Building a Statewide Plan for EmbeddingPositive Behavior Support in Human

Service Organizations

�

Journal of Positive Behavior Interventions

Volume 7, Number 2, Spring 2005, pages 109–119

Abstract: Staff development efforts are being designed to have a greater impact on the systems

in which professionals work to increase the likelihood that individual positive behavior support

(PBS) plans will be effective. Statewide efforts aimed at embedding PBS into developmental

disability organizations and other agencies must include longitudinal training using a systems

approach to provide the best climate in which professionals can learn new skills. Although the

majority of research on the development of “host” environments has been conducted within

school settings, many of the strategies used in schoolwide PBS can be adapted to address other

organizations supporting children and adults with disabilities. This article will introduce one

statewide project created to build capacity by (a) training in PBS and person-centered planning

for professionals who can access fiscal incentives after completing the program, (b) dissemi-

nating online instructional materials for awareness and expert-level training across the state,

and (c) facilitating organizationwide and statewide PBS planning processes that emphasize

data-based decision making.

Rachel FreemanChristopher Smith

Jennifer ZarconePat Kimbrough

Marie Tieghi-BenetDonna Wickham

Matt ReeseKatie Hine

University of Kansas

109

New and innovative strategies for training human serviceprofessionals in positive behavior support (PBS) are nowavailable for those interested in systems change (Anderson,Albin, Mesaros, Dunlap, & Morelli-Robbins, 1993; Dunlapet al., 2000; Reid et al., 2003). Increasingly, these profes-sional development efforts are being designed to have agreater impact on the systems in which human service pro-fessionals work to increase the likelihood that individualPBS plans will be effective. Statewide needs assessments arenow being used to inform planning processes (Reid et al.,2003; Shannon, Daly, Malatchi, Kvarfordt, & Yoder, 2001),allowing for more strategic implementation of PBS train-ing efforts. These initiatives build upon past research(Fredericks & Templeman, 1990; Page, Iwata, & Reid, 1982;Smith, Parker, Taubman, & Lovaas, 1992) by targetinghuman service systems professionals who will take a leadrole in building capacity using performance-based prac-tices (Reid et al., 2003).

Training methods that rely on short-term workshopswhere groups of professionals learn new information ingeneric formats have proven to be minimally effective(Sailor et al., 2000; Smith et al., 1992). Activities occurring

in these traditional workshops often included guided read-ings, presentations and lectures, guided discussions, roleplaying, and group exercises. Approaches that combinethese traditional training methods with “working sessions”over a longer time period provide opportunities for pro-fessionals to apply new skills using case study formats andgeneralize the information learned to real situations andeveryday settings (Anderson et al., 1993). Comprehensive,longitudinal training systems address the developmentalpace of learning (Colvin, Kameenui, & Sugai, 1993) andprovide professionals with the opportunity to integrate theinformation they are learning with skills they have alreadymastered.

One way to increase the effectiveness of professionaldevelopment efforts is to create proactive “host” environ-ments (Sugai, Kameenui, Horner, & Simmons, 2000)where systems are designed to provide the best climate forprofessionals to learn new skills. The creation of “host” en-vironments has been documented in school settings wherePBS is applied as a comprehensive systemwide approach(Nakasoto, 2000; Nersesian, Todd, Lehmann, & Watson,2000; Taylor-Greene et al., 1997; Taylor-Greene & Kartub,

2000). Instead of using a patchwork of individual behaviorplans, schools are now designing environments using teamsthat systematically make data-based decisions to changepolicies and procedures, design coordinated inservices,modify less effective environments, and evaluate progress.

Although human service systems for individuals withdevelopmental disabilities are significantly different fromschools, the planning processes can be easily adapted toaddress unique organizational characteristics and chal-lenges. A training framework that facilitates organization-wide PBS planning and implementation while teachingprofessionals how to effectively facilitate individualized be-havior plans creates an ideal situation for capacity build-ing. The need for long-term, application-based learningmethods makes the design of statewide training in PBS achallenge, particularly in larger states and areas with higherpopulation densities. Rural states with large geographicareas and diversely distributed support systems pose achallenge to training systems as well. In addition, in moststates, organizations that serve individuals with develop-mental disabilities struggle to provide adequate supportwith limited resources. The development of flexible train-ing systems that allow professionals to learn new skills overa longer period of time while decreasing the need for ex-tensive travel is a critical consideration.

The purpose of this article is to introduce one state-wide training project created to build capacity by (a) train-ing in PBS and person-centered planning for professionalswho can access fiscal incentives after completing the pro-gram, (b) providing access to a continuum of online in-structional materials across the state, and (c) facilitatingorganizationwide and statewide planning processes thatemphasize data-based decision making. The article beginswith a description of the training project and curriculum.Strategies for implementing organizationwide and state-wide planning processes will follow the description of theKansas Institute for Positive Behavior Support (KIPBS)training project.

Kansas Institute for Positive Behavior Support

The University of Kansas Center for Developmental Dis-abilities, in collaboration with the Kansas Department ofSocial and Rehabilitation Services (SRS), has designed astatewide training program for professionals in develop-mental disability organizations. This project, the KansasInstitute for Positive Behavior Support, provides intensivetraining in PBS and person-centered planning. The pur-pose of the Institute is to (a) train KIPBS facilitators whowill build capacity in their regions, (b) provide Kansas or-ganizations with free access to online resources and in-struction at various levels of complexity, and (c) assist inorganizationwide and statewide PBS planning processes.Resources for the training project come from Kansas De-

partment of Social and Rehabilitation Services Medicaidfederal fiscal participation funding, with a 50% matchfrom state funds provided by the University of Kansas. Thestate Medicaid plan for Kansas includes PBS as a mandatedservice for children eligible under Kan-be-Healthy, a pro-gram providing medical health screening for children. Fis-cal incentives allow organizations to afford systems changeefforts by providing Medicaid reimbursement for PBS andperson-centered planning to a select number of profes-sionals who complete an intensive training program. Med-icaid reimbursement for PBS services is provided with a40% state match from the SRS budget.

TRAINING PROCESS AND CURRICULUM

The 12-month KIPBS training involves both online in-struction and field-based classes, with approximately 20professionals across the state each year. Four regionalclasses were designed to decrease the amount of travel re-quired. Each regional site has unique characteristics, de-pending on the number of professionals in training andthe distances between them. These differences in numberand geographic diversity impact how the classes are con-ducted. For instance, in western Kansas, the distance be-tween professionals is greater, requiring classes to occuronce per month for longer periods of time. In northeastKansas, professionals are relatively closer in proximity;therefore, classes are scheduled twice a month for a shortertime period. The central Kansas class rotates their meetingsite each month to make travel issues more equitable foreveryone. Despite these differences, the training systemand curriculum are the same for all four regions.

Professionals spend approximately 8 to 10 hours aweek completing KIPBS-related training activities. Twice ayear, group meetings are held to facilitate networkingamong professionals, provide additional training from na-tional experts, and engage in systems-level planning. Pro-fessionals must successfully complete online instructionalhomework assignments, field-based activities, and two on-line exams, as well as develop a portfolio containing ap-plied case study examples. To assess generalization of skills,two additional cases must be started with successful dem-onstrations of a person-centered plan, functional behav-ioral assessment, and the initial PBS plan report beforebilling can commence. Course credit is available for pro-fessionals in the departments of special education and ap-plied behavioral science at the University of Kansas forthose interested in graduate credits. The training offered atthe Kansas Institute is free to any professional with a bach-elor’s degree working in a human service organization, andthere is no expectation that he or she must continueuniversity coursework. If professionals choose to obtaincourse credit, the cost of enrolling is a personal responsi-bility. In addition, as each organization has different ex-pectations for professional development goals, the Kansas

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Volume 7, Number 2, Spring 2005 111

Institute is willing to provide documentation necessary tofurther professional careers. A description of key elementsof the training follows.

Online Instruction

Online instructional strategies are used to provide profes-sionals with easy access to the conceptual content. The useof online instruction to disseminate conceptual informa-tion allows the regional instructors to devote the majorityof their time to application-based activities. In addition,online instruction increases flexibility for professionalswho can complete online homework assignments when itis convenient for them and reduces the cost of expensivetextbooks and materials. Students and instructors can eas-ily keep track of their progress and work on homework as-signments at any time of day. The course is designed withapproximately one module being completed each month.Once professionals have completed the online homeworkassignments, they prepare for field-based activities thatwill occur within each regional class.

Field-Based Activities

Field-based activities are provided to make sure profes-sionals have opportunities to apply the information theyare learning and to practice new skills with the assistanceof instructors located across four geographic regions of thestate. Field-based activities also include scheduled oppor-tunities to observe experts facilitating person-centeredplanning (PCP) and key features of the PBS process. Classactivities include group discussion, role play, modeling,and problem-solving activities related to the content beingcovered. Instructors supervise and grade each profes-sional’s participation in the field-based activities as part of the overall training evaluation. Field-based assignments,for example, include preparing and presenting an intro-ductory presentation about PBS and bringing operationaldefinitions of problem behaviors to class to start designinga measurement strategy for case studies.

Portfolio Development

Each professional in training identifies a child or adult inneed of PBS planning for his or her case study. By the endof the year, every professional submits a portfolio contain-ing a PCP, functional behavioral assessment, PBS plan(including evaluation data), and systems change demon-stration. Some of the field-based activities just mentionedresult in products that are included within the portfoliowhile other activities are intended to ensure understandingof the online instructional content. Checklists containingthe critical features necessary for exemplary PBS and PCPplans were created as a self-assessment tool and for evalu-ation purposes based on the PBS checklist by Horner,Sugai, Todd, and Lewis-Palmer (2000). Professionals aretaught to use a PBS and person-centered “locator” check-list sheet indicating where each critical feature can be

found in the plan. This locator sheet is placed on the frontof each report submitted and is also used to monitor fi-delity of the PBS PCPs. Students receive feedback on areasthat are in need of improvement based on this evaluationof the self-assessment checklist.

Curriculum

The curriculum used within the KIPBS is based on thework of previous researchers (Anderson et al., 1993; An-derson, Russo, Dunlap, & Albin, 1996; Dunlap et al., 2000)and was designed with the guidance of a national advisoryboard of experts in both PBS and PCP. The integration ofvalued outcomes, behavioral and biomedical science, vali-dated procedures, and systems change to enhance qualityof life and reduce problem behaviors is the definition ofPBS adopted by the Kansas Institute (Carr et al., 2002).Professionals in training are taught that their role is that ofa facilitator rather than an expert. The role of the KIPBSfacilitator is to teach each team to maintain PBS and PCPand to mentor professionals within the organization whowill take a lead role in ongoing behavioral support plan-ning. Professionals must complete 10 online modules, eachof which addresses important learning objectives. Moduletitles and selected supported references are listed in Ta-ble 1.

Toolbox

A strong emphasis is placed on the development of effec-tive problem-solving skills in order to implement PBS andPCPs effectively. For instance, KIPBS facilitators mustlearn to identify what tools are most useful in a functionalbehavioral assessment, given the unique characteristics ofthe children they are supporting; how to help teams thatmay be struggling to work together more effectively; orwhy a particular intervention is not effective. One of theunique challenges encountered when a number of profes-sionals are learning to apply PBS with different case stud-ies at the same time is how to pace instruction. Invariably,one professional will encounter a problem while workingwith his or her case study before reaching the content thatwill address that particular problem. This places instruc-tors in a difficult role and causes a challenge for those de-veloping the PBS and PCP curriculum. An instructorworking with a group of professionals can direct a profes-sional to the toolbox and provide additional advice andguidance on a one-on-one basis or include the informa-tion within the next field-based class so all of the studentscan benefit.

PROJECT EVALUATION

Comprehensive evaluation of the effectiveness of theKIPBS training process and online materials is necessary todemonstrate the importance of the project and improvethe existing system. Pre- and posttraining fidelity measures

on PBS and PCPs are being conducted as both a self-assessment process and an evaluative tool. At the time ofpublication, 10 of the 11 KIPBS professionals in Cohort 1have completed their first portfolio PCP case studies and 9have completed their first PBS case studies. A number ofprofessionals are in the process of completing the two ad-ditional case studies that must be submitted before be-coming eligible to receive reimbursement. These twoadditional cases are intended to ensure professionals cansuccessfully generalize the information learned while com-pleting their portfolio with their first PBS and PCP plan.

Three of the KIPBS professionals have finished the addi-tional two case studies required for billing.

Four of the 11 professionals who took the course pro-vided PBS and PCP plans as pretraining examples (samefacilitator, different case than that of the portfolio) sub-mitted with the initial application to the training program.The other professionals had not facilitated a PBS or PCPplan prior to the training. PBS and PCP plans were scoredby experts, defined by their certification in a specific PCPapproach (e.g., Essential Lifestyle Planning), who havepublished in peer-reviewed journals related to PBS or PCP,and who have more than 10 years’ experience in their re-spective fields.

The fidelity measures, which are available on request,contain a three-point scoring system (In Place, Partially inPlace, Not in Place). The development of the PBS fidelitymeasure, based on the self-assessment tool developed byHorner and his colleagues (2000), contains 37 items thatare scored. The PCP fidelity measure, derived in part fromthe Kansas regulations for PCP, contains 25 items that arescored. Figures 1 and 2 report the average scores on thepretraining and posttraining PCP and PBS plans com-pleted by professionals in training thus far.

Additional data that are being collected include PBSplans for each case study gathered before the KIPBS pro-fessional became involved (same case study individual, dif-ferent facilitator than the KIPBS professional). In 9 of the15 cases currently completed, no PBS plans were com-pleted before a KIPBS professional became involved. One

112 Journal of Positive Behavior Interventions

Table 1. Kansas Institute for Positive Behavior Support (PBS) Modules and Training Objectives

Module Title Selected supporting references

1 Introduction to PBS Carr et al., 2002; Carr et al., 1999; Koegel, Koegel, & Dunlap, 1996; Luchsyn,Dunlap, & Albin, 2002

2 Person-centered planning Blue-Banning et al., 2000; O’Brien, 1987; Smull & Harrison, 1992; Vander-cook et al., 1989

3 Introduction to applied behavior analysis Baer et al., 1968, 1987; Michael, 1993; Stokes & Baer, 1977; Wolf, 1978

4 Measurement & data Carr & Burkholder, 1998; Hawkins, 1986; Kahng & Iwata, 1998; Thompson,Felce, & Symons, 2000

5 Functional behavioral assessment Bijou et al., 1968; Carr, 1977; Iwata et al., 1994; O’Neill et al., 1997;Touchette et al., 1985

6 Multi-component interventions Durand & Carr, 1991; Horner, Vaughn, Day, & Ard, 1996; Sprague & Horner, 1992; Vollmer et al., 1993

7 Designing positive behavior support plans Horner, Albin, et al., 2000; Kincaid et al., 2002; O’Neill et al., 1997

8 Emotional and behavioral health Cataldo & Harris, 1982; Mace & Mauk, 1995; Matson et al., 2000; Reiss,2000

9 Systems change Dunlap et al., 2000; Gordon, 1983; Sugai, Sprague, et al., 2000; Walker et al.,1996

10 Facilitator guidelines Horner et al., 2000

Note. See reference list for full citations.

Figure 1. Average scores on the Positive BehaviorSupport (PBS) Plan Checklist.

Applicationn = 4

All Case StudiesN = 16

Perc

enta

ge S

core

48.31

72.79

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case study had a prior PBS plan, but the report could notbe obtained due to consent issues. One KIPBS professionaldid not confirm whether PBS plans were completed priorto involvement due to a temporary absence. Four of the 15pretraining PBS plans are currently being scored using thefidelity checklist. In 7 out of 16 PCP cases currently com-pleted, no PCPs were available before the KIPBS profes-sional became involved. One case study had a prior PCP,but the report could not be obtained due to consent issues.One KIPBS professional has not confirmed whether a PCPwas completed prior to involvement due to a temporaryabsence, and one student has not reported the preinvolve-ment status. As a result, 6 out of 16 preinvolvement PCPscores will be completed using the PCP checklist. Once allof the data are gathered, the pretraining PCP and PBSplans will be compared to post-KIPBS facilitator training.

Raw data still being collected from Cohort 1 graduatesinclude measures of problem behavior, adaptive behavior,and quality of life. Consumer satisfaction and contextualfit data are completed with students using the same surveytools so data can be aggregated—the Self-Assessment ofContextual Fit Survey developed by Horner, Albin, Borg-meier, and Salentine (2003) and the Person-Centered Plan-ning Process Satisfaction Survey (Abery, McBride, &Rotholz, 1999)—from team members participating in eachof the case studies. When all of the data are gathered, hier-archical linear modeling will be conducted using casestudy information from both the first and second cohortsof students (graduating in February, 2004, and 2005). It isexpected that the additional data from KIPBS graduatesbilling new cases and the addition of the second cohort ofstudents (n = 17) will be sufficient to run these analyses.

KIPBS MENTORS

When a professional has completed the KIPBS training, heor she is referred to as a “mentor.” Mentors are consideredsystems change agents as well as trainers. To maintain eli-gibility for billing purposes, KIPBS facilitators are expectedto donate 12 hours per year to the Institute. Each year, pro-fessionals create a mentor action plan for using these 12 hours by engaging in organizationwide PBS planningprocesses, assisting in mentoring new professionals com-pleting training within the Institute, conducting awareness-level training across the state, or providing other systemschange efforts that will build capacity in the state ofKansas. The first cohort of KIPBS facilitators finished thetraining program and began working on systems changeactivities across the state in 2004.

Organization and Statewide Planning

Schoolwide PBS, described in Figure 3, includes a contin-uum of strategies and processes to address the needs of allstudents within a school:

1. primary prevention, including universal inter-ventions for teaching schoolwide social skillsinstruction and systems for reinforcing allstudents;

2. secondary prevention—designing specializedand group interventions for students at risk forengaging in more serious problem behavior; and

3. tertiary prevention—implementing individual-ized interventions for students with chronic,intense problem behavior (Gorden, 1983; Walkeret al., 1996).

This triangle logic was first introduced in the public healthliterature to describe the importance of addressing diseaseprevention and subsequently has been applied to the pre-

Perc

enta

ge S

core

Applicationn = 4

All Case StudiesN = 16

Figure 2. Average scores on the Person-CenteredPlanning (PCP) Checklist.

Figure 3. Schoolwide triangle.

38.50

60.88

vention of antisocial behavior. The school implements pri-mary, secondary, and tertiary prevention strategies by cre-ating a planning team representing teachers across eachgrade level, administrative staff, special education profes-sionals, and other school faculty. This planning team meetson a regular basis to conduct a self-assessment, create anaction plan, and make data-based decisions. Each schoolhas a professional designated as a “coach” who dedicatestime to PBS activities. The coach assists in facilitating plan-ning meetings, collecting and summarizing data, andproviding leadership in the implementation process. Be-havioral expertise is needed within each school in order tofacilitate individual student PBS plans and teach function-based approaches to problem behavior.

Figure 4 describes how schoolwide positive behaviorsupport can be applied to organizations in developmentaldisability services. Similar to schools, organizations sup-porting individuals with disabilities need to establish sys-tems that include professionals with behavioral expertise

who can facilitate teams and ensure that PBS plans are ef-fective and sustainable across time. The Kansas Instituteteaches KIPBS facilitators to provide this type of facilita-tion and to mentor other professionals in each team im-plementing PBS and PCP.

The key to building effective individual PBS plans is tocreate organizational environments that support data-based decision making. Organizationwide planning, led bya team of professionals within a human service organiza-tion, should include professionals who represent adminis-tration, managerial staff, training personnel, supervisors,direct contact staff members, individuals with disabilities,and family members or guardians. Planning teams thatmeet on a regular basis can be used to assess resources, col-lect data, and create strategies for primary, secondary, andtertiary interventions adapted for human service environ-ments. The types of interventions used in primary, sec-ondary, and tertiary prevention will vary depending on thedifferent types and purposes of each organization.

114 Journal of Positive Behavior Interventions

Figure 4. Behavior support elements. Note. From Moving From Functional Assessment to the Design of Behav-ior Support. Paper presented at the Association for Behavior Analysis Annual Convention, San Francisco, CA, byR. H. Horner and R. Albin, 2003. Copyright 2003 by R. H. Horner. Reprinted with permission.

Volume 7, Number 2, Spring 2005 115

RESIDENTIAL SUPPORT

Organizations that provide residential support assist in-dividuals with disabilities living in the community. Staffmembers may regularly check on an individual living in-dependently in an apartment setting or may offer supporton a 24-hour basis to individuals living with one or moreroommates. Regardless of how these living arrangementsare organized, an organization’s planning team can iden-tify and teach social skills and reinforce the acquisition ofthese new skills with all of the individuals served within anorganization using primary prevention interventions.

School faculty identify three to five schoolwide expec-tations that reflect the social skills that are highly valued bythe school, such as being respectful with others, honoringdiversity, and being ready to learn. Specific behaviors thatdefine respect are identified (e.g., moving aside to let otherstudents reach their lockers) and taught across all theschool settings (e.g., classrooms, hallways, cafeteria). Theplanning team, with input from school faculty, then de-signs systems to systematically introduce, teach, and rein-force students who engage in these behaviors. Strategiesare designed for the occurrence of problem behaviors andare clearly outlined so that all faculty respond in a consis-tent manner.

The important message from schoolwide PBS is thatthe first step is to better understand the extent to which theindividual’s environment has the basic features needed forsuccess, rather than conducting an assessment of why achild or adult is engaging in problem behavior. Primaryprevention in residential support settings will focus on es-tablishing a person-centered foundation that embraces op-portunities for choice making, rich activity patterns forphysical and social well-being, prompts and reinforcementfor communicating wants and needs, and access to indi-vidualized and valued social networks. Primary preventionlogic from the school literature argues that environmentsshould support all individuals, regardless of ability levelsor the types of problem behaviors observed. Examples of primary prevention in residential settings include theidentification of person-centered interventions that aresystematically identified and taught within preservice andinservice settings. These person-centered interventions in-clude topics such as prompting choice making, ensuringphysical and mental health, creating predictable environ-ments, establishing rich social networks, promoting activelifestyles, honoring routines, and encouraging indepen-dence. The self-assessment process at the primary preven-tion level involves measuring and assessing the settingconditions that may contribute to the occurrence of prob-lem behaviors. These conditions include environmental is-sues such as pollution density, noise, and temperature, aswell as opportunities for choice making and reinforcementof communication skills. Access to appropriate medical,dental, and mental health care are key areas for assessmentat the primary prevention level as well. Policy and proce-

dures should be reviewed to gather information aboutwhat mechanisms are in place for collecting and identify-ing data about environmental issues associated with prob-lem behaviors and what management structures are neededto modify these environmental conditions. The active par-ticipation of staff members in the development of primaryprevention interventions is as critical to ensure ownershipand motivation as it is in school systems. The creation ofperson-centered practices and interventions that are em-bedded within environments will enhance the impact ofPCP plans that are developed on an individual basis and encourage more systemic implementation of person-centered processes.

Targeted interventions are designed as secondary pre-vention strategies within an organization. The purpose ofa targeted intervention is to support a number of individ-uals who may be at risk for engaging in more serious prob-lem behavior. Social skills instructional classes are targetedto support smaller groups of individuals who can benefitfrom learning how to identify emotions, learn strategies to cope with anger, or resolve conflicts. These classes can be designed to address problem behaviors maintained by similar functions, social situations, and settings to pro-vide tailored training sessions. Classes can be linked to self-management plans that assist individuals in self-monitoring the use of new skills and reinforcing them-selves as they meet their goals.

Assessment at the secondary prevention level involvesexamining an organization’s ability to identify individualswho are at risk of engaging in more chronic and severeproblem behaviors. Individuals with health conditions thatcreate discomfort, sensory impairments and communica-tion problems, histories of abuse or neglect, comorbid psy-chiatric disorders, or sleeping and eating problems can beidentified systematically during a self-assessment processand interventions implemented before any serious prob-lem behaviors occur.

Tertiary prevention in developmental disability orga-nizations will involve developing the internal capacity toensure that all teams have access to someone with experi-ence and training in PBS. Identifying professionals whohave or will develop behavioral expertise, creating stafftraining systems to teach intervention strategies, and in-troducing the skills that will ensure staff members cancontribute to the team process in PBS and PCP throughpreservice and inservice opportunities can increase the ef-fectiveness of tertiary level interventions.

FAMILY SUPPORT

Providing PBS technical assistance to families requires adifferent type of systems-wide approach (Becker-Cottrill,McFarland, & Anderson, 2003; Dunlap & Fox, 1999). Theapplication of primary, secondary, and tertiary interven-tions will require adaptations to meet the needs of organi-

zations supporting families with children both with andwithout disabilities. Examples of family support organiza-tions include agencies addressing the needs of childrenwith autism or agencies preventing foster home place-ments. Primary prevention strategies in family settings willalso emphasize person-centered environments but must bedevelopmentally and culturally appropriate to each familyunit. Parents interested in learning how to create healthyenvironments for their children are invited to group ses-sions, where information about preventing problem be-havior involves teaching and reinforcing (a) social andcommunication skills, (b) the importance of supervisionand consistent discipline, and (c) other issues related to es-tablishing positive environments and avoiding conflicts.Family organizations can provide targeted social skillstraining sessions for children who are at risk for develop-ing more severe behaviors and help family members de-velop self-management plans that are linked to the socialskills being taught.

Interventions that are individualized for children en-gaging in more serious problem behavior require exper-tise from a trainer who can facilitate team meetings andprovide on-site support while interventions are being im-plemented. Once the initial training period has been com-pleted, monthly support meetings can be scheduled wherea number of families meet to share success stories, reviewdata, problem-solve, and receive guidance from someonewith more expertise in PBS. These group meetings allow alower level of technical assistance to be delivered by anexpert facilitator and can provide an early warning if afamily begins experiencing difficulties maintaining the in-terventions or when new problem behaviors arise.

DATA-BASED DECISION MAKING

Evaluation is a critical part of organizationwide planning.Developmental disability organizations are similar toschools in that data are often collected to be sent to county,state, and federal systems but are rarely used internally fordecision-making purposes. The ways in which these dataare gathered and summarized do not easily lend itself tovisual analyses. Organizationwide planning includes de-veloping easy and efficient data collection and summaryprocesses that allow teams to engage in self-assessment andevaluation on an ongoing basis. Outcome measures thatmay be used to evaluate organizationwide efforts include,for example, incident report summaries, organizational as-sessments of behavior support capacity (Baker, 1995), thenumber of short-term institutional placements each year,staff stress questionnaires, staff turn-over rates, consumersatisfaction ratings, family stress questionnaires, and train-ing outcome data. Fidelity and assessment measures oforganizationwide PBS implementation, although not cur-rently available, can be adapted based on tools alreadyavailable for schools (Horner et al., 2004; Positive Behav-

ioral Interventions and Supports, 2004; Sugai, Todd, &Horner, 1998). Individual PBS outcome data can be in-cluded in an organizationwide evaluation process as well.

The last feature that contributes to the effectiveness ofindividual PBS plans is statewide planning. Statewide plan-ning increases the ability for both state and federalresources to be used more efficiently, increases communi-cation across initiatives, and enhances the impact of train-ing efforts across projects. The statewide planning team inKansas met in 2004 to discuss how to embed PBS trainingacross developmental disability, child welfare, and mentalhealth services. Long-term statewide planning will result instrategic training of technical assistance providers whosupport children and adults across different types of Kan-sas services. KIPBS facilitator-donated mentor time will beused to assist statewide implementation activities.

Conclusion

Until systematic efforts are made to embed PBS within thecommunity culture, small localized professional develop-ment efforts will experience limited success. Comprehen-sive research on effective PBS training is currently difficultto find in the literature, despite the great need for buildingbehavioral expertise. Changing the unit of analysis fromthat of individuals with problem behavior to larger unitssuch as organizations, provider agencies with multiplefield sites in a given state or region, and statewide levels iscritical for large-scale systems change. The research currentlyunder way within the Kansas Institute will contribute toevaluation literature describing a systematic, statewide train-ing system that combines both organization- and state-wide action planning.

One key to providing effective training is to worksmarter with the resources that are available. Organiza-tionwide planning is one way to begin using limited re-sources wisely. An important consideration for strategicplanning is the development of easy and efficient data col-lection systems that can be used by planning teams toimplement organizationwide interventions, staff develop-ment processes, and individual PBS planning systems.

A growing number of states are now engaging in large-scale state- and districtwide PBS planning in schools.Schools that are implementing PBS are reporting from20% to 60% decreases in the average number of office re-ferrals per day each month (Chapman & Hofweber, 2000;Colvin & Fernandez, 2000; Horner & Sugai, 2000;Lohrman-O’Rourke et al., 2000; Nakasato, 2000; Nersesianet al., 2000; Sadler, 2000; Taylor-Greene & Kartub, 2000). Itis likely that other types of organizations who adopt data-based decision-making processes at an organization levelcan achieve decreases in problem behavior reflected byoutcomes such as behavioral incident reports and days outof the home due to respite or institutional stays. Unfortu-nately, data collection systems in many human service or-

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ganizations are rarely designed to provide simple access tovisual summaries of data that can be used on an ongoingbasis. There is a great need for easy-to-use software pro-grams that allow for data-based decision making at theorganizational level.

Creating effective professional development systemsthat foster skillful teaching within a supportive setting re-quires “an optimal mix of individual and organizationalprocesses that will contribute to the success in a particularcontext” (Guskey, 1995, p. 117). Although Kansas has justbegun state and organizationwide PBS planning, many ofthe initial steps in the process are under way. The long-term goal in Kansas is to create strategies for linking PBStraining and resources across schools, mental health, childwelfare, and developmental disability services to betterserve all Kansans. The KIPBS provides one example of howstatewide training and capacity building can be organized.However, more examples of state training systems for em-bedding positive behavior support are greatly needed tocreate an atmosphere where new ideas are generated andresources are shared collaboratively.

ABOUT THE AUTHORS

Rachel Freeman, PhD, is the project director for the KansasInstitute for Positive Behavior Support at the University ofKansas. She works collaboratively with schools, families, andother professionals to design effective environments that sup-port children’s educational and social needs. ChristopherSmith, PhD, is a co-project director for the Kansas Institutefor Positive Behavior Support at the University of Kansas. Hehas experience working in many school and human servicesettings, as well as with families, and specializes in evalua-tion. Jennifer Zarcone, PhD, is a co-director in the KansasInstitute for Positive Behavior Support, leading curriculumwriting and design in online instruction. Her background in-cludes single-subject research, multidisciplinary research re-lated to physiology and problem behavior, and behavioralconsultation with schools, families, and other service systems.Pat Kimbrough, MSEd, is the training coordinator and web-master at the Kansas Institute for Positive Behavior Supportat the University of Kansas and provides leadership of alldatabase design, software support, and training. MarieTieghi-Benet, MS, is a doctoral student in human develop-ment and family life at the University of Kansas and assistsKansas Institute for Positive Behavior Support trainees withcase study development and conducts evaluation research.Donna Wickham, PhD, is the associate director of the Inter-disciplinary Human Development Institute, a UniversityCenter for Excellence in Developmental Disabilities Educa-tion, Research and Service at the University of Kentucky.Matt Reese, PhD, is the director of training at the KansasCenter of Excellence in Developmental Disabilities at the KUMedical Center. He has more than 25 years of experiencewith children and adults with developmental disabilities.

Katie Hine, PhD, is the outreach director for the Dual Diag-nosis Treatment & Training Services project at Parsons StateHospital & Training Center in Parsons, Kansas. Address:Rachel Freeman, University of Kansas, Dole Human Devel-opment Center, Room 1028, 1000 Sunnyside Ave., Lawrence,KS 66045-7555.

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Action Editor: Robert L. Koegel

Journal of Positive Behavior Interventions

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