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Using Care Teams to Problem Solve

for Students

Alicia Diaz, Lauren Palmer, & Liz Yoder

School Psychology Effective Practice Specialists

Adrienne Azama, School Psychologist

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Outcomes

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Identify purpose served by Care Team
Identify key component/principles of effective Care Teams
Identify responsibilities of Care Teams
Identify how to begin implementing effective Care Teams in buildings
Or, revise current Care Team processes

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Reference to SPED Law

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Every Student Succeeds Act (ESSA; PL 114-95)

“provide all children significant opportunity to receive a fair, equitable, and high-quality education, and to close educational achievement gaps.’’
Accountability

MSIP 6

Schools provide a comprehensive multi-tiered system of supports that address the academic, emotional, behavioral, social, and physical needs of each student

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Data Based Problem Solving and RTI/MTSS as a Best Practice

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Data-based problem solving is a systematic process designed to facilitate continuous improvement.

Collect and analyze data to understand needs

academic and behavioral

Evidence based interventions are identified to address need
Data is collected and analyzed to understand:

Success of intervention
Changes to intervention if goal is not met

(Pluymert, 2014)

RTI is fundamentally a data-based problem solving approach to supporting appropriate instruction for students.

“Delivering scientifically based interventions with integrity and monitoring (frequently) how the student responds to those interventions provides an invaluable data base of important information about the need to change or sustain the intervention in a timely fashion. An RTI approach to determining educational need…keeps the focus of our professional resources where they need to be, on student outcomes.”

(Prasse, retrieved May, 13 2022)

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Care Teams as a Problem Solving Team for Students

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School based teams designed to support individual student needs go by many names: Care Team, Student Support Team, Student Intervention Team, Student Study Team, Student Assistance Team

Each of these teams might by definition have slightly different purposes, but often we find that these terms are used interchangeably to describe the team’s engagement in the problem solving process and using data to make instructional decisions for students within an RTI/MTSS system.

“The student support team’s primary aims are to establish, monitor, and adapt the systems at Tiers 2 and 3.” This includes:

planning for students, including determining (or designing) appropriate interventions for both academic and behavior skill development
monitors the effectiveness of interventions
supporting staff in their implementation of interventions, data collection, and data analysis

(McIntosh, K. and Goodman, S. 2016. pp. 166-167)

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Leadership in the Team Process

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One of the most important and even necessary components of the implementation of RTI and CARE teams is leadership from the school principal.

The school principal supports the process by with active engagement in:

Participation in CARE team meetings
Developing a school climate that envelopes RTI systems and continuous improvement

The team’s purpose is to define the problem and determine appropriate intervention (s) in order for the student to remain in the classroom. The end goal is not a referral for special education.
Data utilized to reflect on practices and the systems with an understanding that these practices impact student success

Allocates resources including, time for interventions and CARE team meetings, staff involvement in intervention and meetings, and intervention and progress monitoring tools
Ongoing professional development

The principal should expect that implementing RTI will take time and result in shifts to staff and school dynamic.

Development and implementation of a full scale RTI system can take 3-5 years to be established.

(McCook, 2006, pp. 39-40 ; Pluymert, 2014 pp. 25; Hall retrieved May 2022; Batsche retrieved May 2022)

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Implementing an Effective Team Process

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It’s important to build a foundation including support from district leadership and parents.

School staff and team members should be trained.

Team members could include special education teachers, behavior coaches, reading specialists, counselors, social workers, and psychologists. These should be chaired by the school principal.

When working with your team:

The Principal leads the team
The Principal trains team members and any new team members over time
Each member has an assigned and understood role
All ideas are considered in a collaborative consensus building process

(McIntosh, K. and Goodman, S. 2016 and McCook, 2006)

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With the problem solving method as a foundation for the CARE team process, there are specific practices that the CARE team will engage in to support effective implementation of RTI.

Data Sources:

Universal Screening
Progress monitoring
Classroom assessments
District assessments

Reminder of the three tiers of intervention:

Tier 1-core instruction
Tier 2- supplemental instruction
Tier 3- intensive instruction

RTI and the Problem Solving Structure as the Foundation for CARE Team

Intervention Support and Fidelity:

Selecting appropriate interventions

Evidence-based and appropriate to address skill deficit

Provide intervention for up to 10 weeks. Document the frequency and content of the intervention.

Data Decision Rules:

Establish rules for the interpretation and instructional implications of data
Establish consistent entrance and exit criteria for Tier 2 and Tier 3 participation

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Team Responsibilities

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Following universal screening/collecting benchmark data and the implementation of evidence-based Tier 1 instruction and universal supports, teachers should review their data to identify students that are falling below benchmark targets.

The Care Team referral process, “must become an institutionalized process, consistently administered and monitored in order to bring about effective change.” McCook. 2006. pg. 47

students are referred to Care Team only when there is data, and universal supports

have not been effective (pg. 48)

At the Care Team meeting the Team will:

Define the problem
Develop a plan and
Implement the plan
Evaluate

(McCook, J.E. 2006 ;Pluymert, K. 2014, Brown-Chidsey and Steege 2005)

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Define & Analyze Problem

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Include appropriate expertise on team
Develop a clear, measurable, and operational definition of the problem.

Define difference between target student performance and expected performance
State problem in observable terms

Use available data to analyze the problem

Skill vs. performance
Is data sufficient to confirm/refuse hypothesis of root cause?
Is root cause within the school’s influence?

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Develop Plan

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Develop clearly defined goals that are specific and measurable
Collect baseline data and set long range goal
Determine the who, what, where, and when, for implementation of the intervention and a plan for on-going data collection (progress monitoring)
Identify and describe intervention that targets the identified problem

consider acceptability of intervention

Identify progress monitoring that measures the skill(s) being addressed by the intervention
Identify how implementation integrity/fidelity will be ensured and measured
Identify decision-making rules

When is the intervention successful/when does it need to be changed?

Schedule regular progress reviews (generally 6-8 weeks)

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Implement Plan

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Follow written intervention plan created during plan development stage
Collect progress monitoring data

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Evaluate

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Review goals and data

If goal has been met:

decrease or discontinue intervention
continue to progress monitor to ensure success is maintained

If goal has not been met:

consider restarting the problem solving process to ensure correct problem identification or correct hypothesis was chosen
review fidelity of intervention
consider increasing intensity of intervention (time, frequency)
consider need for additional, layered supports to increase intensity to overall intervention plan

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Strategies for Effective Teaming

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Buy In!

At least 80% of group must be in agreement to support implementation

Other strategies:

Mission Statement or set of beliefs

Decisions are best made with data
No child should be left behind

Team Norms
Specified team member roles (for example, facilitator, note taker, time keeper, data manager)
Agenda
Use of forms for consistency in documentation, such as referral form, CARE team decision documentation, intervention and progress monitoring documentation

(Batsche, retrieved May 2022; McIntosh, K. and Goodman, S. 2016)

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Hazelwood School District-Brown Elementary School

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Thank you to Adrienne Azama, SSD School Psychologist, at Brown Elementary in the Hazelwood School District, and the Brown Elementary team for providing the following content.

Adrienne is one of the leaders of the development, implementation, and maintenance of the CARE team process at Brown Elementary.

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RTI Process Overview

Tier 1 Core Instruction - PLC Team

1) Focus on Core Instruction /PBIS Implementation &

2) Review of Universal Screening Data (BESS-T for behavior) /Dyslexia Screeners

Is there a need for classwide intervention? - Is the class median score below benchmark?

1

Tier 2 Interventions -

PLC Team

Classrooms data on track - Start Tier 2 interventions for needed students - skills determined by screening data percentiles & grade level guidelines

Document on RTI Timeline Document during PLC decisions made and any need for changes.

Create PM schedules in AIMSweb with long term goals: At-Risk bi-weekly, Some Risk - 1x/month

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Tier 3 Interventions - Care Team

1) Review of Screening Data indicates need for intensive intervention

2) Complete CARE Team Referral Form following unsuccessful Tier 1/2

3) Intervention Plans reviewed in 6 week cycles

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Starts Quarter 1

Universal Screening 3x/year

Starts Quarter 1

Progress Monitor bi-weekly

Driven by data

PM

Weekly

RTI Block: 8:50-9:20 am Tuesday-Friday

Target: 2 days e.g. ELA, 2 days Math

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PLC and CARE Team Prep

August-September:

Establish Leadership Team
PLC and CARE Team schedule finalized
Intervention schedule finalized (including interventionist)
Intervention, Progress Monitoring, and Benchmark Tools are identified
Classroom and building Universals are established
Benchmarking is completed
Grade Level Targets are established (see example on next slide)

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Brown Elementary Grade Level Targets

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PLC/ CARE Team Timeline

Quarter 1:

PLC’s Determine need for Classroom Intervention vs. Tier 2

Refer to CARE team if data presents significant need, such as a history of Tier 2 and Tier 3 support.

Quarter 2:

PLC’s Determine to continue with Tier 2 or change

No additional need for intervention, different Tier 2, move to CARE team and Tier 3 etc.
Students who do not meet grade level targets by the end of the first semester should be placed in Tier 2 Intervention

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Tier 1: Grade Level Teams/PLC’s

Tier 1:

For all students
Universal instruction and supports
Universal screening
Approximately 80% -90% of students should be academically and behaviorally successful with the support of effective Tier 1

Brown’s Grade Level PLC’s meet weekly to discuss student data and guide core instruction.

The team’s responsibilities:

Use data to set grade level goals and develop grade level instructional plans and differentiated instruction plans
Based on data, discuss students not responding to Tier 1 who may need Tier 2 or 3 level interventions

Who:

Administrator
Instructional Specialist/Coach
All teachers supporting the specific grade level
Paraprofessionals providing intervention supports

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Tier 2: Grade Level Team/PLC’s

Tier 2:

10-15% of students (not responding to Tier 1)
Small group supplemental teaching and support
Progress monitoring

Brown’s PLC’s designate 1 meeting every 6 weeks to discuss student data.

Responsibilities of the Team:

Review data to determine intervention progress and next steps for students identified for or currently participating in Tier 2
Identify the problem to determine:

Groups for RTI blocks
Intervention who, what, when, where
Data collection who, what, when, where

Who:

Administrator
Counselor and School Psychologist
Instructional Specialist/Coach
All teachers supporting the specific grade level
Paraprofessionals providing intervention support

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Brown Elementary Intervention Groups

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Tier 2: Grade Level Problem Solving

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Meet 6 week cycles for data days reviewing academic or behavioral needs driving intervention planning

2021-2022: On avg 9.3 students/grade or 22.4% academic and on avg 11 students/grade or 26.4% behavior

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Tier 3: CARE Team

Tier 3:

1-5% of students
Small group, more frequent and/or longer duration

Could be the same interventions curriculum as Tier 2

Individualized and comprehensive intervention
Specific and individual needs
Progress Monitoring

Brown’s Teachers request at PLC’s and complete referral form. These meetings are scheduled as needed.

Responsibilities:

Review data to determine intervention progress and next steps for students referred to or receiving tier 3 intervention supports
Identify the problem to determine:

Intervention who, what, when, where
Data collection who, what, when, where

Who:

School Administrator
Parent
General Education Teachers
Counselor
School Psychologist
Special Education Teachers
ESL Teachers, Interpreters, if needed

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Tier 3 Care Team

2021-2022

20 individual student initial meetings
15 students at least 1-2 or more data review meetings
roughly 8% of our students

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CARE Team Meeting

Two CARE Team Options:

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Individual Student Meeting	Care Team Staffing Meeting
Individual Student Meeting	CARE Team Staffing
Meet as Needed	Meet on a regular schedule
Parent invited	Parent consulted ahead of meeting
Identify skills areas for improvement	Identify skill areas for improvement
Develop individual intervention plan	Develop group intervention plan
Set Action Goals	Set Action Goals
Determine Progress Monitoring	Determine Progress Monitoring
Identify Case Manager and date for review meeting	Reviewed after 9-12 weeks, identify date for review meeting

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Following the CARE Team:

Implement CARE Team Recommendations

Intervention
Progress Monitoring
Duration 9-12 weeks with fidelity
Have data prepared for scheduled Review Meeting

CARE Team Data Review

Problem Solved-Return to Tier 1
Adequate Progress, consider continuing intervention or modify

OR

Limited Progress, Intensify/Change if rate of improvement is not adequate

intensify
consider referral for special education

If needed, set date for CARE Team Data Review

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CARE Team Members and Roles

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Team Member:	Role:
Building Administrator (Principal or Assistant Principal)	Leadership
Team Coordinator (Counselor)	Review teacher referrals, ensure referrals are complete, schedule meetings. Invites parents (see sample parent letter / phone call).
Team Facilitator	Facilitate meeting: introductions, goals for the meeting, keep on track, summarize plan.
Data Manager (School Psychologist)	Provides interpretation of progress monitoring and other available data. Makes recommendations for interventions and progress monitoring.
Note Taker	Completes ongoing intervention plan form with meeting notes which includes: progress toward intervention, changes to interventions and progress monitoring, additional notes. Distributes copies of intervention plan to parents, teacher, staff who are interventionist following each meeting.
Time Keeper	Keeps meeting on track and politely reminds of time remaining.
Parent	Active participant. Can pair a staff member to support parent understanding during meeting.
Case Manager	Support teacher before meeting to ensure prepared and follow up after meeting to ensure intervention plans are understood and in place.

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Academics

Social, Emotional, Behavior

Tier 3

Tier 2

Tier 1

1-2 student(s)

Intensive

Evidence Based Intervention

Small group

Evidence Based Interventions

Core Curriculum/Instruction, Family/School Communication

PBIS Model: school/class wide expectations, Character Education, SEL Curriculum (e.g., Zones of Regulation), Restorative Practices, Student Code of Conduct

Building Plan, Functional Behavioral Assessments/Behavioral Intervention Plans, Mental Health Services, 1:1 Counseling, Crisis Intervention (building based de-escalation team), Student Code of Conduct Levels 3, 4

Counselor Groups, Behavior Consultation, Check-in/Check Out Restorative Circles, Student Code of Conduct Levels 1, 2

Brown’s Interventions

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Brown’s Data Collection Tools

Tier 3

Tier 2

Tier 1

K-5 AIMSWEB Reading and Math Progress Monitoring

K-5 AIMSWEB Reading and Math

Progress Monitoring

K-2 AIMSWEB

3-5 SRI

Hazelwood Screening for Tier 3 Reading

Intervention Progress Monitoring Data

Attendance (group or individual)

Discipline Referrals

BESS-Teacher

Attendance

Discipline Referrals

Intervention Progress Monitoring Data (group or individual)

BESS-Teacher

Attendance

Academics

Social, Emotional, Behavioral

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Resources for Support

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http://www.rtinetwork.org/getstarted/develop/developingplan

Self-Assessment of Problem Solving Implementation

http://www.rtinetwork.org/getstarted/develop/create-your-implementation-blueprint-stage-1-exploration

Self-Assessment of Problem Solving Implementation

http://www.rtinetwork.org/getstarted/checklists-and-forms

Downloadable Checklists: Problem Solving Checklist and Critical Components Checklist

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References

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Batsche. G. Retrieved May 16, 2022. Developing a Plan. RTI Network.http://www.rtinetwork.org/getstarted/develop/developingplan

Brown-Chidsey, R. and Steege, M.W. (2005) Response to Intervention: Principles and Strategies for Effective Practice. The Guilford Press.

Every Student Succeeds Act, 20 U.S.C. § 6301 (2015). congress.gov/114/plaws/publ95/PLAW-114publ95.pdf

Hall, S. L. (retrieved May 16, 2022) Creating Your Implementation Blueprint Stage 1: Exploration. RTI Network. http://www.rtinetwork.org/getstarted/develop/create-your-implementation-blueprint-stage-1-exploration

McCook, J. E. (2006) The RTI Guide: Developing and Implementing a Model in Your Schools. LRP Publications.

McIntosh, K. and Goodman, S. (2016). Integrated Multi-tiered Systems of Support: Blending RTI and PBIS. The Guilford Press.

Missouri School Improvement Program 6, 5 CSR 20-100.125. https://dese.mo.gov/media/pdf/msip-6-rule

Pluymert, K. (2014) Problem-Solving Foundations for School Psychological Services. In P. L. Harrison (Ed.) and A. Thomas (Ed.), Best Practices in School Psychology: Data Based and Collaborative Decision Making. pp.25-40. National Association of School Psychologists.

Prasse, D.P. (retrieved May 13, 2022) Why Adopt an RTI Model? RTI Network. http://www.rtinetwork.org/learn/what/whyrti