1047571

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ISCXXX10.1177/10534512211047571Intervention in School and ClinicGettinger et al.

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Intervention in School and Clinic 1­–6
© Hammill Institute on Disabilities 2021
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DOI: 10.1177/10534512211047571
https://doi.org/10.1177/10534512211047571
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Development and Implementation of an Integrated

Academic-Behavior Intervention

Maribeth Gettinger, PhD1, Thomas R. Kratochwill, PhD1, Alison Foy, PhD1,

and Abigail Eubanks, MS1

Abstract
The relationship between learning disabilities and behavior disorders is well documented and has led to the development of
integrated interventions that target both academic and behavior deficits in elementary students. This paper describes the
rationale, development, and implementation of an integrated academic-behavior intervention called academic and behavior
combined support (ABC Support). The intervention was developed by integrating the critical intervention elements from
two single-focus interventions (i.e., repeated reading and check-in/check-out) into a single comprehensive intervention
designed to improve reading fluency for early elementary students with reading disorders while also strengthening their
engagement and compliance with behavior expectations.

Keywords
academic interventions, elementary students, behavior interventions, social and academic skills development, integration
models

The well-documented connection between learning disabil- are reinforced and rehearsed simultaneously within the
ities and behavior disorders has contributed to the develop- same intervention context.
ment of integrated interventions that target both academic
and behavior deficits (McIntosh & Goodman, 2016).
Integrated interventions result from “the fusing of indepen-
Development of Academic and
dent strategies or programs into one enhanced, coherent Behavior Combined Support
intervention approach” (Domitrovich et al., 2010, p. 74). Academic and behavior combined support (ABC Support)
The availability of integrated interventions enables school is an integrated intervention that combines a focus on
teams to coordinate supplemental academic and behavior developing oral reading fluency with strengthening behav-
support for students who require intensive interventions ioral engagement and compliance. The intervention was
across both domains. Integrated interventions may be more created to provide integrated support for elementary stu-
efficient and effective in promoting change compared to dents whose poor reading fluency (i.e., difficulty reading
single-focus approaches because their complementary with sufficient accuracy, expression, and automaticity to
active ingredients interact synergistically (Cook et al., understand what they read) and low compliance with
2012). Consider, for example, a single-focus behavior inter- behavior expectations put them at high risk for long-term,
vention that incorporates reinforcement procedures to negative school outcomes.
strengthen learning-related behaviors (e.g., attention) but
lacks opportunities for students to practice new behaviors in 1
University of Wisconsin-Madison, Madison, WI, USA
the context of performing academic tasks. When merged
Corresponding Author:
with an academic intervention that includes repeated prac- Maribeth Gettinger, Wisconsin Center for Education Research,
tice, the benefits of both interventions are maximized University of Wisconsin-Madison, Madison, WI 53705, USA.
because the targeted academic skills and desired behaviors Email: mgetting@wisc.edu
2 Intervention in School and Clinic 00(0)

ABC Support addresses reading and behavior deficits Implementation of Development of

simultaneously through an integrated implementation of Combined Support
two single-focus, evidence-based interventions, repeated
reading (RR; Chard et al., 2009) and check-in/check-out The structure of ABC Support ensures that each of the 10
(CICO; Crone et al., 2010). Repeated reading is an oral intervention elements is incorporated into a comprehensive
reading intervention in which students read short, mean- approach for improving reading fluency and behavior
ingful passages repeatedly to improve their fluency (i.e., simultaneously. The intervention is designed to be con-
accuracy and rate). Repeated reading has demonstrated a ducted in a one-on-one format with individual students or
significant positive effect on fluency for students with as a small-group intervention with 2 to 3 students. Although
reading disabilities, especially in the elementary grades procedures vary slightly between individual versus small-
(Lee & Yoon, 2017). Check-in/check-out was designed to group implementation, the same intervention elements are
reduce the frequency and severity of behavior challenges present in either individual or small-group formats. The
by providing explicit behavior expectations, frequent recommended length for the intervention period is 6 to 8
feedback about compliance with expectations, and rein- consecutive weeks, with at least three 20-minute sessions
forcement for appropriate behavior. It has been shown to per week.
be highly effective for reducing problem behavior among
students at risk for behavior disorders (Hawken et al., Targeted Students
2014).
The ABC Support intervention was developed by delin- Students targeted for ABC Support are early elementary
eating the critical intervention elements across both RR and students who fall below grade-level benchmarks for fluency
CICO and then integrating the elements into a comprehen- (i.e., based on school-wide reading screening such as oral
sive packaged intervention. The process of integration reading fluency probes) and engagement and compliance
involved (a) adding intervention elements present in one (i.e., based on school-wide behavior screening such as the
intervention but not the other to strengthen overall effec- Social, Academic, and Emotional Behavior Risk Screener;
tiveness while (b) merging elements shared across both Kilgus et al., 2013). With an intentional focus on reading
interventions to maximize efficiency. The 10 intervention fluency, students who lack proficiency in pre-reading skills,
elements include the following: such as alphabet knowledge or phonemic awareness, are not
likely to benefit from this intervention. Likewise, students
1. Expectations: Reading and behavior expectations who are fluent readers but lack vocabulary knowledge or
are clearly worded, positively stated, posted, taught, comprehension skills may not benefit directly, unless weak
and reviewed. comprehension is due to limited fluency. In terms of behav-
2. Goal-setting: Intervention session goals for reading ior deficiencies, ABC Support was designed for students
and behavior are established. who demonstrate challenges in engagement and compli-
3. Modeling: Fluent reading and appropriate behavior ance. Students with extreme internalizing behaviors (e.g.,
are demonstrated directly by the teacher. social withdrawal) or severe externalizing behaviors (e.g.,
4. Repeated practice: Repeated practice opportuni- aggression) are not likely to have their needs addressed.
ties for both reading and behavior are provided.
5. Prompting: Prompts are given to ensure high suc-
cess in meeting reading and behavior expectations
Intervention Materials
and then gradually eliminated to support mainte- Each intervention session incorporates the same standard
nance of effects. sequence of intervention steps. Two manualized resources
6. Feedback: Specific feedback and praise for reading guide and facilitate implementation and are available
and behavior are delivered. online at https://projects.wcer.wisc.edu/abcsupport. The
7. Error correction: Explicit reading error correction first resource, ABC Support Manual, provides a detailed
and behavior redirection are given as needed. explanation of procedural guidelines and step-by-step,
8. Graphing: Performance relative to reading and semi-scripted directions for conducting intervention
behavior goals is recorded and graphed. sessions with individual students or small groups.
9. Rewards: Rewards are provided for meeting read- The second resource, Implementation Materials
ing and behavior goals. Handbook, contains all materials that are necessary for
10. Generalization: Generalization of reading and implementation. Included in the materials are 24 training pas-
behavior expectations to non-intervention settings sages of 145 to 150 words each for repeated reading practice.
(e.g., classroom) is supported through a visual aid to Half of the passages are narrative (i.e., fiction) and half are
guide self-evaluation. expository (i.e., non-fiction). Narrative and expository
Gettinger et al. 3

[Side 1]

I am here to READ.
I will Read carefully, but not too slowly.
I will read with Expression, Enthusiasm and Excitement
in my voice.

I will have a positive Attitude and show good Attention

when I read.

I will Do my best reading and best behavior!

[Side 2]
Expectations Examples Non-Examples
Read I read smoothly and stay focused I read too slowly, so the story is hard to
carefully on my reading. I try to go a little remember. I do not read carefully, so I
faster every time I read so I can make a lot of mistakes and do not
read more words correctly. understand what I read.
Expression, I change my voice when I read to My voice is boring and always sounds
Enthusiasm, make the story sound interesting the same when I read, so the story is not
Excitement and exciting. interesting for me.
Attitude and I SMILE! I stay happy and ready I get mad or grumpy if I make mistakes
Attention to read even when it is hard. I when I read. I look around the room or
pay attention to the teacher and get out of my seat instead of reading.
to what I am reading.

Do best I tell myself to do my best I tell myself I do not want to read or

reading and reading and show my best show my best behavior, and I refuse to
behavior behavior all the time. try.

Figure 1. READ expectations card.

passages are alternated across intervention sessions. Based for the entire session. The backside of the card should
on the Spache (1953) readability formula, the difficulty level contain specific examples and non-examples of each
of passages is late second grade, ranging from 2.8 to 3.1. expectation that are relevant to classroom rules and the
Two versions of each passage are included in the handbook: student’s specific concerns.
(a) teacher copy for recording errors and number of words Step 2: Goal setting. Determine the reading goal (i.e.,
read and (b) large-print copy for students to read. words correct per minute; WCPM) and behavior goal
(i.e., behavior points) for the session using the goal-­
setting guidelines included in the manual. Record the
Intervention Steps session goals on the reading and behavior graphs and
Each session incorporates the following sequence of inter- help the student draw a goal line on each graph. In
vention steps. Interventionists use an implementation self- Figure 2, for example, the student’s reading goal is 60
guide to ensure that steps are implemented in the correct WCPM by the third passage, and the behavior goal is
order and as prescribed in the manual. 32 points that are earned across three check points.
Step 3: Prompting and repeated practice. Prior to the
Step 1: Expectations. Begin each session with a review first timed reading of the training passage, remind the
of expectations. The READ expectations card (see student about the READ expectations (e.g., “Remember
Figure 1) displays four expectations that address both to read carefully, but not too slowly; read with expres-
reading and behavior. This card should remain in view sion, excitement and enthusiasm in your voice; pay
4 Intervention in School and Clinic 00(0)

WCPM Session Goal 60 Behavior Points Session Goal 32

1st Read 2nd Read 3rd Read
90 36
35
85 34
33
80 32
31
75 30
29
70 28
27
65 26
25
60 24
23
55 22
21
50 20
19
45 18
17
40 16
15
35 14
13
30 12

25

Figure 2. Reading and behavior graphs.

Note. WCPM = words correct per minute.

attention and keep a good attitude; and do your best read- at least one specific praise statement about the student’s
ing and behavior.”). Ask the student to read aloud for 1 reading performance (e.g., “You read that passage with a
min from the student copy of the training passage for the lot of good expression in your voice.”).
session. As the student reads aloud, record reading errors Step 5: Behavior feedback, praise, and recording. Use
on the teacher copy. the behavior points card (see Figure 3) to provide feed-
Step 4: Reading feedback, praise, and recording. back about the student’s behavior. For example, in
Following the first passage reading, provide feedback Figure 3, the student earned only one point for “positive
about the student’s reading fluency (e.g., “You read 46 attitude and good attention” because he complained
words correctly on that try.”). Ask the student to draw a about having to read. Ask the student to circle the num-
circle on the reading graph to show the WCPM for the ber of points earned for each expectation, ranging from
first passage reading. In Figure 2, for example, the stu- 1 to 3 on the card. Finally, give at least one specific
dent drew a circle to represent 46 WCPM. Finally, give praise statement about the student’s behavior during the
Gettinger et al. 5

Am I Reading very Is there Expression, Do I have a positive Am I Doing Total

carefully, but not too Enthusiasm, Excitement Attitude my best reading Points
slowly? in my voice? and good Attention? and my best behavior?

Time 1 1 2 3 1 2 3 1 2 3 1 2 3 10

Time 2 1 2 3 1 2 3 1 2 3 1 2 3 11

Time 3 1 2 3 1 2 3 1 2 3 1 2 3 11

How many behavior points altogether for today? 32

3 = I did this behavior all the time without needing to be reminded.

2 = I did this behavior some of the time with some reminders.
1 = I did not do this behavior much at all and needed a lot of reminders.

Figure 3. Behavior points card.

passage reading. Note that the order of Steps 4 and 5 by asking the student to demonstrate two positive exam-
may be reversed, with a focus on behavior (i.e., feed- ples of the expected behavior.
back, praise, recording) preceding the focus on reading. Steps 9 and 10: Reading and behavior feedback, praise,
Step 6: Modeling. Prior to the second passage reading, and recording. Implement the same procedures used in
demonstrate the READ expectations (i.e., appropriate Steps 4 to 5 to provide feedback and record performance
behavior and fluent reading) while reading the training for reading and behavior based on the second passage
passage aloud from the teacher copy. Implement the fol- reading. For example, on the second passage reading, the
lowing procedure, which enables the student to see as student had 57 WCPM (see Figure 2) and earned 11
well as practice fluent reading and appropriate behavior behavior points (see Figure 3).
while reading. Specifically, read about one third of the Steps 11, 12, and 13: Prompting and repeated practice
passage at a rate that is appropriate for the passage con- followed by feedback, praise, and recording. Implement
tent and commensurate with the student’s skill level. the same procedures in Steps 3 to 5 for the third timed
Stop reading in the middle of a sentence and ask the stu- passage reading.
dent to finish reading to the end of the sentence. After the Step 14: Graphing and rewards. After three repeated
student has finished reading, begin reading again. At two readings of the training passage, direct the student to
additional points in the remainder of the passage, repeat draw a line to connect the three WCPM values on the
the procedure, that is, stop reading and ask the student to reading graph and compare performance to the reading
read to the end of the sentence. goal line (see Figure 2). Place a star on a reward chart if
Step 7: Prompting and repeated practice. Similar to Step the reading goal was met. For example, the student read
3, remind the student about the READ expectations 66 WCPM by the third passage reading and surpassed
before doing a second timed reading of the training the goal of 60 WCPM. Similarly, direct the student to
passage. record the total behavior points earned on the behavior
Step 8: Reading error correction and behavior redirection. graph and compare performance to the behavior goal
Implement an error-correction procedure immediately line. Give a star if the behavior goal was met. In the
following the second passage reading. For this proce- example, the student earned 32 points and met the goal.
dure, select one to three words the student read incor- If both reading and behavior goals are met, award a
rectly or with limited fluency, particularly words that are bonus star. Teachers may choose to yoke the stars earned
central to the meaning of the passage. For each word, (a) during ABC Support intervention sessions to a class-
say the name and sound of missed letters within the word room point-system allowing the student to earn a back-
(letter correction), (b) read the entire word correctly and up reinforcer, such as extra computer time.
ask the student to repeat the word 2 times (word correc- Step 15: Generalization and self-check. As a final inter-
tion), and (c) read aloud a phrase from the passage that vention step, remind the student to use the I can read
includes the word and ask the student to read the phrase card outside of the intervention context (e.g., during
2 times, pointing to each word while reading. In a similar homework completion, independent reading, or class-
fashion, redirect behavior that did not meet expectations room instruction). This card is a small self-check tool
6 Intervention in School and Clinic 00(0)

affixed to the student’s desk or notebook designed to Funding

promote generalization of fluent reading and appropriate The author(s) disclosed receipt of the following financial support
behavior during regular classroom reading activities. for the research, authorship, and/or publication of this article: The
The card lists the READ expectations and cues the stu- content and preparation of this paper were supported by the
dent to self-evaluate whether each expectation was met Institute of Education Sciences, U.S. Department of Education,
or not met during the targeted classroom period. through Grant R305A179961 to the University of Wisconsin-
Madison, Wisconsin Center for Education Research. The opinions
expressed are those of the authors and do not represent views of
Intervention Adaptations the Institute or the U.S. Department of Education.
The ABC Support intervention was designed to be imple-
mented with fidelity by a variety of school personnel (e.g., References
teachers, support staff, interventionists). The resources Chard, D. J., Ketterlin-Geller, L. R., Baker, S. K., Doabler, C.,
include manualized procedures and materials, as well as an & Apichatabutra, C. (2009). Repeated reading interventions
implementation self-guide that describes each intervention for students with learning disabilities: Status of the evidence.
step in the specific order as prescribed in the manual. Exceptional Children, 75(3), 263–281. https://doi.org/10.117
7%2F001440290907500301
Although important for all students to be exposed to the
Cook, C. R., Dart, E., Collins, T., Restori, A., Daikos, C., &
essential elements of the intervention, there is flexibility in Delport, J. (2012). Preliminary study of the confined, col-
the procedures to provide individualized support as needed. lateral, and combined effects of reading and behavioral
Interventionists are encouraged to adapt the amount of interventions: Evidence for a transactional relationship.
support to accommodate individual needs for varying levels Behavior Disorders, 38(1), 38–56. https://doi.org/10.1177
of scaffolding. For example, whereas some students may %2F019874291203800104
require additional prompts and more frequent praise than Crone, D. A., Hawken, L. S., & Horner, R. H. (2010). Responding
what is scripted in the manual, others may be successful to problem behavior in schools: The behavior education pro-
with a reduced level of prompting or less frequent praise. gram (2nd ed.). Guilford.
Although a detailed explanation of how to adapt all inter- Domitrovich, C. E., Bradshaw, C. P., Greenberg, M. T., Embry,
vention procedures is beyond the scope of this article, the D., Poduska, J. M., & Ialongo, N. S. (2010). Integrated models
of school-based prevention: Logic and theory. Psychology in
manual describes several strategies for providing more-­
the Schools, 47(1), 71–88. https://doi.org/10.1002/pits.20452
versus-less support within each intervention element while Hawken, L. S., Bundock, K., Kladis, K., O’Keeffe, B., & Barret,
maintaining a necessary level of adherence to the manual- C. A. (2014). Systematic review of the check-in/check-out
ized procedures. intervention for students at risk for emotional and behavioral
disorders. Education and Treatment of Children, 37(4),
635–658. https://www.jstor.org/stable/44683941
Conclusion Kilgus, S. P., Chafouleas, S. M., & Riley-Tillman, T. C. (2013).
In a climate of declining resources and greater demands on Development and initial validation of the social and aca-
schools, the benefits of single-focus academic and behavior demic behavior risk screener for elementary grades. School
Psychology Quarterly, 28(3), 210–226. https://doi.org/10
interventions must be balanced against the potential for
.1037/spq0000024
greater effectiveness and efficiency through integrated Kuchle, L. B., Edmonds, R. Z., Danielson, L. C., Peterson, A.,
academic-behavior interventions (Kuchle et al., 2015). & Riley-Tillman, T. C., (2015). The next big idea: A frame-
Integrated approaches are not limited to the reading-fluency work for integrated academic and behavioral intensive inter-
skills and engagement-compliance behaviors targeted in vention. Learning Disabilities: Research and Practice, 30(4),
ABC Support. The strong academic-behavior connection, 150–158. https://doi.org/10.1111/ldrp.12084
combined with a growing need for efficient and effective Lee, J., & Yoon, S. Y. (2017). The effects of repeated reading on
interventions, underscores the value of developing inte- reading fluency for students with reading disabilities: A meta-
grated interventions for multiple types of academic skill analysis. Journal of Learning Disabilities, 50(2), 213–224.
deficits and behavior challenges. https://doi.org/10.1177/0022219415605194
McIntosh, K., & Goodman, S. (2016). Integrated multi-tiered
systems of support: Blending RTI and PBIS. Guilford.
Declaration of Conflicting Interests Spache, G. (1953). A new readability formula for primary-grade
The author(s) declared no potential conflicts of interest with respect reading materials. The Elementary School Journal, 53(7),
to the research, authorship, and/or publication of this article. 410–413. https://doi.org/10.1086/458513