Tuning in to High-Fidelity Interventions

How did you get into the field of the education of children with emotional and behavioral challenges?

The short story is that I got my undergraduate degree in botany from the University of California at Santa Barbara in the 1970s. This was a time of war protests, changing mores, hippy culture, and the civil rights movement. My life goal was to become a park ranger and environmentalist and work with trees, not people. During my sophomore year, I got a summer job as nature director in an Easter Seals camp for kids with physical disabilities, mental retardation, cerebral palsy, and so forth. On the first day of camp, a cabin counselor failed to show up, so they asked me to become a cabin counselor with six campers. I had the older group. I had a gentleman 54 years old with Down syndrome and a 16-year-old with muscular dystrophy all in the same cabin unit.

That’s quite a diverse group.

I had no experience with individuals with disabilities. I only knew about plants. I had no idea what it meant to push a wheelchair, use sign language, assist with feeding, or anything else. Working and living with campers 24 hours a day, 6 days in a row, shifted my attention from botany to working with kids with developmental disabilities. I finished my degree in botany; however, I heard about a special education program at the University of Washington (UW), which sounded like a fun thing to try after my camping experience. At UW, I met Rick Neel who gave me my first opportunity to work with kids with behavior disorders.

It’s amazing how many people we’ve talked with who have had a camp experience that kind of got them into the field.

Amazing and unexpected things happen when a bunch of young people, who have an altruistic vision about saving the world and curiosity about doing good, are put together in a close, personal, and challenging situation.

How would you describe your career in the field?

Probably two or three ways. One, I frequently think about how lucky I have been. I have had so many great experiences that have shaped who I am today, like, camping, public school teaching, and university life.

Second, I think about my early mentors who have guided and shaped my experiences, vision, and possibilities, like Rick Neel, Gene Edgar, David Ryckman, Ellis Evans, Norris Haring, Owen White, and Felix Billingsley at the University of Washington. Like Mark Wolery, Don Bailey, John Emerson, who were my peer models in graduate school. Like Mike Nelson, Ed Blackhurst, Bill Berdine, David Gast, Ed Kame’enui, Geoff Colvin, Rob Horner, and Jerry Tindal who taught me about being a researcher and teacher. Like Tim Lewis, Terry Scott, Brandi Simonsen, Sarah Fairbanks, Teri Lewis, Shanna Hagan, Mack Burke, Tary Tobin, and Jorge Preciado who were my students and are now my colleagues and the next generation of researchers and teachers.

Third, I’ll be forever grateful for how my family has shaped my personal and professional values and habits. My parents taught me about perseverance, tolerance, and generosity. My wife taught me about balance, working in schools, and family. Our son and daughter have taught me about responsibility, letting go, and independence.

Are there other ways that you would describe your career?

My first teaching job was in 1974. If you recall, that’s when P.L. 94-142 started, and I was one of three brand new special education teachers in Aurora, Colorado. We established the first resource room programs for students with behavior disorders, and wrote some of the first behavior disordered IEPs. I say “BD IEPS” on purpose because I think my IEPs were behavior disordered and, frankly not very good.

After working in resource rooms for 3 years, we realized that a number of kids needed a bit more. So, I proposed a new program at a new middle school, and took a couple who were blowing out of their resource room programs throughout the district. At the time, it was considered a high-end, one of kind, specialized self-contained program within the district. Although my program was called a self-contained program, I had access to school classrooms, curriculum, and programs, and we basically functioned as a resource room. To tell you the truth, my kids taught me more about being a special education teacher than I taught them about how to navigate classrooms and hallways.

What events, policies, innovations, and people have had the most influence in your professional life?

Wow, that’s an interesting question! One way to answer that question is the shift from working with individual kids to working with systems. I think I’m fairly good at working with individual kids with behavior disorders. That is, I know how to do assessments and write and implement plans. What I’ve learned over the last 25 years, however, is that the impact of my assessments and plans is influenced by how and where they are being implemented. Classrooms and schools that have negative school climates, heavy use of reactive management, and zero tolerance are not good places to implement specialized supports for individual students. I was slow in getting the obvious: effective classroom management and positive schoolwide discipline are important requisites for successful implementation of individualized behavior support plans. Credit goes to people like Ed Kame’enui, Geoff Colvin, and Zig Engleman, who taught me that social behavior errors require teaching solutions at the individual student, classroom, and schoolwide levels.

Another important shift for me is thinking about organizational systems. Doug Carnine, Rob Horner, Tom Bellamy, and Ed Kame’enui taught me that many system change efforts do not operate from a clear and defendable “theory of action.” I think our success with PBIS (positive behavior intervention and supports) is linked to our grounding in applied behavior analysis which has given us the foundation to develop, implement, study, and evolve our systems change work.

What do you believe has had the greatest positive impact on the field of emotional/behavior disorders?

For me, the biggest impact is the realization that although we have a number of effective interventions, we have not created the opportunity for teachers to implement them with high fidelity. You can have the best interventions in your tool box; however, if we don’t implement them with the highest degree of fidelity, everyone fails.

All of us—consultants, researchers, personnel preparers, clinicians, special educators—have the responsibility of creating competent teaching environments where the emphasis is on successful implementation of effective strategies. The PBIS effort started as a traditional consultation and technical assistance approach where outside experts respond to a need, identify a possible solution, provide intervention training (or even deliver the intervention), wish everyone “good luck,” and then leave. We failed to direct enough attention toward developing local capacity for sustained and accurate implementation of the intervention or practice. In addition, we have not used “student benefit” as the main criterion for our decision making. Most of our attention at the PBIS Center is directed toward improving the implementation quality and capacity of local implementers. Kids will benefit if we do our job well.

How does that translate into teacher preparation programs that are increasingly called on to cut back on the services, cut back on the things that we teach our teachers?

I think successful teacher education programs prepare teachers, school psychologists, counselors, administrators, etc. to be smart consumers and more importantly, smart implementers of effective interventions and practices. It’s not about learning every single possible behavior intervention strategy that might work. It is about organizing them into a logical implementation framework where good decisions can be made and implementation can be done relevantly and with fidelity. Rob Horner taught me to invest in and measure the smallest and most effective thing that has the potential to have the biggest durable effect. That logic should be applied to classroom management, school discipline or individual kid programming. I would love for teacher training programs to say, “If you’re going to be a good behavior manager, here are the top ten things you need to do in the classroom the first day and every day. Don’t try to do everything, do a few things really well, and make decisions based on how kids respond.”

Do you have your list of top ten strategies?

I like to start by ensuring that academics are being taught well, which means teaching explicitly, maximizing opportunities to respond, using instructional time wisely, and using data to assess teaching effectiveness. Academic success is one of our best behavior management tools.

The second is to develop positive relationships, which to me is the direct outcome of the quality of the kinds of overt interactions we have with kids. This begins with making sure every student is academically challenged and successful. Academic success is maximized by ensuring that classroom routines have been taught, practiced, monitored, and acknowledged continuously throughout the school year. All day planning and implementation are important. For example, a social skill lesson from 9:00 to 9:30 doesn’t stop at 9:31. It’s an 8 to 3 o’clock effort.

The third is to increase the general rate of positive contact that we have with all students. It is troubling that some kids experience no daily adult contact and that if contact does occur, its corrective, directive, and negative.

Its important to understand that some kids, especially those with problem behavior histories, require more frequent and overt forms of positive feedback than other students . . . not less. If a student is not responsive to the general level of praise available to most students, we tend to give him or her less because “it isn’t working.” It’s better to maintain a high level of general positive contact, but also supplement with more intensive and individualized positive behavior supports.

I like to tell first-year teachers and all teachers that they should meet every kid at the classroom door every day with a positive personal greeting and statement of high expectation. The quality of the first contact can shape the next 10 minutes, 30 minutes, and next hour. While most kids do fine with a simple “good morning” at the beginning of the day, some require greetings every hour. My kids with behavior disorders fall into that category . . . give ’em more, not less.

The last thing I want to acknowledge is that kids need feedback when they violate a local social norm or rule; however, it must be followed with an opportunity to reteach or practice a better way of responding and with more opportunities to be positively reinforced for getting it right, which requires continuous monitoring. If the rule violation is chronic, I need to identify the conditions and/or setting in which it is most likely, and rearrange that environment to increase the likelihood of appropriate behavior. If I don’t change it, the kid will use the same behavior again. My friend, Geoff Colvin, says we must arrange for a “precorrection,” which is prompting the desired behavior before a predictable error can occur.

That’s great advice. What do you think has had the greatest negative impact on the field of emotional/behavioral disorders?

I think the biggest struggle is acting with a clear understanding that behavior support is a necessary but insufficient contributor to academic success. Behavior and academic are not independent efforts, but instead are integrally intertwined, both are required for success in the classroom and at school. Related and equally important, positive classroom and school climates are prerequisites for development of academic and social competence.

I don’t know that we prepare teachers early with the logic that academic and behavior support and success are intertwined and their responsibility. I’m also not sure that we prepare administrators to lead schools with this perspective.

When I first started teaching, it became apparent early on that if you could develop students’ academic skills, you could certainly teach behavior and social skills throughout your academic teaching.

I agree, we have to develop academic and behavior skills continuously and together. I would also argue that we err when we teach social skills as one time events, that is in isolated lessons, only during homeroom, on Mondays during morning meetings, or during weekly 1 hour group sessions by the school counselor. Developing social competence, maximizing school climate, and promoting behavior skills for academic success must occur all day across all school classrooms and settings with all adults and students. In addition, all school personnel—teachers, paraprofessionals, school psychologists, custodians, office staff, administrators, and school resource officers—must prompt, model, and acknowledge any displays of positive social behavior all day and every day.

What do you see in the future for the field of educating of students with emotional-behavioral disorders?

I’m pretty optimistic about what we can do to support and educate kids with behavior disorders. I like how we’re focusing on evidence-based practices, integrating academic and behavior success, considering all in the context of the individual culture, integrating our school mental health efforts, viewing individual students as the responsibility of the whole school, and investing in positive classroom- and schoolwide climates.

Having said all that, one of my concerns is that we have traditionally under-identified kids with behavior disorders which is still the case today. My hope is that by improving our schoolwide academic and behavior support environments and implementation efforts, we’ll be better at identifying students who require more intensive behavior supports, that is, kids with behavior disorders and mental health challenges. We have not done a good job of considering kids who have behavioral deficits and less overt behavior disorders, like crying easily, social withdrawal, self-injury, social disengagement, and poor problem solving.

We get those ones that explode. That’s readily apparent to people, but not those that engage in internalizing behavior.

I must admit that I struggle with the internalized versus externalized continuum. Students who violate disciplinary rules can be depressed. Students who are anxious express anxiety by verbal and physical outbursts. Students who cry easily can be targets and/or perpetuators of bullying behavior. Students who express suicidal ideation can be maintained by escape or access to adult attention. Some students express trauma with social disengagement and others by actively engaging the social environment. For me, a medical and behavioral approach to assessment and intervention may be more efficacious as long as we maintain a focus on learning history, context, responsiveness, and support. And, I’m most comfortable when describing, understanding, and affecting a phenomenon if I begin with an applied behavior analytic perspective.

What advice would you offer to those entering the field?

I have learned that the problems and issues that we are being asked to address are complex and multifaceted, and I strongly recommend that anyone entering the field should adopt and operationalize a conceptual framework or theory of action that is defendable, parsimonious, comprehensive, empirically supported, and translatable into overt actions. As I indicated earlier, I’m a behavior analyst, and I’m comfortable with the principles, tools, and decision rules that are derived from a behavior analytic perspective. I’m not suggesting that everyone should be a behavior analyst; however, each of us should be well versed and fluent with a perspective that can be defended, tested, articulated, and most importantly related to achieving important student benefit and outcome. Be a developmentalist, cognitivist, psychoanalyst, etc. That’s fine; just be sure student benefit can be documented. I’m also not convinced that being eclectic is most efficient, effective, or educationally justified.

For example, in the last 10 years, bullying has become a big issue. It’s taken on a life of it’s own. I would argue that bullying is not a diagnosis, mental illness, behavioral category, etc. It’s a social label that has been attached to a response class made up of harassment, teasing, intimidation, and aggression behaviors. An important aspect of these behaviors is context, that is, who’s involved, where it occurs, how often it happens, what effects it has on others, and what maintains it over time.

From a behavioral perspective, we’ve always said that teasing, intimidation, and aggressive behaviors occur in context, with another person, at different rates, and under the influence of a variety of contingencies. Let’s use that logic as a way of responding to the behavior and not to the “bullying” label. I’m not convinced that responding to bullying necessarily requires a different set of interventions or systemic responses. A schoolwide prevention system that fosters a positive school climate has a big impact on reducing opportunities for teasing, intimidation, and aggressive behavior. Having a team in place that looks at kids who have chronic displays of these behaviors is a response to students who require more than a universal schoolwide intervention. We may need institutionalized policies to bring increased attention to the problem; however, I’m not certain that we require uniquely different interventions and practices. I worry that too much attention on the label might redirect our attention from existing effective interventions and systems and sound data-based decision making. Clearly, the responsibility is on researchers and practitioners to document what works and under what conditions.

For example, my wife was a principal in a school that had a tiered system for behavioral support in place. When the bullying initiative came into her district and her school, she didn’t create a separate bullying team, a separate data system for bullying, a new bullying coordinator, or a different behavior support curriculum. She went back to her behavior support leadership team and said, “What do we have in place now that addresses these behaviors of concern? Let’s use our behavior support team as a way of looking at kids who are chronically engaged in teasing and intimidation. Let’s look at how our teachers and our supports teams can address the needs of those who are chronically victimized. Let’s use our data systems that we have now to track who, what, where, and when. We don’t have to create a separate one.”

Most of what I know I’ve learned from my wife. She’s smart and she’s saying, “We don’t have to re-create a separate parallel system for bullying, because we already have an effective mechanism for problem-solving that will address our needs.” Using her team, her data, and her existing behavior support continuum, she realized she had a structure in place to address a specific behavior need.

You’re saying we should work with the structures that we already have rather than creating new systems?

Many districts and states have many of the important elements; however, they lack the opportunity, capacity, and experience to establish an effective, efficient, and relevant organizational system to maximize implementation fidelity and student benefit. Without this system, every new challenge or problem is treated independently and reactively. Much of the work of our Center is assisting school systems to work smarter with existing resources, and establish the expert capacity to sustain high fidelity implementation.

Our exemplar schools have a full continuum of behavior support in place for all kids and adults and across all school settings. A teaming structure and data system exist to guide and coordinate new and old behavior supports. Prevention becomes that primary mode of operation: prevention of new problems and prevention of occurrence of old problems.

Dr. Sugai, thank you very much for sharing your wisdom.

Thank you for giving me the opportunity to acknowledge and highlight some of the many influences and influencers that have shaped what and how I do my work.