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Using Daily Report Cards as a Progress Monitoring Tool for Students with ADHD in Special Education


Using Daily Report Cards as a Progress Monitoring Tool for Students with ADHD in Special Education Gregory A. Fabiano, Ph.D. University at Buffalo – PowerPoint PPT presentation

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Title: Using Daily Report Cards as a Progress Monitoring Tool for Students with ADHD in Special Education

Using Daily Report Cards as a Progress Monitoring
Tool for Students with ADHD in Special Education
  • Gregory A. Fabiano, Ph.D.
  • University at Buffalo
  • Department of Counseling, School, and Educational

Attention-deficit hyperactivity disorder (ADHD)
  • ADHD is characterized by developmentally
    inappropriate levels of
  • Inattention
  • Hyperactivity
  • Impulsivity
  • ADHD behaviors are developmentally inappropriate,
    pervasive, chronic, and result in considerable
    impairment in social and academic functioning.

Impact of ADHD - Impairment
  • Peer relationships
  • Adult relationships
  • Sibling relationships
  • Academic Progress
  • Self-esteem
  • Group functioning
  • Associated problems
  • Cost of illness (Pelham, Foster, Robb, 2007)

ADHD and Special Education
Interface between ADHD and Special Education
  • Difficult to describe precisely due to no ADHD
  • Majority of children in Other Health Impaired and
    Emotionally/Behaviorally disturbed categories.
  • About 20 of children in Learning Disabled
  • However, considerable number of children with
    ADHD are at risk for or receive special education
    in schools.

Bussing et al., 2002 Reid et al., 1994 Schnoes
et al., 2006
ADHD Impacts General and Special Education
  • 63 of time is spent in a general education
  • Approximately 60-70 of children spend the
    majority of their time in general education

Schnoes et al., 2006
General educators were asked Does this child
with ADHD have an IEP?
Progress Monitoring
  • With the advent of the Response to Intervention
    (RtI) approach, progress monitoring has become
  • Progress monitoring is complicated for children
    with ADHD.
  • Represented at all tiers
  • Behavior is variable
  • Typically in general and special education
    settings working with multiple teachers

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Typical progress monitoring approach
  • Progress monitoring
  • 72 of children with ADHD are reported to have
    progress monitored by a special educator, but
    typically with long lags between assessments
    (i.e., weeks or months)

Fabiano et al., in preparation Schnoes et al.,
Progress Monitoring Needs
  • A hallmark of ADHD is behavioral variability
  • Assessments need to be fluid, socially valid, and
    tied to important functional outcomes.
  • These assessments cannot be static, but need to
    be ongoing and frequent (i.e., daily)
  • Must work on an individual/idiographic level
  • Based on these issues/criteria, the Daily Report
    Card may be a useful approach to progress

Daily Report Cards for Progress Monitoring
What is a Daily Report Card (DRC)?
  • The DRC is an operationalized list of a childs
    target behaviors
  • Specific criteria
  • Immediate feedback
  • Communication tool
  • Home-based privileges contingent on meeting DRC

Why Use a DRC?
  • Lack of evidence based interventions specified in
    the IEPs of students diagnosed with ADHD
  • The DRC is an evidence-based intervention for
    ADHD in schools (Pelham Fabiano, 2008 DuPaul
    Stoner, 2004 Evans Youngstrom, 2006 U.S.
    Department of Education, 2003)
  • Feasible for teachers (e.g., Fabiano et al.,
    2010 Murray et al., 2008)
  • Students receive immediate feedback
  • Explicit feedback from the teacher may also serve
    as an antecedent to future appropriate behavior
    (Sugai Colvin, 1997)

Why Use a DRC?
  • Provides daily communication
  • Important for an intervention to facilitate
    communication (Pisecco, et al, 1999)
  • May contribute to amenable parent-teacher
    relationships (Dussault, 1996).
  • May enhance relationships between teacher, parent
    and child (e.g., Pianta, 1996 Sheridan
    Kratochwill, 2008)
  • Allow for continued progress monitoring
    monitoring outcomes (e.g., Chafouleas,
    Riley-Tillman, McDougal, 2002 Cheney, Flower,
    Templeton, 2008 DuPaul Stoner, 2003 Evans
    et al., 1995 Pelham, Fabiano, Massetti, 2005
    Riley-Tillman, Chafouleas, Breisch, 2007)

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Creating the DRC
Pelham, Fabiano, Massetti (2005)
Evidence-based assessment for ADHD
  • DRCs have adequate psychometric properties
  • Alpha .77- .88
  • r .62 for test-retest
  • Correlates with symptom-based ratings of ADHD
  • r .51 - .72
  • Correlates with objective measures of behavior
    (i.e., observations)
  • r .47- .84
  • Discriminates between treatment conditions

Long History of Using Targeted Behavior Lists as
Measures of Outcome
  • Patterson (1975)
  • Used targeted behaviors listed by parents at
    referral (noncompliance, temper tantrum, teasing)
    as measures of treatment outcome
  • Parent Daily Report (PDR) is a psychometrically
    sound measure (Chamberlain Reid, 1987).

Examples of Existing Studies of the DRC as a
Progress Monitoring Measure
  • Cheney, Flower, and Templeton (2008)
  • Used a Daily Progress Report
  • Classified Students as responders/non-responders
    in an RtI model
  • Used the DRC as a measure of on-going progress
    monitoring for students on Tier 2

  • Chafouleas, Riley-Tillman, Christ, Briesch
  • Direct Behavior Ratings (DBRs)
  • Conducted a sophisticated and comprehensive
    program of research to validate DBRs as a measure
    of screening, progress monitoring, and outcome
  • DBRs are reliable, valid, and sensitive to
    treatment (Chafouleas, Christ, Riley-Tillman,
    Briesch, Chanese, 2007 Chafouleas,
    Riley-Tillman, Christ, 2009 Christ,
    Riley-Tillman, Chafouleas, 2009)

  • Pelham
  • Developed the DRC as an intervention for ADHD
    (e.g., OLeary, Pelham, Rosenbaum, Price, 1976
    OLeary Pelham, 1978)
  • More recently used the DRC as a method of
    progress monitoring
  • Medication effects (Pelham et al., 2001 Pelham
    et al., 2005)
  • Behavior Modification effects (Pelham et al.,
  • Combined treatment effects (Pelham et al., 2005)
  • Ongoing Monitoring (Coles et al., 2010 Pelham et
    al., 2010 a,b)

Pelham et al., 2001 medication effects
Pelham Fabiano (2001) Behavioral Treatment
Pelham et al., 2005 single and combined
treatment effects
Enhancing the Effectiveness of Special Education
Services for Children with ADHD Using a Daily
Report Card Program
Institute of Education Sciences Goal 2 Grant
R324J06024 Fabiano, Vujnovic, Pelham, Waschbusch,
Massetti, Pariseau, et al., in press
  • Co-Investigators
  • William E. Pelham, Jr.
  • Daniel A. Waschbusch
  • Greta M. Massetti
  • Jihnhee Yu
  • Martin Volker
  • Christopher J. Lopata
  • Clinicians
  • Justin Naylor
  • Meaghan Summerlee
  • Rebecca Vujnovic
  • Research Assistants
  • Tarah Carnefix
  • Melissa Robins
  • Jenna Rennemann

Summary and Main Findings of Goal 2 Project
(Fabiano, et al., 2010)
  • 63 children with ADHD and IEPs were randomly
    assigned to
  • Business as Usual (BAU)
  • BAU a DRC with targets based on IEP goals and
  • Children were assessed in October and May of the
    school year.

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Main Findings
  • DRC group was significantly better than BAU on
  • Blind observations of disruptive behavior
  • Teacher ratings of
  • Academic productivity
  • Disruptive behavior
  • IEP goal attainment
  • Normalization of functioning
  • No difference on academic achievement, ratings of
    ADHD symptoms, or student-teacher relationship

Fabiano et al., 2010
Psychometric Properties of the DRC as a Progress
Monitoring Measure
  • Correlations between odd and even days suggested
    considerable temporal stability (r .94,
    p lt .05)
  • Correlation between the DRC and an independent
    observation code ranged from r -.45 to -.46

Fabiano et al., 2009
  • Content validity
  • academic goals represented in the IEP were at
    least adequately included on the DRC
  • there was not a significant correspondence
    between social goals reported on the IEP and the
    DRC goals related to social functioning.
  • It is notable that a considerable number of
    children with no IEP goals related to social
    behavior had a social goal added to the DRC
    during the school year.
  • Social goals may not be well-represented on IEPs

Fabiano, et al., 2009
Top 10 Academic and Social Targets on DRCs/ITBEs
Fabiano et al., 2010
Box and whiskers plot for a sample month of
DRCs/ITBEs in the study
Fabiano, et al., 2009
Comparison of ITBEs vs. DRCs
  • Teachers report satisfaction with DRC procedures
    related to monitoring and intervention
    (Chafouleas, Riley-Tillman, Sassu, 2006
    Fabiano et al., 2010 Pelham et al., under

  • DRC is supported as a psychometrically sound
    progress monitoring tool.
  • May be better for monitoring progress for social
    behavior relative to typical methods such as IEP
  • Due to significant behavioral variability, daily
    implementation is preferred frequency of
  • Background intervention may impact variability

Future Directions
  • Teachers/School staff are not trained in
    interpreting single-subject research results
  • How will daily progress monitoring be utilized?
  • Additional study of context effects
  • Integration within a problem-solving model

Thank you!
  • Greg Fabiano
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