Introduction to Special Issue on Tier 2 Adaptations to Behavioral Interventions: A Focus on Innovations and Recommendations

Given the rapid growth and expansion of multi-tiered interventions and supports to address behavior, educators and researchers are increasingly seeking support and innovations regarding the implementation of interventions at the more advanced tiers. While there is still a need for work related to implementation of universal or Tier 1 interventions and programs, there has been a considerable gap in relation to Tier 2 behavioral interventions more specifically. Several studies have documented significant outcomes of Tier 2 behavioral interventions on student outcomes (e.g., Check-in/Check-out; Drevon, Hixson, Wyse, & Rigney, 2019), yet there is limited research and guidance around methods for improving the effectiveness and efficiency of these interventions by adapting them to students’ needs and the contexts in which they are delivered. As a result, this special issue includes a set of original papers focused on Tier 2 behavioral interventions that move beyond typical “one size fits all” approaches to Tier 2 interventions for behavior problems and builds on a previous special issue on current issues in Tier 2 in the Journal of Applied School Psychology (Stormont & Reinke, 2013) published 6 years ago. Specifically, this special issue provides conceptual and research-based papers that describe approaches to adapting Tier 2 behavioral interventions.

Building on the prior work on this topic by Stormont and Reinke (2013), we organized a special issue with the overarching goal of advancing empirical and theoretical work related to adapting Tier 2 interventions and adaptive processes within Tier 2. Specifically, this set of conceptual and research-based papers describe several practical, feasible approaches to adapting Tier 2 behavioral interventions to meet the varying needs of students requiring Tier 2 intervention, thus improving effectiveness and potentially reducing overidentification for Tier 3 supports.

Toward this end, we drew upon applied research across multiple fields, including general education, special education, psychology, counseling, prevention and implementation science. Given this interdisciplinary perspective, it is not surprising that the authors conceptualized some of the ideas and terms related to Tier 2 adaptations slightly differently. For example, in the first two articles authors conceptualized a tailoring process for Tier 2 interventions while authors of the fourth article conceptualized a transdiagnostic approach to address multiple Tier 2 needs within one comprehensive intervention. The articles also ranged in style and format, including conceptual pieces, literature review, experimental research, and secondary data analysis as part of a larger randomized controlled trial.

Specifically, in the first article in this special issue, entitled Reengineering Tier 2 Interventions for Responsive Decision Making: An Adaptive Intervention Process, Majieka, Bruhn, Sterrett, and McDaniel presented descriptions of evidence-based Tier 2 interventions and introduce the concept of horizontal and vertical adaptations. Whereas horizontal adaptations are based on student and contextual factors, vertical adaptations are based on data indicating student response to intervention. These adaptations are offered in an effort to reduce over-identification of students for Tier 3 with the hypothesis that many students may not necessarily need Tier 3 supports, but may benefit from a more tailored version of a Tier 2 program. The purpose of this conceptual article was to propose an adaptive, responsive, data-based approach to Tier 2 interventions that ensures the stability of core components, while considering malleable features that when adjusted, increase the likelihood of student success. Finally, authors discussed the importance of using data to identify and implement adaptations that are contextually relevant to students’ needs.

In the second article, Evidence-Informed Strategies for Adapting Tier 2 Interventions, Sterrett, McDaniel, Majieka, and Bruhn identified a gap in the existing literature regarding the components of Tier 2 interventions that should remain intact, and those that should be adapted to address (a) student characteristics, (b) intervention factors, and (c) setting characteristics. Authors offered examples and considerations for adapting Tier 2 interventions adaptations across these categories while maintaining intended fidelity of implementation of evidence-based interventions. The authors described adaptations designed to support feasibility, usability, and acceptability for educators, students, and caregivers, while also improving intervention effectiveness.

In the third article, An Evaluation of the Adaptations Made to Tier 2 Social Skill Training Programs, Kern and colleagues conducted a systematic review of 19 studies on social skills training (SST) and the adaptations made to these interventions. Aligned with the logic of Tier 2 supports, many SST programs have a standard protocol meant to be implemented in a consistent fashion across all students. However, as has been reported in previous reviews, the effect of SST is often quite variable and adaptations to SST programs are quite common in the literature. The purpose of this review was to explore the types of, rationale for, and timing of adaptations made to SST intervention programs. Authors reported a range of adaptations, with most adaptations occurring prior to SST implementation—not during implementation when data may have indicated an adaptation was necessary. Authors also reported on the extent to which studies met quality indicators for research.

In the fourth article, Both/And: Tier 2 Interventions with Transdiagnostic Utility in Addressing Emotional and Behavioral Disorders in Youth, Clifford, Nguyen, and Bradshaw recognized high rates of co-morbidity of internalizing and externalizing problems in children and youth. Across these problems are a set of core deficits including emotional dysregulation, negative affect, distress intolerance, maladaptive schemas, and social skill deficits. Given the common deficits across disorders, the authors suggested shifting from a problem-specific approach to making minor planned adaptations to the content of current Tier 2 interventions to optimize their transdiagnostic utility. In their conceptual and narrative review of the literature, they described utilizing a transdiagnostic approach within a Tier 2 intervention framework and identified specific Tier 2 interventions that are effective for addressing both externalizing and internalizing symptoms.

The fifth and final original article, Identifying Factors Associated with Patterns of Student Attendance and Participation in a Group Tier 2 Preventive Intervention: Implications for Adaptation, focused on the important issue of intervention dosage. Specifically, Pas, Kaiser, Rabinowitz, Lochman, and Bradshaw used latent profile analysis to examine the attendance patterns of 369 middle school students receiving the Coping Power Tier 2 student sessions as part of a randomized controlled trial. Authors identified specific factors relating to attendance that can inform potential targets for increasing uptake of the intervention through planned adaptations by clinicians. The analyses provided evidence of two attendance patterns: (1) high and stable attendance and (2) low and declining attendance. They discussed findings relative to within-student and group factors contributing to these attendance patterns. Finally, practical implications for how to identify students who may be at risk for poor attendance and strategies for adapting and tailoring interventions were discussed with the goal of maximizing student engagement in intervention.

Although we recognize the limits of only five articles to address the all of the issues related to Tier 2 implementation, innovation, and adaptation; these articles offer varying cross- disciplinary perspectives that may advance the conversation, research, and practice associated with Tier 2 interventions. Thus, we concluded the special issue with commentary from Drs. Reinke and Stormont, who led the original special issue in 2013 upon which this special issue is based. This brief commentary highlighted some common themes, implications, and future research directions related to the Tier 2 issues presented across papers. It is our hope and intent that this collection of papers advances the field of Tier 2 adaptations, and provides a framework for future work and dissemination of these approaches.