Preventing problem behaviors: Primary, secondary, and tertiary level prevention interventions for young children

Tary J. Tobin, George Sugai
2005 Journal of Early and Intensive Behavior Intervention  
The purpose of this report is to compare changes in social skills, problem behaviors, and academic competence for kindergarten or first grade students identified as being at risk for serious behavior problems who received primary, secondary, or tertiary level preventive interventions. Of the 93 participants in this study, 73% were male; 86% were Caucasian, and 65% were characterized as having externalizing behavior problems. A repeated measures analysis of variance indicated statistically
more » ... statistically significant differences (p < .01) between the groups based on type of intervention received the Self-Control subscale (e.g., controlling temper, responding appropriately to teasing) of the Social Skills Rating System (Gresham & Elliott, 1990) . School-wide Positive Behavior Support is an effective primary prevention intervention, even for young children with serious internalizing or externalizing behavior problems. Behavior problems interfere with success in school for many children and create unpleasant situations for teachers and other children. Although traditionally schools often responded reactively to problem behaviors, with punishments and exclusion, today many educators are seeking to prevent problem behaviors by using proactive, early interventions. A three-tiered model of prevention, popular in many fields, involves primary, secondary, and tertiary levels of prevention. When problem behaviors at school are the concern, Positive Behavior Support (PBS) is an approach that offers these three levels of prevention (see http://pbis.org ). Schoolwide discipline, at the primary prevention level, emphasizes teaching, prompting, and reinforcing appropriate behavior proactively and universally, to all children in the school (Sugai & Horner, 2002). When well implemented, it can be exp ected to enable most students to behave well in school. Some students may be given additional, support, at the secondary prevention level, if they are considered "at risk" for problem behaviors. Decisions about who is "at risk" may be based on a variety of factors and assessed in different ways. One way of deciding that a child needs some extra behavioral support is simply to notice that the child seems to have some difficulties with peers or in following instructions. In the early elementary grades, teachers often notice behaviors that, while in themselves not particularly severe, might lead to greater problems later, and the teachers may decide to implement some type of early intervention. A more formal way of making this decis ion is to use a rating scale or other instrument that indicates which children have known risk factors. A few children come to school, from the beginning, with serious behavior problems that are already well established. These children are in need of tertiary level prevention interventions, which are preventive in the sense of preventing the problem from getting worse. What evidence supports the use of three levels of preventive interventions in Positive Behavior Support in schools? Although the concept is logical, data are needed to show specific effects. In addition, other questions beg for answers: • What is the nature of secondary and tertiary level prevention of problem behavior? JEIBI
doi:10.1037/h0100309 fatcat:qpeqix6uvjaxrn36qqnsbswevq