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Defining Cognitive Behavior Management Cognitive behavior management is the use of intervention strategies designed to teach students to control their own behaviors. Through cognitive behavior management, students are taught how their behaviors create ripple effects that affect their relationships with others and their academic and behavior outcomes, just as dropping a pebble in still waters creates ripples emanating outward that affect everything in their path. Under a universal design for classroom management, cognitive behavior management is a proactive strategy. Teaching students to manage their own behaviors can prevent the occurrence of behavior difficulties in the classroom. When students can manage their own behaviors, they do not rely on external controls (Rafferty, 2010) such as nonverbal and verbal interventions, reinforcements, and token economies. Implementing a Self-Management Plan Self-management techniques may be effective alternatives to teacher-mediated interventions in reducing incidents of disruptive behavior (Briesch & Chafouleas, 2009). Self-management is an umbrella term that includes a number of techniques specifically designed to teach students to control their own behaviors (Chafouleas, Hagermoser Sanetti, Jaffery, & Fallon, 2012). Much of the research conducted on self-management has involved students with disabilities; however, self-management techniques have also been found to be effective for students without disabilities (Moore, Anderson, Glassenbury, Lang, & Didden, 2013). Self-management techniques vary in a number of ways, but common features among these techniques include identification of the target behavior, self-observation, and self-recording. Both general education students and students with disabilities can be taught to manage their own behavior. Students can be taught to use any of several different techniques to change their behavior. Whatever techniques teachers choose, they need to take the following steps in implementing a self-management plan: Identify the target behavior. Determine the criteria for mastery of the appropriate behavior. Discuss with the student the relevance of the appropriate behavior. Introduce the self-management technique. Model the technique. Provide guided practice in the technique. Practice the technique in authentic settings. (King-Sears, 2008; Patton, Jolivette, & Ramsey, 2006) The first step in implementing a self-management plan is to identify the target behavior. Target behaviors are observable, measurable, and repeatable, and they are usually expressed in terms of action in a positive tone (see Chapter 8). For example, Charlie, a third grader, often pushes peers during transition times, when in line going to lunch or recess, and when the teacher is not looking. Since the inappropriate behavior is pushing peers, Charlie’s target behavior would be to keep his hands to himself. Once the inappropriate behavior has been identified, the teacher needs to determine the criteria for mastery of the target behavior. Charlie’s teacher monitored Charlie’s behavior during transition times, while in line, during lunch, and during recess. The teacher noted that over a 2-day period, Charlie displayed his inappropriate behavior eight times. The third step is to discuss the relevance of the appropriate behavior. Charlie needs to understand the benefits to himself for displaying the target behavior, such as developing positive relationships with his peers, being able to eat lunch in the cafeteria, being able to go to recess, and having positive notes sent home. Once Charlie understands the difference between the inappropriate behavior and the target behavior, the teacher selects a self-management technique and explains the technique to Charlie. The teacher provides a worksheet for Charlie to use in monitoring his behavior across settings and shows him how to mark the worksheet. For example, Charlie is to circle “yes” or “no” depending on whether he displayed the appropriate behavior in specific settings (see Figure 7.1). At the end of each day, if Charlie has answered yes four times on the worksheet, he rewards himself in a way that he and his teacher previously determined. After a self-management technique has been chosen, the teacher needs to model how to use it. Charlie’s teacher verbalizes her thought process while she models appropriate and inappropriate behaviors, and while she marks the self-management worksheet as yes, she did keep her hands to herself, or no, she did not keep her hands to herself. Then the teacher provides Charlie an opportunity to practice using the self-management worksheet. During guided practice, the teacher offers feedback and helps Charlie learn the self-management procedures. Finally, the self-management plan is implemented in “authentic” settings. In Charlie’s case, this means he demonstrates appropriate behavior during transitions within the classroom, while in line, and during lunch and recess. Figure 7.1 Self-Monitoring Worksheet for Charlie Self-Management Techniques Teachers often use five common techniques of self-management to help students regulate their own behavior: goal setting, self-instruction, self-monitoring, self-evaluation, and self-reinforcement (Mooney, Ryan, Uhing, Reid, & Epstein, 2005). Goal Setting As part of ringing in the New Year, many adults begin self-improvement plans by engaging in goal setting. They may set goals for getting in shape, eating healthy, or learning a new hobby. Students can also set goals, and they can be taught how to do so. In the classroom, students set goals for performance in both academic and behavioral areas. Here we focus on student goal setting for behavior improvement. In setting a behavior improvement goal, it is best to address a behavior that the student can already perform in some situations and that will result in positive outcomes when it is used in naturally occurring environments. It is also recommended that the student and teacher choose an emerging skill for the student and set a goal to increase the student’s independent use of that skill, rather than set a goal that the student will acquire a new skill. It is useful for the teacher to have a discussion with the student about what the student would like to have happen with regard to his or her behavior. Finally, a student might select an individual behavioral goal that is aligned with a classroom or school-wide behavior expectation (Oakes et al., 2012). Self-Instruction Prior to teaching the student self-instruction strategies, the teacher should make sure that the behavioral goal chosen during goal setting is observable and measurable. In other words, the student needs to know what the target behavior looks like in order to be able to record when it happens. For example, if the target behavior chosen during goal setting is on-task behavior, then the student should understand that on-task behavior means that the student is either looking at the teacher or looking at and engaging with materials during a lesson. Self-instruction involves self-talk that assists in regulating behaviors. It includes self-statements that students are taught to use to direct their own behavior. That is, students literally talk to themselves to help them finish tasks, solve problems, or mediate social situations (Menzies, Lane, & Lee, 2009). Most individuals have engaged in self-instruction at one time or another, talking themselves through difficult tasks or situations. When they do so silently, the self-instruction is covert. Sometimes, however, people engage in overt self-instruction, speaking to themselves aloud, especially for the most difficult of tasks. Most guidelines for teaching self-instruction to students have been adapted from seminal work by Meichenbaum and Goodman (1971). In teaching self-instruction to a student, the following steps can be used: The teacher models the task for the student while talking aloud. The student performs the task while the teacher talks aloud. The teacher uses a quiet voice and the student talks aloud while performing the task. The student whispers while performing the task. The teacher may mouth the words to the task or use body language or facial expressions to guide or prompt the student to complete the task. The student performs the task while using silent self-instruction. Self-Monitoring During self-monitoring, students observe their own behaviors and self-record whether they are exhibiting particular behaviors (Rafferty, 2010). A student can record the occurrences of behavior to be decreased (e.g., talking without permission) or behavior to be increased (e.g., time on task). Examples of self-monitoring include crossing things off a to-do list and tracking how much water one drinks in a day. In the classroom, students can be taught to self-monitor just about any behavior, from completing homework tasks to speaking out inappropriately. Successful self-monitoring can enhance and improve academic and social performance. Although self-monitoring can be used in isolation, it is most often used in tandem with self-evaluation, in which the student compares the data collected from self-recording with an established performance standard (Briesch & Chafouleas, 2009). Self-recording can be cued or noncued. In cued self-recording, students record their behavior when a signal is given. The signal is usually a recorded tone, such as a chime or bell. When students hear the tone, they indicate on a data collection sheet if they are engaged in a given behavior at that time. In noncued self-recording, students are asked to make a notation on a data collection sheet each time they perform the target behavior. It is recommended that teachers take the following steps in implementing self-monitoring strategies with students: Select a target behavior, if this was not done during the goal-setting phase of the behavior management plan. Define the behavior in observable, measurable terms. Help the student recognize examples as well as nonexamples of the behavior. For example, the teacher may ask the student, “Belinda, are you on task or off task?” Instruct the student in the use of an appropriate data collection system and its corresponding form. For example, for discrete behaviors (those with a clear beginning and end), event recording (recording each time the target behavior occurs) is most appropriate (see Figure 7.2). To self-record continuous behaviors, such as being on task, students might use time sampling or interval recording (see Figure 7.3). Instruct the student how to self-monitor. The student should be able to determine the difference between engaging and not engaging in the target behavior. Monitor the student during a practice data-recording time period. The teacher may want to keep her own record in order to compare accuracy. Fade the use of the intervention, so that the student self-monitors without the intervention. (Rafferty, 2010) Self-Evaluation During self-evaluation, students compare their performance to a set criterion (Menzies et al., 2009). Examples of self-evaluation include a person’s assessment of his own job performance and an athlete’s determination of how well she ran a race or played a game. In the classroom, students may evaluate how well they did in a musical performance, or they may assess their participation in a group project. When a student uses self-evaluation, he compares his own behavior to a predetermined standard set either by the student himself or by the teacher. Self-evaluation occurs after the student has collected data during the self-monitoring phase of self-management of behavior. Additionally, self-evaluation determines self-reinforcement and therefore takes place before such reinforcement. The self-monitoring charts presented in Figures 7.2 and 7.3 have been modified in Figures 7.4 and 7.5 to include self-evaluation components. The addition of the “my achievements” line allows the student to evaluate himself against the goal that was set at the beginning of the self-monitoring period. Figure 7.2 Self-Monitoring Chart for Class Preparedness Figure 7.3 Self-Monitoring Chart for On Task Behavior What Would You Do? Belinda Belinda is a sixth grader in her first month at Sheffield Middle School. She is a good student and is thrilled to be in middle school. She has made a lot of friends and likes all her new classes and teachers. She particularly likes that she moves from class to class and has a different teacher for each class. Belinda’s teachers state that she does well in class. She is very attentive, her time on task is excellent, and she seems to learn new concepts quickly. The only thing that Belinda seems to be struggling with is remembering to bring her homework and the correct notebook and materials to each class. For example, when she arrives at math class, she has her English homework and her biology notebook, but not her materials for math. She also usually forgets her pencil, and the teacher does not accept work done in pen in math class. As one of her teachers, what would you do to help Belinda remember to bring the correct homework and materials to each of her classes? Self-Reinforcement With self-reinforcement, students manage their behaviors by rewarding themselves when they successfully complete self-prescribed activities (Bandura, 1976). Many of us have engaged in self-reinforcement in our daily lives. For example, you may buy yourself new clothes when you have lost 10 pounds or go out on a Friday night with friends after you have completed your workweek productively. The behavior management interventions described above are more effective when combined with self-reinforcement—that is, when students give themselves reinforcers if they conclude they have met the standard for the target behavior. Reinforcers may be points, tokens, or activities—whatever the student decides. Figure 7.4 Self-Evaluation for Class Preparedness Figure 7.5 Time Sampling or Interval Recording with Self-Evaluation When using self-reinforcement strategies with students as part of a behavior management plan, it is best to start with teacher-initiated contingencies with which students are already involved. Students may already be allowed to choose their own reinforcers, such as extra computer time after finishing a worksheet. The transition from teacher-mediated reinforcement of behavior to student-managed reinforcement is made easier when students are explicitly taught to use self-reinforcement. Self-reinforcement may involve the students choosing their own reinforcers, setting criteria for earning reinforcers, or both. Goal setting, self-instruction, self-monitoring, self-evaluation, and self-reinforcement form the basis for effective cognitive behavior management interventions. The learning and behavior of students with and without disabilities in the general education classroom setting can be enhanced through the use of self-management techniques (Moore et al., 2013). Furthermore, self-management meets the criteria for being an evidence-based practice that can be used across age groups and settings (Rafferty, 2010). Case Study Jane and Ms. Daniels Jane is a third grader at Abydos Elementary School. Her physical education teacher, Ms. Daniels, has recently noticed that Jane has been consistently arriving late at the gymnasium for class after changing into her gym clothes in the locker room. Ms. Daniels talks to Jane, and she finds out that Jane likes and can do the activities in the class. It seems to Ms. Daniels that what is making Jane late is that she is socializing in the locker room rather than concentrating on changing clothes and getting to class in a timely fashion. Ms. Daniels decides to use a self-management strategy with Jane. Together, Jane and Ms. Daniels define the target behavior as follows: Jane will leave the locker room at 9:10 a.m. (in order to be on the gymnasium floor at 9:15) on 4 of 5 class days each week for 1 month. They design a self-recording worksheet that consists of a chart with boxes for 20 days (5 days for 4 weeks) and tape it to the inside of Jane’s locker. Jane puts a checkmark in a box each day she is ready to leave the locker room and the clock says 9:10 a.m. If Jane is at her station in the gym by 9:15 a.m., Ms. Daniels also records a checkmark on a chart. So that Jane does not have to wait until the end of the month for reinforcement, Jane and Ms. Daniels decide that if Jane meets her goal for a week, she will be allowed to pass out the equipment the following Monday. If Jane meets her goal for the month, she will be allowed to be the team leader for the activity of her choice during the next “free choice” Friday. Additionally, every time Jane is on time and ready for class by 9:15, Ms. Daniels gives her a thumbs-up. Jane’s on-time arrival to PE class increases significantly over the next few weeks. Eventually, Ms. Daniels is able to fade the self-monitoring sheet and Jane continues to arrive to class on time when she is reinforced, on a variable-interval schedule, with being allowed to pass out team equipment. Problem-Solving Strategies In addition to the components discussed previously, cognitive behavior management programs rely on students’ use of problem-solving strategies. Problem solving is a “systematic process in which concerns are identified, defined, actions taken, and solutions evaluated” (Miller & Nunn, 2001, p. 472). Teachers need to provide problem-solving strategy instruction for those students who fail to use effective problem-solving strategies on their own (e.g., students with emotional/behavioral disabilities). Teachers should provide instruction in the area of problem solving just as they would provide instruction in an academic subject. Modeling appropriate problem-solving skills as part of daily classroom routines is also important (Robinson, 2007). Teachers can use self-instruction as an approach to teaching problem-solving skills. Using a five-step process, students are first taught to define the problem. Next, students identify as many solutions as possible. Then, students evaluate the potential outcomes of the possible solutions identified in the previous step. Next, students choose and implement a solution. Finally, students evaluate the outcome and begin the process over if the solution was not successful (Robinson, 2007; Robinson, Smith, & Miller, 2002). Social problem solving is the “process of solving all types of problems that may affect a person’s ability to function in the natural environment, or ‘real world’” (Isbell & Jolivette, 2011, p. 32). Using a strategy called “stop, think, proceed,” students use steps with visual cues and questions to prompt them through the social problem-solving process. In the first phase, stop, students recognize the emotional clues, take a few breaths to calm down, and identify the problem. In the second phase, think, students come up with possible solutions, evaluate each solution, and decide which solution to try. In the final phase, proceed, students carry out the solution, verify the outcomes, and try another solution if the problem is unresolved (Isbell & Jolivette, 2011). Social problem-solving strategies can be integrated into class meetings (Gartrell, 2006) or group discussions (Miller & Nunn, 2001) in which all students are allowed to become participants who work together to solve a problem. Class meetings should be regular activities in classrooms, especially at the preschool and primary levels. Holding class meetings on a consistent basis allows the group to address students’ concerns before they become problems or conflicts. Teachers and students are likely to appreciate the full potential of class meetings when they are used to resolve problems and conflicts that affect the whole group. Teachers can be proactive leaders during classroom meetings by first setting guidelines for interactions. Teachers should make sure students understand that everyone will be given a chance to speak, that students should listen to one another, and that students should treat one another with respect. When solving problems during class meetings, teachers should follow a five-step procedure: Calm everyone, including themselves if necessary, and orient the students to the process. Define the problem cooperatively. Brainstorm possible solutions together. Decide together on a plan using the solutions suggested. Take an active role in guiding the plan’s implementation. (Gartrell, 2006, p. 55) Problem-solving instruction can also take place within the framework of bibliotherapy. Bibliotherapy allows students to identify with characters from books that are similar to them, so that they can discuss their own behaviors and situations through the safe distance of fictional characters (Cook, Earles-Vollrath, & Ganz, 2006). Teachers can use children’s literature to help students generate possible solutions to problems. This happens as students discuss the conflict that a character encounters and brainstorm and evaluate possible solutions using a problem-solving method (Konrad, Helf, & Itoi, 2007). Teachers can use bibliotherapy in their classrooms by engaging students in prereading, guided reading, postreading, and problem-solving/reinforcement activities (Forgan, 2002). During prereading, materials are selected and the teacher activates students’ background knowledge in order to help them link their past experiences to the content of the book they will read. During guided reading, the teacher reads the book aloud to the students. After finishing the book, the teacher may want to allow students to react to the book by writing in journals before discussion begins. During the postreading discussion, students can first retell the story. Then the teacher asks probing questions that help the students engage with the book’s main character and the situation the character is facing. During the ensuing discussion, students come to understand that others experience the same problems they do and can gain insight into the problem as they come up with possible solutions. Throughout the discussion, the teacher should see students passing through the stages of identification, catharsis, and resolution as they learn to problem solve (Forgan, 2002). During the final phase of teaching with bibliotherapy, students can apply the I SOLVE problem-solving strategy, which uses the following steps: I Identify the problem. S Solutions to the problem? O Obstacles to the solutions? L Look at the solutions again—choose one. V Very good! Try it! E Evaluate the outcome. (Forgan, 2002, p. 78) Allen and colleagues (2012) have suggested four similar steps in the use of bibliotherapy: Identify the problem. Come up with possible solutions. Consider the consequences of different actions. Choose the best solution. Finally, teachers should provide some type of reinforcement activity so that students can practice applying the solutions they have learned. A sample lesson plan that includes the four steps of bibliotherapy is presented in Figure 7.6. Figure 7.6 Sample Bibliotherapy Lesson Plan Source: Adapted from Forgan (2002). Anger Management Strategies In Chapter 1, we discussed the distinction between classical conditioning, which accounts for respondent behaviors, and operant conditioning. The behavior management strategies examined so far in this chapter are effective in either increasing appropriate behaviors or decreasing inappropriate behaviors—that is, operant behaviors, or learned behaviors. Some respondent behaviors, particularly conditioned emotional responses, such as anger and anxiety, can also be addressed using management strategies, including relaxation techniques (Sarafino, 2012). Before teaching anger management strategies to students, it is important for teachers to help students understand that anger is a human and sometimes common emotion. Everyone feels angry at one time or another. Some individuals get angry more frequently than others. Some students get angry over things like bad grades, while others get angry over things like parents fighting. Students need to understand that it is okay to feel angry, but it is not okay is for them to hurt themselves or others when they are angry. Students can be taught to recognize anger and practice positive responses to anger. These responses might include going for a walk, talking to someone, counting to 10, writing about the feeling, or distracting oneself. Students who demonstrate disruptive behavior in the classroom often have problems expressing anger in acceptable ways. Some students learned when they were young that they could control circumstances and get what they wanted through anger. When people gave into their aggressive behavior, the connection between demonstrating inappropriate behavior when angry and control was strengthened. These students need to learn acceptable ways of showing frustration and anger. Teaching students to manage anger, and other emotions, should begin with young children in the preschool classroom. Cognitive behavioral intervention (CBI) can provide students with the skills they need to control anger and handle disappointment. CBI strategies can help them to interact appropriately in school and other settings (Robinson, 2007). In preschool and elementary settings, many incidents occur in which children bump into and knock over constructions made by others. Sometimes students interpret these accidents as purposeful and hostile acts. The “turtle technique” (Robin, Schneider, & Dolnick, 1976) is a CBI strategy that has been used successfully with preschool and kindergarten children. Through an illustrative story, children are told about a turtle that has problems at school because he does not stop and think: Little Turtle was very upset about going to school. When he was there he got into trouble because he fought with his mates. Other turtles teased, bumped, or hit him. He then became angry and started fights. The teacher then punished him. One day he met the big old tortoise, who told him that his shell was the secret answer to many problems. The tortoise told Little Turtle to withdraw into his shell whenever he felt angry, and rest until he felt better. Little Turtle tried it the next day and it worked. He no longer became angry or started fights, his teacher now smiled at him, and he began to like school. (Robin et al., 1976, p. 450) The turtle technique consists of four basic steps: Recognizing that you feel angry Thinking “stop” Going into your “shell” and taking three deep breaths and thinking calming, coping thoughts (“It was an accident. I can calm down and think of good solutions. I am a good problem solver.”) Coming out of your “shell” when calm and thinking of some solutions to the problem (Joseph & Strain, 2010) This technique can be adapted for use with both large and small groups. Research findings support the use of a metaphor, such as this technique’s turtle, in teaching relaxation strategies. In one study, all children selected the “turtle game” as their favorite technique over others, such as literal instruction, for engaging in relaxation exercise (Heffner, Greco, & Eifert, 2003). In a recent study, Drogan and Kern (2014) studied the use of the turtle technique as a Tier 2 intervention with preschool children who engaged in problem behavior. At the end of the intervention, the researchers found a decrease in the level of problem behavior for all participants. The primary goal of strategies like the turtle technique and accompanying teaching supports is to offer children the cognitive and behavioral repertoire they need to be good managers of their feelings—particularly those occasioned by frustrating and anger-provoking circumstances (Joseph & Strain, 2010). Anger management programs address a variety of skills, including coping, emotional awareness, self-control, problem solving, and relaxation (Candelaria, Fedewa, & Ahn, 2012). An example of one such program is In Control (Kellner, 2001), which is designed to teach coping skills to middle school students as a way of managing anger. The program can be used with an entire class, with small groups, or with individuals. It consists of step-by-step lessons with teaching guidelines, materials, scripts, and activities. The lessons and activities can be adapted to meet student needs, abilities, and interests. Student Created Aggression Replacement Education (SCARE) is a school-based anger and aggression management program. The primary goals of the program are to “teach young people how to control impulsive, aggressive emotions, to encourage them to make better decisions in responding to provocative situations, and to provide alternatives to violent behavior” (Herrmann & McWhirter, 2001, p. xxii). The program has 15 sessions and is organized into three sections: recognizing anger and violence in our community, managing/reducing anger in yourself, and defusing anger and violence in others/prevention strategies. (SCARE, which is considered a model program by the U.S. Department of Justice’s Office of Juvenile Justice and Delinquency Prevention and a promising program by the U.S. Department of Education, is available at http://www.arizonachildpsychology.com/The%20SCARE%20Program.pdf.) The violence prevention curriculum Second Step (Committee for Children, 2002) is designed to help children, grades pre-K to 8, increase their social competency skills, thereby reducing impulsive and aggressive behavior. The elementary curriculum uses group discussion, modeling, coaching, and practices to “increase students’ social competence, risk assessment, decision-making ability, self-regulation, and positive goal setting” (Office of Juvenile Justice and Delinquency Prevention, n.d.). It includes empathy training, impulse control, problem solving, and anger management. In addition to this content, middle school students learn how to deal with peer pressure and bullying, how to resist gang pressure, and how to defuse fights. Stress Management Strategies Students can use anxiety management/relaxation training (AM/RT) interventions to manage anxiety caused by stressors, both major and minor, in their lives. Individuals’ responses to stressors have impacts on their anxiety levels. If they can learn more appropriate ways to respond to life’s stressors, they can avoid the negative effects of anxiety, including depression (Lane, Cook, & Tankersley, 2013). Although AM/RT interventions vary in content, they tend to have several common components. One of these is their emphasis that “it is important for students to understand how their stress and anxiety are related to feelings of depression and how managing their reactions to stress can lessen depressive symptoms” (Lane et al., 2013, p. 65). Another commonality is the use of some form of progressive relaxation training, a technique first described by Jacobson (1938) and later adapted by Wolpe (1958). Relaxation Procedures Students’ anger, stress, and anxiety can be tempered through the use of relaxation procedures that are easy to learn. Anger management interventions typically include relaxation exercises for stress and anxiety reduction, and these exercises often focus breathing (Gaines & Barry, 2008). Relaxation has been defined as “a state of calmness with low psychological and physiological tension or arousal” (Sarafino, 2012, p. 323). Relaxation therapy is an effective, self-regulatory intervention that allows students to develop direct self-control of their behaviors (Robinson, 2007). Progressive muscle relaxation (PMR) and yoga are two examples of relaxation technique approaches. The goal of PMR is to improve daily performance by reducing factors such as arousal (increases in muscle tension, respiration, and heart rate), anxiety, tension, and stress, thus producing a relaxed and calm state that is inconsistent with aggressive behavior. PMR exercises consist of systematic tensing and releasing of different muscle groups. While performing these exercises, students gain increased awareness of the resulting sensations of tension and relaxation (Lopata, Nida, & Marable, 2006). PMR can be utilized in various settings, including the classroom, with all types of students. For instance, one study examined the effectiveness of PMR as an intervention for preventing aggression in elementary students with emotional/behavior disorders. Students who participated in PMR showed a significant decrease in physical aggression following the treatment phase, whereas students who did not participate in PMR showed no change in physical aggression (Lopata, 2003). Additional studies have demonstrated the positive psychological and physiological effects of PMR (Gaines & Barry, 2008; Lopata et al., 2006). When using PMR in the general education or special education classroom, the teacher should use a calm and reassuring tone of voice to provide students with a sense of security and promote participation and relaxation. The PMR technique is very adaptable and can be integrated into different dynamics of the classroom routine and modified to accommodate student needs (Lopata, 2003; Lopata et al., 2006). Figure 7.7 details the PMR technique. In addition to PMR, yoga is recommended as a relaxation technique in self-regulatory intervention treatment. The National Institute of Mental Health (2005) has suggested that mild exercise or yoga may have positive effects on various aspects of mental and physical health. Yoga therapy is one type of psychophysiological treatment, and yogic practices (including breathing, relaxation, and meditation techniques) have been found to influence the activity of the autonomic nervous system in studies of participants with and without externalizing and internalizing behaviors. The yoga nidra relaxation technique has been found to improve stability in amplitude and rate in breathing patterns in boys between the ages of 10 and 15 with disruptive behavior. Teachers can be trained to use this technique in the classroom (Jensen, Stevens, & Kenny, 2012). Figure 7.7 Progressive Muscle Relaxation Summary Cognitive behavior management includes intervention strategies designed to teach students to control their own behaviors. It is considered a proactive strategy in the universal design for classroom management. Self-management techniques include goal setting, self-instruction, self-monitoring, self-evaluation, and self-reinforcement. Cognitive behavior management programs use problem-solving strategies with students. Students who fail to use effective problem-solving strategies on their own will require problem-solving strategy instruction. The “stop, think, proceed” technique is an example of a problem-solving strategy that teachers might use. Additionally, bibliotherapy provides opportunities for students to solve problems through the reading and discussion of books. This procedure includes the steps of prereading, guided reading, postreading, and problem-solving/reinforcement activities. Anger management strategies, such as the “turtle technique” for younger students and anger management programs such as In Control, SCARE, and Second Step, provide teachers with ways to help children and youth manage their anger and aggression. Finally, progressive muscle relaxation and yoga are two examples of relaxation procedures that can help students manage stress.

The Evolution of Response-to-Intervention With the passage of the Education for All Handicapped Children Act in 1975, schools began identifying children with learning disabilities through the use of a discrepancy model. Under such a model, a child is identified as having a specific learning disability if there is a severe difference between the child’s potential (measured by IQ) and the child’s achievement. For example, if a student has an average IQ score (around 100) and an average score on achievement tests (again, around 100), then the student is performing as expected. If a student has an IQ score of 100 and an average score of 65 on achievement tests, then a severe discrepancy exists between the student’s potential and achievement. The discrepancy model is objective and uses statistical, quantitative procedures to identify learning disabilities. Despite the advantages of this method, many educators became concerned that the use of the discrepancy model requires students to fail before they can be identified as having learning disabilities. Additionally, the discrepancy model is not practical for use with young students. As a result, response-to-intervention was developed as an alternative to the discrepancy model. Response-to-intervention (RTI) has been conceptualized as a multitiered approach to the provision of interventions and services at increasing levels of intensity for students with academic and behavior problems. RTI became an important intervention strategy after the passage of the No Child Left Behind Act of 2001, which mandated that educational professionals use scientifically based research methods in instruction and interventions. Mirroring No Child Left Behind, the Individuals with Disabilities Education Improvement Act (IDEA, 2004) states that schools are no longer required to use the discrepancy model when determining whether a child has a learning disability, but “may use a process that determines if the child responds to scientific, research-based intervention as part of the evaluation procedures” (Section 1414[b][6]). While response-to-intervention is not mentioned in IDEA, the law emphasizes scientifically based interventions as means to identify students with learning disabilities (Sugai & Horner, 2009). Response-to-intervention is not a new concept. It is an outgrowth of earlier prereferral intervention strategies in which interventions were made in the general education classroom before students were referred for special education services. However, while accommodations were developed for students with academic difficulties, these interventions were not carried out to the degree needed to meet the needs of the students. RTI provides interventions through an inclusive service delivery model by integrating general education and special education (Sanger, Friedli, Brunken, Snow, & Ritzman, 2012). Although response-to-intervention was initially developed as an alternative to the discrepancy model for identifying students with learning disabilities, it is increasingly being used to identify and provide interventions for students with emotional and behavioral disorders (Fairbanks, Sugai, Guardino, & Lathrop, 2007; Gresham, Hunter, Corwin, & Fischer, 2013), autism spectrum disorders (Hammond, Campbell, & Ruble, 2013), anxiety disorders (Sulkowski, Joyce, & Storch, 2012), blindness and visual impairments (Kamei-Hannan, Holbrook, & Ricci, 2012), and attention-deficit/hyperactivity disorder (Vujnovic & Fabiano, 2011). As part of a universal design for classroom management, RTI can be used as a universal screening strategy and to provide interventions for all students with academic, behavioral, and emotional difficulties. Components of RTI The major components of response-to-intervention include universal screening, early intervention, problem solving with emphasis on continuous progress monitoring, and increasingly intensive interventions at different levels (National Association of State Directors of Special Education, 2008). The basic premise of RTI requires school personnel to develop effective instruction and interventions using scientifically based methods appropriate to the needs of the students. The three different levels or tiers of RTI provide interventions and services at progressive levels of intensity for students with academic and behavioral problems. If a student shows adequate response to an intervention at the first level, then he remains at that level and continues to receive the intervention. However, if the student does not meet benchmarks after he has received appropriate intervention, he is provided services at the next level, which involves more intensive instruction or interventions. If the student does not show adequate response to the interventions at this stage, he proceeds to the final level. The three levels of the standard treatment RTI model are known as the primary, secondary, and tertiary tiers. Primary Tier The primary tier is the “point of entry into subsequent tiers” of response-to-intervention (Johnson, Melard, Fuchs, & McKnight, 2006). This tier involves all students and has three functions. First, culturally responsive teachers provide high-quality instruction (Klingner & Edwards, 2006) and effective classroom management within the general education classroom. Teachers need to provide opportunities for differentiated instruction with accommodations that allow all students access to the high-quality instructional and behavior programs of the primary tier (Fuchs, Fuchs, & Compton, 2012). A number of strategies for universal design for classroom management can be implemented at the primary tier. These include development and implementation of a hierarchical behavior management plan, development and implementation of culturally responsive strategies, management of content, management of conduct, teaching of routines and expectations, equitable treatment, and universal interventions (see Chapters 2 and 5). Schools need to teach school-wide expectations to students, consistently provide consequences for inappropriate behaviors and acknowledgments of appropriate behaviors, and review their progress toward meeting school-wide goals (Fairbanks et al., 2007; Sanger et al., 2012). Second, the primary tier provides for universal screening to identify students who are at risk for academic, behavioral, and social difficulties (Ferri, 2012). This universal screening generally includes routine assessments of all students, including group intelligence tests, achievement tests (such as state-mandated examinations), and vision and hearing tests. For example, Alexander, a second-grade student, is having difficulty paying attention when his teacher presents lessons in class. A vision examination reveals that Alexander is nearsighted and unable to see the front of the classroom from his seat at the back of the room. He is provided with eyeglasses and the teacher moves him to the front of the classroom. As a result of these interventions, Alexander now can focus on the lessons. Universal screening may also include school data about students, such as numbers of days absent or tardy, and behavioral observations. Information on the frequency of and reasons for a student’s time-outs or office referrals can shed valuable light on the student’s academic and behavior difficulties. During the screening process, teachers should use the problem-solving model of response-to-intervention when determining interventions for students with academic, behavioral, and social difficulties. Teachers should develop interventions based on individual students’ needs, working in consultation with the students’ other teachers and the students’ parents. At the primary tier, many of the interventions for students displaying inappropriate behaviors in the classroom are basic classroom management strategies, such as positive and negative reinforcement, token economies, and time-outs (see Chapter 6). The final function of the primary tier is continuous progress monitoring (Klingner & Edwards, 2006; Sanger et al., 2012). Continuous progress monitoring is a procedure in which a teacher gathers information on a student’s behaviors to determine whether interventions are effective in modifying the behaviors (Gresham et al., 2013). By implementing continuous progress monitoring, teachers can determine whether students are responding to the interventions that are provided and making adequate progress or need to be referred to the next tier. What Would You Do? Luis Luis is a first-generation Hispanic student in the third grade. His parents emigrated from Mexico, and the primary language the family speaks at home is Spanish. Luis has had difficulty complying with requests made by Mrs. Clarke, his general education teacher; Ms. Vermilyer, his music teacher; and Mrs. Daily, his art teacher. He has not had any difficulty in his class with Mr. Salyer, his teacher for physical education. As a teacher, how would you develop a primary tier of a response-to-intervention program for Luis? Secondary Tier When a student does not show adequate progress after receiving appropriate interventions at the primary tier, she is provided more intensive intervention at the secondary tier. The main focus of the secondary tier is to provide specific services for students with academic, behavioral, and social difficulties in instructional groups that are smaller and more homogeneous than those of the general education classroom (Sugai, O’Keeffe, & Fallon, 2012). Along with smaller instructional groups, four additional strategies increase the intensity of interventions for students at the secondary tier: More teacher-centered instruction More frequent instruction Increased duration of instruction Inclusion of educational personnel with greater expertise in specific areas. (Fuchs & Fuchs, 2006, p. 94) Behavior and classroom management strategies appropriate for the secondary tier include contingency contracts (see Chapter 6), self-management techniques (see Chapter 7), functional communication training, differential reinforcements (see Chapter 9), and social skills training (see Chapter 14). Teachers also need to determine whether students’ inappropriate behaviors stem from skill deficits or performance deficits when trying to decide on interventions. A student who has a skill deficit does not have the ability to perform the appropriate behavior or skill. For example, Benjamin punches peers in the arm because he does not know any other way to initiate a conversation with a peer. Knowing that this is a skill deficit, the teacher provides social skills training to address the deficiency. Conversely, a student who has a performance deficit has the ability to perform the appropriate behavior or skill but chooses not to do so. For example, Natalie is always tardy to math class because she does not like math class. Since this is a motivational issue, the teacher may try to modify the behavior through differential reinforcements. For example, if Natalie is on time for class, she gets to pass out the math worksheets to other students (a preferred activity). As with the primary tier, teachers should continue to monitor students’ progress at the secondary tier to determine whether they have made adequate progress or need to be referred to the next tier. Tertiary Tier At the final level of response-to-intervention, the tertiary tier, students are provided intensive, individualized interventions (Bradley, Danielson, & Doolittle, 2005; Sanger et al., 2012). Interventions at the tertiary level often include functional assessments of the unacceptable behaviors and behavior intervention plans (Gresham et al., 2013). Again, continuous progress monitoring should be incorporated at the tertiary level. Teachers can use progress monitoring data to evaluate the adequacy of student progress, determine when instructional changes are necessary, and determine when modifications to interventions are necessary. Additionally, teachers can use these data to develop goals for students’ individualized education programs if they need special education services (Stecker, 2007). Case Study Timothy Timothy is a fifth-grade student at Washington Elementary School, a school that has adopted a response-to-intervention program to identify at-risk students and provide interventions designed to meet their academic, behavioral, and social needs. Timothy’s teachers have noted that he is not completing his assignments and is failing or close to failing nearly all of his classes. Additionally, Timothy does not interact with peers, often choosing to keep to himself. School records indicate that he had some academic and social difficulties last year, but not to the extent he is having difficulties this year. During the primary tier of response-to-intervention, Timothy was provided differential instruction with accommodations in many of his classes. He was allowed more time to complete assignments, was provided with peer tutors, and had the numbers of questions on examinations reduced. A review of Timothy’s performance on a state-mandated standardized test revealed that while he scored poorly on the test because of a number of unanswered questions, the answers he did provide were generally correct. Unfortunately, continuous progress monitoring showed that the interventions Timothy received were not effective, even though universal screening seemed to indicate that Timothy had the ability to do his academic assignments. The at-risk team determined that Timothy needed to move to the next tier for more intensive interventions. At the secondary tier, Timothy received instruction with a small of group of students also experiencing academic difficulties. Believing that Timothy’s difficulties stemmed from a performance deficit, the at-risk team implemented various types of differential reinforcement as a primary intervention, but it was difficult finding an alternative behavior that was effective with Timothy. Additionally, Timothy was provided social skills training in an effort to improve his peer interactions. However, continuous progress monitoring indicated that the interventions at the secondary tier were ineffective; in fact, Timothy’s academic and social difficulties had increased. He was no longer attempting to complete assignments or making any effort to interact with peers. Timothy was moved to the tertiary tier, where he was provided intensive, individualized instruction and interventions. A voluntary classroom assistant was assigned to Timothy to help him with his assignments. Differential instruction and differential reinforcements were continued. Additionally, a clinical mental health counselor from the community was asked to evaluate Timothy. She determined that Timothy was suffering from depression. Timothy’s parents were never married, and his father was increasingly absent from Timothy’s life. The pain of his father’s absence became more acute for Timothy as he grew older. The at-risk team determined that Timothy should remain on the tertiary tier with weekly counseling sessions to treat the depression. However, if Timothy did not show any improvement in a reasonable amount of time, the team would refer him for a nondiscriminatory evaluation to determine whether he might qualify for classification as a student with emotional and behavioral disorders. While response-to-intervention was initially conceived as an alternative method for identifying students with learning disabilities, it has evolved into a strategy for addressing the academic, behavioral, and social difficulties of all students. As a result, disagreements have arisen regarding whether special education should have a role in RTI (Fuchs et al., 2012). Since special education teachers often have expertise that many general education teachers do not have, their involvement in the development of intensive, individualized interventions at the tertiary tier can be helpful. However, the tertiary tier should not be considered the “special education level”; rather, it is the level at which experts provide intensive interventions in the general education setting. Under a universal design for classroom management, response-to-intervention should be embedded in the second level of a school-wide positive behavior support program (see Chapter 13). If a student does not make adequate progress at this level, she should move to the third level, or comprehensive level, of the school-wide positive behavior support program. At this level, the student should receive a nondiscriminatory evaluation. The Individuals with Disabilities Education Improvement Act requires a nondiscriminatory evaluation to determine if a student has a disability and whether the child needs special education and related services. A culturally sensitive, multidisciplinary team should conduct the nondiscriminatory evaluation and compile student data based on a variety of assessments. These assessments must be free of cultural and linguistic biases. RTI and Culturally and Linguistically Diverse Students Response-to-intervention can improve educational opportunities for culturally and linguistically diverse students by providing supports and interventions to meet these students’ academic, behavioral, and social needs (McKinney, Bartholomew, & Gray, 2010; Xu & Drame, 2008). Additionally, RTI has the potential to address long-standing issues of equity in the representation of culturally and linguistically diverse learners among students with learning disabilities and emotional and behavioral disorders (Artiles, Bal, & King Thorius, 2010). However, some education professionals have raised concerns that, owing to the rapid acceptance of response-to-intervention, little empirical evidence exists to support the efficacy of RTI for culturally and linguistically diverse students (Artiles et al., 2010; Reynolds & Shaywitz, 2009). Response-to-intervention is predicated on the belief that students receive high-quality instruction and effective behavior and classroom management strategies. However, teachers cannot assume that instructional and behavior strategies that work for European American students will also work for culturally and linguistically diverse students. Teachers need to determine whether students with academic and behavioral difficulties, particularly culturally and linguistically diverse students, are receiving adequate instruction in the general education classroom (Klingner & Edwards, 2006). A strong foundation of high-quality instruction and effective behavior management strategies is necessary at the primary level if RTI is to be successful. Figure 12.1 Tiers of Response-to-Intervention RTI can also give teachers false confidence that assessments and instructional practices are aligned with the educational needs of culturally and linguistically diverse students (Orosco & Klingner, 2010). In other words, teachers might believe that since assessments and instructional practices are scientifically based, they are effective for all students. However, culturally and linguistically diverse students are often not included when benchmarks for assessments and instructional practices are normed (Linan-Thompson, Cirino, & Vaughn, 2007). Thus, diverse students are often provided interventions and more restrictive services based on invalid assessment data. Many teachers assume that the implementation of response-to-intervention removes cultural bias from their decisions to move students from one tier to another or to refer students for special education services. As a result, they employ the same deficit-based assumptions as the discrepancy model—that is, they assume that students who exhibit academic or behavioral difficulties do not have the ability to perform well academically or behave appropriately (Ferri, 2012; Klingner & Edwards, 2006). As part of a universal design for classroom management, teachers must consider the needs of culturally and linguistically diverse students when developing and implementing the response-to-intervention model in schools. Teachers need to reflect on whether their behavior and classroom management strategies are effective with culturally and linguistically diverse students and whether these strategies are in conflict with the cultural backgrounds of students. For example, research has shown that structured cooperative methods and small-group instruction are effective with culturally and linguistically diverse students (Calderón, Slavin, & Sánchez, 2011). These are especially important strategies for the primary level, where cooperative learning can be effective for diverse students who put the needs of the group first. Teachers should also incorporate local norms, or local achievement levels, that include culturally and linguistically diverse students in continuous progress monitoring procedures (Linan-Thompson et al., 2007). Since it should be used in all three tiers, continuous progress monitoring that accurately evaluates the progress of diverse students is crucial for providing culturally responsive instruction and behavior management for students. The need to use reliable norms that include diverse students applies also to assessments used for nondiscriminatory evaluations at the tertiary tier. To put it simply, the use of strategies and assessments that do not consider the characteristics of culturally and linguistically diverse students is unacceptable in behavior and classroom management programs. Concerns of RTI Although RTI has gained national acceptance, some education professionals have voiced concerns regarding its implementation and effectiveness. RTI is aligned with the premise of inclusion and a universal design for classroom management, but little empirical research has been conducted on the efficacy of the approach (Ferri, 2012). This lack of research is most problematic for the implementation of the primary tier (Hill, King, Lemons, & Partanen, 2012; Xu & Drame, 2008), which is where all students should be provided high-quality, evidence-based instruction and behavior management strategies. The primary tier is the gateway to the succeeding levels and the foundation on which interventions and strategies for the secondary and tertiary tiers are based. High-quality instruction, effective behavior management strategies, universal screening, and continuous progress monitoring are essential elements of an effective RTI program. If the primary tier is not fully implemented, a number of students will be moved inappropriately to the secondary tier. Further, teachers may assume that students who do not respond to instruction or interventions are deficient and need more intensive interventions. Such assumptions are often supported by the belief that instruction and interventions embedded in RTI programs are evidenced based. However, this does not consider the fact that what may be effective for a majority of students is not effective for all students (Ferri, 2012). This belief is the complete antithesis of inclusion, differential instruction, and a universal design for classroom management, and it reduces response-to-intervention to a deficit-based model similar to the discrepancy model. It is assumed that the student is deficient rather than the instructional strategies or interventions. Teachers and administrators need to determine whether students with academic, behavioral, and social difficulties are receiving adequate instruction and interventions in the general education classroom before making decisions regarding response-to-intervention. Finally, RTI does not include a formal process for evaluating the cognitive ability of students; such a process could lead to identifying slow learners as having specific learning disabilities (Lindstrom & Sayeski, 2013). Additionally, response-to-intervention cannot differentiate specific learning disabilities from emotional and behavioral disorders, intellectual disabilities, attention-deficit/hyperactivity disorder, or other disabilities (Mastropieri & Scruggs, 2005). For response-to-intervention to be effective in providing preventive and intervention strategies for all students with academic, behavioral, and social difficulties, administrators and teachers must be fully committed to making it work. The essential elements of a successful RTI program are as follows: A scientifically based method of screening a large number of students who are at risk for academic, behavioral, and social difficulties Teachers who have the knowledge and pedagogy to provide high-quality core academic instruction and effective behavior and classroom management strategies Evidence-based continuous progress monitoring Well-defined benchmarks to determine whether students are responding to academic and behavior interventions Resources to implement supplemental strategies and programs for students who are at risk for academic, behavioral, and social difficulties (Vaughn & Fuchs, 2003) If teachers and school administrators are not committed to implementing an effective program, response-to-intervention becomes another deficit-based method in which teachers feel justified in moving students from one tier to another until they are referred for special education services or more restrictive settings. Response-to-intervention is not simply noticing that students are having difficulties, providing them with interventions, and checking their progress (Barnes & Harlacher, 2008). It is a carefully developed and implemented program that addresses the academic, behavioral, and social needs of all students by providing evidence-based instruction, interventions, strategies, and evaluation at all levels. Summary Response-to-intervention has fundamentally changed general education into a multilevel system of early intervention (e.g., National Association of State Directors of Special Education & Council of Administrators of Special Education, 2006). While RTI was initially developed as an alternative to the discrepancy model for identifying students with learning disabilities, it is increasingly being used to identify and provide interventions for all students with academic, behavioral, and social difficulties. Response-to-intervention has three levels or tiers of progressive intensity for providing interventions and services for students with academic and behavior problems. The primary tier provides all students with high-quality instruction and effective classroom management, universal screening, and continuous progress monitoring. The secondary tier provides specific services for students in smaller and more homogeneous instructional groups. The tertiary tier provides students with intensive, individualized interventions. Response-to-intervention has the potential to improve educational opportunities for culturally and linguistically diverse students by providing them with appropriate supports and interventions. Additionally, RTI may provide a means of addressing the issue of overrepresentation of culturally and linguistically diverse students in special education (Artiles et al., 2010). Teachers need to consider the needs of culturally and linguistically diverse students when developing and implementing a response-to-intervention model. Teachers should also incorporate local norms that include culturally and linguistically diverse students in continuous progress monitoring procedures. Some education professionals have voiced concerns regarding the implementation and effectiveness of response-to-intervention, and little empirical research has examined the efficacy of RTI. Essential elements of an effective RTI program include high-quality instruction, appropriate interventions and behavior management strategies, universal screening, and continuous progress monitoring. An effective response-to-intervention program should be part of a systemic school-wide positive behavior support program (Hernández Finch, 2012).