Future research directions for the field of E/BD: standing on the shoulders of giants.
Article Type:
Report
Subject:
Classroom management (Methods)
Mentally ill children (Care and treatment)
Mentally ill children (Education)
Best practices (Research)
Authors:
Lane, Kathleen Lynne
Jolivette, Kristine
Conroy, Maureen
Nelson, C. Michael
Benner, Gregory J.
Pub Date:
11/01/2011
Publication:
Name: Education & Treatment of Children Publisher: West Virginia University Press, University of West Virginia Audience: Professional Format: Magazine/Journal Subject: Education; Family and marriage; Social sciences Copyright: COPYRIGHT 2011 West Virginia University Press, University of West Virginia ISSN: 0748-8491
Issue:
Date: Nov, 2011 Source Volume: 34 Source Issue: 4
Topic:
Event Code: 310 Science & research
Geographic:
Geographic Scope: United States Geographic Code: 1USA United States

Accession Number:
271811385
Full Text:
Abstract

The origins and evolution of the field of emotional/behavioral disorders (E/BD) provide a context for offering suggestions for advancing the field. Building from this historical past and the research of others in the field, four broad recommendations which focus on academic and social needs of students with E/BD are offered: (a) ensuring high fidelity of implementation of effective intervention practices, (b) working within a systems-level approach, (c) developing a knowledge base through service-based research, and (d) preparing teachers of students with E/BD to meet the challenge. Embedded in these recommendations are three critical themes: the use of evidence-based practices, a response to intervention decision-making framework, and implementation of interventions with fidelity.

Students with emotional and behavioral disorders (E/BD) have been referred to as unclaimed children (Knitzer & Olson, 1982). These students have externalizing (e.g., delinquency, aggression, noncompliance) and internalizing (e.g., anxiety, depression, somatic complaints) behavior patterns, with many students displaying behaviors in both domains (Achenbach, 1991; Walker, Ramsey, & Gresham, 2004). Not surprisingly, students with E/BD struggle in many aspects of their life including interpersonal relationships with peers and adults, academic demands of the classroom setting, and self-determined behaviors (Greenwood, Hart, Walker, & Risely, 1994; Patterson, Reid, & Dishion, 1992; Wehmeyer & Field, 2007). These collective concerns in academic, social, and behavioral domains persist into adulthood, leading to other challenges during adulthood such as under-and unemployment, divorce, the need for mental health services, and even contact with the justice system (Moffitt, 1993; Wagner, Kutash, Duchnowski, Epstein, & Sumi, 2005).

While less than 1% of school-age students receive special education services for emotional disturbance (ED) as defined in the Individuals with Disabilities Education Improvement Act (IDEA; 2004), there are far more children and youth with E/BD who are unidentified and unserved during their educational years. The prevalence estimates suggest between 3%-20% of students have E/BD, with conservative estimates suggesting 6% (Kauffman & Landrum, 2006). Thus, the magnitude of the problem of unidentified and unserved students with E/BD is substantial and will impact the special and general education service communities alike. Given the majority of these students will not access special education services, it is important for the field of education to produce teachers with the knowledge, skills, and confidence to work in collaborative, inclusive environments using evidence-based practices to better support students with ED and at-risk for E/BD (Lane, Oakes, & Menzies, 2010).

In this paper, we offer global recommendations based on our collective experiences as researchers and practitioners for advancing the field of E/BD as we move into the [21.sup.st] century. These recommendations are broad in nature and scope so that each may apply to the various academic deficits and social excesses and deficits which students with E/BD of any age present within educational, home, and community settings. These recommendations may be best understood in the context of the history of the field of E/BD, and therefore, a brief introduction of how the field came to be and evolved over time.

Our Historical Context

Any account of history is influenced by the knowledge and biases of its author or authors, and this is no exception. In the sections that follow, we offer a brief overview of some key historical events that constitute the building blocks of the field of E/BD, in our opinion. Readers interested in more comprehensive historical summaries of the field of E/BD may wish to consult Coleman and Weber (2002), Lewis (1974), Kauffman and Landrum (2006), or Wood (1999).

The Early Years to Mid-20th Century

The early history of the field is predominantly one of treatment for persons afflicted with mental illness. The first record of an educative approach to treatment of a person with significantly challenging behavior arguably is Jean Itard's work with Victor, the "wild boy of Aveyron" in 1799. Itard's student, Eduard Seguin, continued to work with Victor after Itard himself became discouraged. Seguin later immigrated to the U.S. and was one of the early progenitors of Moral Treatment, a humanitarian/educational methodology for working with the mentally ill and persons with severe cognitive disabilities and challenging behavior.

Roughly 100 years later, psychiatrists, psychologists, and educators in the U.S. began to explore new methods for treating children and youth who exhibited E/BD (although no special classification for children exhibiting such disabilities existed at that time). Leo Kanner (1949) described a syndrome he labeled "early infantile autism," and Bruno Bettelheim established the Orthogenic School for severely disturbed children in Chicago. Fritz Redl and David Wineman opened Pioneer House in 1946, and New York City began the "600 schools" for disturbed children in 1946. Carl Fenichel founded the League School for schizophrenic children in 1953, and Eli Bower published his research on the identification of students with E/BD by school personnel in 1958.

Although programs like Pioneer House and the League School focused on more direct educational interventions, psychodynamic theory continued to dominate efforts to educate children with E/BD well into the 1960s (Bender, 1968; Berkowitz & Rothman, 1960, 1967). But in 1962, Haring and Phillips published Educating Emotionally Disturbed Children, which presented a highly structured behavioral approach to instruction and behavior management for students with E/ BD, based on the work of William Cruickshank. About the same time, Nicholas Hobbs introduced Project Re-ED, an ecological model he based on the concept of a teacher-counselor (educateur) being used in Europe and Canada. William Morse explicated the crisis teacher approach, the centerpiece of which was life space interviewing, a verbal counseling model developed by Fritz Redl.

During the decade of the 1960s, behavioral approaches became increasingly dominant (Lindsley, 1964; Whelan, 1966). Frank Hewett's work resulted in a structured, competency-based approach to educating students with E/BD that he called the "engineered classroom" (Hewett, 1968), and Achievement Place, a contingency managed residential program for antisocial and disturbed boys, was established in Lawrence, Kansas (Fixsen, Phillips, & Wolf, 1973). The foundations for much of this work of course were laid by the research on operant conditioning by B. F. Skinner, which began in the 1930s and flourished throughout the remainder of the century, led by Skinner and his many students (including Lloyd Homme, the originator of contingency contracting, and Ogden Lindsley, the creator of precision teaching). In 1968, the inaugural issue of Journal of Applied Behavior Analysis was published, launching the field of applied behavior analysis (Baer, Wolf, & Risley, 1968). Other early contributors to behaviorism included Wesley Becker, K. Daniel O'Leary, Gerald Patterson, and Albert Bandura. The latter two are more closely associated with social learning theory, which added the dimension of observational learning to the analysis of behavior.

In 1964, the Council for Children with Behavioral Disorders, the sixth division within the Council for Exceptional Children, was established. An informal organization of higher education professionals who were engaged in the newly funded federal initiative to prepare teachers to work with students exhibiting E/BD, Teacher Educators for Children with Behavioral Disorders (TECBD), was established in the early 1970s, holding a research symposium in Las Vegas in 1973, and migrating to Tempe, AZ where an annual research conference has been held since 1976.

Mid-to Late 20th Century

The latter half of the 20th Century witnessed an explosion of research in the developing field of E/BD. Beginning in the early 1970s, Bill Rhodes and colleagues published a compendium of work explicating the major conceptual models applicable to understanding and addressing child variance (Rhodes & Head, 1974; Rhodes & Tracy, 1972a, 1972b). Researchers employed behavioral measurement methodology to assess teachers7 use of praise and disapproval (White, 1975), social interactions among students (Strain, Shores, & Kerr, 1976), and to conduct behavior analyses of entire settings, including juvenile correctional facilities (Buehler, Patterson, & Furniss, 1966) and high-juvenile crime neighborhoods (Aiken, Stumphauser, & Veloz, 1977; Stumphauser, Aiken, & Veloz, 1977). Cohen and Filipczak (1971) designed a contingency managed milieu for youth in a juvenile correctional setting. In the latter years of the century, significant advances occurred in the ability of researchers to assess and understand deviant child behavior. Using longitudinal methodology, researchers identified differences between the developmental and school histories of at-risk and antisocial youth (Loeber et al., 1993; Walker, Shinn, O'Neill, & Ramsey, 1987). Shores and colleagues developed procedures to capture sequences of social and academic interactions between teachers and students (Shores & Wehby, 1999; Shores Jack, Gunter, Ellis, De-Briere, & Wehby, 1993). Refinements in assessment methodology led to more effective and efficient procedures for screening students for E/BD (Walker & Severson, 1992) and the assessment of social skills (Gresham & Elliott, 1990). School-wide positive behavioral interventions and supports (PBIS) and response to intervention (RtI) provided a framework that has revamped school discipline and intervention decision-making (Sugai et al., 2000).

One development in this period that has particular significance is a focus on evidence-based practices for improving the academic performance of students with E/BD. Much of the previous history of research in the field placed disproportionate emphasis on strategies for addressing the behavior of these students, to the detriment of academic interventions. In the decade of the 1990s, researchers questioned the lack of attention to academic instruction (e.g., Gunter, Hummel, & Venn, 1998) and began investigating the effects of improved teacher instructional behavior on the academic and social behavior of students with E/BD (Kame'enui & Darch, 1995). That work continues today, and has expanded dramatically.

However, this period also witnessed some unfortunate setbacks. Beginning in the 1960s and continuing into the '90s, the U.S. Department of Education provided financial support for programs to prepare teachers of special education, including teachers of students with E/BD, but in the closing years of the [20.sup.th] century, funding for personnel preparation virtually disappeared. Accompanying this decline is a 50% reduction in the community of educators belonging to our major professional organization, CCBD (Nelson & Kauffman, 2009). A related issue is the full inclusion of students with disabilities, the merits of which continue to be hotly debated. This policy has resulted in the majority of students with disability being placed in general education classrooms, with varying levels of support by trained specialists. Arguably, students with E/BD are not well served by educators who are not trained in or do not receive adequate technical assistance to implement effective classroom and behavior management strategies. The rates of school failure, suspension, expulsion, and dropout by students with E/BD are grim testimony to the ineffectiveness of physical placement of students with challenging behavior in mainstream educational settings (Kauffman & Landrum, 2009; Kerr & Nelson, 2010).

Early 21st Century

As we enter the 21st century, our field looks very different than it did even 25 years ago. From our rich historical background, we have learned a great deal about the characteristics and needs of students with E/BD, as well as how to select, use, and evaluate strategies for addressing these characteristics and needs. The current emphases on evidence-based practices, RtI, and PBIS are laudable. However, there is much we have yet to learn. The research and teaching communities continue to seek additional knowledge and skill sets to support students with and at-risk for E/BD asking questions such as: What are we going to do now? What are the best strategies for early identification, prevention, and amelioration of behavioral deficits? How are we going to teach teachers and families to support children and youth at risk or with E/BD? What are the most effective strategies to prevent or break the negative trajectory for children and youth at risk for or with E/BD, including the school to prison pipeline? How will teacher preparation programs be modified to yield teachers able to work in the context of three-tiered models of prevention to support students at risk for or with E/BD? How will special education teachers acquire the skills necessary to maintain their specializations while gaining additional skill sets to support collaboration? How can we expand services within our schools to include wrap-around supports to meet the diverse needs of these children, youth, and families?

Moving Forward

While there are many opportunities and directions for improving the educational experiences and outcomes of students with E/BD, four broad recommendations are offered to continue the advancement of the field of E/BD. These recommendations are not linked specifically to an individual researcher, a single intervention, or one period of time in our history, but are broad enough to encompass multiple facets of the field. In the sections that follow, we describe four recommendations: (a) ensuring high fidelity of implementation of intervention practices, (b) working within a systems-level approach, (c) developing a knowledge base through service-based research, and (d) preparing teachers to meet the challenges of an increasingly difficult job.

Recommendation 1: Ensuring High Fidelity of Implementation of Effective Intervention Practices

Effective instructional and classroom management practices provide the foundation for student engagement and learning, which in return may be associated with decreases of problem behaviors (Conroy, Sutherland, Haydon, Stormont, & Harman, 2008). While the relationship between academic and behavioral performance has been demonstrated, proof that improving student behavior increases academic performance (or vice versa) has been elusive. What is becoming clear is that "teaching both academic content and behavior [using evidence-based practices] is better than teaching one because it might change the other" (Algozzine, Wang, & Violette, 2011, p. 13). However, sometimes an evidence-based intervention used to address academic or behavioral performance, in and of itself, may be ineffective for a particular student. A contributing factor to the failure to achieve anticipated outcomes may be that the intervention was not implemented with integrity. Although often discussed as a critical component of research and practice, comprehensive examination of treatment integrity has been missing from or inconsistently measured and reported within the empirical research base for many years.

As the focus on implementation of evidence-based interventions in classroom settings continues, current research trends are to prepare teachers to implement these strategies in their classrooms and investigate both the teachers' implementation and the collateral changes in student behavior. Given that classrooms are free operant environments (with many competing variables), teachers' implementation of interventions with integrity can be a challenging area for researchers. Researchers have found that teacher fidelity of implementation of behavioral and academic interventions has a statistically significant influence on student responsiveness to the intervention (Benner, Beau-doin, Chen, Davis, & Ralston, 2010; Benner, Nelson, Stage, & Ralston, 2011). The following are several factors researchers should consider to ensure high treatment integrity (for further discussion, see Greenwood, 2009). First, consistent implementation and replication of interventions across teacher participants is essential for examining the efficacy of an intervention; therefore, the intervention training and implementation procedures need to be manualized and training should occur until teachers master the skills needed to implement the intervention with high fidelity prior to actual application (Buzhardt, Greenwood, Abbott, & Tapia, 2006). Second, behavioral coaching, including performance feedback, may be necessary to make certain that teachers master the essential components of an intervention. Once teachers have mastered the skills needed to implement the intervention, three areas of measuring treatment integrity should be considered: (a) procedural adherence (i.e., thoroughness of intervention implementation), (b) quality (or competence) with which the intervention is implemented, and (c) differentiation (i.e., how the intervention differs from typical classroom practices or other interventions). In the past, the majority of studies measuring treatment integrity primarily have examined only procedural adherence without attending to the quality of implementation or measuring differentiation. Although adherence is essential when examining intervention effects, it is important to examine the quality in which the intervention is implemented and how the intervention differs from typical classroom practice. For instance, when evaluating the efficacy of "behavior-specific praise" implemented by the classroom teacher, one must consider whether the teacher incorporates all the required elements. That is, was the praise provided contingently and did the teacher use specific language, labeling the student behavior being praised? Additionally, researchers should evaluate the quality in which praise was delivered. Did the teacher use the applicable intonation and enthusiasm when voicing praise? However, a larger question remains: Does the topography or ratio of praise change from typical practice when implemented as a purposeful intervention?

In addition to a more comprehensive approach toward training teachers and measuring treatment integrity, Greenwood (2009) recommends examining the influence of moderating and mediating variables on teachers' implementation of classroom practices. For instance, teachers' training and experience may potentially serve a mediating role in the implementation of the intervention. Consider the general education teacher who has received generic preservice training on behavioral interventions for addressing problem behaviors in the classroom and who has limited experience in teaching students with learning and behavioral problems. Increasing this teacher's level of knowledge and skills through intensive inservice training and coaching may increase the fidelity in which effective practices are implemented as well as the quality of implementation. On the other hand, the intensity or frequency of the student behavior may serve as a moderator for the teachers' use of a particular strategy. Additionally, teachers may be more likely to implement instructional strategies if the intensity or severity of a student's behavior is impacting the overall classroom atmosphere or interfering with other students' learning.

In sum, ensuring that interventions are implemented with high levels of integrity, including adherence, quality, and differentiation, is critical for examining the efficacy of an intervention. The number of studies reporting treatment integrity is increasing; however, researchers need to further emphasize quality, differentiation, and examination of mediators or moderators when reporting findings in classroom based research. Hopefully, as research in the field of E/BD expands, so will our ability to assure high levels of treatment integrity.

Recommendation 2: Working Within a Systems-Level Approach

In recent years, the field of education has shifted toward a systems level approach for supporting students' academic, behavioral, and social needs. Rather than focusing on "within-child problems or issues" or a "wait-to-fail" model of service delivery, the focus of this approach is on delivering systems of supports according to student need (Horner & Sugai, 2000; Lane, Kalberg, & Menzies, 2009). This approach includes graduated levels of prevention beginning with primary prevention efforts (Tier 1) for all students followed by progressively more intensive secondary (Tier 2) and tertiary (Tier 3) supports according to students' needs. Whereas primary prevention efforts include whole school programs such as core reading programs (e.g., Open Court or Harcourt Brace) and schoolwide instruction in social skills or character development programs (e.g., Social Skills Improvement System: Classwide Intervention Program; Elliott & Gresham, 2007a), secondary supports often consist of small group interventions for students with common acquisition (can't do), fluency (trouble doing), and performance (won't do) deficits (Elliott & Gresham, 2007b). These secondary supports may include check-in/ check-out programs to encourage desired behaviors (Crone, Horner, & Hawken, 2004), self-monitoring strategies where the student has some ownership of his/her behavioral change (Mooney, Ryan, Uhing, Reid, & Epstein, 2005), and reading interventions, such as repeated readings to increase reading fluency (Chard, Ketterlin-Geller, Baker, Doabler, & Apichatabutra, 2009), and other evidence-based practices. Tertiary supports such as individualized reading instruction, functional assessment-based interventions, and family-based supports are reserved for students with the most intensive needs (Umbreit, Ferro, Liaupsin, & Lane, 2007).

Several three-tiered models of prevention currently are being implemented in U.S. schools that involve similar (although not identical) decision-making processes, but vary in focus. For example, response-to-intervention (Rtl) models focus primarily on academic domains, particularly reading (Fuchs & Fuchs, 2006; Sugai, Horner, & Gresham, 2002); PBIS models focus primarily on behavioral domains (Sugai & Homer, 2002); and comprehensive, integrated, three-tiered (CI3T) models of prevention focus on academic, behavioral, and social domains to address all facets of student needs (Lane, Menzies, Oakes, & Kalberg, in press). Central to each of these models is accurate identification of which tiered supports students may require beyond primary prevention.

Three-tiered models hold particular promise for students with ED and at-risk for E/BD as they offer a unified structure to (a) prevent the development of E/BD and (b) address existing instances. In terms of prevention, academic (e.g., AIMSweb, Pearson Education, 2008), and behavioral screening tools (e.g., Systematic Screening for Behavior Disorders [SSBD], Walker & Severson, 1992; Social Skills Improvement System-Performance Screening Guide [SSiS-PSG], Elliott & Gresham, 2007b) are now available to identify students who may need instruction and support beyond primary prevention. By implementing these screening tools across the K-12 continuum, it is possible to identify learning and behavioral problems at the earliest sign of difficulty, allowing school-site leadership teams to make data-based decisions concerning which students require additional supports.

Using such coordinated systems of supports allow those at-risk for E/BD to be detected before behavior concerns (e.g., aggression, reading deficits) become increasingly stable over time and consequently less amenable to intervention (Kazdin, 1987). Such models also benefit students with existing instances of E/BD, as all teachers (including general education teachers) are encouraged to acquire the knowledge, skills, and confidence necessary to implement evidence-based practices. The hope is that as general education and special education teachers implement these models and continue to develop their expertise in secondary and tertiary strategies, they will be increasingly more capable of serving not only students with E/BD who do not qualify for special education services, but also students receiving special education services under the ED category who are educated in inclusive settings. Finally, these models are not only socially responsible, but fiscally responsible in the sense that the most intensive (and costly) supports are reserved for students most in need.

Recommendation 3: Developing a Knowledge Base Through Service-based Research

As a field, we have much to add to our existing knowledge base. The challenges children and youth with ED face every day across contexts (school, home, community), persons (teachers, family members, peers), and periods in time (child, adolescence, adulthood) warrant the attention and assistance from multiple stakeholders. Stakeholders may include family members, school staff, community advocates, mental health and medical staff, and researchers. To best understand and address these challenges, all stakeholders need to work in tandem and within the contexts in which challenges occur; in many cases, school is a primary context. One method to accomplish this is for the field of E/BD to develop a knowledge base via service-based research.

Service-based research bridges the needs of those who work in applied contexts (e.g., schools) with the interests and scientific knowledge of researchers. The goal of service-based research is to build upon the strengths and expertise in applied contexts in order to improve the overall quality of services while promoting growth, well-being, health, and academic/social success of the constituents in these contexts. For example, a school brings expertise related to the needs and challenges of its students with ED and those unidentified with E/BD and knowledge of the logistics and pragmatics of school processes, whereas a researcher brings expertise related to hypothesis development, design, evidence-based practices, and evaluative/decision-making processes. Service-based research requires stakeholders to (a) work together forming ongoing and trusting relationships; (b) communicate openly and honestly regarding specific academic and/ or social challenges being experienced; (c) share responsibility in addressing the challenges unique to the context; (d) methodologically, experimentally, and purposefully implement, monitor, and evaluate evidence-based strategies, interventions, and methods to address challenges; and (e) share and translate the findings to inform future actions.

It makes sense for the field of E/BD as a whole to take a service-based approach as a means to conduct research. With the host of academic and social challenges children and youth with ED experience in school settings, many school administrators, teachers, and support staff solicit the assistance of university researchers. In addition, many university researchers contact schools to offer assistance for current challenges and issues as part of their service and/or pro bono work. No matter who reaches out to whom, this is the beginning of service-based research. Once a partnership has been initiated, a dialogue focus on "systems change" begins. That is, how can children and youth with ED be provided with improved services and quality of care within a specific context? A systems change perspective does not preclude individual children and youth with ED from receiving specialized interventions; however, there is a broader discussion of how the knowledge gained from service-based research may allow stakeholders to translate new practices to the constituents within the context and to meet the needs of other current and future students.

A service-based research approach may benefit the field of E/BD in several ways. First, it provides a venue for real-time decisionmaking based on data and goals/objectives to improve student academic and/or social success while limiting a continuing history of academic and/or social failure. Students with ED often experience years of failure, which can negatively impact their academic as well as social growth. Also, this real-time approach provides a context for the researcher to teach, model, and reinforce the decision-making processes to school administrators, teachers, staff, and family members. After gaining competence in this skill set, they can use such processes unassisted in the future. Second, service-based research is applied research that may address real, complex academic and social challenges experienced by children and youth with E/BD through the implementation of scientifically-based practices. To the extent that practices are (a) generalizable across environments, similar challenges and students, and change agents; (b) maintainable over time across stakeholders without researcher support; and (c) more socially valid across stakeholders, their application in daily practice by educators may increase. Compared with peers with and without other disabilities, students with ED experience the bleakest school and post-school outcomes (Wagner et al., 2005). The partnerships and activities of school personnel and researchers should address these issues by focusing on generalization and maintenance of appropriate academic and social behavior through interventions that are socially validated by teachers, students, and parents and implemented with fidelity. Third, a service-based approach to research provides a venue for comprehensive, tiered interventions developed for the benefit of multiple constituents within an applied context. The availability of PBIS, RtI, and CI3T models of prevention facilitate addressing both the academic and social deficits of students with E/BD across grade levels and environments within a school.

Overall, a service-based research approach can positively affect the field of E/BD by focusing on scientific inquiry across systems while simultaneously sharing the expertise offered by multiple stakeholders. A shift toward a service-based approach and working within the context of three-tiered models of prevention also has implications for how the field prepares future teachers.

Recommendation 4: Preparing Teachers of Students with E/BD to Meet the Challenge

There is a critical need to build the capacity of professionals who serve students with E/BD. The key issues for the preparation of teachers of students with ED focus on the content of professional development and the quality of the professional development activities. We suggest the content of professional development activities center on building teacher's capacity to support students within the framework of the RtI decision-making model (Nelson, Benner, & Mooney, 2008). As discussed previously, the two key facets of the RtI decision-making framework include academic RtI systems and PBIS, of the latter including functional behavioral assessment and effective behavior intervention planning. These key areas overlap, and they provide the core content of professional development and mentoring supports over the first several years for teaching students with ED. Professional development centering on RtI has produced statistically significant gains in teacher knowledge and skills as well as on student social adjustment (Beaudoin, Benner, & Knuth, 2006). Training on academic RtI systems should include screening and progress monitoring with technically adequate assessments, interpreting diagnostic assessment data, determining response to intervention, ensuring that intervention is delivered with fidelity, and determining the intensity of the support that a student needs to be responsive to instruction. A more proactive and results driven approach to meeting the academic needs of students with ED is possible with teacher capacity-building to implement and sustain these key components of RtI (President's Commission on Excellence in Special Education, 2002).

School-wide PBIS also uses an RtI decision-making framework. Teachers of students with the most challenging behaviors (e.g., those identified as ED) need to implement interventions at all three levels of prevention, including the structure and process of functional behavioral assessments, assessment-based behavior intervention planning, de-escalation of behavior events, linking community supports to families and youth needs, self-monitoring, and behavioral measurement. Moreover, students requiring intensive individualized behavioral supports will need scientifically-based standard protocol violence prevention or social skills curricula [e.g., The Incredible Years: Parents, Teachers, and Children Training Series (Webster-Stratton, 2001)] that must be delivered with fidelity to accomplish treatment goals. The ability to operate across all three tiers is pivotal to implementing and coordinating behavioral supports for students with E/BD.

CI3T models incorporate both RtI and PBIS, as well as validated social skills or character development programs containing graduated levels of prevention. This model was developed with the goal of having one unified system of support to meet students' multiple needs in academic, behavioral domains (Lane et al., 2010).

In addition to the initial preparation of teachers, the process of ongoing professional development is critical to supporting practitioners in the field and contributing to their professional growth. Professional development activities that are coherent, content focused, active and situated in real world contexts, and are data-driven appear to be most likely to lead to lasting change (Gersten, Chard, & Baker, 2000; Gersten, Morvant, & Brengelman, 1995; Leko & Brownell, 2009). Coherent professional development is aligned to the goals and needs of teachers, to local, state, and national standards and accountability mechanisms, and to core academic and behavioral approaches (Garet, Porter, Desimone, Birman, & Yoon, 2001; Penuel, Fishman, Yamagu-chi, & Gallagher, 2007). Content-focused professional development builds basic pedagogical knowledge of effective teaching practices for students with E/BD. In their review of the literature on quality professional development in special education, content-focused professional development is the most important component in improving teachers' knowledge and practice, in addition to improving student achievement (Desimone, Porter, Garet, Yoon, & Birman, 2002).

Teachers of students with E/BD build their capacity to implement and sustain best practices when they have opportunities to actively engage in learning those practices (such as through service-based research partnerships) and to situate them in classroom settings (Desimone et al., 2002). Teachers of these students need more than just trainings or workshops to become fluent with best practices; they need explicit instruction by expert teachers, frequent opportunities for practice with continuous feedback and coaching, and opportunities to discuss how implementation is progressing. Ongoing coaching is essential to building the capacity of teachers of students with E/BD. Joyce and Showers (2002) meta-analysis of teacher training studies revealed that about 5% of the teachers effectively used interventions when they received excellent training that included opportunities to practice new skills and receive feedback during training, whereas 95% used interventions effectively when training was followed by in-class coaching by a competent coach. To build capacity in any area, teacher support should continue for at least 12-15 months (National Institute of Child Health and Human Development, 2000).

Finally, Leko and Brownell (2009) stress that effective professional development is collaborative and focused on student data. Data-based collaborative professional development aimed at improving student achievement affords teachers opportunities to work collectively to discuss ideas that they are learning and problems that arise from implementing those ideas, share common curriculum materials, reflect on student assessments, and determine whether new practices are making a difference (Garet et al., 2001; Penuel et al., 2007). When teachers participate in collaborative professional development efforts, their students make stronger achievement gains in both reading and mathematics than students of colleagues who do not participate in such efforts (Gersten & Dimino, 2001).

Conclusions

As we reflect on these recommendations and the current status of the field of E/BD, it is clear that all stakeholders-researchers, teachers, students, and families-are here today standing on the shoulders of the giants of the field of E/BD, respectfully asking teachers, support staff, and parents to pay it forward. These recommendations are intended to spark further discussion among those individuals dedicated to supporting students with E/BD, including those currently receiving services under the ED label as well as those who are not eligible for special education services. The recommendations provided touched upon three salient themes that we hope will continue to be emphasized: evidence-based practices implemented with fidelity, tiered supports, and purposeful professional development for educators, with an emphasis on service-based research. Based on what the field of E/BD has learned and accomplished to date, many areas remain for future researchers to focus upon in efforts to improve the quality and range of services provided to students with E/BD both to prevent and remediate problem behaviors. The remainder of the [21.sup.st] century holds much promise for refinement and advancements of our current practices and models.

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Correspondence to Kathleen Lynne Lane, School of Education, 201-E Peabody Hall, Campus Box 3500, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3500; e-mail: Kathleen.Lane@unc.edu.

Kathleen Lynne Lane University of North Carolina at Chapel Hill Kristine Jolivette Georgia State University Maureen Conroy University of Florida C. Michael Nelson University of Louisville Gregory J. Benner University of Washington
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