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One successful approach for proactively reducing problem behavior is the use of a multitiered system of supports (MTSS). MTSS is usually comprised of three tiers, with an increasing intensity of support at each tier to meet student needs. Tier 1 includes preventive strategies staff implement with all students. Typically, Tier 2 behavioral interventions are intended for students with frequent distracting or disruptive behavior problems. Interventions for Tier 2 are typically provided in small-group format and are standardized so they require minimal time and resources on the part of the classroom teacher. However, students who do not respond sufficiently to Tiers 1 and 2 require Tier 3 supports, which are intensive and individualized interventions. Researchers and practitioners have begun to consider whether Tier 2 interventions can be modified to increase their effectiveness. In this article, the authors describe how to adapt social skills instruction (SSI), a common Tier 2 intervention, to increase its effectiveness.

Multi-tiered systems of support are frequently used in school settings because of their efficiency and effectiveness (McIntosh & Goodman, 2016). The rationale for multi-tiered systems of support is to provide early and systematic intervention to all students with increasing intensity of intervention provided as needed (Sugai & Horner, 2009). These systems generally offer three levels of support in which Tier 1 is applied with all students in a school, Tier 2 is used with about 15% of students who are at risk for more serious concerns, and Tier 3 is reserved for 3-5% of the school population with the most serious academic or behavior problems. Tier 2 supports have been defined as interventions that are standardized across students and are quickly and continuously available (Hawken, Adolphson, MacLeod, & Schumann, 2009). One common Tier 2 intervention is Check In/Check Out (CICO). As with all Tier 2 interventions, CICO is designed to reduce mild problem behavior and increase academic engagement (Crone, Hawken, & Horner, 2010). Although Tier 2 support was initially conceptualized as employing standardized intervention protocols for ease of implementation, researchers and practitioners have begun to make adaptations to standard protocols to increase their effectiveness (e.g., Boyd & Anderson, 2013; Kilgus, Fallon, & Feinberg, 2016; Melius, Swoszowski, & Siders, 2015). Adaptations are changes to core components of the standard protocol (Majeika et al., in press). These changes require a problem solving process to tailor a program so that it is better aligned with student needs. After providing an overview of CICO, this article addresses how adaptations can be beneficial, how they have been made, and when they should be made. Additionally, it discusses ways to adapt CICO, modifying the intensity or dosage of CICO, and individualizing components to meet students' needs. Classroom case studies and steps to fading CICO are also described.

In an earlier article (EJ1058920), Lee Kern and Joseph H. Wehby identified the reasons and process for using adaptive intensive behavioral intervention. Kern and Wehby use this article to present a fictional example of how the intervention is applied. Isaac, a 12 year old, 7th grade student at Highland Middle School, had a history of behavior problems that became more intensive and frequent after he began middle school. This article describes how his teachers began instruction at Tier 1 of a response-to-intervention model of school-wide behavior interventions, which proved insufficient for addressing his behavior problems. His teachers proceeded through several interventions in Tier 2, which provided insufficient support. Isaac was then moved to a Tier 3 intervention, which proved successful. The article shows how school staff--and Isaac's mother--developed an intensive and individualized intervention plan based on the results of a functional behavioral assessment. Tiered intervention is an effective and efficient approach for preventing and addressing student behavior problems. As illustrated with Isaac, interventions are gradually intensified and increasingly individualized only as needed, based on student responsiveness.

This article describes intensive behavior intervention that is used with students who have behavioural difficulties. Joseph H. Wehby and Lee Kern report on 35 years of research in this area and note two conclusions: (1) Students with significant behavioral difficulties, including those with emotional disturbance (ED), have among the poorest social and academic outcomes of any group of students; and (2) Teachers and other school personnel feel inadequately prepared to work with these students. A probable contributing factor to these poor school outcomes is that educators often receive inadequate training on managing and supporting students with significant behavior issues. Wehby and Kern introduce "Intensifying Behavioral Interventions with an Adaptive Intervention Approach," an idea that has its roots in the tradition of good clinical practice and DBI. Teachers can easily use their experience and history with a student or use response patterns shown on typical school measures to modify a particular behavior intervention. The article provides an example that illustrates the process of adaptation and uses the most frequently reported Tier 2 intervention (involving small-group support programs that incorporate validated methods to help students develop self-control strategies or enhance social relationships in addition to improving academic performance), then describes the intensive and individualized Tier 3--functional assessment process, a problem-solving approach that relies on selecting relevant environmental factors for identifying the primary motivations for problem behavior and using that information as the centerpiece for developing an individualized behavior intervention plan. As teachers move forward toward improving the outcomes for this difficult-to-teach population, systematic adaptations of Tier 2 interventions and individualization of support within a multitiered system may furnish the best avenue for meaningful change.

Rather than abandoning the Tier 2 intervention and moving to a more labor-intensive Tier 3 intervention in the case of nonresponders, Tier 2 interventions can be adapted to better address individual student needs. Several teachers expressed concern over Ali's behavior and referred him to their school's Tier 2 team. Graph Students who engage in problem behaviors within the classroom disrupt the learning environment, resulting in a loss of instructional time. [Extracted from the article]