing. Testing is there as a resource for school pyschologists. It is a tool that will we use to interpret the help and support children will need. However, as Udoka said, it is completely ineffective if the correct steps are not taken after the testing is done.

On the other hand, do you think testing is always required? For example- For a child who has behavioral issues and is completely capable of doing well on their academics, yet their behavioral issues get in the way, do you still believe testing is necessary in order to implement effective interventions?

Rachel schneider said...

Keri, in response to your question, I think testing in a situation where the child is doing well academically but is showing behavioral issues could be a waste of time. I think this is done often and is blatant example of over-testing. I think if there are obvious behavioral issues it would be more effective to implement a behavioral intervention instead of wasting your time testing the child. If testing is done it should be used as a supplement but other steps should be taken to make sure the student is getting help efficiently and quickly.

Jenny Pagonis said...

Although yelling at the child could grab their attention, the chapter finds that highly punitive tactics are reductive, so the child is more likely to increase avoidance and escape behaviors, as opposed to learning any new adaptive skills. If the goal is highly socialized and optimally educated behavior, this is a huge step backwards in our efforts. High levels of emotional arousement can diminish cognitive functioning. I think it is most important to educate to a child's conservation, which allows different experiences to pertain to a central rule. The book gave an example of always, keyword, always, looking both ways before you cross the street. If we develop a child's sense of conservation, the child can actively apply these methods to a range of scenarios, rather than viewing the single session as an isolated, "island" experience I would call it.
I think it is imperative to be actively aware, as a parent, teacher, or team to be aware of when you are using positive and strengths-based approaches, like Giselle mentioned.