THE SUCCESSFUL REPLICATION OF D-PBIS ACROSS MULTIPLE CENTERS - - PowerPoint PPT Presentation

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THE SUCCESSFUL REPLICATION OF D-PBIS ACROSS MULTIPLE CENTERS - - PowerPoint PPT Presentation

Apr 09, 2024 225 likes •597 views

THE SUCCESSFUL REPLICATION OF D-PBIS ACROSS MULTIPLE CENTERS SERVING ADULTS WITH I/DD Leeann Haffner, MS DPBIS Project Coordinator PA Adult Services Michelle Lipchock, DSW, LCSW Clinical Director, Devereux New Jersey Michelle Wonders, Psy.D

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PROPRIETARY AND CONFIDENTIAL

THE SUCCESSFUL REPLICATION OF D-PBIS ACROSS MULTIPLE CENTERS SERVING ADULTS WITH I/DD

Leeann Haffner, MS – DPBIS Project Coordinator PA Adult Services Michelle Lipchock, DSW, LCSW Clinical Director, Devereux New Jersey Michelle Wonders, Psy.D – Clinical Director, Devereux Pocono

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PROPRIETARY AND CONFIDENTIAL

PRESENTATION OBJECTIVES

  • Participants will be able to define the components of D-

PBIS and describe the framework for implementation.

  • Participants will learn how the D-PBIS framework has

been successfully implemented across multiple centers and how it can be adapted to fit individual programmatic needs.

  • Participants will be able to describe measures necessary

to sustain D-PBIS in programs servicing adults with I/DD.

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PROPRIETARY AND CONFIDENTIAL

DEVEREUX-POSITIVE BEHAVIOR INTERVENTIONS AND SUPPORTS (D-PBIS I/DD)

Scope

  • The Devereux organization
  • perates in 13 states
  • There are 8 Centers across

the United States serving I/DD

  • Centers are located in (NY,

NJ, PA (2), MA, Florida, Texas, California) Implementation Issues

  • All centers are rolling out the D-

PBIS I/DD framework w/ modifications

  • Coordination across/within

centers

  • Focus on implementing with

fidelity

  • Necessary to develop measures

that ensure sustainability

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PROPRIETARY AND CONFIDENTIAL

3 TIERED APPROACH

~80% ? of Clients ~5%

~15% TERTIARY PREVENTION

Comprehensive FBA Positive Behavior Support Plans Increased Supervision Individual and Family Therapy Trauma-Focused CBT Modified PE

SECONDARY PREVENTION

Check-in/Check out Mentoring Peer support Group Therapy Specialized Group Skills Training

PRIMARY PREVENTION

Behavioral Assessment & Consultation Clear expectations Proactive Focus Skills Training Data Based Decision Making Self-Management Safe and Positive Environment Lesson Plans Corrective Instruction Staff and Individual Acknowledgements

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PROPRIETARY AND CONFIDENTIAL

Devereux Organizational FWPBIS Steering Committee Meets quarterly Center-based FWPBIS Leadership Team Meets monthly

Self- Management Guided Self- Management Acknowledgements Performance Based Feedback Level of Safety Teaching for Positive Learning Teaching Matrix and Lesson Plans

Program Components

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PROPRIETARY AND CONFIDENTIAL

Self- Management Guided Self- Management Acknowledgements Performance Based Feedback Level of Safety Teaching for Positive Learning Teaching Matrix and Lesson Plans

Program Components

SYSTEM-SELF MANAGEMENT

Self Monitoring – Once lesson plans are written, models for self monitoring will be developed Must take into account various levels of intellectual disability and communication

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PROPRIETARY AND CONFIDENTIAL

Self- Management Guided Self- Management Acknowledgements Performance Based Feedback Level of Safety Teaching for Positive Learning Teaching Matrix and Lesson Plans

Program Components

CORRECTIVE INSTRUCTION

Step 1: GET THE PERSON’S ATTENTION Step 2 ACKNOWLEDGE THE PERSON’S EMOTION Step 3 STATE THE SKILL THAT CAN BE PRACTICED IN THE MOMENT Step 4: PRACTICE THE SKILL Step 5: REVIEW AND PRAISE

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PROPRIETARY AND CONFIDENTIAL

Self- Management Guided Self- Management Acknowledgements Corrective Instruction Level of Safety Teaching for Positive Learning Teaching Matrix and Lesson Plans

Program Components

ACKNOWLEDGEMENTS

Center-wide celebrations Checklist of unit likes/Reinforcement Inventories Employee Appreciation Committee interface Rewards packet for students and staff

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PROPRIETARY AND CONFIDENTIAL

Self- Management Guided Self- Management Acknowledgements Corrective Instruction Level of Safety Teaching for Positive Learning Teaching Matrix and Lesson Plans

Program Components

LESSON PLANS

Scripts were revised to remove incorrect model of the skill or behavior Lesson Plans will be develop for two levels of learners: Mild to Moderate level of disability Severe to Profound level of disability 9 Essential Signs

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PROPRIETARY AND CONFIDENTIAL

TEACHING MATRIX

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PROPRIETARY AND CONFIDENTIAL

Self- Management Guided Self- Management Acknowledgements Corrective Instruction Level of Safety Teaching for Positive Learning Teaching Matrix and Lesson Plans

Program Components

LEVEL OF SAFETY

Universal List of Major and Minor Infractions was revised to include adult issues and concerns. Language was revised to positive and adults terminology and was expanded to include enhanced medical and wellness concerns Teach skills vs intervention

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PROPRIETARY AND CONFIDENTIAL

REPLICATION OF D-PBIS

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PROPRIETARY AND CONFIDENTIAL

OVERVIEW OF D-PBIS IMPLEMENTATION ACROSS MULTIPLE CENTERS

National Board

  • f Directors
  • 2012 mandate for all Devereux programs to implement PBIS
  • Goal to develop D-PBIS models (EBD, I-DD and Autism)
  • Balanced scorecard for all centers

D-PBIS Fidelity Advisory Committee

  • Creation of D-PBIS models
  • Assigned consultants to work with centers on specific

implementation of PBIS

  • Ensure fidelity of all implementing centers
  • Measuring progress the same manner—same data collection

across all centers

Center Leadership Teams

  • Team of center specific staff charged with D-PBIS

Implementation including center leadership

  • Meet once a month to review center implementation (fidelity,

data analysis, and problem solving)

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PROPRIETARY AND CONFIDENTIAL

D-PBIS IMPLEMENTATION ACROSS MULTIPLE CENTERS

  • The primary goal is to ensure implementation of D-PBIS with

integrity and to ensure positive gains of staff and the individuals we serve.

  • In partnership with corporate liaisons, the leadership team is

composed of representatives from various disciplines in the center.

  • Provides oversight of implementation of D-PBIS across center.
  • Ensures our D-PBIS implementation maintains a high degree of

fidelity through on-going data based decision making.

Center Leadership Team

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PROPRIETARY AND CONFIDENTIAL

D-PBIS IMPLEMENTATION ACROSS MULTIPLE CENTERS

  • Monthly meetings are held to review and trend various data

sets, create or alter permanent products for the programs and problem solve any issues or obstacles that may arise.

  • Charged with maintaining further implementation of D-PBIS

programs across the center.

  • Consultation between Centers
  • Data collection is embedded in the Electronic Health Record

Center Leadership Team

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PROPRIETARY AND CONFIDENTIAL

D-PBIS DATA ANALYSIS ACROSS IMPLEMENTING CENTERS

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PROPRIETARY AND CONFIDENTIAL

D-PBIS DATA ANALYSIS ACROSS IMPLEMENTING CENTERS

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PROPRIETARY AND CONFIDENTIAL

D-PBIS IMPLEMENTATION ACROSS MULTIPLE CENTERS

Individual Direct Care Staff Management and Clinical Staff Leadership Team Fidelity Committee

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PROPRIETARY AND CONFIDENTIAL

HOW D-PBIS CAN BE ADAPTED TO FIT INDIVIDUAL PROGRAM NEEDS

  • Baseline data from observations of staff Active

Engagement (materials and positive interactions)

  • Preference assessments for individuals: motivators and

activities that are specific to each program

  • Use of sign language (9 basic signs)
  • Customized teaching matrix: expected behaviors for each

setting that D-PBIS is used: home, work and the community and the categories for expected behavior of the individual

  • Lesson plans: instructional scripts to teach the individuals

appropriate prosocial behaviors: the instructional process uses an errorless learning approach to teach the skills to the individuals with a minimal amount of errors.

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PROPRIETARY AND CONFIDENTIAL

SUSTAINABILITY OF D-PBIS

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PROPRIETARY AND CONFIDENTIAL

SUSTAINABILITY

Why is it important?

  • Reduce challenging behavior
  • Increase independence and use
  • f prosocial behavior
  • Provide structure and

acknowledgments

  • Increase/sustain satisfaction
  • Improve quality of life

How to Sustain

  • Develop a plan and build an

infrastructure

  • Monitor compliance
  • Analyze data for fidelity
  • Determine impact on outcomes
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PROPRIETARY AND CONFIDENTIAL

TOOLS FOR SUSTAINABILITY

  • Contingency Plan
  • Acknowledgements
  • D-PBIS Certification
  • Home Visit Spot Check
  • Satisfaction Surveys
  • Leadership Meeting and Compliance Data
  • Peer Mentoring
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PROPRIETARY AND CONFIDENTIAL

CONTINGENCY PLAN

  • Crucial for sustainability as there will always be staff

turnover, vacancies, and leaves of absence.

  • Ensures D-PBIS implementation, oversight, and

consultation occurs when there is an open position in any role. – Home visit spot check – Direct observation, data consultation, and performance feedback schedule – Acknowledgement procedure

  • Monitors compliance of implementation through data

analysis

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PROPRIETARY AND CONFIDENTIAL

CONTINGENCY PLAN

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PROPRIETARY AND CONFIDENTIAL

ACKNOWLEDGEMENTS

  • When desired behaviors are observed, staff provide

individuals with acknowledgement cards, paired with verbal behavior specific praise.

  • Weekly or bi-weekly drawings for individuals and monthly

drawings for staff to receive a prize (gift card, dinner,

  • uting, DVD, etc.).
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PROPRIETARY AND CONFIDENTIAL

D-PBIS CERTIFICATION

  • Certified clinical staff are responsible for certifying supervisors
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PROPRIETARY AND CONFIDENTIAL

HOME VISIT SPOT CHECK

  • Completed once per month by clinical staff and operational

staff

  • Information and Implementation scores analyzed to identify

trends

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PROPRIETARY AND CONFIDENTIAL

SATISFACTION SURVEYS

  • Completed by individuals, staff, and supervisors on a

quarterly basis

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PROPRIETARY AND CONFIDENTIAL

SATISFACTION SURVEYS

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PROPRIETARY AND CONFIDENTIAL

SATISFACTION SURVEYS

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PROPRIETARY AND CONFIDENTIAL

LEADERSHIP AND COMPLIANCE

  • Monthly leadership meetings held at each center
  • Data compliance graphed and reviewed monthly by

clinical team and operations

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PROPRIETARY AND CONFIDENTIAL

PEER MENTORING

All D-PBIS certified supervisors are eligible to become a peer mentor for a supervisor rolling out their first D-PBIS program.

D-PBIS I/DD Peer Mentoring Teaching Procedure

  • 1. Introduce the skill to be taught
  • 2. Give the rationale for using the skill
  • 3. State the steps of the skill
  • 4. Demonstrate the skill
  • 5. Have the trainee model the skill that was demonstrated
  • 6. Give the trainee feedback on their demonstration of the skill
  • 7. Have trainee demonstrate the skill with the individuals or staff
  • 8. Document on the checklist when the skill is performed correctly
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PROPRIETARY AND CONFIDENTIAL

PEER MENTORING

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Questions?

Contact Information: Michelle Wonders, Psy.D mwonders@devereux.org Leeann Haffner, MS lhaffner@devereux.org Michelle Lipchock, DSW, LCSW mlipchoc@devereux.org