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2/14/2019“MOST OF THE WORLD WILL MAKEDECISIONS BY EITHER GUESSINGOR USING THEIR GUT. THEY WILLBE EITHER LUCKY OR WRONG.”-USING DATA FOR DECISION MAKINGIN IDD SETTINGSSUHAIL DOSHI, CEO, MIXPANELChristine Downs, M.Ed.Bob Putnam Ph.D. BCBA-D. LABAMay Institute, Inc.12PeerCollaborationIntensiveOVERVIEWContinuum ofSupport for ALLSoc skillsTargeted Importance of using Data for Decision MakingSelf Advocacy Teams Fidelity DataSelf Care Outcome DataFinancesUniversalCommunicationBasketballLabel behavior not people34Agency WidePBISPracticesProgram AreaNon-ProgramAreasCRITICAL FEATURES OF PBISSupporting Culturally EquitableSocial Competence & Academic AchievementOUTCOMESSupportingCulturally KnowledgeableStaff BehaviorFamilyIndividual Smallest # Evidencebased Biggest,durable effectSupportingCulturally ValidDecision MakingPRACTICESSupporting Culturally RelevantEvidence-based Interventions561

2/14/2019TEAMSTier 1 Universal Team Purpose – Implement, Monitor, & Evaluate Tier 1 (Programwide) supports Composition – Program directors, clinical staff, direct staff,individuals, family memberIntensive Tier 3 Systems Team Purpose – Brief data based monthlyreview of individuals receiving intensivesupports. Composition – Administrative and seniorclinical and other representative staff of theagency7Intensive Tier 3 Individual Team Purpose – Conducting Functional BehaviorAssessments (FBA) and developing positivebehavior plans and are responsible forimplementing the BSP. Composition – Clinical, staff, family, whoknow the individual best and the individualwhere feasible.8TYPES OF INFORMATION(DATA)IMPORTANT DATA POINTS INPBISFidelity of Implementation IDD TFI – Implementation of PBIS by Agency or Program - TIER 1, 2, & 3FidelityDataOutcomeData QUIC – Implementation of Practices by Staff - TIER 1Outcome Data Incident Tracking – Externalizing Disruptive Behavior (Agency, Program, Individual) - TIER 1, 2, & 3 Quality of Life Screener – Individual Goals and Progress - TIER 1 Behavior Rating Scale – Individual progress on Targeted Behaviors - Tier 3Did we implement thesystems and strategies weagreed on?Is the plan resulting inprogress toward our goals?910FIDELITY OF IMPLEMENTATIONMEASURING FIDELITY OFPROGRAM OR AGENCYIDD Tiered Fidelity Inventory (TFI)Implementation of PBIS by Agency or ProgramQuality of Universal Implementation Checklist (QUIC)Tiered Fidelity Inventory(TFI)Implementation of Practices by Staff11122

2/14/2019TIERED FIDELITY INVENTORY IDDTIERED FIDELITY INVENTORY IDDThe TFI Evaluates all three tiersThe purpose of the SWPBIS TieredFidelity Inventory is to provide a valid,reliable, and efficient measure of theextent to which program personnel areapplying the core features of programwide positive behavioral interventionsand supports.Each tier can be evaluatedseparately and at different timesThe Inventory is completed bythe program team togetherannuallyEach tier has an action planOSEP Technical Assistance Center on Positive Behavioral Interventions and Supports - 20151314TIERED FIDELITY INVENTORYTIER 1TFI TIER 1 DATA- IDDCategories Measured: Team Implementation Evaluation1516TIERED FIDELITY INVENTORYTIER 3TFI TIER 3 DATACategories Measured: Team Resources Support Plans Evaluation17183

2/14/2019ACTION PLANNINGDECISION MAKINGTFI Tier 1 Is the program implementing with fidelity? Yes/no What changes do we need to make to Tier 1 so that allindividuals are accessing Tier 1 supports? What training does staff need?TFI Tier 3 Do the behavior support plans include prevention, teaching andconsequence strategies Are staff implementing plans with integrity? What training does staff need?1920QUALITY OF UNIVERSAL IMPLEMENTATIONCHECKLIST - QUICThe QUIC was designed by theMassachusetts Department ofDevelopmental ServicesMEASURING STAFF FIDELITYOctober 2013Revised August 2014The QUIC is designed to provide abrief snapshot of PBS universalsupport interactions occurring in asetting.Quality of Universal Implementation Checklist(QUIC)Adapt to meet the needs of youragency2122QUALITY OF UNIVERSAL IMPLEMENTATIONCHECKLIST - QUICQUALITY OF UNIVERSAL IMPLEMENTATIONCHECKLIST - QUICQUIC SubscaleQUIC - Total tal Score23244

2/14/2019DECISION MAKINGOUTCOME DATAQUIC Incident Tracking – Externalizing Disruptive Behavior (Agency,Program, Individual) Are the questions on the QUIC relevant to your program guidelines? What changes should be made to the QUIC? Quality of Life Indicators – Individual Goals and Progress How often should the QUIC be used? By whom? Behavior Rating Scale – Individual Intensive Behavior Tracking Are staff interacting with individual in accordance to programguidelines? What training does staff need?2526QUALITY OF LIFE SCREENINGThe QLS was designed by the MayInstitute, Inc. 2015EVALUATING OUTCOMESThe QLS is designed to evaluate lifeskills and goals for individualsreceiving supports. It may becompleted by staff or when ablewith input from the individual.Quality of Life Screener (QoL)2728QUALITY OF LIFE SCREENINGQUALITY OF LIFE SCREENINGPer Individual Scoring: Complete the QLSQuestionnaire once per year (or more frequently asneeded) Enter the data from the Questionnaire intothe QLS DATA sheet for the year it was taken. Createaction Support/Teaching plan for items that scorelow.ADAPTAION: Use one Score Sheet per Residence orProgram. Type the name of the house or program inthe NAME Area. Change the years to names ofindividuals in house or program. Analyze data byhouse or program and determine which skills need tobe taught.29305

2/14/2019QUALITY OF LIFE SCREENINGDECISION MAKINGQuality of Life Screener Does the screener match the needs/desires of the individualsserved? What changes do we want to make to the screener? How often will we use the screener? How will we create individual goals from the screener? What training does staff need?3132PROGRESS MONITORINGMEASURES: EVALUATING OUTCOMESare validare reliableare quick to administerare relatively easy to complete & to summarizecan be repeated frequently are relatively inexpensive provide instant information provide relevant information can indicate potential problem(s)INCIDENT REPORTS are sensitive to small changes3334INCIDENT TRACKINGINCIDENT TRACKING Incident tracking allows the PBIS Data Team toreview externalizing behavior and look forpatterns and red flags that need to be addressed. Teams identify areas for improvement and thenaction plans to implement new or improvedsystems and practices for staff and individuals. Incident data should be readily available and easy toread. Preferably in graph format. Teams should review this data at a minimummonthly. Data should be shared with staff monthly35366

2/14/2019INCIDENT TRACKING BYPROGRAM LOCATION37INCIDENT TRACKING BYBEHAVIOR38INCIDENT TRACKING BY DAYOF THE WEEKINCIDENT TRACKING BYPROGRAM3940PIVOT TABLES FOR DRILLDOWNINCIDENT TRACKING PER DAYPER MONTH41427

2/14/2019PIVOT TABLES FOR DRILLDOWNPRECISE PROBLEM STATEMENT: Many Individuals are engaging inproblem behavior in the indoor and outdoor common areas during lunchtransition times and the behavior is maintained by attention.Goal: Reduce problems in common Area by 50% by Jan. 31SolutionComponentsPreventionWhat are the ActionSteps?Increase active supervisionPBIS Team will coordinateMovie by January 31 Movie Night Attendancetickets used at the Spirit StorePost weekly dataQuick redirection – low attention formisbehaviorsQuick recognition for expectedbehaviorsAll staffOngoingWho is responsible forgathering the data?What data?DataCollection43How will Fidelity beMeasured?Movie PartyRecognition tickets for followingexpected behavior in common areasTeach behavioral expectations for thecommons and hallwaysExtinctionBy When?OngoingTeachingRecognitionWho isResponsible?Program LeadsAll staffStaff will teachhallway/common areaexpectations to their programgroupIncident recordJanuary 15Staff visible in the indoor and outdoorcommon areasStaff sign-off sheet next to the PBISbulletin board in the faculty lounge toindicate completion-Review video onteaching expectations -Weekly data posted in the commonsand hallwayWhen/How often willdata be gathered?Incident Data Entry person and principal Weeklyshare report with teachers.Notes/UpdatesWhere will data beshared?Emailed to staff and posted in thehallways and commons forindividuals and familiesWho will see thedata?All staff and individuals44DECISION MAKINGIncident TrackingANALYZING AND EVALUATINGOUTCOMES Are you collecting all relevant problem behaviors? Who enters data into incident tracker? How often will we review data? (minimum monthly) Will sub-programs, residences, work programs review dataseparately from overall program? How often?Tier 3 Who will share the data with staff? How often? What training does staff need?4546FEASIBLE AND EFFICIENT PROGRESSMONITORING WITHIN A TIER 3SYSTEM: INDIVIDUAL OUTCOMESDirect Observation Frequency, RateLatencyDurationIntensityEXAMPLE: DIRECT OBSERVATION(FREQUENCY, SPECIfiC TIME PERIOD)Monitoring Ralph’s Outcomes Whole day Partial day Time periodSelf-Injurious Incidents Behavior Report Cards/Behavior Rating Scale Once per day Throughout dayDate9:00 – 11:0011:00 – 1:00Mondaylllllllll1:00 – 3:00lTuesdayllllllllllll llllllllll lllll2447488

2/14/2019EXAMPLE: BEHAVIOR REPORTCARD WITH SPECIFIC GOALSEXCEL SPREADSHEETDateSupportStrategiesCheckSIBSIBTotal Incidents ofSIBSIB9:00 ‐ 11:00‐1:00 1:00 ‐3:0011:00Support Strategies 5 10/13/2015 10/14/2015 10/15/2015 10/1ti/2015Support Strategies CheckRalph: Self‐Injurious 5/201510/1ti/2015SIBSIBSIBTotal Incidents SIB4950IS THE INDIVIDUAL MAKINGPROGRESS?BEHAVIOR RATING VIOR RATING SCALE - Blank.pdf Addresses Intensive Target behaviorsfor an individual Efficient for staff use Targeted behaviors must beoperationally defined Behaviors can be measured byFrequency, duration or intensity Easily translates into a line graph Requires minimum of 1 appropriateand 1 inappropriate behavior285152EXAMPLE: THE BEHAVIOR RATINGSCALE (IBRST)BEHAVIOR RATING SCALE S overview.pdf3053549

2/14/2019TIER 3 TEAM SYSTEM MEETINGSTIER 3 PRACTICES: BSP DDS Behavior Support Plan Prevention Strategies Antecedent interventions Environmental design Communication style Teaching Replacement and DesiredBehaviors Consequence Strategies Positive acknowledgement & reinforcementprocedures Each person is discussed during the meeting for no more than 2 or 3 minutes. Graphs of the daily frequency of no more than 3 of their most challenging behaviorsover the past 60 days are reviewed. Determine current trends by using trend line and/or mean frequency per day ofbehavior Decreasing trend/Behavior improving ( ) About the same/No change in behavior (0) Increasing trend/Behavior not improving (-) Decisions are made as to what should be done to address the problem behaviorsthat are not improving Develop an action plan5556DECREASING TREND ( )FLAT/NO 1410/3/14010/1/1425758INCREASING TREND (-)4.5DECISION MAKINGAggressionIndividual data tracking4 How can we use Behavior Rating Scale to track problembehaviors? Frequency, duration, intensity3.53 How often will we use the screener?2.5 Who will graph the data? Is the BRS sheet enough forgraphing?Elopement DH2Linear (Elopement DH) How often will we share data with the team/staff?1.5 Do we have data rules for modifying/discontinuing plan?1 What training does staff 6010