Consultation case study

Seminar in PsychoeducationalSeminar in Psychoeducational
Consultation in the SchoolsConsultation in the Schools::
Case Study PresentationCase Study Presentation
V. Paige Harrison, M.S.V. Paige Harrison, M.S.
University of KentuckyUniversity of Kentucky
EDP 671EDP 671

Referral Problem.Referral Problem.
• ‘‘Michael’ is a 7-year-old second-grade male from aMichael’ is a 7-year-old second-grade male from a
regular education classroom.regular education classroom.
• He was struggling in all subject areas. His teacherHe was struggling in all subject areas. His teacher
identified off-task behavior as the primary area ofidentified off-task behavior as the primary area of
concern. She felt that increasing his time on-task wouldconcern. She felt that increasing his time on-task would
help him succeed in the classroom.help him succeed in the classroom.
• He was identified after being referred to the schoolHe was identified after being referred to the school
psychologist for an evaluation. The current study aimedpsychologist for an evaluation. The current study aimed
to assess and address his off-task behaviors before anyto assess and address his off-task behaviors before any
formal assessments (i.e., IQ & Achievement testing)formal assessments (i.e., IQ & Achievement testing)
were conducted.were conducted.

Referral Problem.Referral Problem.
 Michael’s off-task behavior occurred in allMichael’s off-task behavior occurred in all
settings throughout the school day.settings throughout the school day.
 It took on various forms including: staring off,It took on various forms including: staring off,
being out of his seat, playing with his schoolbeing out of his seat, playing with his school
supplies, talking to peers, makingsupplies, talking to peers, making
inappropriate hand motions and verbalizations,inappropriate hand motions and verbalizations,
etc.etc.

Background InformationBackground Information
 Michael lives with his mother and older sister (4Michael lives with his mother and older sister (4thth
grade). His mother is very involved with hisgrade). His mother is very involved with his
education and reports working with him at homeeducation and reports working with him at home
(especially on his reading) and talking to him about(especially on his reading) and talking to him about
the importance of paying attention and staying onthe importance of paying attention and staying on
task.task.
 Mrs. O’Neal described him as a ‘good-natured’ kidMrs. O’Neal described him as a ‘good-natured’ kid
whose behaviors were not necessarily disruptive towhose behaviors were not necessarily disruptive to
the class as a whole but hurt him more than anyonethe class as a whole but hurt him more than anyone
else. This was consistent w/ my own observations andelse. This was consistent w/ my own observations and
interactions w/ him.interactions w/ him.

Background Information (cont.)Background Information (cont.)
 Mrs. O’Neal also stated that his 1Mrs. O’Neal also stated that his 1stst
gradegrade
teacher had reported many of the same off-taskteacher had reported many of the same off-task
behaviors when she taught him last year.behaviors when she taught him last year.
 Attendance was not a problem for him, sinceAttendance was not a problem for him, since
his mother is an employee of the schoolhis mother is an employee of the school
district. No medical problems were reported,district. No medical problems were reported,
and Michael had many friends.and Michael had many friends.

Context & Setting Information.Context & Setting Information.
• The consultation, data collection, and intervention wereThe consultation, data collection, and intervention were
conducted in the student’s regular education classroomconducted in the student’s regular education classroom
during his morning mathematics lesson. This time wasduring his morning mathematics lesson. This time was
chosen because it was convenient for the teacher andchosen because it was convenient for the teacher and
she felt it would be a good time for her to observe andshe felt it would be a good time for her to observe and
document the off-task behavior.document the off-task behavior.
• Students were seated at tables arranged in a large, openStudents were seated at tables arranged in a large, open
rectangle so that everyone could been seen and no onerectangle so that everyone could been seen and no one
had his/her back turned. This allowed the teacher tohad his/her back turned. This allowed the teacher to
walk around the perimeter as well as teach from insidewalk around the perimeter as well as teach from inside
the tables.the tables.

Context & Setting Info (cont.)Context & Setting Info (cont.)
• The room was bright and full of colorfulThe room was bright and full of colorful
decorations and learning materials.decorations and learning materials.
Mathematics lessons varied each day.Mathematics lessons varied each day.
Activities included brief lecture to present newActivities included brief lecture to present new
materials, worksheets, open-responsematerials, worksheets, open-response
assignments, group work, etc.assignments, group work, etc.
• There were 26 students in the classroom (15There were 26 students in the classroom (15
girls, 11 boys).girls, 11 boys).

Consultation Services Provided.Consultation Services Provided.
• As previously mentioned, Michael and his teacher wereAs previously mentioned, Michael and his teacher were
identified as consultation candidates after he wasidentified as consultation candidates after he was
referred to the school psychologist for an evaluation.referred to the school psychologist for an evaluation.
• A permission slip was sent home with Michael andA permission slip was sent home with Michael and
signed prior to the commencement of consultation.signed prior to the commencement of consultation.
• Michael’s teacher agreed to work with the schoolMichael’s teacher agreed to work with the school
psychology practicum student in hopes of increasing hispsychology practicum student in hopes of increasing his
time on task and, subsequently, his success in thetime on task and, subsequently, his success in the
classroom and beyond.classroom and beyond.

Session 1: EntrySession 1: Entry
 During this phase, the teacher and I engaged in aDuring this phase, the teacher and I engaged in a
dialogue about what was expected from the consultationdialogue about what was expected from the consultation
progress as well as the time commitment involved.progress as well as the time commitment involved.
 I believe that his was a key element to my having aI believe that his was a key element to my having a
teacher that stuck with me throughout this process.teacher that stuck with me throughout this process.
 Our respective roles & professional contributions (ourOur respective roles & professional contributions (our
different backgrounds and expertise) were discussed. Itdifferent backgrounds and expertise) were discussed. It
was really important to me to be seen as more than ‘justwas really important to me to be seen as more than ‘just
a student’ trying to fulfill a requirement for a class.a student’ trying to fulfill a requirement for a class.

Session 1: EntrySession 1: Entry
 I also made it clear that she would be collectingI also made it clear that she would be collecting
data, and that we’d work together to find adata, and that we’d work together to find a
method that was easy for her but yielding themethod that was easy for her but yielding the
information we needed.information we needed.
 The concerns of Michael’s mom as well asThe concerns of Michael’s mom as well as
confidentiality were also discussed.confidentiality were also discussed.
 We also set up our next meeting time and talkedWe also set up our next meeting time and talked
about any reservations she might have about theabout any reservations she might have about the
process.process.

Session 2: Problem IdentificationSession 2: Problem Identification
 This session ran more smoothly and rapportThis session ran more smoothly and rapport
was well-established by this point. I hadwas well-established by this point. I had
stopped in and talked with the teacher severalstopped in and talked with the teacher several
times to ‘touch base’ by this point as well.times to ‘touch base’ by this point as well.
 I had also done some additional classroomI had also done some additional classroom
observations prior entering this stage, so thatobservations prior entering this stage, so that
I’d be prepared to discuss his behaviors.I’d be prepared to discuss his behaviors.

(continued)(continued)
 Together, Mrs. O’Neal and I decided upon anTogether, Mrs. O’Neal and I decided upon an
operational definition. Specifically, we set outoperational definition. Specifically, we set out
to define ‘on-task’ behavior.to define ‘on-task’ behavior.
 It was operationally defined as ‘having hisIt was operationally defined as ‘having his
eyes on the teacher while she was talking,eyes on the teacher while she was talking,
pencil in hand w/eyes on the assignment, orpencil in hand w/eyes on the assignment, or
other task appropriate behavior’.other task appropriate behavior’.

(Continued)(Continued)
 This definition was concrete enough, yet allowedThis definition was concrete enough, yet allowed
for flexibility since the activities in the math classfor flexibility since the activities in the math class
varied from day to day.varied from day to day.
 The discussion of his behaviors across settings asThe discussion of his behaviors across settings as
well as deciding on an operational definition ofwell as deciding on an operational definition of
on-task behavior paved the way for the next stage.on-task behavior paved the way for the next stage.
 We also set the lofty goal of increasing his timeWe also set the lofty goal of increasing his time
on-task to 80%.on-task to 80%.

Session 3: Problem AnalysisSession 3: Problem Analysis
 During this session, we further appraisedDuring this session, we further appraised
Michael’s problem behaviors in terms ofMichael’s problem behaviors in terms of
ABCs and discussed ways to measure them.ABCs and discussed ways to measure them.
 This was done through observations. BothThis was done through observations. Both
Mrs. O’Neal and I observed that Michael’sMrs. O’Neal and I observed that Michael’s
off-task behaviors often occurred after a newoff-task behaviors often occurred after a new
assignment was given and/or during a longassignment was given and/or during a long
activity. We also noted that a consequence toactivity. We also noted that a consequence to
his behavior was him not having to do/finishhis behavior was him not having to do/finish
the assignment/activity.the assignment/activity.

Sesson 3: Problem Analysis (cont.)Sesson 3: Problem Analysis (cont.)
 Because of these observations, we both agreed that oneBecause of these observations, we both agreed that one
function of his off-task behavior was escape. He wasfunction of his off-task behavior was escape. He was
also observed asking things like “are we almostalso observed asking things like “are we almost
finished’, so an intervention targeted at helping himfinished’, so an intervention targeted at helping him
gauge how long he needed to work before a break, wasgauge how long he needed to work before a break, was
discussed.discussed.
 When discussing intervention options, Mrs. O’NealWhen discussing intervention options, Mrs. O’Neal
mentioned that a timer that she had used with a studentmentioned that a timer that she had used with a student
in the past. This option was considered because it wasin the past. This option was considered because it was
acceptable to her and she felt comfortable with it.acceptable to her and she felt comfortable with it.

Session 3: Problem Analysis (cont.)Session 3: Problem Analysis (cont.)
 She also expressed interest in setting whateverShe also expressed interest in setting whatever
intervention up so that it would target theintervention up so that it would target the
whole class.whole class.
 Upon our decision to use the timer, I consultedUpon our decision to use the timer, I consulted
research that stated that its use has beenresearch that stated that its use has been
documented to increase self-management anddocumented to increase self-management and
promote on-task behaviors. This suggested thatpromote on-task behaviors. This suggested that
its use would be empirically sound.its use would be empirically sound.

Session 3: Problem Analysis (cont.)Session 3: Problem Analysis (cont.)
 Her idea to use the timer was also adoptedHer idea to use the timer was also adopted
because it would help to ensure that nobecause it would help to ensure that no
unnecessary attention was placed on Michaelunnecessary attention was placed on Michael
and would also have the potential to increasingand would also have the potential to increasing
on-task behavior for the entire class.on-task behavior for the entire class.
 We next developed a plan for implementing itWe next developed a plan for implementing it
which included the ‘Motivaider’ as a promptwhich included the ‘Motivaider’ as a prompt
for recording data for both Michael and hisfor recording data for both Michael and his
classmates (more detailed procedures willclassmates (more detailed procedures will
follow).follow).

Session 4:Session 4:
Implementation/EvaluationImplementation/Evaluation
 I met with Mrs. O’Neal prior to the first day ofI met with Mrs. O’Neal prior to the first day of
data collection to go over procedures. Shedata collection to go over procedures. She
instructed on how to use the motivator andinstructed on how to use the motivator and
record the data correctly.record the data correctly.
 I checked in with her at least twice per week inI checked in with her at least twice per week in
addition to the days I was collectingaddition to the days I was collecting
interobserver agreement data. She didn’t seem tointerobserver agreement data. She didn’t seem to
have any concerns, and was comfortable withhave any concerns, and was comfortable with
the procedures.the procedures.

Implementation/Evaluation (cont.)Implementation/Evaluation (cont.)
 We are still in the ‘Evaluation’ portion of thisWe are still in the ‘Evaluation’ portion of this
stage.stage.
 Michael’s on-task behavior is increasing, but weMichael’s on-task behavior is increasing, but we
have chosen to collect a few more data points tohave chosen to collect a few more data points to
be sure.be sure.
 For now, though, it looks like our original goal ofFor now, though, it looks like our original goal of
80% for Michael might be a little high, and we80% for Michael might be a little high, and we
are shifting our focus to making maintaining anyare shifting our focus to making maintaining any
incremental gains.incremental gains.

Implementation/Evaluation (Cont.)Implementation/Evaluation (Cont.)
 The timer isn’t dramatically changing theThe timer isn’t dramatically changing the
percentage of time on-task of Michael’spercentage of time on-task of Michael’s
classmates, but it isn’t hurting either. We areclassmates, but it isn’t hurting either. We are
considering tweaking the intervention in hope ofconsidering tweaking the intervention in hope of
maximizing its effects for both groups.maximizing its effects for both groups.
 Mrs. O’Neal and I have also discussedMrs. O’Neal and I have also discussed
collecting data for this intervention duringcollecting data for this intervention during
different subjects/times of the day to gaugedifferent subjects/times of the day to gauge
generalization and to also see if it might begeneralization and to also see if it might be
beneficial to use it all day long.beneficial to use it all day long.

Data Collection Procedures:Data Collection Procedures:
• On-task behavior was assessed by theOn-task behavior was assessed by the
classroom teacher using a ‘Motivaider’ wornclassroom teacher using a ‘Motivaider’ worn
on her belt set to vibrate every 3 minutes as aon her belt set to vibrate every 3 minutes as a
reminder to record the students’ behavior.reminder to record the students’ behavior.
• When the ‘Motivaider’ vibrated, the teacherWhen the ‘Motivaider’ vibrated, the teacher
was instructed to look at the student, mark awas instructed to look at the student, mark a
plus sign if he was on-task and a minus sign ifplus sign if he was on-task and a minus sign if
not. She was to then immediately look at anot. She was to then immediately look at a
different same-sex peer do the same ‘+/-’different same-sex peer do the same ‘+/-’
recording procedure.recording procedure.

Data Collection Procedures (cont.)Data Collection Procedures (cont.)
• The number of observations varied on the length andThe number of observations varied on the length and
nature of the mathematics lesson.nature of the mathematics lesson.
• For each observational day, the total of ‘+’ signsFor each observational day, the total of ‘+’ signs
recorded were totaled and then divided by the totalrecorded were totaled and then divided by the total
number of observations, ‘+’ and ‘-’ to come up withnumber of observations, ‘+’ and ‘-’ to come up with
the percent of time on-task.the percent of time on-task.
• This procedure yielded a percentage for both theThis procedure yielded a percentage for both the
student and class. 4 days of baseline and 3 days ofstudent and class. 4 days of baseline and 3 days of
intervention data were collected.intervention data were collected.

 To test our original hypothesis that his off-taskTo test our original hypothesis that his off-task
behavior was escape-maintained, we chose tobehavior was escape-maintained, we chose to
provide a task during one of the interventionprovide a task during one of the intervention
days during which Michael and the class weredays during which Michael and the class were
explicitly told how much time they had toexplicitly told how much time they had to
complete it (i.e. “when the hand touches the 4”,complete it (i.e. “when the hand touches the 4”,
etc.)etc.) manipulation check.manipulation check.
 This continued throughout the activity, so theThis continued throughout the activity, so the
students weren’t left guessing how much timestudents weren’t left guessing how much time
would pass before they could start the nextwould pass before they could start the next
activity.activity.

• It is also important to mention that interobserverIt is also important to mention that interobserver
agreement data was collected during three of the sessionsagreement data was collected during three of the sessions
(2 baseline/1 intervention).(2 baseline/1 intervention).
• Because this study wasn’t looking at a single, specific,Because this study wasn’t looking at a single, specific,
discreet behavior, traditional agreement proceduresdiscreet behavior, traditional agreement procedures
weren’t employed (i.e., calculating it by dividing theweren’t employed (i.e., calculating it by dividing the
number of agreements by the number of agreements plusnumber of agreements by the number of agreements plus
disagreements times 100.) For the purpose of this study,disagreements times 100.) For the purpose of this study,
agreement was calculated by determining the averageagreement was calculated by determining the average
percentage difference in their observations of on-taskpercentage difference in their observations of on-task
behavior.behavior.

Intervention Procedures.Intervention Procedures.
• At the conclusion of the baseline data collection, theAt the conclusion of the baseline data collection, the
teacher wanted an intervention that would help theteacher wanted an intervention that would help the
student manage his behavior and be aware of how muchstudent manage his behavior and be aware of how much
time he had to complete an assignment.time he had to complete an assignment.
• The teacher had used the timer several years before, andThe teacher had used the timer several years before, and
reported that it was very easy and worked out well for thereported that it was very easy and worked out well for the
student. The previous time, though, it sat on the student’sstudent. The previous time, though, it sat on the student’s
desk. This time we chose not to put any undue attentiondesk. This time we chose not to put any undue attention
on the student, and felt that placing it for all to see hadon the student, and felt that placing it for all to see had
the potential of helping other students develop self-the potential of helping other students develop self-
management skills as well.management skills as well.

Intervention Procedures (cont.)Intervention Procedures (cont.)
• The timer was made for students who cannot tell time—The timer was made for students who cannot tell time—
which is perfect for many second graders. It had a redwhich is perfect for many second graders. It had a red
and white face. The red portion demonstrated the timeand white face. The red portion demonstrated the time
left, and the teacher could set it to the length of theleft, and the teacher could set it to the length of the
assignment. This was helpful since the lessons andassignment. This was helpful since the lessons and
activities varied from day to day.activities varied from day to day.
• When introducing the timer, the teacher explained it’sWhen introducing the timer, the teacher explained it’s
purpose on a level that the students could understand.purpose on a level that the students could understand.
She also pointed to it and reminded the kids of itsShe also pointed to it and reminded the kids of its
presence before each assignment or activity transitionpresence before each assignment or activity transition
during the math class. She would alert the students toduring the math class. She would alert the students to
look at it was the time was running out to remind themlook at it was the time was running out to remind them
to attend to the timer.to attend to the timer.

Intervention Procedures (cont.)Intervention Procedures (cont.)
• The timer was placed conspicuously for all to see, andThe timer was placed conspicuously for all to see, and
the students seems excited by it and proud when theythe students seems excited by it and proud when they
could finish before time ran out. The students were alsocould finish before time ran out. The students were also
observed looking up from their assignments to checkobserved looking up from their assignments to check
their progress against the timer.their progress against the timer.
• The teacher continued the same data collectionThe teacher continued the same data collection
procedures when the timer was present. She commentedprocedures when the timer was present. She commented
liking the timer, because it freed her to teach andliking the timer, because it freed her to teach and
engaged the students to monitor their own behaviors.engaged the students to monitor their own behaviors.
She also stated that she could see herself continuing it inShe also stated that she could see herself continuing it in
the future if successful.the future if successful.

Session 5: Termination.Session 5: Termination.
 We have not yet terminated our consultation forWe have not yet terminated our consultation for
the reasons previously discussed.the reasons previously discussed.
 This will probably occur once we are bothThis will probably occur once we are both
convinced that the intervention is working to itsconvinced that the intervention is working to its
fullest potential.fullest potential.
 Mrs. O’Neal is already confident inMrs. O’Neal is already confident in
implementation and data collection procedures.implementation and data collection procedures.

Consultation Outcome Data.Consultation Outcome Data.
Time On-Task
0
10
20
30
40
50
60
70
80
90
100
Sessions
%
Series1 84.6 82.3 76.9 85.7 100 86.6 82.3 85
Series2 46.1 35.2 69.2 50 50 33.3 52.9 65
1 2 3 4 5 6 7 8
Baseline 1
InterventionB-2
M.C

Consultation Outcomes.Consultation Outcomes.
 Michael’s on-task behavior has not increasedMichael’s on-task behavior has not increased
significantly in response to the intervention.significantly in response to the intervention.
 The two most recent data points, though, show anThe two most recent data points, though, show an
upward trend in Michael’s on-task behavior. The on-upward trend in Michael’s on-task behavior. The on-
task behavior of his classmates has increased slightly astask behavior of his classmates has increased slightly as
wellwell
 Because of these, Mrs. O’Neal and I have chosen toBecause of these, Mrs. O’Neal and I have chosen to
record some more data before overhauling therecord some more data before overhauling the
intervention or making any drastic changes.intervention or making any drastic changes.

Consultation Outcomes (cont.)Consultation Outcomes (cont.)
 Overall, a strong consultative relationship hasOverall, a strong consultative relationship has
been forged with Michael’s teacher, and as abeen forged with Michael’s teacher, and as a
result, we committed to work together until weresult, we committed to work together until we
find something that really works for him.find something that really works for him.
 We are at a point where some aspects of theWe are at a point where some aspects of the
intervention may need tweaked, or we mayintervention may need tweaked, or we may
eventually need to try another intervention.eventually need to try another intervention.
Right now, we have decided to monitor theRight now, we have decided to monitor the
results of the current intervention for a littleresults of the current intervention for a little
while longer to see if his on-task behaviorwhile longer to see if his on-task behavior
continues to increase.continues to increase.

Evaluation.Evaluation.
 The teacher has given me good ratings and positiveThe teacher has given me good ratings and positive
feedback on efforts, my guidance, and the results thus far.feedback on efforts, my guidance, and the results thus far.
I would not be surprised if we work together on anotherI would not be surprised if we work together on another
consultation case before the end of the school year.consultation case before the end of the school year.
 I feel that we chose an intervention that was acceptable toI feel that we chose an intervention that was acceptable to
her and hand a real opportunity to positively affecther and hand a real opportunity to positively affect
Michael’s behavior—even though we need to make someMichael’s behavior—even though we need to make some
slight adjustments.slight adjustments.
 I feel that I have done a good job in guiding the Mrs.I feel that I have done a good job in guiding the Mrs.
O’Neal but giving her the reigns. She was not shy aboutO’Neal but giving her the reigns. She was not shy about
contributing and speaking up when she felt somethingcontributing and speaking up when she felt something
would not work.would not work.

Evaluation.Evaluation.
 The best evaluation, though, will come asThe best evaluation, though, will come as
Michael’s percentage of behavior of on-taskMichael’s percentage of behavior of on-task
behavior continues to increase.behavior continues to increase.
 For my first ‘real’ consultation case, I am veryFor my first ‘real’ consultation case, I am very
pleased with the role I played and the progresspleased with the role I played and the progress
I have made since the entry session.I have made since the entry session.

Recommendations.Recommendations.
 One recommendation I have for myself is toOne recommendation I have for myself is to
what the words I use more closely. I need towhat the words I use more closely. I need to
continue to cut out phrases like: “maybe, um,continue to cut out phrases like: “maybe, um,
sort of, kind of, and might”.sort of, kind of, and might”.
 Another challenge is to keep it formal. It isAnother challenge is to keep it formal. It is
easy to get to know your teacher so well thateasy to get to know your teacher so well that
you start of converse about personal things. Iyou start of converse about personal things. I
think I did a good job of steering clear of this,think I did a good job of steering clear of this,
but I can see how it could go downhill and Ibut I can see how it could go downhill and I
could come off as more of a student than acould come off as more of a student than a
fellow professional.fellow professional.

Recommendations.Recommendations.
 To further keep Michael’s mom in the loop, ITo further keep Michael’s mom in the loop, I
wish that I would have devised a way to sendwish that I would have devised a way to send
home a report of his progress. As his numbershome a report of his progress. As his numbers
continue to increase, I might still do this.continue to increase, I might still do this.
 I might also suggest additional alterations inI might also suggest additional alterations in
the intervention as results from his formalthe intervention as results from his formal
evaluation trickle in. This way, we can betterevaluation trickle in. This way, we can better
account for skill deficits and other specialaccount for skill deficits and other special
needs he might have.needs he might have.

Any Questions??Any Questions??
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