Check incheck out effects on students with emotional and behavioral disorders with attention or escape maintained behavior in a residential facility

This article was downloaded by: [University of Nebraska, Lincoln]On: 12 March 2015, At: 00:18 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954

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Exceptionality: A Special Education Journal

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Check In/Check Out: Effects on Students with Emotional and Behavioral Disorders with Attention- or Escape-Maintained Behavior in a Residential Facility

Nicole Cain Swoszowski a , Kristine Jolivette b , Laura D Fredrick b &

L Juane Heflin b a

The University of Alabama b

Georgia State University Published online: 20 Jul 2012

To cite this article: Nicole Cain Swoszowski , Kristine Jolivette , Laura D Fredrick & L Juane

Heflin (2012) Check In/Check Out: Effects on Students with Emotional and Behavioral Disorders with Attention- or Escape-Maintained Behavior in a Residential Facility, Exceptionality: A Special Education Journal, 20:3, 163-178, DOI: 10.1080/09362835.2012.694613

To link to this article: http://dx.doi.org/10.1080/09362835.2012.694613

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Exceptionality, 20:163–178, 2012

Copyright © Taylor & Francis Group, LLC

ISSN: 0936-2835 print/1532-7035 online

DOI: 10.1080/09362835.2012.694613

Check In/Check Out: Effects on Students with Emotional and Behavioral Disorders with Attention- or Escape-Maintained Behavior

in a Residential Facility

Nicole Cain Swoszowski

The University of Alabama

Kristine Jolivette, Laura D Fredrick, and L Juane Heflin

Georgia State University

Check In/Check Out (CICO) is a secondary tier intervention for those students who are not responsive to universal tier, school-wide positive behavioral interventions and supports The present study extended the implementation of CICO to six students with emotional and behavioral disorders

in a residential facility whose behaviors were maintained by either attention or escape Results of

a nonconcurrent multiple baseline across participants design indicate that the mean percentage of problem behavior improved for two of three students with attention-maintained behavior and two

of three students with escape-maintained behavior Future directions and limitations of the research are addressed

Students with emotional and behavioral disorders (E/BD) demonstrate maladaptive behaviors that may affect social and academic performance and may then lead to the isolation of students with E/BD from their same age peers (Coutinho, 1986) Students with E/BD are the most likely

of all disability groups to require supports in alternative education (AE) settings According

to the National Center on Education Statistics (NCES, 2001), 33% to 75% of students served

in alternative school settings have an E/BD eligibility Tobin and Sprague (2000) cited several effective practices for AE settings including highly structured classroom management, an emphasis on positive-behavior management, the inclusion of adult mentors at the school, the inclusion of function-based assessment, and social-skills instruction A research-based framework that incorporates these noted effective practices is positive behavioral interventions and supports (PBIS; Flower, McDaniel, & Jolivette, 2011)

Correspondence should be addressed to Nicole Cain Swoszowski, Department of Special Education and Multiple Abilities Program, The University of Alabama, Box 870232, Tuscaloosa, AL 35487 E-mail: nswosz@bamaed.ua.edu

163

PBIS is a three-tier proactive and preventative framework (Sugai & Horner, 2002) based

on the theory of behaviorism and the principles of applied behavior analysis, which in-volves the fundamentals of conditioning behavior through the modification of antecedents and consequences (Dunlap, 2006; Sugai & Horner, 2002) Researchers have evaluated the effectiveness of universal and tertiary tier PBIS interventions within typical school settings but have not evaluated secondary tier interventions as thoroughly (Hawken, Adolphson, Macleod,

& Schumann, 2009) There is a need for further evaluation of secondary tier interventions

to meet effectively the needs of those students who require more targeted supports than are available at the universal level, such as students with E/BD Secondary tier interventions also are critical to prevent the need for resource intensive individualized supports at the tertiary tier (Horner, Sugai, Todd, & Lewis-Palmer, 2005; Sugai & Horner, 2002) Secondary tier interventions are noted as being (a) designed in combination with school-wide expectations; (b) adapted to address the function of behavior, when needed; and (c) implemented quickly and efficiently as multiple students can be addressed at one time, and the intervention can be implemented quickly using materials and personnel already available in the school environment (Hawken et al., 2009) One such secondary tier intervention is Check In/Check Out (CICO), which may be appropriate for students with E/BD who require support beyond the universal tier

CICO originated as the Behavior Education Plan (BEP; Hawken & Horner, 2003; Hawken, MacLeod, & Rawlings, 2007; March & Horner, 2002) and is based on the fundamentals of a daily report card The use of daily report cards is noted as a reliable means for accurately docu-menting student behavior as well as for providing behavioral feedback to students (Chafouleas, McDougal, Riley-Tillman, Panahon, & Hilt, 2005; Riley-Tillman, Chafouleas, Briesh, & Eckert, 2008) Students are typically chosen for CICO based on nonresponsiveness to universal, school-wide PBIS as indicated by discipline referrals Two to five office discipline referrals (ODRs) within a school year is a recommended criterion for secondary tier referral (Crone, Horner,

& Hawken, 2004; Horner et al., 2005); however, some CICO studies have included students based on general problem behaviors or administrator/teacher recommendations (Campbell & Anderson, 2008; Fairbanks, Sugai, Guardino, & Lathrop, 2007; Filter et al., 2007; Hawken

& Horner, 2003; Hawken et al., 2007; March & Horner, 2002; Todd, Campbell, Meyer, & Horner, 2008) When CICO is implemented, a student is paired with an adult mentor (CICO facilitator) to encourage positive, appropriate behavior throughout the school day Students complete a 5-step CICO cycle including check in with the facilitator at the beginning of the school day to set behavior goals for the day and check out with the facilitator at the end of the day to determine if daily goals were met During the school day, the student’s behavioral performance is assessed per class period by each teacher In addition, the student takes the CICO point sheet home to discuss daily behavior with parents to provide collaboration and planned communication between the school and home environments

The presence of the CICO facilitator and adult in the home environment provide adult attention within the 5-step CICO cycle, thus leading researchers (March & Horner, 2002; McIntosh, Campbell, Carter, & Dickey, 2009) to hypothesize that function of behavior may relate to student responsiveness to CICO especially for students with adult-attention-maintained behavior who may be more likely to respond to CICO To assess function, researchers conduct functional behavior assessments (FBAs) to determine the antecedents that precede or predict behavior and the consequences that follow or maintain behavior, with function in two

CHECK IN/CHECK OUT 165

mary categories: (a) to gain (attention, tangible, sensory stimulation), and (b) to escape/avoid (demand, attention, sensory stimulation) (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982; Maag, 2004; Sugai, Lewis-Palmer, & Hagan-Burke, 1999) Four CICO studies have included

an FBA as part of the initial CICO intervention phase (Campbell & Anderson, 2008; March

& Horner, 2002; McIntosh et al., 2009; Simonsen, Myers, & Briere, 2010) but with mixed approaches: (a) March and Horner (2002) conducted the Functional Assessment Checklist for Teachers and Staff (FACTS; March et al., 2000) interview after the CICO intervention period ended, (b) Campbell and Anderson (2008) used both the FACTS and brief observation

to determine peer-attention–maintained behavior for two students prior to intervention for reading and during intervention for math, (c) McIntosh and colleagues (2009) assessed function using the FACTS interview one to five days before beginning intervention, and (d) Simonsen and associates (2010) administered FACTS interviews prior to intervention as a descriptive measure, not to determine responsiveness by function To date, no studies have assessed function a priori for nomination purposes using an FBA protocol including archival record reviews, teacher interviews, and classroom observations to determine the relationships between antecedents, behavior, and consequences to identify either escape-maintained or attention-maintained behavior While the use of an a priori FBA approach as part of the nomination process may appear in direct contrast with the resource efficient benefits of secondary tier interventions noted previously, interviews alone are not a recommended approach (Horner, Albin, Sprague, & Todd, 1999; O’Neill et al., 1997) and the thorough evaluation of function for research purposes to scientifically evaluate the likelihood of response per function is a necessary contribution to the CICO research literature Without the addition of a priori assessment of function, it is not possible to determine the accurate assessment of function of inappropriate behavior without the impact of the intervention potentially confounding the results of the FBA

as function can change throughout an intervention period over time (March & Horner, 2002)

Of the nine published empirical CICO studies and the two conceptual CICO papers, as identified through a literature search, researchers have evaluated the effectiveness of CICO across traditional elementary (Campbell & Anderson, 2008; Fairbanks et al., 2007; Filter et al., 2007; Hawken et al., 2007; McIntosh et al., 2009; Todd et al., 2008) and middle school settings (Hawken & Horner, 2003; March & Horner, 2002; Simonsen et al., 2010) with 136 students (94 males, 23 females; gender not reported by Filter et al., 2007) in Kindergarten through ninth grade Of the 136 total participants, 11 received services through special education;

3 with learning disabilities and 8 with a disability that was not specified A majority of students exposed to CICO have demonstrated decreases in problem behavior as evidenced

by (a) mean changes in percentage of intervals with problem behavior (Campbell & Anderson, 2008; Fairbanks et al., 2007; Hawken & Horner, 2003; Todd et al., 2008), (b) decreases in ODRs and/or discipline contact (Filter et al., 2007; Hawken et al., 2007; March & Horner, 2002; McIntosh et al., 2009), (c) decreases in problem behavior ratings (McIntosh et al., 2009), and (d) increases in academic engagement (Hawken & Horner, 2003) To assist in the generalization

of the effects of CICO beyond the current 9 studies, it is critical to include (a) students with disabilities (e.g., those with E/BD), (b) settings outside typical schools (e.g., AE settings: day treatment, residential, juvenile justice), and (c) a priori FBAs as part of the nomination process

In this study, researchers extended the 5-step CICO intervention to students with E/BD in an

AE setting, a residential facility, with problem behavior maintained by adult attention or escape from demands with function assessed a priori The research questions were: (a) What effect

does CICO have on the attention-maintained problem behavior of students with E/BD? (b) What effect does CICO have on the escape-maintained problem behavior of students with E/BD? (c) Is the attention-maintained problem behavior of students with E/BD affected differently by CICO than the escape-maintained problem behavior of students with E/BD?

METHOD Participants

Six students in grades 6 through 9 participated: three with problem behavior maintained by adult attention (Tyrone, Leo, Daniel) and three with problem behavior maintained by escape from de-mands (Kevin, Natalie, Nathan) The students participated if they (a) received two to five office discipline referrals (ODRs) since the beginning of the school year prior to baseline, (b) lived

at the residential facility, (c) had a primary eligibility of E/BD, (d) demonstrated inappropriate behavior maintained by either attention (from adults) or escape (from demands) per the a priori FBA, (e) were in grades 6 through 12, and (f) provided informed consent Researchers used the school-wide information system database (SWIS; May et al., 2000) to determine the number

of ODRs students received prior to baseline Throughout baseline and intervention condition,

it was observed that teachers were writing ODRs for minor discipline infractions (e.g., use

of profanity, putting head down on desk) inconsistent with school procedures Researchers discussed this with the facility administrator, and even after the administrator conducted a retraining session regarding ODR referrals no observable improvements were observed to the referral process (i.e., inconsistencies between practice and procedure) Therefore, ODRs were used for inclusion criteria only Refer to Table 1 for student demographics

Three teachers, three housing supervisors, and three housing staff served as CICO facilitators Each student was paired with one CICO facilitator (a teacher) for the school component of CICO and a housing facilitator (either a housing staff or supervisor depending on shift) for the home component See Table 2 for facilitator demographics See Table 3 for facilitator assignments

Setting

The study took place at an urban residential facility for students with E/BD in first through twelfth grades The maximum capacity of this facility is 74 students Classes typically include

5 to 8 students, a teacher, and a behavior specialist to assist with behavioral issues on an as needed basis The school is structured as a typical public school but also provides housing for students on campus The classroom environments are like traditional school classrooms, and instruction is consistent with that in traditional school settings with curricula linked to the State performance standards School-wide universal PBIS has been in place for three years and both school and housing staff have been trained to implement universal PBIS Fidelity of universal PBIS was assessed using the School-Wide Evaluation Tool (SET; Sugai, Lewis-Palmer, Todd

& Horner, 2001) twice each year of universal implementation and all obtained scores exceeded the minimum 80/80

167

TABLE 2 Facilitator Demographics

Name Title/Location Gender Race/Ethnicity

Highest Degree

Years of Experience Age Shannon Teacher/School Female Caucasian Bachelors 10 37 Luke Teacher/School Male Caucasian Bachelors 10 37 Katie Teacher/School Female Caucasian Bachelors 2 29 Ronald Supervisor/Unit Male African American Bachelors 6 39 Maria Staff/Unit Female African American Bachelors 6 34 Larry Supervisor/Unit Male African American Bachelors 2 52 Jennifer Staff/Unit Female Caucasian Bachelors 2 31 Andrew Supervisor/Unit Male African American Bachelors 4 35 Marcy Staff/Unit Female Caucasian Bachelors 1 29

Materials

The materials used in this study included a daily CICO point card (referred to as a STAR point chart), the FACTS (March et al., 2000), and a fidelity checklist

Functional Behavior Assessment

Researchers conducted an FBA a priori according to the steps suggested by Sugai, Lewis-Palmer, and Hagan-Burke (1999) First, we analyzed information from ODR referrals Second, the two teachers who had the most daily contact with the students completed FACTS interviews During the FACTS interviews, the teachers indicated the behavior deemed most problematic for each student and described in detail the topography of the behavior In addition, teachers ranked students’ problematic environments from most to least based on their experiences with the students and on the locations noted on ODRs Third, the researchers operationally defined the target problem behavior for each student based on the descriptions of the behavior provided (see Table 4) Fourth, we formed hypothesis statements based on the FBA data Fifth, researchers conducted 3 direct observations in the classrooms rated as most problematic and to confirm

if (a) the behavioral operational definition was accurate, and (b) the hypothesis statement was supported by the antecedent-behavior-consequence (A-B-C) data collected

TABLE 3 Facilitator Assignment Student School Facilitator Housing Facilitator Tyrone Shannon Ronald Leo Shannon Maria Daniel Katie Larry Kevin Luke Jennifer Nathan Katie Andrew Natalie Luke Marcy

CHECK IN/CHECK OUT 169

TABLE 4 Definitions Name Behavior Definition

Tyrone Disruption Speaking or making vocalizations without first gaining permission to speak from an

adult and/or without being engaged in conversation by an adult during classroom instruction, independent work times, and during transitions—this can include use of profanity and verbal insults toward teachers and peers

Leo Noncompliance Verbally refusing to complete an assignment or to follow a request/demand, putting

head down on desk and/or closing eyes for more than 5 consecutive seconds, failing

to respond to or follow through with an assignment, a request, or a demand for more than 5 consecutive seconds

Daniel Disruption Leaving designated area and/or moving around classroom; speaking or making

vocalizations without first gaining permission to speak from an adult—this can include the use of profanity and verbal insults toward teachers and peers and noises such as singing Also included is intentional coughing and banging hands on desk top or stomping feet on floor

Kevin Noncompliance Putting head down on desk and/or closing eyes for more than 5 consecutive seconds,

failing to respond to or follow through with an assignment, a request, or a demand for more than 5 consecutive seconds

Nathan Noncompliance Putting head down on desk and/or closing eyes for more than 5 seconds, failing to

respond to or follow through with an assignment, a request, or a demand for more than 5 consecutive seconds

Natalie Noncompliance Verbally refusing to complete an assignment or to follow a request/demand, putting

head down on desk and/or closing eyes for more than 5 consecutive seconds, failing

to respond to or follow through with an assignment, a request, or a demand for more than 5 consecutive seconds

Dependent Variables and Data Collection

The dependent variable was percentage of intervals with problem behavior

Percentage of intervals with problem behavior Researchers documented the percentage

of intervals with problem behavior using a 10-second partial interval recording system for 20-minute direct observations The target problem behavior observed was individualized per student and observed in the most problematic classroom four times per week See Table 4 for a description of target problem behavior per student Observers wore an MP3 player with headphones on a splitter for all observations Researchers calculated the percentage of intervals with target problem behavior by dividing the total number of intervals in which the problem behavior occurred by the total number of intervals in the session, and multiplying by 100%

Facilitator Training

All school staff serving as CICO facilitators attended a two-hour training session on the implementation procedures of CICO They were trained on the dialogue to have with students each morning/afternoon, to complete the daily CICO point card (i.e., the STAR point chart), and to complete a checklist as a means to guide them through the intervention steps At the

conclusion of the training, the facilitators role-played the procedure for both check in and check out until they reached 100% fidelity using a variety of scenarios

Housing facilitators attended a separate one-hour training (i.e., unit supervisor, housing staff, school administrator) We scheduled this session separately from the school training to accommodate staff scheduling patterns and the session was shorter in duration as only one step

of the five-step cycle was discussed Housing staff were instructed on how to follow a checklist

as a guide for providing feedback to students and signing the CICO point chart each afternoon

At the conclusion of the training they role-played the procedure for providing feedback and signing the STAR point chart to 100% fidelity using a variety of scenarios

All sixth through ninth grade teachers participated in a one-hour training on how to award points for the daily CICO point card The training included a demonstration of how to complete the CICO point card per class period and examples and nonexamples of when students would earn a 0, 1, or 2 on the CICO point card

Research Design

A nonconcurrent multiple baseline across participants design was used (Kazdin, 1982; Kennedy, 2005) for both attention- and escape-maintained behavior so that responsiveness to the interven-tion by funcinterven-tion could be assessed as students were identified for possible inclusion throughout the semester Researchers chose a nonconcurrent multiple baseline as this design is noted for flexibility as participants can be added to intervention as they are identified given the transient nature of the student population within AE settings

Independent Variable

The independent variable was check in/check out The baseline and intervention phases are described next

Baseline Researchers conducted direct observation of the percentage of intervals with problem behavior School personnel continued implementation of the facility-wide PBIS (FW-PBIS) universal tier supports where students were taught, modeled, and reinforced (e.g., given STAR coupon) for engaging in the 4 facility-wide rules (i.e., show respect, take responsibility, accept adult directions, and respond appropriately) throughout the baseline phase On a weekly basis, students could exchange their STAR coupons for items and/or privileges in the school store

CICO intervention phase Facility-wide PBIS from baseline remained in effect during intervention Prior to implementing CICO, researchers randomly assigned each student a CICO facilitator with the pairing constant throughout See Table 3 for facilitator assignments CICO facilitators implemented the 5-step CICO intervention daily using the following steps: First, the students met individually with their CICO facilitator in the facilitator’s classroom prior to homeroom to set STAR point goals for the day as well as to receive their daily STAR point chart The STAR point chart provided a visual representation of the students’ daily schedules and a place for the teachers to rate students’ daily behavior by class period in accordance with