Early and Timely Intervention Doesn’t Happen without Proactive Detection

Dr. Clay Cook

Schools can serve as highly effective preventative environments by providing a continuum of high quality supports. Through dedicated efforts to align services to student need, schools can achieve important prevention goals: primary, secondary, and tertiary. 

All schools should be intentionally designed to provide students with access to primary, secondary, and tertiary prevention through a multi-tiered system of support (MTSS). 

Early and timely intervention is a critical aspect of MTSS and school-based prevention. Unfortunately, schools have been characterized by the wait-to-fail (WTF) model. In the WTF model, children who have needs do not receive proper intervention. As a result, student needs tend to intensify and when their needs intensify to a point they can no longer be ignored, schools activate the services of a school psychologist or diagnostician to conduct a special education evaluation. The WTF model is the opposite of early and timely intervention. The WTF model in education is akin to medicine adopting a wait-to-die approach in which providers do not engage in efforts to proactively detect needs to provide early and timely intervention that aims to achieve secondary and tertiary prevention goals. The antidote to WTF is developing procedures to proactively detect students who are in need of early and timely intervention, and providing high quality supports that are matched or tailored to the underlying root cause driving the problem they are experiencing.   

Let’s consider cancer treatment for a moment. Early detection of cancer greatly increases the chances for successful treatment. The ways the field of oncology is able to provide early and timely cancer treatment is through (a) education to promote early diagnosis and (b) screening. The field is continually focusing on more effective ways to not only prevent cancer from developing but detecting it when it begins to emerge to provide early and timely intervention. 

In many ways, effective delivery of supports in schools is not different than cancer prevention and treatment. Early detection of social, emotional, behavioral and academic problems greatly increases the chances for successful intervention. In this way, successful early and timely intervention does not occur without educators engaging in proactive detection.  Proactive detection is an essential component of MTSS that drives efforts to provide early and timely intervention.  

There are three different proactive detection procedures that educators can intentionally implement to facilitate early and timely intervention:
 

1.    UNIVERSAL SCREENING

Universal means all and screening means to detect. Therefore, universal screening means assessing all students to detect those who have a need for early and timely intervention. Numerous universal screeners have been developed, and a list of free and commercially available ones are listed below. The three main criteria to consider when selecting a screener are: Feasibility, Technical Adequacy, and Classification Accuracy. Typically, social, emotional, and behavior screeners are administered twice a year, with the first administration occurring 4-6 weeks into the academic year and the second one occurring towards the beginning of the second half of the academic year. 

• Free
  • Student Risk Screening Scale (Externalizing & Internalizing)
  • Youth Internalizing & Externalizing Problem Screeners (YIPS & YEPS)
  • Brief Externalizing and Internalizing Screener for Youth (BEISY)
  • Strengths and Difficulties Questionnaire
• Commercially available
  • Social, Academic, Emotional Behavior Risk Screener (SAEBRS)
  • Behavior and Emotional Screening Scale (BESS)
  • Social Skills Improvement System – Screener (SSIS-S)
  • Systematic Screener for Behavioral Disorders (SSBD)
  • Devereux Students Strengths Assessment-Mini (DESSA-mini)

2.    USE OF EXISTING SCHOOL ADMINISTRATIVE DATA

Many schools already gather data on unexcused absences, tardies, and behavior discipline incidents. These data can be used for the purposes of proactive detection when a school establishes and applies specific decision rules to the data that will activate a process of exploring whether certain students are in need of early and timely intervention. 

• Examples of Decision Rules
  • 2 or 3 office referrals
  • 2 or 3 removals from the classroom
  • 3 unexcused absences

3.    STRUCTURED TEACHER NOMINATION

Subjective teacher referral is one of the more unreliable ways to detect students in need of intervention. Subjective referrals are based on tolerance levels and potentially influenced by biases, resulting in some teachers over referring and some under referring. An alternative is structured teacher nominations that provide operational definitions and example and non-examples of specific behaviors. Teachers then examine each student in their class and nominate those who exhibit behaviors consistent with the operational definition and examples of particular category of a behavior, such as aggressive behavior. 

When combined, these three approaches provide a robust approach to proactively detecting students who may need intervention. Universal screening provides anchors during the school year to proactively detect students, while using extant school administrative data and structured teacher nominations enables proactive detection on more of a rolling basis. 

It is important for educators to understand that although proactive detection is helpful at identifying students who may be in need of intervention, screeners and the other data sources do not tell them what precise intervention to select and implement. 

There is a need for a follow-up process that gathers data to match and select the intervention that has the greatest probability of working. For example, the IM4 platform includes the Student Intervention Matching System which gathers brief data to determine whether the students has an acquisition or performance need. At the Tier 3 level, functional behavioral assessment helps develop a defensible hypothesis statement regarding the factors that evoke and maintain problem behavior that is used to inform the selection of specific antecedent, teaching, and consequent strategies. 

To end, early and timely intervention does not happen without proactive detection. There are different procedures educators can intentionally implement to ensure that proactive detection happens. Beyond proactive detection, schools need a process for effectively matching students to intervention, delivering the intervention with fidelity, and gathering data that drive decisions regarding whether the student responded to the intervention. When combined, proactive detection and effective intervention programming allow for early and timely intervention to be a routine part of school-based service delivery. 
 

About the Author: Dr. Clay Cook is the John and Nancy Peyton Faculty Fellow in Child and Adolescent Wellbeing at the University of Minnesota and Associate Professor in the School Psychology Program. He has extensive research and practical experiences involving the implementation of multi-tiered systems of support to promote children’s social, emotional and behavioral wellbeing as the foundation for academic and life success.