Prevenir y abordar comportamientos que nos desafían

(En inglés)

Preventing and Addressing Behaviors That Challenge Us: We Are All in This Together

Riley Larson: Alright. Hi everyone. Welcome, and thank you for completing the poll in the waiting room. It looks like many of the attendees today are teachers, and then we have a pretty even blend of attendees represented in each of the other roles that were listed, so welcome. Thank you for coming. My name is Riley Larson. I'm an early childhood content specialist at the University of Washington, and I'll be facilitating the webinar.

We're super fortunate to have several really esteemed presenters during the rest of our presentation today. We have Mary Louise Hemmeter who is a professor of special education at Vanderbilt University. She is on MCMI and VPL and is one of the developers of the Pyramid Model.

We also have Lise Fox, who is a professor in Child and Family Studies at the University of South Florida, the principal investigator for the National Center for Pyramid Model Innovation and also a member of the team that developed the Pyramid Model and coauthor of Teaching Pyramid Observation Tool.

And we also have Tom Rendon joining us who has been the state co-lead on the Iowa Early Childhood Positive Behavioral Interventions and Support State Leadership Team for 13 years, and he's also the coordinator of the Head Start State Collaboration Office at the Iowa Department of Education.

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Mary Louise Hemmeter: Alright!

Riley: I'll send this over to Mary Louise.

Mary Louise: Thank you. Hi everybody. We're so glad to be here today with you guys sharing this information. Lise, Tom, and I are going to kind of take turns talking, so I'm going to start by giving you a bit of an overview about the pyramid, and then Lise is going to talk a little bit about system-wide support related to implementing the Pyramid Model, and then Tom is going to talk to y'all about a ... How one state scaled the model up statewide and what the supports were that were related to being able to do that. So, those are our objectives, and I'm just going to kind of move us on here.

So, I want to start by just giving you a big-picture view of the pyramid, and then I'm going to break it down a little bit more, but it's important to know that we see the Pyramid Model as a framework of evidence-based practices, and by that, we mean it's a framework for organizing all the practices you would need to use in an early childhood context to promote children's social-emotional competence, to prevent problem behavior, and to address behavior — challenging behavior — that persists even when we do good promotion and prevention practices. And so, when we started this work, we were ... We started it in response to concerns about children's behavior that challenged adults, but we knew really quickly that our real success was going to be around focusing on promotion and prevention and that if we did that well, we really wouldn't have that many children whose behavior persisted in spite of that. But we knew that to address all the needs of children inclusive early childhood settings, we'd need all tiers of practices.

So, I'll talk about each of those tiers a little bit more in a few minutes, but first, I want to start out by giving you a little bit of history around how the Pyramid Model came to be, the role of the Office of Head Start in the development of the model, and kind of what happened related to the development of materials and tools for supporting the implementation. So, the history of the Pyramid Model is that the people, Lise and I, and the team of people who were involved in the development of the Pyramid Model, had all been conducting research on various strategies for supporting children's social-emotional development and preventing and addressing challenging behavior. And in 2001, the Office of Head Start and the Office of Child Care, put out a call for proposals around developing training materials and supports around this content.

And so, as we started thinking about, you know, how were we going to organize these practices that we knew to be effective, it was concurrent with a lot of research being done around school-wide, positive behavior support, and what we knew was that we needed a tiered model, but we wanted it to be a model that was appropriate for a early childhood setting, so we didn't just want to pull down a school-wide model. We really wanted to look at, what would it look like if we were developing this model to support young children's social-emotional development? And so, that's kind of how the Pyramid Model came to be as part of two federally funded projects.

So, the first one was what many of y'all know as CSEFEL which was the Center on Social-Emotional Foundations for Early Learning, which was funded by the Office of Head Start and the Office of Child Care. Concurrent with them funding a project, the Office of Special Education programs in the U.S. Department of Ed also funded a project that came to be known as TACSEI, and I think a lot of y'all have probably heard about that, too, which is the Technical Assistance Center on Social-Emotional Intervention. So, those projects were funded pretty much at the same time. Across those projects, we were really interested in training materials that would meet the need of teachers serving children who were at risk, children who had disabilities, typically developing children, and it just so happened that this group of researchers were working on both of these projects, so we were able to develop the Pyramid Model which really, from the beginning, was designed to meet the needs of all children, meaning children who are typically developing and children with disabilities and children who are at risk. But it wasn't that we'd taken that model and tried to fit it into different settings. We always wanted it to be a model that would support all children in inclusive early childhood settings.

So, kind of after we had started that work, we received some funding from IES which is the Institute for Education Sciences, which is the U.S. Department of Education, to conduct research on the Pyramid Model, and so we did two large studies on the Pyramid Model in which we found both that the professional developed model, the training materials, the coaching process that we developed was effective for supporting teachers to implement the Pyramid Model and that when they did that, we saw changes in children's social skills and problem behavior. And so, that was a really important finding to be able to talk about the Pyramid Model as an evidence-based approach. Also, as part of that research, we were able to develop the TPOT, which was mentioned in the introduction, which is the Teaching Pyramid Observation Tool, which is a fidelity tool, a way to measure implementation and Pyramid Model practices in preschool classrooms.

Now, fast-forward, and we get more funding, and we're now studying the Pyramid Model in classrooms serving infants and toddlers with our colleagues at the University of Kansas. And so, what we've developed across those projects is the TPOT and TPITOS which are ... TPITOS is the Infant/Toddler Observation System, so they use that in programs serving infants and toddlers to look at implementation of Pyramid Model practices in infant/toddler classrooms, and then we've developed a whole range of training materials for everything from infant/toddler programs to preschool classrooms to parent-infant play groups to parent groups, home visiting. We've just developed some materials about how the pyramid model is aligned with trauma-informed practice.

We've developed coaching materials. We've developed the Pyramid Model Equity Coaching Guide to help coaches support teachers around issues related to equity and implicit bias. And then we've also developed tools for scaling up the Pyramid Model from the classroom, scaling it up to the whole grantee, the whole center and in some cases, states and regions, and Tom and Lise will talk about that a little bit more in a minute.

So, that's the kind of history of the model. Those are the tools we have available and, as many of y'all know, there's lots more materials, but that gives you kind of a good overview of what we have developed. As we developed the Pyramid Model, we were really interested in, as I said earlier, promoting children's social-emotional confidence.

And so, when we looked at, what is it children need around social-emotional confidence to be successful in school, and what do kindergarten teachers report wanting children to be able to do when they come to school? And when we looked at the research on resiliency, the things that you see on this slide around confidence and ability to establish relationships and persist at difficult tasks and communicate emotions and solve social problems, those were the things that we saw help children be successful when they went to kindergarten, but we also knew that when children didn't have these skills, that often looks like challenging behavior. So, children didn't know how to communicate their emotions. They communicated their emotions in inappropriate ways, right? By hitting or kicking or biting or screaming. If children didn't know how to engage with their peers, their way of initiating the peers could sometimes look like aggressive behaviors, and so the Pyramid Model was really about ... Not about, how do we get rid of problem behavior? It was about, how do we ensure that all children have these social-emotional skills? That was really the focus of the Pyramid Model.

So, I'm going to kind of walk you through how the Pyramid Model addressed those things, and what's important to know is that we always knew that the Pyramid Model would also need an approach for addressing challenging behavior, but we wanted that not to be where we started. We really wanted to start with, what do all children need to have healthy social-emotional development? And so, that's the bottom tier of the pyramid which is around relationship and supportive environment, and I'm going to talk about each of those pretty quickly.

So, in our work, we always say that ... I hope y'all are seeing the right slide. Hold on. We always say that it's all about relationships, so it's about relationships between children. It's about relationships between teachers and children, and it's about relationship between parents and children and parents and teachers, right? And so, the slides that I kind of ran through a little bit too quickly, let me go back to this, is, so we start with relationships between peers, so we really want to ... We really assume that children need help learning how to be social. And so, we work on promoting peer relationships. We absolutely believe that much challenging behavior is about a relationship issue with adults or children for families and that we start with, how do we make sure children have meaningful relationships with adults at both home and school? And then we also want to build positive relationships with families so that if children have problem behavior, we have a positive relationship with that family to begin with.

The next tier of the pyramid — or the other part of the universal tier of the pyramid — is around designing supportive environments, and the things that you see on this slide, I obviously don't have time to have time to talk about, are all the things that have to be in place in classrooms to support children's engagement, to help them know the expectations and to prevent problem behavior. The next tier of the pyramid is about being intentional about teaching social-emotional skills and competencies.

We expect that all children need help learning those things, and we expect that some children are going to need more intensive support around those skills, so let me tell you what skills we're talking about. We're talking about friendship skills. How do you share and take turns and help your friend and compliment your friend and do those kinds of things with your friend? How do we teach children to communicate their emotions in appropriate ways and to respond to other children's emotions in appropriate ways?

We also teach children how to calm down when they're angry or scared or anxious, so we not only teach them a process for doing that, but we teach them really explicit strategies for calming down, and then we teach children how to be good social problem solvers. What do I do when someone has a toy I want? What do I do when I need help? What do I do when I don't know what to do? We're intentional about teaching children to do those things, and I think it's important to realize that when you think about emotional competency and anger management and social problem-solving and friendship skills that that's a lot to ask of young children, and we have to be both intentional about how we teach it and intentional about how we respond to it.

We know that when we do all those things well, we know this from our research studies, there aren't many children who need more intensive support, but we know there are some children and that those children are going to need an approach that is team-based that includes the child's teachers and caregivers and family members and whoever else works to support that child that we develop behavior plans based on an understanding of that child's behaviors and social-emotional skills and that our plans for addressing behavior are in fact really about supporting appropriate behaviors versus focus on getting rid of problem behaviors.

It's all about, how do we teach the child what they need to have the social skills or emotional competencies, and how do we support them to use those in place of the problem behavior? And that process really works, but that process is hard, and it's hard for caregivers to implement on their own, and we don't ever expect that when children have those top-of-the-pyramid behaviors, we don't expect that to be a process or strategy that teachers, home visitors, families uses on their own, but we think that is a program-level planning process where the teacher or home visitor or caregiver is supported to develop that plan and implement that plan in the classroom or in the home.

And so, while the Pyramid Model is the framework of practices we want teachers to use, we also know that for teachers to be able to use that well, they need a whole set of program supports that are built around the Pyramid Model. So, I'm going to hand it off to Lise, and she's going to talk a little bit about those program-wise supports.

Lise Fox: Thanks, ML. Yeah, so the Pyramid Model, we can think about it as evidence-based practices and what teachers ought to do, but teachers can only do it if they have program-wide supports in which to do it. And so, the whole idea about implementing the Pyramid Model is that we have a leadership team that is guiding those supports, the development of those supports, and that leadership team is comprised of program administrators, teachers and of course family members, and they meet monthly to think about all the pieces that need to be put in place.

We call that the implementation infrastructure, all the pieces that are necessary, like having activities to ensure staff buy-in and wellness and support, ensuring family partnerships at all levels of the pyramid, identifying and promoting the program-wide expectations, making sure that everyone is on the same page with how to respond to challenging behavior when it occurs so kids get the effective supports that they need, thinking about professional development including classroom coaching and then using data decision-making. I'm going to unpack it just a little bit more for you, and I embedded two little videos in here, so you actually can hear from other people what these things are about.

So, on the challengingbehavior.org website, you'll find this manual, and the leadership team that is guiding implementation can use this manual in their work, so we want the leadership team to include teacher from Early Head Start or Head Start. If you serve both of those in the program, it should have someone on the team who's guiding the behavior support process, and that might be your mental health consultant or behavior specialist or another person like that. It should include the individuals in the program that are providing coaching. We always want an administrator on the team because they can guide resource allocation and set priorities, and we strongly recommend that we have families on the leadership team so that the family perspective is always front and center in the work that we do both in implementation and then our partnerships.

We also strongly recommend that if you're working with a infant early childhood mental health consultant, that you bring them on the team. That's really their role is to guide you and guide those services and the implementation of those services. So, the team meets monthly, and the team has a tool that they can use to assess where they are right now in the program-wide implementation and then to decide on their implementations plan. The tool looks like this.

We call it the program-wide benchmarks of quality. It's on our website on challengingbehavior.org along with an Excel spreadsheet so the team can actually score themselves, kind of see where they are at this point in time, figure out their implementation action plan and then look at their progress over time to reach fidelity on implementation support so not just fidelity of practices in the classroom. That's really important, but those of you who are teachers on the call, you know that there's also the program level, you know?

Are we doing what we should be doing at the program level to help teachers do this work? So, I'm going to move ahead to a video that I pulled where ... This is actually in a school where the principal is a part of the leadership team as an administrator. It includes their Head Start classroom, as well as their preschool development grant classrooms, and she's reflecting on how their leadership team works together.

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Lise: I love that video. It's just nice to hear what people are thinking about this work. So, the leadership team, then, a big piece of what they want to think about is, how are our teachers doing? First of all, are they invested in implementing the Pyramid Model? Have we worked hard to support them to be able to be invested in it? Also, we're talking about supporting kids who have risks in their social-emotional development or have challenging behaviors.

So, we want to also pay attention to staff wellness and whether or not staff are feeling good about the work that they're doing and feel a sense of support if they engage in this work. Our rule of thumb is that we ask the leadership team to work towards 80% of the teachers saying, "I'm on board with this. I really want to do it with fidelity, and I'm with you." We think that buy-in is really critical before people invest a lot of time and effort into doing this work.

And so, the whole idea is that we all want to get on the same page with Pyramid Model implementation, and so the leadership team, if they don't have initial buy-in, one of their first tasks is to figure out why and begin working on that. There are some nice resources as we're thinking about stuff, wellness and the really challenging work around addressing challenging behavior and promoting social-emotional confidence and our partnership with families.

One resource that's fairly new and you might not have discovered yet is the Circle Time Magazine Season Two which is all on this topic. It's at the Cultivate Learning University of Washington website, and then the National Head Start Association has a nice, nurturing staff wellness tool kit, and the Health Services newsletter has some nice kits on staff wellness and managing stress. You should always look at your TA centers. This is a big topic for all of us to be thinking about, how do we nurture the wellness of our staff as we do really important work? So, the leadership team is charged to think about that and to make plans program-wide across their teachers one of their first tasks is to figure out why related to staff buy-in and wellness. They're also asked to think about their family engagement strategies, and so we want parents to be partners in all of this work, including the implementation. The leadership team should have a parent on the ... As a team member, as we just heard on the video.

A lot of programs will do a family roll-out event. It might be a playground party, an open house, a fun fair. They might integrate it into their parent meetings, but we want to inform families that we're implementing a particular model, a framework for doing the work that we're doing, have them excited about it. The leadership team can do a lot to think about across teachers. Often, we think about obviously the family relationship, individual teachers, develop those relationships and really strengthen and have authentic relationships with their families, but the program also can facilitate that by having program-wide information available for families, ways we reach out to families. They can really support teachers in cementing those family relationships and strengthening their family engagement approaches.

The other piece around family engagement, of course, is partnerships around promoting social-emotional outcomes, and then for children who might need more instruction or have individual support plans, how will we partner with families as we do that kind of work? All of those are program-level strategies that the leadership team is in charge of thinking about. So, the next piece are program-wide expectations, and program-wide expectations are different than rules. Program-wide expectations apply to everybody in the program — to the staff, to families, and to our children — and it's what we kind of anchor our rules to, so we want you to be safe, and to be safe, you'll do x, y, and z, so we use ... We anchor what we're doing and what we ask children to do to our agreed-upon expectations.

So, the leadership team will think about, how will we figure out what our expectations are? We find that it really becomes kind of the glue of us all doing this together. So, the leadership team should figure out, how will we figure out what our expectations are? How will we ensure that teachers are part of that and families are a part of that process? And then identify their expectations, and for young children, we just have a few expectations, maybe three to five, and then once you establish a lot of programs, have made them a part of their branding of their programs, then they might use those expectations on a sign outside of the program, on the front of the building.

They might use it on T-shirts, on their stationary. The whole goal here is that everyone is using the language of expectations as we guide children in positive ways and guide each other in what we're doing. So, a staff member might say, "I'm being kind. I'm helping Mateo feel better about his ripped picture," or say to a child, "We are kind. We hold the door open for our friends." So, you can see how that language can really shift the talk within a program, and we think that's really important in Pyramid Model implementation. The leadership team discusses that and figures that out.

The leadership team also needs to think about and establish how children who have behavior challenges will efficiently receive the support that they need, the additional support they need, and the Pyramid Model is very powerful in promotion and prevention, but we know they'll be a few kids, as Mary Louise said, who might need more support. And so, we want teachers in a program to know that if they have a child with challenging behavior, they need to know, "What is it that I do as a teacher, and who's going to support me in reaching out to the family and developing a behavior support plan?"

In the Pyramid Model, we've encouraged our programs to use the prevent, teach, reinforce approach. What it has done is really manualize a process, so one of these is around young children in center programs and prevent, teach, reinforce for families Is how you do this in home and in community, and it manualizes the process of doing a functional assessment, developing a behavior plan and monitoring child progress. In addition, the leadership team should think about other things that need to happen in a program.

For example, they might think about the training people need and de-escalation procedures. They might think about setting up peer-to-peer networks so people can share good ideas and problem-solving around children with challenging behavior. The next component that we ask the leadership team to think about is how they will offer continuous professional development and practice-based coaching that is focused on the Pyramid Model practices, and this is where a tool like the teaching Pyramid Model observation tool is helpful or the TPITOS in our infant and toddler classrooms, so the leadership team will be thinking about what training is next. How do we get people training? How do we orient and train new staff? Who needs coaching? What level of coaching do they need? Who's next for coaching?

All of those kinds of things, and I hope you check out both the ECLKC website, as well as challengingbehavior.org for a lot of materials around how you deliver practice-based coaching as well as training modules for training teachers. Then the final element that's so important and makes all these parts work is data decision-making.

And so, the leadership team will be looking at data each month. For example, when they're thinking about teachers and the implementation of pyramid-model practices, they'll be looking at the TPOT and TPITOS and where their teachers are on those practices and using data to plan their next professional development opportunity. They'll be looking at the benchmarks of quality to figure out what's next for them as a leadership team. They'll be looking at their coaching logs to see, are people getting complete coaching cycles? Are teachers moving on their action plans? They might use the behavior incident report system which is on challengingbehavior.org which helps programs track the responses to child behavior incidents, the activities where those occur, how staff respond to those incidents and any potential issues, examining equity and disproportionality in the data.

And so, they have those really important data to really guide all this work, all those key, critical elements that they're thinking about. So, I pulled another video for you where a coach talks about using these data and what that really means to their program.

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Lise: Alright. So, that is the final element of program-wide implementation, and I'm going to turn it over to Tom who can talk about how to bring this to states.

Tom Rendon: Great. Thank you so much, Lise. I think what Mary Louise and Lise have done is really set up the Pyramid Model and then the implementation framework from a program level, but just the way that Lise was saying that the support that's necessary in a program to really implement the Pyramid Model in individual classrooms, the same can be said about what support systems need to be in place at a state level in order to support those programs, and I like to think of this work really as a state of concentric circles where you have maybe children in the middle and then that classroom setting or teachers in the next concentric circle and programs in the one after that and then perhaps just a regional or a state system that's really supporting implementation, but all of them are aligned around some common purposes which is, how do we see this framework of evidence-based practices as Mary Louise defined the Pyramid Model?

How do we see that as what we want to see in programs? So, I want to talk a little bit about how we've gone about doing this in Iowa, and we've been doing this since 2006. We were one of the original pilot sites when CSEFEL was beginning to explore. You know, we can't just work on programs. We have to really look at states because there's a lot of things happening at the state level that could be really useful in organizing in order to help promote the practices at both the classroom level, the program level and then the state level, and one of the things that the Pyramid Model and CPMI, especially in the last year or so, have done a great job with, is providing tools to help sort of answer two key questions at each of those levels, and what are we supposed to be doing, and then what kind of supports are necessary in order for me to do that?

So, at the classroom level, it might be around program-wide expectations. What are we expecting children to do, and how are we expecting them to act? And we're going to support them in doing that which of course is the whole function of the Pyramid Model. Well, it's the same thing that's happening. What do we want teachers to do, and how do we support them? And then what do we want programs to do, and how do we support them? And then finally, we look at the state level, so from the state perspective, our question is, what do we want our programs to be doing, and how do we support them to do that?

So, I see this as a four by four which is four phases and four pillars. And so, part of that begins with ... I'm going to spend most of my time looking at the four phases because the four phases of exploration, installation, initial implementation, and full implementation really come out of something that many of you may be familiar with about implementation science, saying that effective implementation of any practice, in this case Pyramid Model practices, requires a sort of logical sequence of phases, and if you jump right to implementation without going through exploration and installation, you're going to jeopardize your ability to full implement or implement with fidelity which is finally our goal.

And then the how that we do that is really based around a state leadership team, so almost everything that you heard Lise talk about in terms of program-wide team is equally relevant at the state leadership team, and then we have demonstration sites. We have places where we're actually putting effort and making sure we have program-wide implementation at the level of fidelity that would be suggested by some of the things that Lise was talking about. And then are there ways in which we can coordinate at a state level around professional development? What might that look like? Is there a ways that we can promote state-wide coaching that will support the practice-based coaching that Lise talked about?

And one of the things that happens at the state level is we start to make a distinction between classroom coaches who are in there working with teachers in the implementation to what we call program coaches or external coaches, and these are people that are going to be working with that program-wide team to help them with doing the benchmarks of quality, using those benchmarks of quality to develop implementation plans and supporting them around it. So, as you can see with that kind of activity, it's a direct support that the state's providing to some of those program teams, and finally, like is happening at all these different levels, too, is we have database decision-making, so we're collecting our own data around how we're doing with our implementation.

Where are we finding success in different classrooms that are reaching full fidelity measured by the TPOT? Where are we seeing lots of challenging behaviors occur? Where are we seeing places where we've done our training, and yet there still may be struggles around implementation? That all can give us some great insight into how to organize a professional development or a support system that could be really helpful for programs.

So, when Iowa started this, and we started back in 2006, and as I said, we were ... CSEFEL had selected us — along with two other states — I think it was Maryland and Colorado, to begin some of this work, and one of the things that emerged early on was a vision or a goal within our state leadership team that every setting in which young children found themselves, we would build a pyramid, and I use that language because it explains to me, everything I mean by building pyramids is exactly what you heard Mary Louise say about starting with the relationships and the high-quality environments and the teaching of social skills and the explicit procedures on supporting challenging behavior.

If we can build those pyramids, we know that children are going to grow in their social-emotional competence. That's what the research says very clearly, and then the other thing we know is that when we build those, that we're going to reduce the level of challenging behavior, and we're going to really build children's social-emotional competence, which we all realize is just a radically important foundational skill prior to the beginning of kindergarten for every child, so wherever they are, whatever setting families choose to have for their children, whether it's sending them to a child care program or a state pre-K or a Head Start, or they're going to be stay-at-home parents, and they're going to be taking care ...

All those settings, those all can really benefit from a solid understanding of the pyramid and a solid implementation of it. So, that was sort of our whole vision about preschool, Head Start, child care centers, family child care, and we've had to make some adjustments in what that program-wide outreach looks like based on those settings, and so we've sort of ... We have right now, we have sort of three branches of work: one around program-wide which is really working with Head Start, preschool classrooms, Early Head Start classrooms, child care centers.

And then we have another one that's family child care because there's some unique things about family child care such as they blend. Most family child cares have a blending of infant, toddlers, and preschoolers. We can't just assume that the infant/toddler practices will work or just the preschool practice will work because it's a blend, so we've had to do some adjusting there, and they may not have quite the same ability to create a program-wide team. It's just one single child care provider, so what kinds of supports do we build?

So, we have to kind of rethink because of it, and then the other place where we've done is a lot of work in individual child homes through our home visitation programs. So, all of the programs that are part of our MIECHV system, the Maternal Infant Early Childhood Mental Health or home visitation ... Maternal — Maternal Infant Early Childhood Home Visitation, MIECHV. All over those programs have now gone through ... Or not all the programs, but we have had representation across all of the different home visitation models in our family support modules that, again, basically are training home visitors on how to build those pyramids in individual children's homes with working with parents to do that.

And then of course there's also some parent education pieces that we could very much tie in with our program-wide programs because if they're implementing in the classroom, we really encourage them to say, "Hey, some of the expectations, some of the skills, some of the supports that we're doing in the classroom would work really well with your routines that happen on a daily basis, you know, whether it's going to bed or whether it's having a meal or whatever might be happening at that home base, so how do we support that?"

So, those are some of the things that we've been working really hard on in terms of trying to build these pyramids across these different settings, and so ... But regardless of what that is, we also want to make sure that because we're in the business of social-emotional competence, then there are other things that are happening at the state level. There are a lot of people concerned about social-emotional competency.

So, we want to connect with all of the energy that's happening at a state level around promoting social, school readiness, addressing early childhood trauma, paying attention to adverse childhood experiences, building more inclusive settings that children with disabilities are fully included in that work, reducing suspension and expulsion, advancing early childhood equity because some of us who are looking at equity issues find it's happening at the early childhood level. We see some of the disparities around outcomes occur before children even start kindergarten.

So, are there ways that we can leverage that and connect with that so that the pyramid model can be part of that work as well? And so, that's been part of some of our state work. So, let me just talk a little bit about some of these different ... What we've been doing during some of these different phases, and one is I think creating the state leadership team, and there is a state benchmarks of quality just the way there was the program-wide benchmarks of quality. It's also available on the NCPMI website that Lise alluded to a number of times, and then ... And through that, we really are trying to get buy-in from across some key state agencies.

So, we have a Department of Management who oversees a lot of our early childhood systems work, so our state advisory councils. Those people are represented. The Department of Education, the Department of Human Rights which does a lot of work with our community action programs and also with other kind of economic supports for low-income families, and then the Department of Public Health is a big interest in mental health issues, so we have a person. We just got a recent round of Project LAUNCH. Some of you may be familiar with that, and we are working with Project LAUNCH. Now, we have them on our team so that we can make sure that Pyramid Model work can get integrated with all of this. So, having those key people around the table is really important.

So, once you sort of start to explore and see, "Hey, are these issues that we care about? Is this something we want to do?" Then we might move on to the installation phase, and so we develop an implementation plan. Again, this is going to sound really familiar to the program-wide side, because it is, and really develop systems capacity to implement that plan.

So, training, coaching, data, communication. Those are all going to be things that we're going to be looking at, at the state level to make sure that they're in place, and the benchmarks of quality provide a perfect way for us to say, "Do we have these pieces in place? If not what do we do to get them in place? And if we do, great. How do we solidify them? How do we expand?" And then once we're at that level, then I think we can start moving with initial implementation, and that's when these demonstration sites come up. And I'll just say, right, this year, starting ... I mean, we kind of break into program years, so this program year, which would be 2019, 2020, we will now exceed 90 sites that have been trained to do program-wide. Now, some of them, they're at all different stages.

Some of them are doing, like, amazing work. Others are still struggling. You know, they may have started strong, and they've fallen back, so what we're really actually looking at now is, what could be some consistent and programmatic ways in which we can provide ongoing support to that? But we didn't want to just worry about ... Like, we wanted to keep building and build because the more we're growing, we find that really helps with buy-in, and it really helps with kind of name recognition, so really, almost a key part of our marketing to make people sure they understand what the pyramid model work is that we're doing in the state and how successful it is.

And then in addition to that, we're also looking at training and coaching, and how can we train our coaches that are going to be working in our programs – both as external coaches or as program-based coaches, as well as the classroom-based coaches? And then we typically use the same model that Lise was talking about with the practice-based coaching. And then finally, we're doing some data collection, so even though the programs may be collecting benchmarks of quality, we're collecting their benchmarks of quality, too, and looking at, well, what does the benchmarks look like statewide? Or if they're collecting behavior incident reports, then we'll have a, like, where are we seeing most of the challenges?

What kinds of challenges are we seeing? Is this something that we could address either with statewide policy if we're seeing a lot of suspensions and expulsions? Are there things we could do to really look at statewide policy that impinges on child care through regulation and licensing or impinges on state-based pre-K through state regulation, and then what kind of supports can we add to that as well? We think that if we can be successful in our Pyramid Model building across these settings, we're going to dramatically reduce the level of suspensions and expulsions which has been a concern of ours.

As some of you may know, it's been a concern across a number of different states, and we want to be able to say, can we reduce that? Can we eliminate that entirely? But we can't do that unless we've got something to replace it, some real, positive support, and that's where we think the Pyramid Model can play a really key part, and full implementation is just the scale up of that to happen more oftenly, and as I say, we're probably somewhere between initial implementation and full implementation right now.

So, I just want to talk about, given our long history, this would be my three takeaways, the things that I think have ... When I think about the successes we've had and what's worked well, and believe me, we've made many mistakes. This has been two steps forward, three steps backwards. It's an iterative process. It never feels like it's done, but really invest enough time for the awareness and buy-in would be one suggestion that I had that I think when we did that, we found it worked. And really had this focus on capacity, so how can we ... What we want to do is, like, if we're going to have every setting, we can't have an individual coach for every program, but what we can do is we can build the capacity within an individual program to be self-sustaining. Like, "Hey, we get this work. We know what we need to do. We know how to monitor our ongoing implementation. We know whether we're successful or not. We're going to keep doing this because this is what we think we ought to do."

Maybe we just need to check in with them once a year. Maybe we just need to collect some data from them on a periodic basis to go, "Hey. Here's where they are," and then we can go, "Hey, do you need any extra support? If you're not, you know, you have our blessing. Keep going. Move forward." That's what we want to do. That's the focus on building capacity.

So, when we do our program-wide trainings, and we try to get more programs on board, that's one of the first things I say is — is I keeping saying to them, it's like, "This isn't our work. This is your work, and we want you to own it." Buy-in is more than just saying, "I agree with you." It's, "I am committed as you are to seeing that these pyramid practices are in place in our program. Our children deserve it, and it's part of our mission of our organization." So, you don't need a state person nagging them to go, "Hey, isn't this important work? Don't you think we ought to do it?" And that's part of what we need to do about the focus on capacity.

And finally, taking a long view is realizing to me where we've found the best success is really looking at how ... It's like, you just got to start putting these things in place because, you know, it's a little of that ready, fire, aim idea. Yes, we want to spend time getting the cannon all set up before we fire, but at some point, we got to just go ahead and fire it, and if it falls short, then we know immediately what we need to do, and that can start to create some energy moving forward.

So, if you're involved in state-wide work, those would be some of my recommendations. Now, if you want to get started, if you're a Head Start grantee or even a child care program, and you want to know, "Well, what's happening at my state?" I can tell you that things are going to look very different depending on what state you're in, but basically, here are the states are, so if you see your state with its two-letter code on this map, there is a state leadership team working on these issues, and therefore, we can connect you to them if you want to find out what's happening in your state so that you're not going at this alone. If you're a Head Start program, you don't want to just say, "Hey, I like that program-wide stuff. I like the Pyramid Model. Let's go do it."

I think it's really helpful to know, what kinds of supports could you count on? Because I'm guaranteeing you that there would be interest at that state level in seeing more programs come on board with that. If you're not in there, then if you don't see your state, then that might be a place where you can start to ask some questions at your state advisory council level or with your Head Start State Collaboration Office coordinator or somewhere like that to go, "Hey, why ... What can we do at a statewide level like some of these other states to really build the supports that we need for Pyramid Model implementation?"

So I think ... So here is ... Maybe I kind of spoke a little ahead of myself, but check in with program and statewide leadership which is where you might go based on that map. Learn how Head Start and Early Head Start is involved in that work, and then if your state is not doing that, you can certainly start with that program-wide implementation guide that Lise talked about, and we're strong believers in leading from the middle. It's like everyone is a leader because there's all these different layers in which it's happening, and so you can take charge. You can say, "This is what we want." You can say, "If we want this, this is what we need to have happen," and again, a lot of the resources that are in NCPMI will give you real direction in doing that. That's what we've had found has worked really well in Iowa. So, with that, I will turn it back to ... I'm not sure who's picking it up from here.

Riley: Hi. This is me. It's Riley.

Tom: Riley. I'm sorry. I forgot your name.

Riley: Yep. No, no. No worries. Alright. So, hi again everyone. This is Riley from University of Washington. Thank you so much for joining us for this webinar. I hope it's lots of information today. I hope it leaves you with plenty to think about and enact in your own ...

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