Check incheck out effects on students with emotional and behavioral disorders with attention or escape maintained behavior in a residential facility

This article was downloaded by: [University of Nebraska, Lincoln] On: 12 March 2015, At: 00:18 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK Exceptionality: A Special Education Journal Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/hexc20 Check In/Check Out: Effects on Students with Emotional and Behavioral Disorders with Attention- or Escape-Maintained Behavior in a Residential Facility a b b Nicole Cain Swoszowski , Kristine Jolivette , Laura D Fredrick & L Juane Heflin a b The University of Alabama b Georgia State University Published online: 20 Jul 2012 To cite this article: Nicole Cain Swoszowski , Kristine Jolivette , Laura D Fredrick & L Juane Heflin (2012) Check In/Check Out: Effects on Students with Emotional and Behavioral Disorders with Attention- or Escape-Maintained Behavior in a Residential Facility, Exceptionality: A Special Education Journal, 20:3, 163-178, DOI: 10.1080/09362835.2012.694613 To link to this article: http://dx.doi.org/10.1080/09362835.2012.694613 PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content This article may be used for research, teaching, and private study purposes Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden Terms & Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 Conditions of access and use can be found at http://www.tandfonline.com/page/termsand-conditions Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 Exceptionality, 20:163–178, 2012 Copyright © Taylor & Francis Group, LLC ISSN: 0936-2835 print/1532-7035 online DOI: 10.1080/09362835.2012.694613 Check In/Check Out: Effects on Students with Emotional and Behavioral Disorders with Attention- or Escape-Maintained Behavior in a Residential Facility Nicole Cain Swoszowski The University of Alabama Kristine Jolivette, Laura D Fredrick, and L Juane Heflin Georgia State University Check In/Check Out (CICO) is a secondary tier intervention for those students who are not responsive to universal tier, school-wide positive behavioral interventions and supports The present study extended the implementation of CICO to six students with emotional and behavioral disorders in a residential facility whose behaviors were maintained by either attention or escape Results of a nonconcurrent multiple baseline across participants design indicate that the mean percentage of problem behavior improved for two of three students with attention-maintained behavior and two of three students with escape-maintained behavior Future directions and limitations of the research are addressed Students with emotional and behavioral disorders (E/BD) demonstrate maladaptive behaviors that may affect social and academic performance and may then lead to the isolation of students with E/BD from their same age peers (Coutinho, 1986) Students with E/BD are the most likely of all disability groups to require supports in alternative education (AE) settings According to the National Center on Education Statistics (NCES, 2001), 33% to 75% of students served in alternative school settings have an E/BD eligibility Tobin and Sprague (2000) cited several effective practices for AE settings including highly structured classroom management, an emphasis on positive-behavior management, the inclusion of adult mentors at the school, the inclusion of function-based assessment, and social-skills instruction A research-based framework that incorporates these noted effective practices is positive behavioral interventions and supports (PBIS; Flower, McDaniel, & Jolivette, 2011) Correspondence should be addressed to Nicole Cain Swoszowski, Department of Special Education and Multiple Abilities Program, The University of Alabama, Box 870232, Tuscaloosa, AL 35487 E-mail: nswosz@bamaed.ua.edu 163 Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 164 SWOSZOWSKI ET AL PBIS is a three-tier proactive and preventative framework (Sugai & Horner, 2002) based on the theory of behaviorism and the principles of applied behavior analysis, which involves the fundamentals of conditioning behavior through the modification of antecedents and consequences (Dunlap, 2006; Sugai & Horner, 2002) Researchers have evaluated the effectiveness of universal and tertiary tier PBIS interventions within typical school settings but have not evaluated secondary tier interventions as thoroughly (Hawken, Adolphson, Macleod, & Schumann, 2009) There is a need for further evaluation of secondary tier interventions to meet effectively the needs of those students who require more targeted supports than are available at the universal level, such as students with E/BD Secondary tier interventions also are critical to prevent the need for resource intensive individualized supports at the tertiary tier (Horner, Sugai, Todd, & Lewis-Palmer, 2005; Sugai & Horner, 2002) Secondary tier interventions are noted as being (a) designed in combination with school-wide expectations; (b) adapted to address the function of behavior, when needed; and (c) implemented quickly and efficiently as multiple students can be addressed at one time, and the intervention can be implemented quickly using materials and personnel already available in the school environment (Hawken et al., 2009) One such secondary tier intervention is Check In/Check Out (CICO), which may be appropriate for students with E/BD who require support beyond the universal tier CICO originated as the Behavior Education Plan (BEP; Hawken & Horner, 2003; Hawken, MacLeod, & Rawlings, 2007; March & Horner, 2002) and is based on the fundamentals of a daily report card The use of daily report cards is noted as a reliable means for accurately documenting student behavior as well as for providing behavioral feedback to students (Chafouleas, McDougal, Riley-Tillman, Panahon, & Hilt, 2005; Riley-Tillman, Chafouleas, Briesh, & Eckert, 2008) Students are typically chosen for CICO based on nonresponsiveness to universal, schoolwide PBIS as indicated by discipline referrals Two to five office discipline referrals (ODRs) within a school year is a recommended criterion for secondary tier referral (Crone, Horner, & Hawken, 2004; Horner et al., 2005); however, some CICO studies have included students based on general problem behaviors or administrator/teacher recommendations (Campbell & Anderson, 2008; Fairbanks, Sugai, Guardino, & Lathrop, 2007; Filter et al., 2007; Hawken & Horner, 2003; Hawken et al., 2007; March & Horner, 2002; Todd, Campbell, Meyer, & Horner, 2008) When CICO is implemented, a student is paired with an adult mentor (CICO facilitator) to encourage positive, appropriate behavior throughout the school day Students complete a 5-step CICO cycle including check in with the facilitator at the beginning of the school day to set behavior goals for the day and check out with the facilitator at the end of the day to determine if daily goals were met During the school day, the student’s behavioral performance is assessed per class period by each teacher In addition, the student takes the CICO point sheet home to discuss daily behavior with parents to provide collaboration and planned communication between the school and home environments The presence of the CICO facilitator and adult in the home environment provide adult attention within the 5-step CICO cycle, thus leading researchers (March & Horner, 2002; McIntosh, Campbell, Carter, & Dickey, 2009) to hypothesize that function of behavior may relate to student responsiveness to CICO especially for students with adult-attention-maintained behavior who may be more likely to respond to CICO To assess function, researchers conduct functional behavior assessments (FBAs) to determine the antecedents that precede or predict behavior and the consequences that follow or maintain behavior, with function in two pri- Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 CHECK IN/CHECK OUT 165 mary categories: (a) to gain (attention, tangible, sensory stimulation), and (b) to escape/avoid (demand, attention, sensory stimulation) (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982; Maag, 2004; Sugai, Lewis-Palmer, & Hagan-Burke, 1999) Four CICO studies have included an FBA as part of the initial CICO intervention phase (Campbell & Anderson, 2008; March & Horner, 2002; McIntosh et al., 2009; Simonsen, Myers, & Briere, 2010) but with mixed approaches: (a) March and Horner (2002) conducted the Functional Assessment Checklist for Teachers and Staff (FACTS; March et al., 2000) interview after the CICO intervention period ended, (b) Campbell and Anderson (2008) used both the FACTS and brief observation to determine peer-attention–maintained behavior for two students prior to intervention for reading and during intervention for math, (c) McIntosh and colleagues (2009) assessed function using the FACTS interview one to five days before beginning intervention, and (d) Simonsen and associates (2010) administered FACTS interviews prior to intervention as a descriptive measure, not to determine responsiveness by function To date, no studies have assessed function a priori for nomination purposes using an FBA protocol including archival record reviews, teacher interviews, and classroom observations to determine the relationships between antecedents, behavior, and consequences to identify either escape-maintained or attentionmaintained behavior While the use of an a priori FBA approach as part of the nomination process may appear in direct contrast with the resource efficient benefits of secondary tier interventions noted previously, interviews alone are not a recommended approach (Horner, Albin, Sprague, & Todd, 1999; O’Neill et al., 1997) and the thorough evaluation of function for research purposes to scientifically evaluate the likelihood of response per function is a necessary contribution to the CICO research literature Without the addition of a priori assessment of function, it is not possible to determine the accurate assessment of function of inappropriate behavior without the impact of the intervention potentially confounding the results of the FBA as function can change throughout an intervention period over time (March & Horner, 2002) Of the nine published empirical CICO studies and the two conceptual CICO papers, as identified through a literature search, researchers have evaluated the effectiveness of CICO across traditional elementary (Campbell & Anderson, 2008; Fairbanks et al., 2007; Filter et al., 2007; Hawken et al., 2007; McIntosh et al., 2009; Todd et al., 2008) and middle school settings (Hawken & Horner, 2003; March & Horner, 2002; Simonsen et al., 2010) with 136 students (94 males, 23 females; gender not reported by Filter et al., 2007) in Kindergarten through ninth grade Of the 136 total participants, 11 received services through special education; with learning disabilities and with a disability that was not specified A majority of students exposed to CICO have demonstrated decreases in problem behavior as evidenced by (a) mean changes in percentage of intervals with problem behavior (Campbell & Anderson, 2008; Fairbanks et al., 2007; Hawken & Horner, 2003; Todd et al., 2008), (b) decreases in ODRs and/or discipline contact (Filter et al., 2007; Hawken et al., 2007; March & Horner, 2002; McIntosh et al., 2009), (c) decreases in problem behavior ratings (McIntosh et al., 2009), and (d) increases in academic engagement (Hawken & Horner, 2003) To assist in the generalization of the effects of CICO beyond the current studies, it is critical to include (a) students with disabilities (e.g., those with E/BD), (b) settings outside typical schools (e.g., AE settings: day treatment, residential, juvenile justice), and (c) a priori FBAs as part of the nomination process In this study, researchers extended the 5-step CICO intervention to students with E/BD in an AE setting, a residential facility, with problem behavior maintained by adult attention or escape from demands with function assessed a priori The research questions were: (a) What effect 166 SWOSZOWSKI ET AL does CICO have on the attention-maintained problem behavior of students with E/BD? (b) What effect does CICO have on the escape-maintained problem behavior of students with E/BD? (c) Is the attention-maintained problem behavior of students with E/BD affected differently by CICO than the escape-maintained problem behavior of students with E/BD? METHOD Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 Participants Six students in grades through participated: three with problem behavior maintained by adult attention (Tyrone, Leo, Daniel) and three with problem behavior maintained by escape from demands (Kevin, Natalie, Nathan) The students participated if they (a) received two to five office discipline referrals (ODRs) since the beginning of the school year prior to baseline, (b) lived at the residential facility, (c) had a primary eligibility of E/BD, (d) demonstrated inappropriate behavior maintained by either attention (from adults) or escape (from demands) per the a priori FBA, (e) were in grades through 12, and (f) provided informed consent Researchers used the school-wide information system database (SWIS; May et al., 2000) to determine the number of ODRs students received prior to baseline Throughout baseline and intervention condition, it was observed that teachers were writing ODRs for minor discipline infractions (e.g., use of profanity, putting head down on desk) inconsistent with school procedures Researchers discussed this with the facility administrator, and even after the administrator conducted a retraining session regarding ODR referrals no observable improvements were observed to the referral process (i.e., inconsistencies between practice and procedure) Therefore, ODRs were used for inclusion criteria only Refer to Table for student demographics Three teachers, three housing supervisors, and three housing staff served as CICO facilitators Each student was paired with one CICO facilitator (a teacher) for the school component of CICO and a housing facilitator (either a housing staff or supervisor depending on shift) for the home component See Table for facilitator demographics See Table for facilitator assignments Setting The study took place at an urban residential facility for students with E/BD in first through twelfth grades The maximum capacity of this facility is 74 students Classes typically include to students, a teacher, and a behavior specialist to assist with behavioral issues on an as needed basis The school is structured as a typical public school but also provides housing for students on campus The classroom environments are like traditional school classrooms, and instruction is consistent with that in traditional school settings with curricula linked to the State performance standards School-wide universal PBIS has been in place for three years and both school and housing staff have been trained to implement universal PBIS Fidelity of universal PBIS was assessed using the School-Wide Evaluation Tool (SET; Sugai, Lewis-Palmer, Todd & Horner, 2001) twice each year of universal implementation and all obtained scores exceeded the minimum 80/80 167 12 14 12 15 14 13 Tyrone Leo Daniel Kevin Nathan Natalie 9 Grade M M M M M F Gender African American Caucasian Caucasian Caucasian Caucasian Caucasian Race/Ethnicity Low Low Low Low Low Low SES 5 No of ODRS at Identification Parental Custody DFCS DFCS Parental Custody DFCS Parental Custody Referral Source 22 36 43 37 39 months months months months months months Length of Stay Prior to Study 2, 1, 1, 1, 1, 1, 3, 4, 2, 3, 2, 4, 4, 3, 5, 6, 7 Challenging Behaviors Attention Attention Attention Escape Escape Escape Function Note SES: students in the alternative education setting are considered in state custody All students’ income falls in the range of low SES, and students are eligible for free and reduced lunch; DFCS D Department of Family and Children Services; Challenging behaviors, per SWIS database: D noncompliance, D destruction of property, D physical aggression, D inappropriate vocalizations, D elopement, D sleeping, D disruption Age Name TABLE Participant Demographics Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 168 SWOSZOWSKI ET AL TABLE Facilitator Demographics Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 Name Shannon Luke Katie Ronald Maria Larry Jennifer Andrew Marcy Title/Location Gender Race/Ethnicity Highest Degree Years of Experience Age Teacher/School Teacher/School Teacher/School Supervisor/Unit Staff/Unit Supervisor/Unit Staff/Unit Supervisor/Unit Staff/Unit Female Male Female Male Female Male Female Male Female Caucasian Caucasian Caucasian African American African American African American Caucasian African American Caucasian Bachelors Bachelors Bachelors Bachelors Bachelors Bachelors Bachelors Bachelors Bachelors 10 10 6 2 37 37 29 39 34 52 31 35 29 Materials The materials used in this study included a daily CICO point card (referred to as a STAR point chart), the FACTS (March et al., 2000), and a fidelity checklist Functional Behavior Assessment Researchers conducted an FBA a priori according to the steps suggested by Sugai, LewisPalmer, and Hagan-Burke (1999) First, we analyzed information from ODR referrals Second, the two teachers who had the most daily contact with the students completed FACTS interviews During the FACTS interviews, the teachers indicated the behavior deemed most problematic for each student and described in detail the topography of the behavior In addition, teachers ranked students’ problematic environments from most to least based on their experiences with the students and on the locations noted on ODRs Third, the researchers operationally defined the target problem behavior for each student based on the descriptions of the behavior provided (see Table 4) Fourth, we formed hypothesis statements based on the FBA data Fifth, researchers conducted direct observations in the classrooms rated as most problematic and to confirm if (a) the behavioral operational definition was accurate, and (b) the hypothesis statement was supported by the antecedent-behavior-consequence (A-B-C) data collected TABLE Facilitator Assignment Student School Facilitator Housing Facilitator Tyrone Leo Daniel Kevin Nathan Natalie Shannon Shannon Katie Luke Katie Luke Ronald Maria Larry Jennifer Andrew Marcy CHECK IN/CHECK OUT 169 TABLE Definitions Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 Name Behavior Tyrone Disruption Leo Noncompliance Daniel Disruption Kevin Noncompliance Nathan Noncompliance Natalie Noncompliance Definition Speaking or making vocalizations without first gaining permission to speak from an adult and/or without being engaged in conversation by an adult during classroom instruction, independent work times, and during transitions—this can include use of profanity and verbal insults toward teachers and peers Verbally refusing to complete an assignment or to follow a request/demand, putting head down on desk and/or closing eyes for more than consecutive seconds, failing to respond to or follow through with an assignment, a request, or a demand for more than consecutive seconds Leaving designated area and/or moving around classroom; speaking or making vocalizations without first gaining permission to speak from an adult—this can include the use of profanity and verbal insults toward teachers and peers and noises such as singing Also included is intentional coughing and banging hands on desk top or stomping feet on floor Putting head down on desk and/or closing eyes for more than consecutive seconds, failing to respond to or follow through with an assignment, a request, or a demand for more than consecutive seconds Putting head down on desk and/or closing eyes for more than seconds, failing to respond to or follow through with an assignment, a request, or a demand for more than consecutive seconds Verbally refusing to complete an assignment or to follow a request/demand, putting head down on desk and/or closing eyes for more than consecutive seconds, failing to respond to or follow through with an assignment, a request, or a demand for more than consecutive seconds Dependent Variables and Data Collection The dependent variable was percentage of intervals with problem behavior Percentage of intervals with problem behavior Researchers documented the percentage of intervals with problem behavior using a 10-second partial interval recording system for 20-minute direct observations The target problem behavior observed was individualized per student and observed in the most problematic classroom four times per week See Table for a description of target problem behavior per student Observers wore an MP3 player with headphones on a splitter for all observations Researchers calculated the percentage of intervals with target problem behavior by dividing the total number of intervals in which the problem behavior occurred by the total number of intervals in the session, and multiplying by 100% Facilitator Training All school staff serving as CICO facilitators attended a two-hour training session on the implementation procedures of CICO They were trained on the dialogue to have with students each morning/afternoon, to complete the daily CICO point card (i.e., the STAR point chart), and to complete a checklist as a means to guide them through the intervention steps At the Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 170 SWOSZOWSKI ET AL conclusion of the training, the facilitators role-played the procedure for both check in and check out until they reached 100% fidelity using a variety of scenarios Housing facilitators attended a separate one-hour training (i.e., unit supervisor, housing staff, school administrator) We scheduled this session separately from the school training to accommodate staff scheduling patterns and the session was shorter in duration as only one step of the five-step cycle was discussed Housing staff were instructed on how to follow a checklist as a guide for providing feedback to students and signing the CICO point chart each afternoon At the conclusion of the training they role-played the procedure for providing feedback and signing the STAR point chart to 100% fidelity using a variety of scenarios All sixth through ninth grade teachers participated in a one-hour training on how to award points for the daily CICO point card The training included a demonstration of how to complete the CICO point card per class period and examples and nonexamples of when students would earn a 0, 1, or on the CICO point card Research Design A nonconcurrent multiple baseline across participants design was used (Kazdin, 1982; Kennedy, 2005) for both attention- and escape-maintained behavior so that responsiveness to the intervention by function could be assessed as students were identified for possible inclusion throughout the semester Researchers chose a nonconcurrent multiple baseline as this design is noted for flexibility as participants can be added to intervention as they are identified given the transient nature of the student population within AE settings Independent Variable The independent variable was check in/check out The baseline and intervention phases are described next Baseline Researchers conducted direct observation of the percentage of intervals with problem behavior School personnel continued implementation of the facility-wide PBIS (FWPBIS) universal tier supports where students were taught, modeled, and reinforced (e.g., given STAR coupon) for engaging in the facility-wide rules (i.e., show respect, take responsibility, accept adult directions, and respond appropriately) throughout the baseline phase On a weekly basis, students could exchange their STAR coupons for items and/or privileges in the school store CICO intervention phase Facility-wide PBIS from baseline remained in effect during intervention Prior to implementing CICO, researchers randomly assigned each student a CICO facilitator with the pairing constant throughout See Table for facilitator assignments CICO facilitators implemented the 5-step CICO intervention daily using the following steps: First, the students met individually with their CICO facilitator in the facilitator’s classroom prior to homeroom to set STAR point goals for the day as well as to receive their daily STAR point chart The STAR point chart provided a visual representation of the students’ daily schedules and a place for the teachers to rate students’ daily behavior by class period in accordance with Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 CHECK IN/CHECK OUT 171 the PBIS behavioral expectations (i.e., show respect, take responsibility, accept adult feedback, and respond appropriately) The point goal for each student was 80% of possible points as suggested by Crone and colleagues (2004) All students received their own copy of the form; however, the forms were the same across students as is consistent with the tier two, targeted supports, design Second, the students took the STAR point chart from class to class The students gave the STAR point chart to the teacher at the beginning of each class period and collected it at the end of the period with both verbal and written feedback from the teacher indicating whether they scored a 0, 1, or for the period A score of indicated that the student was dismissed from the classroom and required intervention A score of indicated the student was good overall but did receive warnings for behavior, and a score of indicated the student demonstrated behavior consistent with the school rules and did not require warnings from the teacher Third, 15 minutes prior to dismissal from school each day, each student met individually in the facilitator’s classroom with his or her school CICO facilitator again to discuss behavior for the entire school day and by class as well as to discuss all STAR chart points received The students received verbal praise for scores of (e.g., “Nice job in math today You scored 2s on all STAR rules.”) and the CICO facilitator and student discussed behavior strategies to address scores of or to improve behavior for the next school day For example, if a student earned a in math, the facilitator and student discussed what happened in math If, for example, the student reported he or she threw his or her paper on the floor because the math assignment was viewed as difficult, the facilitator would ask what he or she could differently next time, and would suggest asking for a break from the task at hand to regain behavioral control The students received a STAR coupon when they met their STAR chart point goal (as was agreed upon during check in) A STAR coupon is part of FW-PBIS and is awarded to students when they engage in any of the four positive, appropriate behaviors Fourth, students took their STAR point chart to their housing CICO facilitator When the students entered the house at the end of the school day, each student presented his or her housing CICO facilitator with his/her STAR point chart The housing facilitator reviewed the STAR point chart with the student, praised him or her for areas of strengths (i.e., scores of 2), discussed areas for improvement (i.e., scores of or 1), ended the discussion on a positive note, signed the form, and placed the STAR point chart in the student’s folder Fifth, the students returned the STAR point chart to their school CICO facilitator during check in the following school morning A bonus STAR coupon was given for returning the signed STAR point chart Then, steps through were repeated Fidelity To ensure accurate implementation of the CICO intervention, researchers assessed fidelity for 25% of the 5-step CICO cycle sessions using a 14-item fidelity checklist Researchers calculated fidelity by dividing the total number of observed steps by the total number of expected steps and multiplying by 100% The percentage for each student was: Tyrone, 93.57% (range, 85.71% to 100%); Leo, 95% (range, 85.71% to 100%); Daniel, 98.98% (range, 92.85% to 100%); Kevin, 95.45% (range, 85.71% to 100%); Natalie, 95.71% (range, 92.85% to 100%); and Nathan, 98.98% (92.85% to 100%) A second observer conducted observations for 20% of the fidelity checks to determine interobserver agreement of fidelity Researchers used point-bypoint agreement to calculate interobserver agreement of fidelity by dividing the total number 172 SWOSZOWSKI ET AL of agreements by the total number of agreements plus disagreements and multiplying by 100% (Kennedy, 2005) Interobserver agreement was 100% for Leo, Kevin, and Natalie; and 93.57% (range, 92.86% to 100%) for Tyrone; 96.43% (range, 92.86% to 100%) for Daniel; and 92.86% (range, 85.71% to 100%) for Nathan Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 Interobserver Agreement Researchers measured interobserver agreement for the percentage of intervals with problem behavior during 25% or more of observation sessions We calculated agreement using the point-by-point agreement formula by dividing the total number of agreements by the total number of agreements plus disagreements and multiplying by 100% (Kennedy, 2005) For Tyrone, IOA was conducted for 27.20% of total sessions with IOA at 99.17% (range, 95% to 100%) for disruption; for Leo, IOA was conducted for 25.45% of total sessions with IOA at 99.94% (range, 99.16% to 100%) for noncompliance; for Daniel, IOA was conducted for 28.13% of total sessions with IOA at 100% for disruption; for Kevin, IOA was conducted for 28.30% of total sessions with IOA at 99.62% (range, 98.33% to 100%) for noncompliance; for Natalie, IOA was conducted for 26% of total sessions with IOA at 99.86% (range, 99.16% to 100%) for noncompliance; and for Nathan, IOA was conducted for 27.02% of total sessions with IOA at 100% for noncompliance RESULTS Attention-Maintained Behavior Figure represents the percentage of intervals with problem behavior for students with problem behavior maintained by adult attention, and Table illustrates mean baseline and intervention percentages of intervals with problem behavior as well as percentage of nonoverlapping data points Two of three students with problem behavior maintained by adult attention responded positively to CICO as indicated by mean changes in problem behavior Although Tyrone demonstrated a 46.12% decrease in intervals with problem behavior, he also demonstrated much variability in responding; meaning the effect of CICO on the percentage of intervals with problem behavior for Tyrone is inconclusive While Leo also demonstrated variability in responding, the percentage of change for Leo indicated positive responding Escape-Maintained Behavior Figure represents the percentage of intervals with problem behavior for students with problem behavior maintained by escape from demand, and Table illustrates mean baseline and intervention percentages of intervals with problem behavior as well as percentage of nonoverlapping data points Two of three students with problem behavior maintained by escape from demands responded positively to CICO as indicated by mean changes in problem behavior Although Kevin demonstrated a 22.11% decrease in intervals with problem behavior, he also demonstrated much variability in responding; meaning the effect of CICO on the percentage of intervals with problem behavior for Kevin is inconclusive Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 CHECK IN/CHECK OUT FIGURE 173 Percentage of intervals with problem behavior for students with attention-maintained behavior TABLE Individual Behavior Results Student Behavior Tyrone Disruption Leo Noncompliance Daniel Disruption Kevin Noncompliance Nathan Noncompliance Natalie Noncompliance Baseline Mean1 Intervention Mean1 Percent Change PND 25.41% (range, 12.5% to 43.33%) 100.00% 13.69% (range, 83% to 42.5%) 37.05% (range, 0% to 99.17%) 12.42% (range, 0% to 50%) 47.98% (range, 0% to 100%) 17.32% (range, 0% to 100%) 16.50% (range, 1.67% to 30.83%) 46.12% decrease 57.50% 62.95% decrease 100.00% 75.02% decrease 95.24% 22.11% decrease 38.89% 68.51% decrease 82.60% 79.40% decrease 100.00% 49.72% (range, 35% to 65.83%) 61.60% (range, 25% to 95.83%) 55.00% (range, 28.33% to 80.83%) 80.10% (range, 43.33% to 100%) Mean: The baseline and intervention means reported reflect the mean for percentage of intervals with problem behavior PND D percentage of nonoverlapping data Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 174 SWOSZOWSKI ET AL FIGURE Percentage of intervals with problem behavior for students with escape-maintained behavior DISCUSSION In this study, we evaluated the effects of the 5-step CICO intervention on the problem behavior of six students with E/BD in an AE setting Four of six students positively responded as indicated by mean changes in problem behavior, regardless of function, but the results for Tyrone and Kevin are inconclusive as there was much variability in their data The current study extended the CICO literature base by addressing multiple limitations cited in previous studies These extensions include: (a) conducting a priori FBAs, and (b) selecting students (i.e., with E/BD) and a setting (i.e., residential) not previously studied Implications of results in relation to function as well as limitations will be discussed along with future research directions Researchers hypothesized throughout the CICO literature that students with attention-maintained behavior may be more responsive to CICO than students with escape-maintained behavior (Crone et al., 2004; March & Horner, 2002; McIntosh et al., 2009) Results of this study demonstrate that students with attention- and escape-maintained behavior both responded positively to CICO A possible explanation is that the intervention did provide minimal escape from demands for students in this setting Students were allowed to meet individually with the CICO facilitator at the start of the day and prior to returning to the housing unit in the CHECK IN/CHECK OUT 175 afternoon It may be that students were motivated by this contact as it delayed the start of their morning work prior to school and therapy session, chores, and/or homework time after school, providing a brief, temporary escape from demands Another possible explanation is that students receiving support in a 24-hour/7-day per week facility may have fewer opportunities for one-on-one interactions with adults than students in traditional settings, and therefore, even for students with escape-maintained behaviors, the one-on-one adult attention embedded in CICO was reinforcing Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 Limitations The present study was not without limitations; therefore, the results must be considered in light of the noted limitations First, the data of several students were variable and unstable Tyrone’s data were variable through baseline and intervention Baseline observations indicated low levels of problem behavior for Tyrone, which continued into intervention Therefore, small changes in the percentage of intervals with problem behavior impacted mean changes in problem behavior Additionally, variability in responding may be related to contextual factors in the residential setting including both the school and housing unit and across school, housing, and therapeutic staff Steps were not taken to control for contextual factors (e.g., appropriateness of level of curriculum/ instruction, method of instruction) Second, two function-related limitations were possible The relationship between the student and CICO facilitator was neither evaluated nor controlled for other than two students were randomly paired with each mentor Therefore, it is unknown if the relationship between mentor and facilitator may have impacted student responsiveness to CICO, regardless of function Also, researchers did not adapt the CICO cycle to match function in this study as their goal was to evaluate the impact of traditional CICO on the problem behavior of students with a disability and in a setting not previously evaluated Third, two setting events within the AE setting may have influenced student’s school behavior Student behavior on the unit may have negatively influenced school behavior and school attendance for several students, especially those students demonstrating problem behavior maintained by escape from demands Natalie refused to attend school for first period and fifth period due to consequences of her inappropriate unit behavior Staff reported that Natalie often engaged in negative verbal exchanges (e.g., provocation) before school or during lunch on the unit with her peers, and at times, peers responded with a threat (e.g., “I will get you at school”) By not attending these class periods, the entire CICO cycle could not be implemented and consistent feedback on the CICO point sheet was limited These inappropriate behaviors occurred during baseline to such a level that she was moved to a more restrictive setting within the residential facility known as Emergency and Security (E&S) for 37 days In addition, Kevin frequently refused to get out of bed in the morning This behavior increased at times when Kevin was scheduled for a home visit (e.g., sessions 40 through 45) Additionally, visits from caseworkers and families may have negatively affected student behavior For example, the morning of Session 19, Nathan’s case manager told him he may be moving to another facility Also, Nathan continued to display a high percentage of problem behavior the following two days When asked why he was having such difficulty, he stated that he was being moved to another facility and his behavior did not matter anymore since, “all the papers are already 176 SWOSZOWSKI ET AL signed.” In addition, on Session 26, after meeting with his therapist, Nathan displayed a high percentage of problem behavior when he entered the classroom Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 Future Areas for CICO Research When considering the results of the current study as well as the extensions to the current CICO literature base, future areas for research must be addressed Replication of CICO with students with E/BD as well as in AE settings is warranted as the sample size in this study was small (N D 6) With replication with students with E/BD, researchers should evaluate the relationship between pre-assessment data including percentage of intervals with problem behavior to determine inclusion criterion for students with E/BD While it is expected students with E/BD may demonstrate higher rates of problem behavior than their nondisabled peers and still warrant secondary tier interventions, currently there is not an agreed upon criterion for CICO referral for this population Future researchers also should investigate the relationship between student and facilitator, and should seek to determine the effect of this relationship on responsiveness to CICO Researchers might consider evaluating the impact of facilitator choice on students’ response to CICO Researchers also should evaluate adaptations to the CICO cycle to address potential setting events as discussed previously For example, it may be beneficial for students in AE settings to have more frequent check-ins and check-outs including check in before school, check out before lunch, check in prior to returning to school after lunch, check out at the end of the school day, and an additional check-in for students after they have interacted with family or therapeutic staff In addition, the CICO cycle could be adapted by researchers so that students are referred by their teachers for an additional conversation with their CICO facilitator if they are observed demonstrating behavior that is inconsistent with the expected, appropriate FW-PBIS behaviors Future researchers also may include adaptations to the CICO environment For example, for those students having difficulty coming to school, it may be beneficial to have check-ins completed on the unit as opposed to at school, and the evaluation of behaviors on the unit could be incorporated into feedback as part of the CICO cycle For those students engaging in behavior that disrupts the CICO cycle, a discussion of the behaviors contributing to the consistent completion of the CICO cycle by the student and facilitator may be necessary For example, the facilitator could discuss the consequences of provoking peers with Natalie and could discuss more appropriate ways to interact with peers and respond to conflicts Also, another secondary tier intervention such as a social skills club may be appropriate for students like Natalie Furthermore, it may be valuable for researchers to evaluate function-based adaptations to the five-step CICO cycle such as providing students with escape-maintained behavior escape as part of the reinforcement component or by adding discussions of function-specific replacement behaviors to the check in and check out cycle CONCLUSION This study is a first step at analyzing the effect of CICO on the problem behaviors of students with E/BD with attention-maintained or escape-maintained behavior who were not responsive to universal school-wide PBIS in a residential setting Positive behavioral interventions and supports have been implemented with much success across traditional school environments, CHECK IN/CHECK OUT 177 and the extension to AE settings such as the residential setting addressed in this study is much needed to address the social and academic problem behaviors of students within these settings Students in AE settings may benefit from the three tiers of positive behavioral supports, similar to the interventions provided across these tiers in typical schools Further research evaluating PBIS across the tiers in AE settings is needed as well as CICO with a priori FBAs across settings, participants, and age groups as well as replication of this study for AE settings Downloaded by [University of Nebraska, Lincoln] at 00:18 12 March 2015 REFERENCES Campbell, A., & Anderson, C M (2008) Enhancing effects of check in/check out with function-based support 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In /Check Out: Effects on Students with Emotional and Behavioral Disorders with Attention- or Escape-Maintained Behavior in a Residential Facility Nicole Cain Swoszowski The University of Alabama... Supervisor/Unit Staff/Unit Female Male Female Male Female Male Female Male Female Caucasian Caucasian Caucasian African American African American African American Caucasian African American Caucasian... students with attention- maintained behavior and two of three students with escape-maintained behavior Future directions and limitations of the research are addressed Students with emotional and