RTI: An Intervention-Based Approach to Identification and Treatment of EBD Frank M. Gresham, Ph.D. Louisiana State University [email_address]

Some Issues in ED Determination Students with emotional/behavioral challenges unserved/underserved Students often create chaotic classroom or school environments Prevalence rate for ED projected @ 2% but always has been <1% ED shows greatest state variability than any of 13 disability groups ED definition: Vague Confusing Contradictory (bordering on the oxymoronic) * Estimates suggest that 20% of kids in schools need mental health services Schools often believe they are not responsible for mental health services Schools often see conduct problems as responsibility other agencies “ The term does not include children who are socially maladjusted, unless it is determined that they are seriously emotionally disturbed.”

Students with emotional/behavioral challenges unserved/underserved

Students often create chaotic classroom or school environments

Prevalence rate for ED projected @ 2% but always has been <1%

ED shows greatest state variability than any of 13 disability groups

ED definition:

Vague

Confusing

Contradictory (bordering on the oxymoronic) *

Estimates suggest that 20% of kids in schools need mental health services

Schools often believe they are not responsible for mental health services

Schools often see conduct problems as responsibility other agencies

“ The term does not include children who are socially maladjusted, unless it is determined that they are seriously emotionally disturbed.”

Let’s Play the Logic Game Frank is socially maladjusted. Frank therefore cannot be emotionally disturbed. Frank is determined to be emotionally disturbed. Frank is both socially maladjusted & emotionally disturbed. ???????

Frank is socially maladjusted.

Frank therefore cannot be emotionally disturbed.

Frank is determined to be emotionally disturbed.

Frank is both socially maladjusted & emotionally disturbed.

???????

Some Numbers 27 th Annual Report to Congress (2005) CA (6-21 yrs.) US (6-21 yrs.) ED SLD MR CA under-identifies (under-serves???) ED and MR and overserves SLD relative to US average 4.4% 8.0% 54.4% 47.4% 5.2% 9.6%

Prevalence Rate Relative to Population CA US ED SLD MR 0.29% 0.72% 4.11% 4.33% 0.44% 0.90%

The Real Culprit IDEIA Definition Chronicity (“Long period of time”) Severity (“To a marked degree”) Outcome (“Adversely affects educational performance”) Characteristics Inability to learn Inability to build or maintain satisfactory interpersonal relationships Inappropriate types of behavior under normal circumstances General pervasive mood of unhappiness or depression Tendency to develop physical symptoms or fears associated with personal or school problems Does not include social maladjustment, unless student is ED (???)

Chronicity (“Long period of time”)

Severity (“To a marked degree”)

Outcome (“Adversely affects educational performance”)

Characteristics

Inability to learn

Inability to build or maintain satisfactory interpersonal relationships

Inappropriate types of behavior under normal circumstances

General pervasive mood of unhappiness or depression

Tendency to develop physical symptoms or fears associated with personal or school problems

Does not include social maladjustment, unless student is ED (???)

Social Maladjustment Exclusion Clause Conceptually illogical Over 20 published articles question and refute its existence IDEIA statute provides no definition of SM IDEIA regulations provide not guidelines for distinguishing SM from ED About ½ of the states ignore social maladjustment exclusion Many psychological disorders are co-morbid Conduct Disorder + Depression Oppositional Defiant Disorder + ADHD Conduct Disorder + ADHD “ A youngster cannot be socially maladjusted by any credible interpretation of the term without exhibiting one or more of the five characteristics to a marked degree and over a long period of time.” (Kauffman, 1997, p. 28)

Conceptually illogical

Over 20 published articles question and refute its existence

IDEIA statute provides no definition of SM

IDEIA regulations provide not guidelines for distinguishing SM from ED

About ½ of the states ignore social maladjustment exclusion

Many psychological disorders are co-morbid

Conduct Disorder + Depression

Oppositional Defiant Disorder + ADHD

Conduct Disorder + ADHD

“ A youngster cannot be socially maladjusted by any credible interpretation of the term without exhibiting one or more of the five characteristics to a marked degree and over a long period of time.” (Kauffman, 1997, p. 28)

RTI: Provision of high-quality interventions matched to student need, frequent progress monitoring to guide decisions about changes in interventions, and using student data to guide important educational decisions.* High-Quality Instruction/Intervention Matched to student need Scientifically-based Individually-based Learning Rate and Level of Performance Rate=Growth over time compared to peers Level=Relative standing on dimension of achievement/behavior Data-based decision making (decisions based on student data) Important Educational Decisions Based on individual response Across multiple tiers of intervention Decisions made about Intensity of intervention Special education eligibility Exiting special education * National Association of State Directors of Special Education (2005)

High-Quality Instruction/Intervention

Matched to student need

Scientifically-based

Individually-based

Learning Rate and Level of Performance

Rate=Growth over time compared to peers

Level=Relative standing on dimension of achievement/behavior

Data-based decision making (decisions based on student data)

Important Educational Decisions

Based on individual response

Across multiple tiers of intervention

Decisions made about

Intensity of intervention

Special education eligibility

Exiting special education

NASP Position Statement on ED “ ED is more than a transient, expected response to stressors in the child’s or youth’s environment and would persist even with individualized interventions.” “ No single diagnosis should be used to deny services to students. The impact of the behavior on the student’s educational progress must be the guiding principle for identification.” * “ Persistence: The extent to which difficulties have continued despite the use of well-planned, empirically-based and individualized intervention strategies provided within the least restrictive environment. *Social Maladjustment Exclusion Clause

“ ED is more than a transient, expected response to stressors in the child’s or youth’s environment and would persist even with individualized interventions.”

“ No single diagnosis should be used to deny services to students. The impact of the behavior on the student’s educational progress must be the guiding principle for identification.” *

“ Persistence: The extent to which difficulties have continued despite the use of well-planned, empirically-based and individualized intervention strategies provided within the least restrictive environment.

What is Scientifically-Based Knowledge? Scientifically-based knowledge involves the application of rigorous, systematic, and objective procedures to obtain reliable and valid knowledge relevant to educational activities and programs Scientifically-based knowledge is: Objective Involves direct measurement Reliable and valid Based on high quality experimental design Rules out alternative explanations High sensitivity (high true positive rates) High specificity (high true negative rates) Pseudoscience (4 out of 5 dentists recommend Crest) Nonscience (My kid learned to read with Whole Language) Nonsense (A child cannot be ED if he/she is socially maladjusted)

Scientifically-based knowledge involves the application of rigorous, systematic, and objective procedures to obtain reliable and valid knowledge relevant to educational activities and programs

Scientifically-based knowledge is:

Objective

Involves direct measurement

Reliable and valid

Based on high quality experimental design

Rules out alternative explanations

High sensitivity (high true positive rates)

High specificity (high true negative rates)

Pseudoscience (4 out of 5 dentists recommend Crest)

Nonscience (My kid learned to read with Whole Language)

Nonsense (A child cannot be ED if he/she is socially maladjusted)

What Are Some Evidence-Based Behavioral Interventions? Group Contingencies (Good Behavior Game) Token/Point Systems ( with response cost component) Replacement Behavior Training (teaching functionally equivalent behaviors) Differential Reinforcement (DRO/DRA/DRI/DRL) Antecedent-Based Choice (preferred activities) Task interspersal Modification of task difficulty Precorrection Classroom-Based Behavioral Consultation Performance Feedback (teachers’ integrity) Self-Monitoring

Group Contingencies (Good Behavior Game)

Token/Point Systems ( with response cost component)

Replacement Behavior Training (teaching functionally equivalent behaviors)

Differential Reinforcement (DRO/DRA/DRI/DRL)

Antecedent-Based

Choice (preferred activities)

Task interspersal

Modification of task difficulty

Precorrection

Classroom-Based Behavioral Consultation

Performance Feedback (teachers’ integrity)

Self-Monitoring

Evidence-Based Treatments for DSM Categories ( Journal of Clinical Child and Adolescent Psychology (2008), 37 , pp. 1-301) Disruptive Behavior Disorders (CD/ODD) Anger Control Training (CBM-based intervention) Behavioral Parent Training First Steps to Success (classroom-based behavioral intervention) Multisystemic Therapy (family/community-based treatment) ADHD Behavioral Parent Training Behavioral Classroom Management Anxiety Disorders Individual Cognitive Behavior Therapy Group Cognitive Behavior Therapy Exposure-Based Therapies (specific fears/phobias) Depression Cognitive Behavior Therapy (Individual) Cognitive Behavior Therapy (Group)

Disruptive Behavior Disorders (CD/ODD)

Anger Control Training (CBM-based intervention)

Behavioral Parent Training

First Steps to Success (classroom-based behavioral intervention)

Multisystemic Therapy (family/community-based treatment)

ADHD

Behavioral Parent Training

Behavioral Classroom Management

Anxiety Disorders

Individual Cognitive Behavior Therapy

Group Cognitive Behavior Therapy

Exposure-Based Therapies (specific fears/phobias)

Depression

Cognitive Behavior Therapy (Individual)

Cognitive Behavior Therapy (Group)

Fundamental Principles of RTI Intensity of intervention matched to degree of unresponsiveness Movement through tiers based on inadequate response Decisions regarding movement based data from multiple sources Increasing body of data collected to inform decision-making Change in intervention considered only after inadequate response Intervention delivery approaches Problem solving (consultation) Standard protocol

Intensity of intervention matched to degree of unresponsiveness

Movement through tiers based on inadequate response

Decisions regarding movement based data from multiple sources

Increasing body of data collected to inform decision-making

Change in intervention considered only after inadequate response

Intervention delivery approaches

Problem solving (consultation)

Standard protocol

Advantages of RTI Early identification of learning/behavior problems Conceptualizes learning/behavior problems from risk rather than deficit model Reduction of identification biases (overrepresentation) Strong focus on student outcomes Measures & domains based on relationships to child outcomes Documents relationships to positive child outcomes Emphasizes direct measurement of achievement, behavior, & the instructional environment Focuses on measurable and changeable aspects of instructional environment Identifies ABT students ( Ain’t Been Taught )

Early identification of learning/behavior problems

Conceptualizes learning/behavior problems from risk rather than deficit model

Reduction of identification biases (overrepresentation)

Strong focus on student outcomes

Measures & domains based on relationships to child outcomes

Documents relationships to positive child outcomes

Emphasizes direct measurement of achievement, behavior, & the instructional environment

Focuses on measurable and changeable aspects of instructional environment

Identifies ABT students ( Ain’t Been Taught )

Comparison of Traditional & RTI Assumptions Indirect measurement Within-child focus Nomothetic (groups) Moderate-high inference Behavioral stability Static, 1-shot assessment Lack of treatment validity Direct measurement Environmental focus Idiographic (individual) Low inference Behavioral variability Continuous progress monitoring Treatment validity Traditional RTI

Indirect measurement

Within-child focus

Nomothetic (groups)

Moderate-high inference

Behavioral stability

Static, 1-shot assessment

Lack of treatment validity

Direct measurement

Environmental focus

Idiographic (individual)

Low inference

Behavioral variability

Continuous progress monitoring

Treatment validity

What You Won’t See in a RTI Assessment “ Draw-a-Something” Measures Apperception Tests Rorschach Test MMPI WHY? Because none of the above are directly related to child outcomes and are not useful in either planning interventions or progress monitoring the effects of interventions. This type of information is superfluous to data-based decision making in RTI Almost all are technically inadequate based on the Test Standards

“ Draw-a-Something” Measures

Apperception Tests

Rorschach Test

MMPI

WHY?

Because none of the above are directly related to child outcomes and are not useful in either planning interventions or progress monitoring the effects of interventions.

This type of information is superfluous to data-based decision making in RTI

Almost all are technically inadequate based on the Test Standards

Problem-Solving Logic in RTI What is the problem? Discrepancy between expected & current levels of performance 100% homework completion expected but only 20% completed Problems can be defined differently by different individuals Why is the problem happening? Can’ do Won’t do Low inference What should be done about it? Antecedent strategies Consequent strategies Instructional strategies Did it work? Data-based decision making Benchmarks Social validation

What is the problem?

Discrepancy between expected & current levels of performance

100% homework completion expected but only 20% completed

Problems can be defined differently by different individuals

Why is the problem happening?

Can’ do

Won’t do

Low inference

What should be done about it?

Antecedent strategies

Consequent strategies

Instructional strategies

Did it work?

Data-based decision making

Benchmarks

Social validation

Assessment Principles in RTI Purposes of Assessment Referral Screening Classification Intervention planning Continuous progress monitoring Program evaluation Types of Assessment Data Direct observations of behavior Permanent products Behavior ratings Daily Behavior Reports Assessment Principles Problem Solving Low Inference Functional Assessment Multiple Operationalism Assessment Quality Social Validity

Purposes of Assessment

Referral

Screening

Classification

Intervention planning

Continuous progress monitoring

Program evaluation

Types of Assessment Data

Direct observations of behavior

Permanent products

Behavior ratings

Daily Behavior Reports

Assessment Principles

Problem Solving

Low Inference

Functional Assessment

Multiple Operationalism

Assessment Quality

Social Validity

Basic Principles of Screening for EBD in Schools Similar logic to other fields (e.g., medicine) PSA tests PAP smears Mammograms Instruments must be technically sound Low false negative rates Low false positive rates (willing to tolerate higher) Stable prediction over time Cost beneficial (benefits outweigh costs) Brief Research based Easily understood & applied

Similar logic to other fields (e.g., medicine)

PSA tests

PAP smears

Mammograms

Instruments must be technically sound

Low false negative rates

Low false positive rates (willing to tolerate higher)

Stable prediction over time

Cost beneficial (benefits outweigh costs)

Brief

Research based

Easily understood & applied

A Useful Behavior Screening Tool: Systematic Screening for Behavior Disorders Walker & Severson (1990) Multiple Gating Procedure Grades 1-6 Combination of 3 Assessment Procedures Teacher nominations- Gate 1 Teacher rating scales – Gate 2 Direct observations (classroom & playground)- Gate 3 Nationally standardized ( n =4500) Normative data Extensive reliability & validity data Early Screening Project (ages 3-5 years) Published by Sopris West, Longmont, CO

Multiple Gating Procedure

Grades 1-6

Combination of 3 Assessment Procedures

Teacher nominations- Gate 1

Teacher rating scales – Gate 2

Direct observations (classroom & playground)- Gate 3

Nationally standardized ( n =4500)

Normative data

Extensive reliability & validity data

Early Screening Project (ages 3-5 years)

SSBD (continued) Gate 1 Teachers rank order class on internalizing & externalizing behavior Teacher select top 3 ranks for internalizing & externalizing behavior Internalizing : Defined as overcontrolled behavior pattern characterized by social withdrawal, anxiety, and lacking self-confidence Externalizing : Defined as an undercontrolled behavior pattern characterized by aggression, bullying, noncompliance, and impulsivity Gate 2 Teachers ratings & CEI checklist Exceed normative criteria; move to next gate Gate 3 Direct observation in classroom & playground Exceed normative criteria; move to intervention phase

Gate 1

Teachers rank order class on internalizing & externalizing behavior

Teacher select top 3 ranks for internalizing & externalizing behavior

Internalizing : Defined as overcontrolled behavior pattern characterized by social withdrawal, anxiety, and lacking self-confidence

Externalizing : Defined as an undercontrolled behavior pattern characterized by aggression, bullying, noncompliance, and impulsivity

Gate 2

Teachers ratings & CEI checklist

Exceed normative criteria; move to next gate

Gate 3

Direct observation in classroom & playground

Exceed normative criteria; move to intervention phase

Decision Rules for SSBD Screening At Risk Not At Risk Risk Indicator Present Risk Indicator Absent Accuracy=Correct Decisions/All Decisions A+D/A+B+C+D A Accurate Prediction SENSITIVITY B False Positive C False Negative D Accurate Prediction SPECIFICITY

Another Useful Screening Tool: Student Risk Screening Scale (Drummond, 1993) Steals Lie, Cheat Bx Prob. Peer Reject Low Ach Neg. Att. Agg Beh. Total O-Never; 1-Occasionally; 2-Sometimes; 3-Frequently 9-21 High Risk 4-8 Moderate Risk 0-3 Low Risk Frank 1 1 3 2 3 3 3 16 Clay 1 1 0 1 2 1 0 6 Jill 0 0 1 1 1 0 1 4 Luke 2 2 2 2 3 2 3 16 Matt 1 1 0 1 1 1 1 6

3-Tier Model of RTI Intervention Universal Intervention All students Schoolwide or classwide Examples (reading curriculum, school discipline procedures) 80-85% will respond Selected Interventions Classroom strategies Small group strategies Consultation-based interventions About 7-10% of students Intensive Interventions Individualized interventions Intense & powerful (FBA-based interventions) 3-5% of students

Universal Intervention

All students

Schoolwide or classwide

Examples (reading curriculum, school discipline procedures)

80-85% will respond

Selected Interventions

Classroom strategies

Small group strategies

Consultation-based interventions

About 7-10% of students

Intensive Interventions

Individualized interventions

Intense & powerful (FBA-based interventions)

3-5% of students

Types of RTI Preventive RTI Universal prevention (“primary prevention”) Universal screening (2-3 times per year) Reactive RTI Selected interventions (“secondary prevention”) Replaces refer-test-place model for ED SPED Eligibility RTI Intensive interventions (“tertiary prevention”) “ Disability” versus “Need” decisions

Preventive RTI

Universal prevention (“primary prevention”)

Universal screening (2-3 times per year)

Reactive RTI

Selected interventions (“secondary prevention”)

Replaces refer-test-place model for ED

SPED Eligibility RTI

Intensive interventions (“tertiary prevention”)

“ Disability” versus “Need” decisions

Multi-Tier Social Skills Interventions Social Skills Improvement System (Gresham & Elliott, 2008) Classwide Intervention Program (CIP) Tier 1 Universal Intervention Provides general education teachers with a structured efficient way to integrate opportunities 10 most important social skills for school success CIP has 3 levels Preschool/Kindergarten Early Elementary (Grades 1-3) Late Elementary/Middle (Grades 4-6) Top 10 Social Skills (based on responses of over 800 teachers rating over 100 social skills: 0-Not important, 1-Important, 2-Critical) Listens to others Follows directions Follows classroom rules Ignores peer distractions Asks for help Takes turns in conversations Cooperates with others Controls temper in conflict situations Acts responsibly with others Shows kindness to others

Classwide Intervention Program (CIP) Tier 1 Universal Intervention

Provides general education teachers with a structured efficient way to integrate opportunities 10 most important social skills for school success

CIP has 3 levels

Preschool/Kindergarten

Early Elementary (Grades 1-3)

Late Elementary/Middle (Grades 4-6)

Top 10 Social Skills (based on responses of over 800 teachers rating over 100 social skills: 0-Not important, 1-Important, 2-Critical)

Listens to others

Follows directions

Follows classroom rules

Ignores peer distractions

Asks for help

Takes turns in conversations

Cooperates with others

Controls temper in conflict situations

Acts responsibly with others

Shows kindness to others

Classwide Intervention Program (continued) 6-Step Instructional Sequence Tell (Coaching) Show (Modeling) Do (Behavioral Rehearsal) Practice Monitor Progress Generalize 3 lesson per week, 25 minutes per lesson X 10 weeks Progress Monitoring Tools Treatment Integrity Checks

6-Step Instructional Sequence

Tell (Coaching)

Show (Modeling)

Do (Behavioral Rehearsal)

Practice

Monitor Progress

Generalize

3 lesson per week, 25 minutes per lesson X 10 weeks

Progress Monitoring Tools

Treatment Integrity Checks

SSIS Intervention Guide Tier 2 Selected Intervention Designed for weak responders to CIP Teaches social skills across 6 domains Communication Cooperation Assertion Responsibility Empathy Self-Control Delivered in small pullout group setting (4-6 children) 2 sessions per week, 45 minutes per session X 15 weeks Teaches 20 social skills Top 10 retaught 10 “keystone behaviors” also taught Distinguishes acquisition from performance deficits

Designed for weak responders to CIP

Teaches social skills across 6 domains

Communication

Cooperation

Assertion

Responsibility

Empathy

Self-Control

Delivered in small pullout group setting (4-6 children)

2 sessions per week, 45 minutes per session X 15 weeks

Teaches 20 social skills

Top 10 retaught

10 “keystone behaviors” also taught

Distinguishes acquisition from performance deficits

FBA Replacement Behavior Training Tier 3 Intensive Intervention Designed for weak responders to Tier 2 Intervention Guide Identifies competing problem behaviors using SSIS-Rating Scales Behaviors receiving rating of 2 (Very Often) or 3 (Almost Always) targeted to replacement Descriptive FBA conducted to identify function of competing problem behaviors Social skills replacement behaviors serving same function selected as target of intervention FBA process Records review FBA interviews (teacher, student, parent) Systematic direct observations Behavior ratings Daily behavior reports

Designed for weak responders to Tier 2 Intervention Guide

Identifies competing problem behaviors using SSIS-Rating Scales

Behaviors receiving rating of 2 (Very Often) or 3 (Almost Always) targeted to replacement

Descriptive FBA conducted to identify function of competing problem behaviors

Social skills replacement behaviors serving same function selected as target of intervention

FBA process

Records review

FBA interviews (teacher, student, parent)

Systematic direct observations

Behavior ratings

Daily behavior reports

FBA Replacement Behavior Training (continued) Intervention Strategies Antecedent Strategies Precorrection Prompts Check and connect Altering schedule of activities Choice Task modification Task interspersal Providing frequent breaks Consequent Strategies Differential reinforcement (DRO, DRI, DRA) Response cost Noncontingent reinforcement (NCR) Behavioral contracting School-home notes

Intervention Strategies

Antecedent Strategies

Precorrection

Prompts

Check and connect

Altering schedule of activities

Choice

Task modification

Task interspersal

Providing frequent breaks

Consequent Strategies

Differential reinforcement (DRO, DRI, DRA)

Response cost

Noncontingent reinforcement (NCR)

Behavioral contracting

School-home notes

Responsiveness to Intervention Model Degree of Unresponsiveness to Intervention LOW HIGH HIGH Intensity of treatment Level I Universal Interventions Level II Selected Interventions Level III Intensive Interventions Level IV Special Education IEP Determination

Classification of RTI Outcomes Outcome Status Inadequate Responder Adequate Responder Accuracy=Correct Decisions Relative to All Decisions A+D/A+B+C+D Requires More Intense Services A True Positive SENSITIVITY B False Positive Does Not Require More Intense Services C False Negative D True Negative SPECIFICITY

Measurement of Responsiveness Standards & Procedures Academics (CBM) Norms Benchmark criteria Growth criteria Behavior Direct observations Behavior ratings scales Daily behavior reports Brief, focused behavior rating scales (weekly) Permanent products & progress monitoring Solutions Social validation (peer comparisons & subjective judgments) Visual analysis of graphed data Effect size estimates

Academics (CBM)

Norms

Benchmark criteria

Growth criteria

Behavior

Direct observations

Behavior ratings scales

Daily behavior reports

Brief, focused behavior rating scales (weekly)

Permanent products & progress monitoring

Solutions

Social validation (peer comparisons & subjective judgments)

Visual analysis of graphed data

Effect size estimates

Brief Behavior Rating Scale (Weekly) Difficulty paying attention Never Sometimes Often Almost Always Difficulty organizing tasks Never Sometimes Often Almost Always Fidgets with hands or feet Never Sometimes Often Almost Always Blurts out answers Never Sometimes Often Almost Always Interrupts/intrudes on others Never Sometimes Often Almost Always

Treatment Integrity An Essential Component of RTI Extent to which intervention is implemented as planned Deviations from integrity compromises effectiveness Teacher-implemented interventions high-risk for integrity lapses Integrity can be measured by: Direct observations of implementation Permanent products Self-reports (not recommended) Treatment integrity can be improved by: Specific performance feedback on implementation Contingency management Modeling of intervention implementation

Extent to which intervention is implemented as planned

Deviations from integrity compromises effectiveness

Teacher-implemented interventions high-risk for integrity lapses

Integrity can be measured by:

Direct observations of implementation

Permanent products

Self-reports (not recommended)

Treatment integrity can be improved by:

Specific performance feedback on implementation

Contingency management

Modeling of intervention implementation

Treatment Integrity & Behavior Change Adequate Behavior Change Inadequate Behavior Change Implemented As Planned Not Implemented As Planned High Integrity Expected High Integrity Wrong Treatment Poor Functional Analysis Low Integrity Changed treatment Other unknown variables Low Integrity Expected

Ways of Expressing Integrity Percentage of intervention steps implemented Intervention manual Rating of intervention implementation Permanent products of intervention Task analysis of intervention

Percentage of intervention steps implemented

Intervention manual

Rating of intervention implementation

Permanent products of intervention

Task analysis of intervention

Some RTI References Gresham, F.M. (2002). Responsiveness to intervention: An alternative approach to the identification of learning disabilities. In R. Bradley, L. Danielson, & D. Hallahan (Eds.), Learning disabilities: Research to practice (pp. 467-519). Mahwah, NJ: Lawrence Erlbaum. Gresham, F.M. (2006). Response to intervention. In G. Bear & K. Minke (Eds.), Children’s needs-III (pp. 439-451) . Bethesda, MD: National Association of School Psychologists. Gresham, F.M. Response to intervention: An alternative means of identifying students as emotionally disturbed. Education and Treatment of Children, 28, 328-344. Gresham, F.M. (2004). Current status and future directions of school-based behavioral interventions. School Psychology Review, 33, 326-343. Gresham, F.M. (2005). Response to intervention (RTI): An alternative means of identifying students as emotionally disturbed. Education and Treatment of Children, 28, 328-344. Gresham, F.M. (2007). Best practices in diagnosis. In A. Thomas & J. Grimes (Eds.), Best practices in school psychology-V . Bethesda, MD: National Association of School Psychologists. Brown-Chidsey, R., & Steege, M. (2005). Response to intervention: Principles for effective practice. New York: Guilford Press. National Association of State Directors of Special Education (2005). Response to intervention: Policy considerations and implementation. Alexandria, VA: Author. Jimmerson, S., Burns, M., & VanDerHeyden, A. (Eds.) (2007). Handbook of response to intervention . New York: Springer. Glover, T., DiPerma, J., & Vaughn, S. (Eds.) (2007). Special series on service delivery systems for response to intervention: Considerations for research and practice. School Psychology Review, 36 (4), 526-646. Silverman, W., & Hinshaw, S. (Eds.) (2008). The second special issue on evidence-based psychosocial treatments for children and adolescents: A 10-year update. Journal of Clinical Child and Adolescent Psychology, 37, 1-301.

Gresham, F.M. (2002). Responsiveness to intervention: An alternative approach to the identification of learning disabilities. In R. Bradley, L. Danielson, & D. Hallahan (Eds.), Learning disabilities: Research to practice (pp. 467-519). Mahwah, NJ: Lawrence Erlbaum.

Gresham, F.M. (2006). Response to intervention. In G. Bear & K. Minke (Eds.), Children’s needs-III (pp. 439-451) . Bethesda, MD: National Association of School Psychologists.

Gresham, F.M. Response to intervention: An alternative means of identifying students as emotionally disturbed. Education and Treatment of Children, 28, 328-344.

Gresham, F.M. (2004). Current status and future directions of school-based behavioral interventions. School Psychology Review, 33, 326-343.

Gresham, F.M. (2005). Response to intervention (RTI): An alternative means of identifying students as emotionally disturbed. Education and Treatment of Children, 28, 328-344.

Gresham, F.M. (2007). Best practices in diagnosis. In A. Thomas & J. Grimes (Eds.), Best practices in school psychology-V . Bethesda, MD: National Association of School Psychologists.

Brown-Chidsey, R., & Steege, M. (2005). Response to intervention: Principles for effective practice. New York: Guilford Press.

National Association of State Directors of Special Education (2005). Response to intervention: Policy considerations and implementation. Alexandria, VA: Author.

Jimmerson, S., Burns, M., & VanDerHeyden, A. (Eds.) (2007). Handbook of response to intervention . New York: Springer.

Glover, T., DiPerma, J., & Vaughn, S. (Eds.) (2007). Special series on service delivery systems for response to intervention: Considerations for research and practice. School Psychology Review, 36 (4), 526-646.

Silverman, W., & Hinshaw, S. (Eds.) (2008). The second special issue on evidence-based psychosocial treatments for children and adolescents: A 10-year update. Journal of Clinical Child and Adolescent Psychology, 37, 1-301.

T H A N K Y O U Questions? Laizzez le bon temps rouler !