Program Design Summary

SUMMARY

BACKGROUND

In November 1998, the Board and Superintendent directed staff to create a task force to analyze District behavior intervention practices and determine ways to provide earlier prevention and intervention services for students. The first phase of the implementation of the task force report was presented to the Board and adopted by it unanimously on March 28, 2000. The program has three components: the Early Behavior Intervention Program, the Student/Family Assistance Centers and the Teen Intervention & Support Program. This report concerns the Student/Family Assistance Centers’ component.

PROGRAM DESIGN SUMMARY

The new Student/Family Assistance Centers offer supplemental assessment, short-term intensive intervention and behavior stabilization services for students, schools and families when behavior problems are a major factor contributing to a student's school failure. The first three centers assist high need students at low achieving (API 1) elementary and middle schools.

The design includes discrete triage, assessment, intervention and on-going support phases. Interdisciplinary meetings mark the transition from one phase to the next and serve as major organizing structures for the process. Strength based assessments and an ecological family systems model are used to develop a range of multidisciplinary interventions to help support both the school and family in working through the currently presenting school difficulties. All interventions are established in a collaborative fashion involving both school personnel and families. Primary activities to support students through this research-based program include…

Consultation with school and district staff, parents and community agencies;

Multidisciplinary, strength-based assessment;

Development of intervention plans to support students;

Intensive short term intervention and counseling, based on identified assets and needs;

Connection of the student and family with support both within the district and the community; and

Development of a case management plan for ongoing support.

FALL 2000, DESIGN PHASE

Initial design of the program was achieved through interdisciplinary workgroups, which began in August with input from university faculty and the CA State Diagnostic Center. By November 2000, the draft design was complete and the Student/Family Assistance Centers began to pilot the process and hold focus groups with stakeholders. Focus groups were held with all stakeholders, and interviews were completed with parents and teachers. The procedures and system of support were modified and then additional pilot cases and focus groups were held. Three cycles of pilot cases, focus groups and program modifications were completed from November 2000 to January 2001. In January 2001, program materials and referral information were sent to every local district superintendent, API 1 school principal, school psychologist and nurse, organization facilitator, Early Behavior Intervention Program counselor, and coordinator of Nursing, Psychological Services Pupil Services and Attendance and School Mental Health. Staff presented at multiple meetings to share the new program with schools.

Staffing - By August 22nd the coordinator and ten professional staff had been assigned to the SFAC program. Three additional professional staff, the three paraprofessional family support coordinators and two clerical staff were hired in the fall. All professional staff are experienced District employees who were selected for their excellent skills. Six of the professional staff and all three paraprofessional family support coordinators are bilingual. Staff participated in 8 days of training in August and weekly staff development, training and program design meetings throughout the fall semester.

Support for the Early Behavior Intervention Program (EBIP) - Many of the fall activities of the members of the Student/Family Assistance Centers focused on support of the initial implementation of the coordinated EBIP prevention activities at API 1 elementary and middle schools. Activities by SFAC Center staff included: facilitation of small group training of counselors and nurses; consultation on program development; school-site support for implementation; support with activities, such as needs assessment and asset mapping; training and cross-training for school and EBIP staff; and facilitation of local district planning. During the remainder of the Fall Semester, SFAC staff provided 148 training sessions for 2,858 District staff and parents. In addition, staff provided 1,750 consultations on the school sites, of which 39% were with EBIP staff. Of the additional 1,043 telephone consultations, 46% were with EBIP staff. SFAC staff also provided direct consultation and support for 416 individual students.

SPRING 2001, IMPLEMENTATION PHASE

Beginning February 5, 2001, the three Centers opened officially for operation. These centers provide intervention and support service to three geographic areas covering all designated API 1 elementary and middle schools in the 11 local Districts. The Valley/West Center serves schools in Districts A-E; the East Center serves Districts F, H and J; and the Mid-City/South Center serves Districts G, I and K.

Services to Students, Families and Schools– From March 1st to April 1st, the SFAC received 101 new referrals. The Centers initiated assessment and triage with 76 of those students. Early results suggest that the largest amount of time spent in intervention will be to improve family functioning in order to assist the family’s support of the student at school. The assessment process in half of the initial referrals identified significant parent/guardian mental health concerns. A substantial number of referrals have had a history of Department of Children and Family Services involvement. The Centers are involved in discussions, with the LA County Departments of Mental Health and Children and Family Services, concerning a partnership designed to address these family concerns.

The Centers continue to provide consultation concerning students to administrators and school staff members. In March, Center staff consulted with school administrators concerning 74 students and with other school staff concerning 135 students. The Center counseled with 69 parents during March.

Program Development- Work groups continue to refine Center protocols and procedures based on input from stakeholders. The spring semester design focus is on development of program options to fit the needs of different local Districts, creation of partnerships with local community providers, and negotiation of potential contracts which would expand billing MediCal/MediCaid for Center activities. Presentations continue to school groups and local Resource Coordinating Councils as a part of ongoing outreach. Input is gained from the local Districts through the Health and Human Services Steering Committee.

Staff and Location

Ongoing staff development efforts continue bi-weekly with presentations and interactive discussion of all Center staff. Presentations include local providers who might be able to partner with the Centers in their efforts. Work groups scheduled during the same time period continue to refine protocols and procedures. On alternate weeks, each Center meets separately for case conferences and discussion of local center issues. Sites have been identified for the three centers and are expected to be in use by the end of the school year. Services to students, schools and families will continue to be provided primarily on site in the local school, home and community.

EVALUATION - The Student/Family Assistance Centers are evaluating priority intervention outcomes at the school, individual child and family level as well as developing a mechanism to determine long term efficacy and cost/benefit. In most areas pre –and post- intervention scales and reports will measure impact on markers, such as grades, teacher reports, school records, and fewer office referrals. Student outcomes include: increased achievement, change in target behaviors, improved interpersonal skills, and increased self-esteem. School outcomes include: fewer office referrals and suspensions, increased time on task, improved task completion and more effective classroom behavior strategies. Family outcomes include: improved parenting skills, improved parent/child relations and engagement of the family with supportive community institutions.

The Centers will also be evaluating cost per child of the program and the percentage of that cost reimbursable through MediCal (EPSDT, MAA, LEA) and other sources. In addition, the Student/Family Assistance Centers is discussing a research partnership with U.C.L.A. to assist with evaluation of the long-term efficacy of Center interventions and future cost avoidance. The partnership would review potential areas of savings, such as a: 1. decrease in inappropriate referrals to special education programs and related expenses associated with assessments by school psychologists; 2. reduction in the frequency of expulsions and related expenses of providing alternative services (i.e. Community Day Schools and Continuation Schools); 3. reduction in the costs associated with funding additional serious behavior control programs; 4. increased use by families of non-District community resources; and 5. reduction in placements of students in Emotionally Disturbed (ED) classes. (Nationally, two-thirds of these students are placed because of conduct disorders[1]).

ADDITIONAL INFORMATION

Schools wishing consultation or assistance with referrals may page:

Districts A-E: Gerri Como (213) 963-3917

Districts F, H & J:Zaida Ramos (213) 398-5181

Districts G, I & K:Dr. Richard Weinstein (213) 303-1668

If you have any questions concerning this report or need additional information concerning the program, please contact Michael Shannon, Coordinator, Student/Family Assistance Centers at 213 763-8312, or John Di Cecco, Director, Integrated Health Partnerships, at 213 763-8355.

Last printed 05/15/2001 4:34 PM 1

BACKGROUND

In November 1998, the Board and Superintendent directed staff to create a task force charged with the analysis of District behavior intervention practices. The task force charge was to determine ways to provide prevention and intervention services for students before their behavior escalated to the point where an expulsion recommendation became necessary. The first phase of the implementation of the task force report, and its accompanying budget requirements, was presented to the Board and adopted by it unanimously on March 28, 2000. The Board-adopted Behavior Intervention Program includes the elementary and middle school level Early Behavior Intervention Program, the Senior High School Teen Intervention and Support Program and the Student/Family Assistance Centers (SFAC). This report concerns the Student Family Assistance Centers’ component. The SFAC is designed to support high-need students whose behavior problems are a major factor contributing to school failure. All services of the Student and Family Assistance Centers aim to reduce the numbers of students who are at risk of retention, suspension and expulsion in the District's lowest-performing schools.

OVERVIEW OF RESEARCH

In many schools, the educational mission is thwarted because of many factors that interfere with youngsters’ learning and performance. Schools invest in support programs and services in order to address the many internal and external barriers interfering with student learning and development. A report on the conference of Full Service Schools held at Harvard University (1999) concluded that, although the primary role of schools is to teach, the public is becoming increasingly aware of how children’s academic needs are integrally related to social-emotional development and well being. They further concluded that education reforms aimed exclusively at improving schools by raising test scores, without strengthening the human connections in a student’s life, will fail. In fact, it can increase the disconnect between students and adults.

The Educational Testing Service analyzed a database of 16,000 students nationwide who were surveyed between 1988 and 1994. Researchers reviewed students’ discipline records and test scores as they progressed from 8th to 12th grades. They found a clear relationship between discipline problems and performance on achievement with students who committed minor or serious offenses scoring 10 percent lower on achievement tests in mathematics, reading, social science, and science than students who do not have discipline problems.

The Multnomah County Schools conducted a developmental assets study of their schools in 1997. This study looked at presence or absence of 40 developmental and behavioral assets that research indicates are needed for students to develop into effective learners and citizens. The findings suggested that their district profile mirrored that of many school districts across the nation. Regardless of size or demographics, students typically:

• Receive too little support through sustained and positive intergenerational relationships
• Lack opportunities for leadership and involvement
• Disengage from youth-serving programs in the community
• Experience inconsistent or unarticulated boundaries
• Feel disconnected from their community
• Lack the formation of social competencies and positive values

POVERTY & LIMITED COMMUNITY SUPPORT ARE FACTORS - Current data for California show a growing percentage of children are living in poverty and are uninsured or underinsured. As a result of these economic and social trends, it has been suggested that children attending many public schools may not have the same access to childcare, recreation, or other health care services as their counterparts in other more affluent areas. In Los Angeles County, one in four children have no medical insurance. In the Los Angeles Unified School District (LAUSD) more than 70 percent of the 713,905 students qualify for free lunch[2]. An additional five percent qualify for reduced-cost lunches[3][4]. But, only about 45 percent of LAUSD students are enrolled in health insurance now available to uninsured poor children[5]. Based upon estimates from the student free lunch program alone, at least thirty percent of LAUSD students (220,051) may be eligible, but not enrolled in a health insurance program now available to them. The chart below illustrates the level of poverty and the need of students attending LAUSD.

An apparent high correlation exists among poor health indicators, poverty, and low achievement, suggesting that multiple factors may contribute to the student’s failure. Addressing service gaps and unmet student need may be of strategic importance to the success of instructional reforms and efforts to attain improved educational outcomes.

It would be a mistake, however, to think of behavior problems only in terms of poverty. As recent widely-reported incidents underscore, potential violence is a specter hanging over all schools. And, while guns and killings capture media attention, other forms of violence affect and debilitate youngsters at every school. Hawkins and Catalano (1992) have summarized the research and categorized the various factors that should be addressed by schools, communities and families.

HOW MANY ARE AFFECTED BY BEHAVIOR PROBLEMS? - Many children are confronted with high levels of parental absence, fragmentation of many socializing systems, barriers to healthy development, programs and services, and families who need assistance with providing supportive environments. Sugai, Horner et al of the University of Oregon (2000), suggest that there are three levels of behavior at schools based upon national validation studies. According to their model, 80 to 90 percent of students do not present serious behavior problems, and as a result schools incorrectly assume that these students are well-versed in appropriate learning behaviors. Students who are at risk for behavior problems typically constitute 5 to 15 percent of the school population. This group of students will usually need some type of individual treatment, but will respond well to school-wide structure and behavioral supports. At the top level of this model, approximately 3 percent to 5 percent are students with chronic and intense behavior problems, who will need one-to-one attention beyond the scope of a school-wide prevention approach.

SUGAI AND HORNER MODEL (2000)

Some California program studies suggest that percentages represented in the Horner and Sugai population model may be conservative when applied differentially to regional rural or urban school district populations. In California, for example, the Early Mental Health Initiative (EMHI), operated by the State Department of Mental Health, estimates that at least 30 percent of all elementary school children experience moderate to severe school adjustment difficulties in rural areas. The percentages jump to nearly 70% when they examine their findings for urban areas in California. This would suggest that the following population model more accurately reflects our student population when employing the screening criteria of the California EMHI program:

STATE OF CALIFORNIA DEPARTMENT OF MENTAL HEALTH EMHI PROGRAM

The State of California reports that the behaviors leading to adjustment problems are often detectable at an early age and can be ameliorated through a systematic screening and intervention program.

OUTSIDE REFERRALS OFTEN ARE NOT SUFFICIENT - - When students are struggling in school because of emotional or behavioral challenges, they are often referred for outside services and ultimately fail to receive them for a variety of reasons (Poduska & Kendziora, 1999). Among youth referred for outside mental health treatment, 50 to 75 % either do not initiate treatment or terminate prematurely; and, in terms of cost, it is estimated that mental disorders in children under 14 years of age cost our nation about $1.5 billion per year (Kazdin, 1994). School-based intervention teams are highly recommended since students, developmentally, must negotiate two crucial social-behavioral adjustments while at school: Teacher-related and peer-related. In early adolescence, self-related adjustment e.g. managing emotions, being organized, etc, becomes a third key factor (Walker et al, 1995)

SPECIAL EDUCATION IS NOT SUFFICIENT - Special education placements for emotionally disturbed students continue to increase without supporting the majority of students with behavior problems. Walker et al (1995) state that the number of students with serious conduct disorders is many times the size of the currently certified emotionally disturbed school-age population. They cite sources that document that conduct-disordered behaviors are dramatically increasing and are impairing the ability of schools to educate all students effectively. In turn, such a pattern of antisocial behavior appears to be “...the single best predictor of adolescent delinquency...[and] of adult criminality” (Wahler & Dumas, 1986, as cited by Walker et al, 1995.)