The implementation of the Affordable Care Act (ACA, 2010) has resulted in efforts to make healthcare more affordable and effective. One strategy for making healthcare more affordable and effective is the integration of behavioral health and primary care. In today’s healthcare system, it is estimated that approximately one in three patients seen in a primary care setting meet the criteria for a mental health disorder and another third – while not meeting those criteria – are experiencing psychological symptoms that impair their functioning (Kessler, 2005). Despite the evidence supporting behavioral health services in a primary care setting, treatments tend to be diagnosis specific (Archer et al., 2012; Lemmens, Molema, Versnel, Baan, & deBruin, 2015) and as such do not capture patients’ varied presentations. Patient feedback offers a potential strategy to improve the quality of services provided. Patient feedback is the use of measures administered at each session to assess distress and track progress. There is a robust psychotherapy literature demonstrating the effectiveness of using routine progress monitoring in clinical practice but it has not been evaluated in an integrated care setting. Therefore, the purpose of this study was to evaluate the efficacy of patient feedback in this setting. Preliminary results of this ongoing study revealed there was a moderate feedback effect using both the ORS (d = 0.38) and PHQ-9 (d = 0.12) as the outcome measures. Using the ORS as the outcome measure, patients in the feedback condition demonstrated faster treatment gains, which suggests that they improved faster compared to those patients in the TAU condition. Additionally, patients in the feedback condition incurred significantly more reliable change compared to TAU. However, this result was not replicated when the PHQ-9 was used to measure outcome. Overall, the results suggest that PCOMS may be a potentially useful quality improvement strategy.

Support for the use of progress monitoring results for high-stakes decisions is emerging in the literature, but few studies support the reliability of the measures for this level of decision-making. What little research exists is limited to oral reading fluency measures, and their reliability for progress monitoring (PM) is not supported. This dissertation explored methods rarely applied in the literature for summarizing and analyzing progress monitoring results for medium- to high-stakes decisions. The study was conducted using extant data from 92 "low performing" third graders who were progress monitored using mathematics concept and application measures. The results for the participants in this study identified 1) the number of weeks needed to reliably assess growth on the measure; 2) if slopes differed when results were analyzed with parametric or nonparametric analyses; 3) the reliability of growth; and 4) the extent to which the group did or did not meet parametric assumptions inherent in the ordinary least square regression model. The results indicate reliable growth from static scores can be obtained in as few as 10 weeks of progress monitoring. It was also found that within this dataset, growth through parametric and nonparametric analyses was similar. These findings are limited to the dataset analyzed in this study but provide promising methods not widely known among practitioners and rarely applied in the PM literature.

In this descriptive study, I researched five elementary general education teachers' reading assessment practices as they worked within the context of IDEA (2004), NCLB (2002) and Response to Intervention (RTI). My own connection to the classroom and reading assessment practices brought me to this research. I presented my personal and professional connection through vignettes about my own classroom assessment practices. Relevant literature on both the context and culture of assessment were pertinent to this research. I used a qualitative design, specifically, Colaizzi's (1978) method of phenomenological analysis. Data were three in-depth phenomenological interviews, relevant documents and artifacts, and use of a researcher reflective blog. I summarized the initial findings of this research through 10 clustered themes; shift of focus, ever changing accountability, independent efforts with data, collaborative efforts with data, working environment, interventions and reading assessment practices in action, authenticity in practice, lack of decision making power, teacher emotion, and teacher needs and wants and a composite narrative in order to describe the lived experience of these teachers reading assessment practices. Implications from my research with regard to policy include a perceived incongruence between an RTI framework and the teacher evaluation system with regard to active collaboration. Those toward practice include difficulty with the day-to-day implementation of an RTI framework and the perception of a singular focus of RTI as disability determination. My recommendations for future research include an action research agenda designed to explore increased involvement of stakeholders such as students, parents and other school personnel.

In this mixed-methods study I report on a three-part investigation related to reading intervention at Grade 1 in one Ontario school board during the 2009-2010 school year. First, I report the results that Peer Assisted Learning Strategies (PALS) had on the reading outcomes for all Grade 1 students (n = 436) in terms of sex, aboriginal status, and at-risk status. Second, I use progress monitoring benchmark data to show how students unresponsive to instruction may have benefitted from additional instruction generated from monthly data-informed In-School Team meetings. Third, I report on educators’ perceptions of how monthly data-informed In-School Team meetings influenced their knowledge, confidence, and willingness to plan additional reading interventions for students persistently at-risk for reading failure. Findings indicate that compared to previous years, when PALS was not used, students in this study made significantly greater gains in reading scores. Boys made similar gains to girls, First Nations students made similar gains to non First Nations students, and at-risk students closed the achievement gap slightly with their typically-achieving peers. For students who did not make adequate progress in reading throughout the year a logistic regression analysis of the data indicates that the best predictor of at-risk status is not a student’s sex or First Nations status, but their letter sound fluency and word identification fluency scores at the beginning of the school year. Findings also indicate that the slope of improvement in reading scores for nonresponders begins to increase once In-School Team meetings begin. Educators’ perceptions of how the monthly In-School team meetings influenced practice differed according to the perceived role that each held of his or her position, and according to the level of involvement, training, and access that each had to the data used in this study. The more professional development that educators had in the theory, use, and application of progress monitoring data the more likely they were to report that they were willing to use it to inform their practice. Likewise, the more access that educators had to the data in terms of collecting, viewing, and interpreting it, the more likely they were in reporting knowledge, confidence, and willingness to use it to plan additional interventions for students. / Thesis (Ph.D, Education) -- Queen's University, 2011-09-13 10:03:09.664

xvi, 136 p. : ill. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number. / An examination of evidence-based practices for mathematics reveals that a solid grasp of key algebraic topics is essential for successful transition from concrete to abstract reasoning in mathematics. In addition, experts indicate a need to emphasize formative assessment to allow results to inform instruction. To address the dearth of technically adequate assessments designed to support data based decision making in algebra, this study examined (a) the validity of algebra and mixed computation curriculum-based measurement for predicting mid-year general math and algebra outcomes in 8th grade (b) growth rates for algebra and mixed computation CBM in the fall of 8th grade, (c) whether slope is a significant predictor of general math and algebra outcomes after controlling for initial skill, and (d) whether growth rates differ for pre-algebra and algebra students. Participants were 198 eighth grade pre-algebra ( n = 70) and algebra (n = 128) students from three middle schools in the Pacific Northwest. Results indicate moderate relationships between fall performance on mixed computation and algebra CBM and winter SAT-10 and algebra performance and significant growth across the fall. Growth was not found to predict general math and algebra outcomes after controlling for initial skill. Future studies should examine (a) growth rates over an extended period of time with a larger sample of classrooms, (b) instructional variables that may impact growth across classrooms, and (c) the impact on student performance when data gleaned from the mixed computation and algebra CBM are used to support data based decision making in middle school algebra and pre-algebra classrooms. / Committee in charge: Roland Good, Chairperson, Special Education and Clinical Sciences; Elizabeth Ham, Member, Special Education and Clinical Sciences; Leanne Ketterlin Geller, Member, Educational Methodology, Policy, and Leadership; Christopher Phillips, Outside Member, Mathematics

Because of a greater need to focus on early achievement in mathematics and increased global competition in this area, emphasis is increasingly being placed upon screening and monitoring of math development in early elementary to ensure progress for all students. Although protocols for early literacy assessment exist, research of psychometrically sound and instructionally useful early numeracy assessment methods is still developing. Thus, the current study was undertaken to further develop and examine early numeracy measures. In a two-year investigation, 72 kindergarten and 57 first-grade students completed a set of existing and newly developed early numeracy curriculum-based measurement (EN-CBM) tools. Reliability and validity of these measures were examined both within and across years. The nature of score change across the academic year was also analyzed. Findings were generally similar to those published in previous EN-CBM research. Alternate-form reliability estimates were largely adequate for screening purposes. Although concurrent and predictive validity estimates varied as a function of screening period and the outcome criterion, these estimates were generally moderate to strong. EN-CBM discriminant validity evidence was mixed for the kindergarten measures but more evident for first-grade tools. All measures demonstrated score change that was statistically significant over time with at least moderate to large effect sizes for most measures. Implications for EN-CBM use as screening tools are discussed. Study limitations are presented as are suggestions for future EN-CBM research.

One major concern when developing a response to intervention (RTI) program is to select effective practices that will be successfully implemented and sustained with adequate organizational guidance and support. The purpose of this study was to explore patterns of student tier placement data as a school-based case example of the nature and utility of RTI in an applied setting. Specifically, this study aimed to explore the extent that the percentages of students placed in a three-tier program based on student oral reading fluency (ORF) level and growth trajectories reflect the standard RTI tier placement (80%, 15%, and 5%) at fall, winter, and spring in a school setting. Percentages of the total student population tier placement were explored with ORF data from third- and fourth-grade students (N = 429) at two schools in fall, winter, and spring. Results showed that school and ORF data reflected the standard percentages of student populations within each tier in fall, winter, and spring. However, slope data showed greater percentages of students in the more intensive tiers. Moreover, flexible grouping, or movement between tiers occurred for few students when movement occurred based on school or ORF level data. No significant differences were found between the school and ORF student tier placements in fall, winter, and spring. A significant difference was found in spring between placement methods with a larger proportion of students in Tier 1 based on the school assignments and a larger proportion of students in Tier 2 and Tier 3 based on ORF slope assignments.

No description available.

Progress monitoring and data analysis are essential skills needed by classroom teachers within the implementation of multi-tiered systems of support for making data-based decisions about student progress and instruction. Within the early childhood MTSS research, consideration of teacher-collected progress monitoring data followed by data-based decision-making is rare. To provide teachers with a robust progress monitoring strategy, I trained preschool teachers of inclusive classrooms to use direct behavioral observations to collect data and inform their instruction. The project experimentally evaluated teachers’ generalization of acquired behaviors within the context of a single-case research design. The project’s independent variable, teacher training, consisted of a video-based multimedia presentation and in-vivo feedback. The primary dependent variable was teachers’ implementation of teacher-directed behavior observation procedures. Results indicate that teacher training was effective for three teachers, as evidenced by teachers reaching criterion levels of performance across consecutive days and sessions. Data on the durations of teacher training activities indicate that an average of 21 minutes of in-vivo feedback was provided to the teachers throughout training. Social and ecological validity data suggest that teachers perceived the training activities to be relatively non-intrusiveness and that the target progress monitoring strategies were of value to the teachers. A functional relation was established between training and teachers’ implementation of direct behavioral observation procedures.

The ability to read is highly valued in American society and important for social and economic advancement. One of the best strategies to prevent reading difficulties is to build basic literacy skills, thereby ensuring that all children are readers early in their educational careers. The purpose of this study was to determine the relationship between third-grade students' oral reading rate and scores on the Florida Comprehensive Assessment Test. The present study examined the relationship between the independent variables of Curriculum-Based Measurement Reading (R-CBM), ethnicity and socioeconomic status and the dependent variable of performance on the reading portion of the Florida Comprehensive Assessment Test (FCAT) in 215 third-grade students. The data presented in this study were collected by the Florida Center for Reading Research (FCRR) as part of a larger assessment battery across three school districts and nine elementary schools in Florida. Student demographic variables as well as performance on three different types of oral reading probes (generic, content, and FCAT passages) were investigated in relation to each student's performance on the reading portion of the FCAT. Results of the current study were similar to investigations in other states; the correlations among the R-CBM probes and between all R-CBM probes and FCAT scores were high and statistically significant. These results indicate that student performance on any or all R-CBM probe types can be used to predict FCAT score. Ethnicity and SES were not significant predictors of FCAT score above R-CBM score. Implications for educators and specifically school psychologists are discussed including opportunities for school psychologists to train educational personnel in the use of R-CBM. As evidenced by the current study, R-CBM may help identify students who are at-risk for reading failure and FCAT failure so that intensive interventions can be implemented early and student progress frequently monitored.