Academic journal article Education & Treatment of Children

Primary Prevention Programs at the Elementary Level: Issues of Treatment Integrity, Systematic Screening, and Reinforcement

Academic journal article Education & Treatment of Children

Primary Prevention Programs at the Elementary Level: Issues of Treatment Integrity, Systematic Screening, and Reinforcement

Article excerpt


This study examined issues of treatment integrity, systematic screenings, and access to reinforcement relative to school-wide positive behavior support programs (SW-PBS) implemented in two rural elementary schools during the first year of program implementation. Results suggested that treatment fidelity, as measured by self-report and direct observation methodologies, varied according to rater and method of measurement. Findings also illustrated techniques for using systematic screening tools implemented as part of elementary level SW-PBS programs to (a) assess the overall index of risk as well as (b) identify how different types of students respond to the SW-PBS plan over time, with an emphasis on how to identify students for targeted prevention efforts. Finally, results of multivariate analyses suggested that students' rate of access to reinforcement was significantly different between schools and between students with high and low risk status as measured by the Student Risk Screening Scale (SRSS; Drummond, 1994). Educational implications of the findings related to these issues are discussed, and directions for future research offered.


Many schools across the country have adopted three tiered models of positive behavior support (PBS) to (a) prevent the development of problem behaviors and (b) respond more efficiently to existing cases with the appropriate level of intensity (Kamps, Kravits, Stolze, & Swaggart, 1999; Lane, 2007; Satcher, 2001; Sugai & Horner, 2006). These models contain three levels of prevention: primary, secondary, and tertiary. As with Response to Intervention (RTI) models, the intervention tiers increase in intensity and students are identified for supports beyond the primary level using data-based decision making (Lane, Kalberg, & Menzies, 2008).

The intent of this primary prevention program is to reduce harm from occurring by delineating, teaching, and reinforcing school-wide expectations and implementing other validated school-wide programs (e.g., anti-bullying programs; Shapiro, Burgoon, Welker, & Clough, 2002; Stevens, De Bourdeaudhuij, & Van Oost, 2000). Approximately 80% of the student body is anticipated to respond to this level of support. School-wide data, often office discipline referral (ODR) data, are used to determine which students require secondary or tertiary prevention efforts (Robertson & Lane, 2007). Only a handful of studies conducted at the elementary level have used systematic screening tools such as the Systematic Screening for Behavior Disorders (SSBD; Walker & Severson, 1992) or the Student Risk Screening Scale (SRSS; Drummond, 1994), to identify nonresponsive students for secondary supports (Cheney, Blum, & Walker, 2004; Lane, Menzies, Munton, Von Duering, & English, 2005; Lane, Wehby, Menzies, Doukas, Munton, & Gregg, 2003; Lane, Wehby, Menzies, Gregg, Doukas, & Munton, 2002; Walker, Cheney, Stage, & Blum, 2005).

Secondary prevention efforts often include targeted interventions such as small group instruction for students with common acquisition or performance deficits in areas such as social skills, anger management, conflict resolution skills, self-determination skills, and study skills (Gresham, 2002; Lane, Kalberg, & Menzies, 2008; Robertson & Lane, 2007). Approximately 10-15% of the student body is apt to require this level of prevention.

Students who do not respond to the secondary prevention efforts and/or those with multiple risk factors are placed in appropriate tertiary supports based on their particular area of need. This includes highly individualized interventions such as functional assessment-based interventions, curricular modifications, intensive family counseling, or other mental health services (Kern & Manz, 2004; Lane, 2007; Umbreit, Ferro, Liaupsin, & Lane, 2007).

Central to this model are the following components: (a) a primary plan based on values held by the teaching community, ideally with input from parents and students to enhance social validity and, consequently, treatment fidelity (Lane & Beebe-Frankenberger, 2004; Lane, Kalberg, & Menzies, 2008); (b) a primary plan implemented with a high degree of fidelity to ensure that non-responsiveness is not due to low levels of program implementation and instead reflects students actually in need of additional supports (Gresham, 1989; Lane, 2007); and (c) data-based decision-making using reliable, validated measures that afford reliability detection of students requiring additional levels of prevention (American Educational Research Association, 1999; Lane, Parks, Kalberg, & Carter, 2007; Lanyon, 2006). …

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