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IES Grant

Title: Evidence-Based Interventions for Severe Behavior Problems: The Prevent-Teach-Reinforce Model
Center: NCSER Year:
Principal Investigator: Kincaid, Donald Awardee: University of South Florida
Program: Unsolicited and Other Awards: Special Education Research      [Program Details]
Award Period: 1/1/2005 to 12/31/2008 Award Amount: $4,301,000*
Award Number: H324P040003

Funded through the Office of Special Education Programs prior to the establishment of NCSER.

Co-Principal Investigators: Phillip Strain, Glen Dunlap

Purpose: The purpose is to conduct an intensive analysis of a standardized intervention, "Prevent-Teach-Reinforce (PTR)," that is based on the extensive research literatures of applied behavior analysis and positive behavior support. The principal objective of the research will be to investigate the impact of the PTR intervention when applied by typical school personnel, as compared to control conditions. Secondary goals include (a) differentiating those students for whom the PTR intervention is effective from those students who will need more intensive or comprehensive supports, and (b) examining variables that predict the fidelity with which school personnel implement the intervention.

Project Activities: PTR includes three core components: (a) preventing behavior problems from occurring by adjusting the student's curriculum and social and physical environment, (b) teaching proactive communication skills to replace behavior problems, and (c) reinforcing prosocial advancements academic achievement. The intervention will be systematically evaluated with 200 children who represent a broad range of ages (Grades K-8) and diagnostic and demographic characteristics in two metropolitan areas: Tampa Bay, Florida and Denver, Colorado. All of the children will have been identified as having severe behavior problems.

Products: This project will provide several important contributions to the support of students with severe problem behavior. First, it will provide a groundbreaking validity demonstration of a standardized process of intervention in a population-based research model. Second, through analysis of student, team, and school characteristics it will provide data on the variables associated with sustainability of practices and outcomes. Third, it will provide a greater understanding of the circumstances that enable or inhibit behavioral interventions. Finally, the model and materials (PTR manual, Web-based training modules) will be widely disseminated so that educators and behavior support personnel will have the evidence, information, and materials needed to adopt and implement this model within their programs.

Setting: Elementary school classrooms in public schools in Colorado and Florida are participating in the study across the schools, there is wide variation in racial/ethnic composition and socioeconomic status of the students.

Population: To be eligible to participate, students must engage in severe behavior problems that are disruptive and/or dangerous, occur at least once a week, and have been sustained for at least 6 months. School staff nominates students using a standardized referral form. Approximately 50% of the sample will be receiving more than 50% of their educational services in segregated settings. A total of 200 school teams resulting in 200 students from two consecutive cohorts (100 per year) will be recruited.

Intervention: PTR is a team-based model that follows a five-step team process: team building, assessment, planning, intervention, and evaluation. The researchers will standardize the model through which an individualized intervention is developed and implemented for participating students. PTR teams develop the intervention with the following procedures: (1) a functional behavior analysis is conducted, (2) a behavior support plan is developed to Prevent the occurrence of severe behavior problems (with environmental modifications), Teach alternative skills for the targeted behavior (i.e., replacement skills), and Reinforce student's prosocial behaviors.

Teams may be developed from within existing teams (i.e. Child Study Team, Behavior Support Team) and will include at minimum (1) the teacher who teaches the child for majority of the day, (2) a special educator or paraprofessional if the child receives part-time services in special education, and (3) a behavior specialist or identified staff person who has expertise in behavior analysis. Other persons may be included (e.g., paraprofessionals, special area teachers), but it is recommended that PTR teams remain relatively small to promote efficiency of the team process.

Intervention duration is individualized but most likely to last 6-9 weeks after the behavior plan is developed.

Research Design and Methods: Students are randomly assigned to the intervention or wait-list control group. Participants from different classrooms are matched based on key student characteristics (e.g., age, problem behavior intensity, gender). After each child has a matched pair, one child is randomly assigned to the intervention and the other to the comparison condition (pairs cannot be in the same classroom). Efforts will be made to control for contamination across classrooms. During the first year of implementation, 50 students will be in the PTR intervention and 50 students will be in the comparison condition. During the second year of implementation, the 50 students from the comparison condition cross over into the intervention group and 50 new students are recruited for the comparison condition.

Control Condition: A "business as usual" control condition is used.

Key Measures: The researchers collect information across a variety of domains including contextual and covariate information such as student and teacher demographics, household profiles completed by parents, and community involvement in school (degree to which agencies provide resources). On the student level, multiple measures are collected about the student's behavior at school (direct observations and standardized measures). Behavior at home is assessed through parents' report on the Social Skills Rating System (SSRS). Level of engagement in the classroom and academic achievement is also collected at the student-level. Classroom/school level outcomes include office disciplinary referrals, and measures of the school's behavior support environment (e.g., Effective Behavior Support (EBS) Survey, a survey of school level supports). Level of family involvement in the intervention will be assessed. Parents will also provide information regarding family functioning (e.g., Parental Stress Index (PSI)). Staff will also complete measures of intervention acceptability and satisfaction. Finally, data on costs associated with implementation and sustainability of the program will also be collected.

Data Analytic Strategy: Analyses associated with intervention efficacy and moderators of efficacy will use hierarchical linear modeling (HLM), which deals effectively with nested nature of the study (time points nested within student, student nested within schools). Initially data will be analyzed separately for the two sites. Estimates across multiple sites will then be pooled using meta-analytic procedures. Intervention and comparison groups will be compared across a range of baseline characteristics to test equivalence. Studies of fidelity will measure (1) the degree to which fidelity (consistent implementation of the PTR intervention) is affected by student, teacher, family or systems variables and (2) the degree to which fidelity, in turn, is related to the outcomes achieved by individual students. Descriptive information about cost data will also be analyzed.



Dunlap, G., Iovannone, R., Kincaid, D., Wilson, K., Christiansen, K., Strain, P., and English, C. (2010). Prevent-Teach-Reinforce: The School-Based Model of Individualized Positive Behavior Support. Baltimore: Paul H. Brookes.

Book chapter

Iovannone, R., and Briesch, A. (2016). Individual Interventions. In S. Chafouleas, T.C. Riley-Tillman, and T. Christ (Eds.), Direct Behavior Rating (DBR): Linking Assessment, Communication, and Interventions. New York: Guilford.

Journal article, monograph, or newsletter

Dunlap, G., Iovannone, R., Wilson, K.J., Kincaid, D., and Strain, P. (2010). Prevent-Teach-Reinforce: A Standardized Model of School-Based Behavioral Intervention. Journal of Positive Behavior Interventions, 12(1): 9–22. doi:10.1177/1098300708330880

Iovannone, R., Greenbaum, P., Wang, W., Kincaid, D., and Dunlap, G. (2014). Interrater Agreement of the Individualized Behavior Rating Scale Tool. Assessment for Effective Intervention, 39(4): 195–207. doi:10.1177/1534508413488414

Iovannone, R., Greenbaum, P.E., Wang, W., Kincaid, D., Dunlap, G.D., and Strain, P. (2009). Randomized Controlled Trial of the Prevent-Teach-Reinforce (PTR) Tertiary Intervention for Students with Problem Behaviors: Preliminary Outcomes. Journal of Emotional and Behavioral Disorders, 17(4): 213–225. doi:10.1177/1063426609337389

Strain, P.S., Wilson, K., and Dunlap, G. (2011). Prevent-Teach-Reinforce: Addressing Problem Behaviors of Students With Autism in General Education Classrooms. Behavioral Disorders, 36(3): 160–171.

* The dollar amount includes funds from the Office of Special Education Programs (OSEP) and NCSER.