Frank Gresham, Ph.D. Louisiana State University RTI: An Intervention-Based Approach to Delivering Services to Students At-Risk for Emotional and Behavioral Disorders. Almost 20% of school-age students could qualify for a mental health diagnosis, however less than 1% of these students are served in schools as emotionally disturbed. Students with these emotional and behavioral challenges are therefore either unserved or underserved in American schools. Most of these children experience a number of difficulties in the development and maintenance of satisfactory interpersonal relationships with peers and teachers. This presentation focuses on the development and implementation of multiple tiers of social skills instructional interventions that are evidence-based and effective. Issues of screening, assessment, and program evaluation are discussed.

1. RTI: An Intervention-Based Approach to Identification and Treatment of EBD Frank M. Gresham, Ph.D. Louisiana State University [email_address]

4. Some Numbers 27 th Annual Report to Congress (2005) CA (6-21 yrs.) US (6-21 yrs.) ED SLD MR CA under-identifies (under-serves???) ED and MR and overserves SLD relative to US average 4.4% 8.0% 54.4% 47.4% 5.2% 9.6%

5. Prevalence Rate Relative to Population CA US ED SLD MR 0.29% 0.72% 4.11% 4.33% 0.44% 0.90%

22. Decision Rules for SSBD Screening At Risk Not At Risk Risk Indicator Present Risk Indicator Absent Accuracy=Correct Decisions/All Decisions A+D/A+B+C+D A Accurate Prediction SENSITIVITY B False Positive C False Negative D Accurate Prediction SPECIFICITY

23. Another Useful Screening Tool: Student Risk Screening Scale (Drummond, 1993) Steals Lie, Cheat Bx Prob. Peer Reject Low Ach Neg. Att. Agg Beh. Total O-Never; 1-Occasionally; 2-Sometimes; 3-Frequently 9-21 High Risk 4-8 Moderate Risk 0-3 Low Risk Frank 1 1 3 2 3 3 3 16 Clay 1 1 0 1 2 1 0 6 Jill 0 0 1 1 1 0 1 4 Luke 2 2 2 2 3 2 3 16 Matt 1 1 0 1 1 1 1 6

31. Responsiveness to Intervention Model Degree of Unresponsiveness to Intervention LOW HIGH HIGH Intensity of treatment Level I Universal Interventions Level II Selected Interventions Level III Intensive Interventions Level IV Special Education IEP Determination

32. Classification of RTI Outcomes Outcome Status Inadequate Responder Adequate Responder Accuracy=Correct Decisions Relative to All Decisions A+D/A+B+C+D Requires More Intense Services A True Positive SENSITIVITY B False Positive Does Not Require More Intense Services C False Negative D True Negative SPECIFICITY

34. Brief Behavior Rating Scale (Weekly) Difficulty paying attention Never Sometimes Often Almost Always Difficulty organizing tasks Never Sometimes Often Almost Always Fidgets with hands or feet Never Sometimes Often Almost Always Blurts out answers Never Sometimes Often Almost Always Interrupts/intrudes on others Never Sometimes Often Almost Always

36. Treatment Integrity & Behavior Change Adequate Behavior Change Inadequate Behavior Change Implemented As Planned Not Implemented As Planned High Integrity Expected High Integrity Wrong Treatment Poor Functional Analysis Low Integrity Changed treatment Other unknown variables Low Integrity Expected

39. T H A N K Y O U Questions? Laizzez le bon temps rouler !