scholarly journals Helping Children with Emotional Difficulties

2018 ◽  
Vol 30 (2) ◽  
Author(s):  
Lee R. Pearce
Keyword(s):  
Behavioral Interventions ◽  
Skills Training ◽  
Fifth Grade ◽  
Future Research ◽  
Tier 2 ◽  
Prosocial Skills ◽  
Tier 1 ◽  
Rti Model ◽  
Tier 3 ◽  
Rural Elementary School

This article describes a Response to Intervention (RTI) model of service delivery implemented within a rural elementary school for students in kindergarten through fifth grade experiencing significant emotional and behavioral difficulties. A multi-tiered model is presented that includes school wide interventions in Tier 1, as well as a six separate interventions applied within Tier 2 and Tier 3. These included applied behavioral analysis, social skills training, counseling,  differentiated instruction, cognitive behavioral interventions and parent involvement designed to assist identified students with improving prosocial skills. Nine children were treated within this program model over a two year period, resulting in two students being placed in special education under the category of emotional disturbance by the project’s termination. Positive and negative aspects of the project’s implementation are reviewed, along with directions for future research.  

Optimal Timing for Launching Installation of Tier 2 and 3 Systems of School-Wide Positive Behavioral Interventions and Supports

2021 ◽  
pp. 109830072199608
Author(s):  
Angus Kittelman ◽  
Sterett H. Mercer ◽  
Kent McIntosh ◽  
Robert Hoselton
Keyword(s):  
Longitudinal Study ◽  
Behavioral Interventions ◽  
Structural Equation ◽  
Equation Modeling ◽  
Optimal Timing ◽  
First Year ◽  
Tier 2 ◽  
Positive Behavioral Interventions ◽  
Tier 1 ◽  
Tier 3

The purpose of this longitudinal study was to examine patterns in implementation of Tier 2 and 3 school-wide positive behavioral interventions and supports (SWPBIS) systems to identify timings of installation that led to higher implementation of advanced tiers. Extant data from 776 schools in 27 states reporting on the first 3 years of Tier 2 implementation and 359 schools in 23 states reporting on the first year of Tier 3 implementation were analyzed. Using structural equation modeling, we found that higher Tier 1 implementation predicted subsequent Tier 2 and Tier 3 implementation. In addition, waiting 2 or 3 years after initial Tier 1 implementation to launch Tier 2 systems predicted higher initial Tier 2 implementation (compared with implementing the next year). Finally, we found that launching Tier 3 systems after Tier 2 systems, compared with launching both tiers simultaneously, predicted higher Tier 2 implementation in the second and third year, so long as Tier 3 systems were launched within 3 years of Tier 2 systems. These findings provide empirical guidance for when to launch Tier 2 and 3 systems; however, we emphasize that delays in launching advanced systems should not equate to delays in more intensive supports for students.

Multitiered Systems of Supports, Response to Intervention, and Positive Behavioral Interventions and Supports

2021 ◽  
pp. 107-117
Author(s):  
Samantha Bates ◽  
LaShonda Linnen ◽  
Stephanie Columbia ◽  
Dawn Anderson-Butcher
Keyword(s):  
Response To Intervention ◽  
Social Workers ◽  
Behavioral Interventions ◽  
Evidence Based ◽  
Tier 2 ◽  
Students At Risk ◽  
Positive Behavioral Interventions ◽  
School Based ◽  
Tier 1 ◽  
Tier 3

This chapter covers the Response to Intervention framework, Positive Behavioral Interventions and Supports, and multitiered systems of supports (MTSS). The Response to Intervention framework is a central step in implementing a successful MTSS framework. MTSS delivers school-based supports across three tiers: tier 1 (universal), tier 2 (targeted), and tier 3 (individualized). The MTSS framework is a resource that enables schools to use data not only to identify students at risk for poor learning outcomes but also to monitor student progress and deliver evidence-based interventions. The chapter provides examples of ways social workers can maximize the utility of these models and school teams to improve student outcomes.

Responsiveness to Intervention in Reading

2012 ◽  
Vol 36 (1) ◽  
pp. 36-46 ◽  
Author(s):  
Joseph R. Jenkins ◽  
Ellen Schiller ◽  
Jose Blackorby ◽  
Sara Kalb Thayer ◽  
W. David Tilly
Keyword(s):  
Differentiated Instruction ◽  
Progress Monitoring ◽  
Educational Programs ◽  
Tier 2 ◽  
Model Schools ◽  
Tier 2 Interventions ◽  
Tier 1 ◽  
Individualized Educational Programs ◽  
Rti Model ◽  
Tier 3

This article describes how a purposeful sample of 62 elementary schools from 17 states implemented a Response to Intervention (RtI) framework for reading. School informants answered surveys and were interviewed about differentiated instruction in Tier 1, screening/benchmarking, where Tier 2 interventions were located, typical group size and the minutes/day of intervention in Tiers 2 and 3 groups, and how students with individualized educational programs (IEPs) in reading were served in the school’s RtI model. Schools reported using differentiated instruction in Tier 1, favored curriculum-based measures for screening/benchmarking and progress monitoring, reported more intensive interventions and more progress monitoring in Tier 3, and used a wide variety of models for serving students with IEPs within the schools’ RtI models.

scholarly journals Global Inland Capture and Culture Finfisheries Follow Different Trends When Evaluated by the Human Development Index

2021 ◽  
Vol 13 (15) ◽  
pp. 8420
Author(s):  
Peter W. Sorensen ◽  
Maria Lourdes D. Palomares
Keyword(s):  
Socioeconomic Factors ◽  
Human Development ◽  
Human Development Index ◽  
Developed Countries ◽  
Global Scale ◽  
Tier 2 ◽  
Development Index ◽  
Tier 1 ◽  
Catch Reconstruction ◽  
Tier 3

To assess whether and how socioeconomic factors might be influencing global freshwater finfisheries, inland fishery data reported to the FAO between 1950 and 2015 were grouped by capture and culture, country human development index, plotted, and compared. We found that while capture inland finfishes have greatly increased on a global scale, this trend is being driven almost entirely by poorly developed (Tier-3) countries which also identify only 17% of their catch. In contrast, capture finfisheries have recently plateaued in moderately-developed (Tier-2) countries which are also identifying 16% of their catch but are dominated by a single country, China. In contrast, reported capture finfisheries are declining in well-developed (Tier-1) countries which identify nearly all (78%) of their fishes. Simultaneously, aquacultural activity has been increasing rapidly in both Tier-2 and Tier-3 countries, but only slowly in Tier-1 countries; remarkably, nearly all cultured species are being identified by all tier groups. These distinctly different trends suggest that socioeconomic factors influence how countries report and conduct capture finfisheries. Reported rapid increases in capture fisheries are worrisome in poorly developed countries because they cannot be explained and thus these fisheries cannot be managed meaningfully even though they depend on them for food. Our descriptive, proof-of-concept study suggests that socioeconomic factors should be considered in future, more sophisticated efforts to understand global freshwater fisheries which might include catch reconstruction.

Incorporation of plasma-based next-generation sequencing to improve guideline-concordant molecular testing in patients with newly diagnosed metastatic nonsquamous non-small cell lung cancer.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 14-14
Author(s):  
Charu Aggarwal ◽  
Melina Elpi Marmarelis ◽  
Wei-Ting Hwang ◽  
Dylan G. Scholes ◽  
Aditi Puri Singh ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Practice Change ◽  
Molecular Testing ◽  
Tier 2 ◽  
Newly Diagnosed ◽  
Next Generation ◽  
First Line ◽  
Tier 1 ◽  
Tier 3 ◽  
The Impact

14 Background: Current NCCN guidelines recommend comprehensive molecular profiling for all newly diagnosed patients with metastatic non-squamous NSCLC to enable the delivery of personalized medicine. We have previously demonstrated that incorporation of plasma based next-generation gene sequencing (NGS) improves detection of clinically actionable mutations in patients with advanced NSCLC (Aggarwal et al, JAMA Oncology, 2018). To increase rates of comprehensive molecular testing at our institution, we adapted our clinical practice to include concurrent use of plasma (P) and tissue (T) based NGS upon initial diagnosis. P NGS testing was performed using a commercial 74 gene assay. We analyzed the impact of this practice change on guideline concordant molecular testing at our institution. Methods: A retrospective cohort study of patients with newly diagnosed metastatic non-squamous NSCLC following the implementation of this practice change in 12/2018 was performed. Tiers of NCCN guideline concordant testing were defined, Tier 1: complete EGFR, ALK, BRAF, ROS1, MET, RET, NTRK testing, Tier 2: included above, but with incomplete NTRK testing, Tier 3: > 2 genes tested, Tier 4: single gene testing, Tier 5: no testing. Proportion of patients with comprehensive molecular testing by modality (T NGS vs. T+P NGS) were compared using one-sided Fisher’s exact test. Results: Between 01/2019, and 12/2019, 170 patients with newly diagnosed metastatic non-Sq NSCLC were treated at our institution. Overall, 98.2% (167/170) patients underwent molecular testing, Tier 1: n = 100 (59%), Tier 2: n = 39 (23%), Tier 3/4: n = 28 (16.5%), Tier 5: n = 3 (2%). Amongst these patients, 43.1% (72/167) were tested with T NGS alone, 8% (15/167) with P NGS alone, and 47.9% (80/167) with T+P NGS. A higher proportion of patients underwent comprehensive molecular testing (Tiers 1+2) using T+P NGS: 95.7% (79/80) compared to T alone: 62.5% (45/72), p < 0.0005. Prior to the initiation of first line treatment, 72.4% (123/170) patients underwent molecular testing, Tier 1: n = 73 (59%), Tier 2: n = 27 (22%) and Tier 3/4: n = 23 (18%). Amongst these, 39% (48/123) were tested with T NGS alone, 7% (9/123) with P NGS alone and 53.6% (66/123) with T+P NGS. A higher proportion of patients underwent comprehensive molecular testing (Tiers 1+2) using T+P NGS, 100% (66/66) compared to 52% (25/48) with T NGS alone (p < 0.0005). Conclusions: Incorporation of concurrent T+P NGS testing in treatment naïve metastatic non-Sq NSCLC significantly increased the proportion of patients undergoing guideline concordant molecular testing, including prior to initiation of first-line therapy at our institution. Concurrent T+P NGS should be adopted into institutional pathways and routine clinical practice.

Examining Teaming and Tier 2 and 3 Practices Within a PBIS Framework

2021 ◽  
pp. 109830072110510
Author(s):  
Rhonda N. T. Nese ◽  
Angus Kittelman ◽  
M. Kathleen Strickland-Cohen ◽  
Kent McIntosh
Keyword(s):  
Behavioral Interventions ◽  
Data Use ◽  
Future Research ◽  
Evidence Based ◽  
Tier 2 ◽  
Behavior Support ◽  
Evidence Based Practices ◽  
Research And Practice ◽  
Positive Behavioral Interventions ◽  
Core Feature

One core feature of Positive Behavioral Interventions and Support (PBIS) is a systems-level teaming process for coordinating staff implementation of evidence-based practices and monitoring student progress across all three tiers. Prior research has shown schools that report regular teaming and team-based data use are more likely to successfully adopt and sustain implementation of multi-tiered systems of behavior support. However, more research is currently needed to better understand the various teaming configurations, structures, and practices commonly used by PBIS teams in typical schools, particularly at advanced tiers. For the current study, members of school and district PBIS teams representing 718 schools were surveyed to better understand (a) teaming configurations and practices currently being used in schools implementing PBIS and (b) common interventions that PBIS teams report implementing at Tiers 2 and 3. Survey findings are discussed, along with implications of those results for future research and practice in applied settings.

scholarly journals Initial Experience in Predicting the Risk of Hospitalization of 496 Outpatients with COVID-19 Using a Telemedicine Risk Assessment Tool

2020 ◽  
Author(s):  
James B O'Keefe ◽  
Elizabeth J Tong ◽  
Thomas H Taylor ◽  
Ghazala D Datoo O'Keefe ◽  
David C Tong
Keyword(s):  
Risk Assessment ◽  
Assessment Tool ◽  
Cox Regression ◽  
Risk Assessment Tool ◽  
Individual Risk ◽  
Tier 2 ◽  
Tier 1 ◽  
Risk Patients ◽  
Tier 3

Objective: To determine whether a risk prediction tool developed and implemented in March 2020 accurately predicts subsequent hospitalizations. Design: Retrospective cohort study, enrollment from March 24 to May 26, 2020 with follow-up calls until hospitalization or clinical improvement (final calls until June 19, 2020) Setting: Single center telemedicine program managing outpatients from a large medical system in Atlanta, Georgia Participants: 496 patients with laboratory-confirmed COVID-19 in isolation at home. Exclusion criteria included: (1) hospitalization prior to telemedicine program enrollment, (2) immediate discharge with no follow-up calls due to resolution. Exposure: Acute COVID-19 illness Main Outcome and Measures: Hospitalization was the outcome. Days to hospitalization was the metric. Survival analysis using Cox regression was used to determine factors associated with hospitalization. Results: The risk-assessment rubric assigned 496 outpatients to risk tiers as follows: Tier 1, 237 (47.8%); Tier 2, 185 (37.3%); Tier 3, 74 (14.9%). Subsequent hospitalizations numbered 3 (1%), 15 (7%), and 17 (23%) and for Tiers 1-3, respectively. From a Cox regression model with age ≥ 60, gender, and self-reported obesity as covariates, the adjusted hazard ratios using Tier 1 as reference were: Tier 2 HR=3.74 (95% CI, 1.06-13.27; P=0.041); Tier 3 HR=10.87 (95% CI, 3.09-38.27; P<0.001). Tier was the strongest predictor of time to hospitalization. Conclusions and Relevance: A telemedicine risk assessment tool prospectively applied to an outpatient population with COVID-19 identified both low-risk and high-risk patients with better performance than individual risk factors alone. This approach may be appropriate for optimum allocation of resources.

The Effects of Response to Intervention on Literacy Development in Multiple-Language Settings

2007 ◽  
Vol 30 (3) ◽  
pp. 197-212 ◽  
Author(s):  
Angela Stephens McIntosh ◽  
Anne Graves ◽  
Russell Gersten
Keyword(s):  
Response To Intervention ◽  
Reading Fluency ◽  
Oral Reading ◽  
English Learners ◽  
Oral Reading Fluency ◽  
Literacy Practices ◽  
First Grade ◽  
Future Research ◽  
Tier 2 ◽  
Tier 1

This descriptive study documents the effects of response-to-intervention type practices in four first-grade classrooms of English learners (ELs) from 11 native languages in three schools in a large urban school district in southern California. Observations and interviews in four classrooms across two consecutive years were compared to first-grade gains in oral reading fluency ( N = 111). Reading fluency data were examined in relation to ratings of literacy practices, including the degree to which Tier 1 alone or Tier 1 plus Tier 2-type instruction was implemented. The correlation between classroom ratings on the English Learners Classroom Observation Instrument (ELCOI) and gain from pre- to posttest in first grade on oral reading fluency was moderately strong in both Year 1 ( r = .61) and Year 2 ( r = .57). The correlation between Cluster II teacher ratings and ORF gains was strong in both Year 1 ( r = .75) and Year 2 ( r = .70), suggesting a strong relationship between Tier 2-type literacy practices and end-of-first-grade oral reading fluency. Results indicated a strong correlation ( r = -.81) between the number of students below DIBELS benchmark thresholds at the end of first grade and the teacher rating on the amount of instruction provided for low performers. Followup data at the end of third grade in oral reading fluency and comprehension indicate moderate correlations to first-grade scores ( N = 51). Patterns of practice among first-grade teachers and patterns among ELs who were ultimately labeled as having learning disabilities are discussed. Educational implications and recommendations for future research are also presented.

SFBT Within the Tier 2 Framework

2017 ◽  
Author(s):  
Michael S. Kelly ◽  
Johnny S. Kim ◽  
Cynthia Franklin
Keyword(s):  
Classroom Climate ◽  
Tier 2 ◽  
Social Emotional ◽  
Prevention Services ◽  
Coaching Intervention ◽  
Tier 1 ◽  
American Schools ◽  
Tier 2 Intervention ◽  
Tier 3 ◽  
Teacher Coaching

The educational policy changes of the past 20 years have increased the focus on the provision of prevention services within schools, both for individual students and for social-emotional programming delivered in their classroom. Whether characterized as Response to Intervention (RTI), Positive Behavior Intervention and Supports (PBIS), or Multi-Tiered Systems of Supports (MTSS), the focus on a 3-tier framework of universal (Tier 1), selective (Tier 2) and indicated (Tier 3) has become one of the largest evidence-based framework ever scaled up within American schools, with over 19,000 schools across all 50 states having implemented PBIS by this writing. This chapter focuses on an example of a SFBT Tier 2 intervention, the Working on What Works (WOWW) teacher coaching intervention, that strives to create a better classroom climate for teachers and their students.

TIER-2 IN EAST ASIA1: CHALLENGES AND ANSWERS

2008 ◽  
Vol 2008 (1) ◽  
pp. 49-55
Author(s):  
Alexander Nicolau
Keyword(s):  
Media Coverage ◽  
Oil Spills ◽  
Oil Industry ◽  
Government Agencies ◽  
Tier 2 ◽  
International Media ◽  
The Past ◽  
Tier 1 ◽  
Tier 3 ◽  
And Training

ABSTRACT On numerous occasions, East Asia has been affected by marine oil spills incidents, originating from tankers and other types of ships. Important spills incidents that involved the IOPC Funds in the last decade (e.g. Nakhodka, Evoikos, Natuna Sea and Solar 1 …) indicate an average occurrence of one spill per year. This figure remains significantly high when considering that some States in the region are still not parties to international compensation regimes. In addition, numerous incidents do not benefit of international media coverage, thus making them often unnoticed. Lower scale incidents (within the range of hundreds of tonnes) occur on a more frequent basis and may appear trivial to respond to. Nevertheless, they represent the same range of difficulties experienced during larger scale incidents (logistics, suitable means to apply dispersants promptly and effectively, availability of temporary storage, lack of plan and training …) In terms of response, the ultimate authority in the coordination of spill response activities is in the hands of Government Agencies. However, the equipment and manpower available belong in various proportions to both Government Agencies and the Oil Industry. The latter operates numerous oil terminals and offshore facilities and is responsible to respond to minor spills defined as Tier 1. In the case of a large spill that exceeds the on-site capability, Tier 3 Cooperatives funded by the vast majority of major companies were created to assist and complement the local response, by offering access to a large range of special supplementary resources and services, such as the Airborne Dispersant Delivery System. Whilst Tiers 1 and 3 are well defined and are respectively synonyms of small and huge oil spill incidents, there is a lack of clarity and consistency in-between, thus making the Tier 2 response difficult to define. This gap that is often underestimated and may result in a preparedness weakness leading to unfortunate consequences. The aim of this paper is to analyse the Tier-2 response requirements and to discuss on the challenges of implementing effective measures in a region where the only imports of crude oil of China have more than doubled in the past five years.

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