Multi- Dimensional Multi‑Tiered System of Supports for Attendance.
What is a MD-MTSS?
I have written about Multi‑Tiered System of Supports (MTSS) before, but watching a presentation at the International Network for School Attendance (INSA) in the Netherlands recently has prompted me to delve deeper. My personal interest with MTSS spans back to my time as a school inclusive learning coordinator. At the time we had an increasing number of young people presenting with difficulty learning yet limited resources to investigate or provide the support they needed. I saw it as a breakthrough in proactively identifying need and concurrently determining intensity of support required. I recently went back to an article published by Kearney and Graczyk (2020) that promoted in detail the potential power of a multi-dimensional MTSS to promote school attendance and address absenteeism.
There is a collective acknowledgement across education stakeholders that there are many dimensions to educating and supporting the wellbeing of young people in schools. However, there has historically been a division of labour between advancing students academically and supporting their wellbeing. Let us call this the two dimensional perspective. A key characteristic of the two dimensional perspective is the domain silo.
To illustrate, my first role was working in a small country town in Western NSW as a History Teacher. Whenever I think of ‘domain silos’ it creates flashbacks of the tiny faculty staffrooms hidden around schools. The pastoral coordinators occupied one office and special education were tucked away in a demountable building out the back of the school. Domain silo’s result in multiple parties working parallel seeking the same goal yet being oblivious to the interconnection or the influence of another silo. MTSS has traditionally been two dimensional and domain specific represented as a three layered triangle. Multi- dimensional MTSS breaks down domain silos and integrates graduated intensity of supports across multiple domains (eg. academic, behaviour, disability, mental health, attendance etc).
MTSS Origins in Response to Intervention (RTI)
MTSS has its origins in Response to Intervention (RTI). RTI is traditionally depicted as a three tiered triangle. Most MTSS follow the underlying principles of RTI characterised by all students initially receive high-quality universal core instruction (Tier 1), followed by additional tiers of increasing support (e.g. tier 2 and tier 3) as needed for those students who require additional support.
Key practices within an RTI approach include:
early and regular screening to identify students at risk for a particular problem,
data-based decision-making regarding student needs and the least restrictive environments in which to address those needs
Utilisation of evidence-based interventions to improve student skills in reading, writing or numeracy.
frequent progress monitoring to evaluate the effectiveness of interventions.
Expansion of RTI towards more broad concept of MTSS
As the MTSS approach became empirically validated it was increasingly appropriated to support students presenting with a more broad range of barriers to learning. For example, it has readily been applied to the Positive Behaviour for Learning framework and the allocation of support for young people with disability. An RTI approach towards behaviour may include:
Effective classroom behaviour management at the universal level. This may take the form of implicit and explicit teaching and reinforcement of appropriate behaviours, school-based environmental change.
At a tier 2 level it has included principles of applied behaviour analysis and targeted approaches to apply functional behaviour supports to groups and individuals.
Young people who do not respond to universal and tier 2 support may be afforded increasingly intense support across additional tiers as needed.
An integrated multi-dimensional Attendance MTSS?
As greater efficiencies have been sought to meet the multi-faceted needs of young people, researchers have proposed a more blended and integrated approach towards supporting attendance. Integrated approaches work to blend student and school centred models of provision to collectively address a broader range of issues. These integrated models have developed to address the increasing number of barriers that young people face towards accessing education (e.g. mental health, behaviour, learning difficulty etc).
Integrated approaches I see as adopting an ecological perspective towards a complex or even wicked problem. Ecological perspectives seek to describe:
“...the interaction between, and interdependence of, factors within and across all levels of a problem. It highlights people’s interactions with their physical and sociocultural environments.”
Ecological models acknowledge the interconnected influence on an individual’s physical, social and economic wellbeing. According to Stoiber and Gettinger (2016):
researchers and school-based professionals have moved toward more blended, integrated models of multitiered service delivery to simultaneously address multiple domains of functioning or content areas such as academic performance, social and behavioural competencies, and mental health.
A significant development of multi-tiered service delivery models within schools has been to consider a nuanced three-dimensional perspective that integrate supports with increasing intensity as and when required. Kearney and Graczyk (2020) argue that flat two dimensional triangle models ignore the heterogeneity of young people, instead reinforcing the requirement for students to adapt to the supports as opposed to tailoring the supports for the students.
To achieve an integrated model it is necessary to view support as multidimensional. In this model, multiple tiers of support are integrated across multiple domains (e.g. mental health, learning, behaviour etc) so that simultaneous and yet nuanced strategies may be used for each domain (Dulaney et al. 2013).
Dimensions that schools may focus on across a MD-MTSS
The following section describes some dimensions presented by Kearney and Graczyk (2020) that may be added to a multi-dimensional approach to MTSS. As outlined previously the commonality across all approaches are the provision of universal supports, monitoring of data and the graduation of intensity of support.
Dimension 1 - School Refusal/Truancy/School Withdrawal/School Exclusion
Tier 1
Assessment for student-initiated school absenteeism may include universal screening on brief questionnaires for internalizing and externalizing behaviour problems, standardised test results (e.g. NAPLAN, PAT, AGAT), academic grades, and behaviour referrals, all of which may be pre-cursor to school attendance problems. Kearney et. al.’s (2019) spectrum of school attendance problems may also be useful for screening indicators of school attendance problems.
Tier 2
Supports at a Tier 2 level may include anxiety management techniques (e.g. mindfulness), gradually return of the young person through exposure to school and instruction to strengthen social emotional management and interpersonal relationship skills.
Supports may also include removal of academic barriers through assessment for learning difficulty and adjustment of activities. Family support may also be initiated to address issues regarding inequity or transport etc.
Tier 3
More intensive supports at Tier 3 may be provided through individual and group-based treatments implemented by school-based mental health professionals (e.g., school psychologists, school social workers).
Dimension 2 - Functional Profile analysis
One approach, borrowed from socio-behavioural models has been to adopt a functional profile analysis of school attendance problems based on the maintaining factors or motivating conditions of a child’s absenteeism. The identified functional profile is then used to select relevant interventions.
Kearney and Silverman (1996) presented a behavioural functional model for child’s difficulty attending school. School absenteeism is described as being driven by:
avoiding school that is seen to provoke anxiousness/ depression
escape social and/or evaluative situations at school
seek attention from significant others
pursue tangible rewards outside of school (e.g. peer attention, gaming)
Tier 1
School wide supports may include monitoring antecedents of problematic behaviour to identify possible functions. This may also allow schools to predict absence through disengagement. For example, if attendance is not followed up regularly it may prompt attendance problems to manifest beyond emerging issues. Functions of problematic behaviour such as avoiding school may indicate antecedents of bullying or limited opportunities for social connection and sense of belonging among peers. School wide positive behaviour supports and activities that build students sense of connectedness may be introduced to ameliorate school attendance problems.
Tier 2
At a tier two level supports would be nuanced and targeted towards the motivation drivers of the young person. A young person who displays avoidant behaviour and is observed to be withdrawn in class and the playground may be afforded anxiety management and exposure based supports if that is what is required. On the other hand a young person who is confrontational, defiant and absent from class may be afforded greater academic supports, mentoring and/or social supports.
Tier 3
Functional approaches at a tier 3 level will include more intensive and broader assessment to identify setting events, replacement behaviours, social and environmental triggers and closer examination of academic profile, and family support needs.
Dimension 3 - Ecological Levels of Impact on School Attendance and Its Problems
An ecological dimension perspective represents a systems approach to integrated MTSS models. An ecological perspective may include examining the interconnected relationship between psychological factors, factors impacting the family, the role of professionals, school, local community, cultural, socio-economic and legislative contexts. Research has examined school refusal from a multi-systemic viewpoint drawing ecological links from microsystems, mesosystems, macrosystems to exo-systems.
To illustrate, school attendance problems have been examined through Bronfenbrenner’s bioecological systems model (Melvin et al. 2019) The bioecological model argues that human development is influenced by interactions that occur within various contexts in which a person is embedded. These contexts range from immediate (microsystem, e.g., interactions with peers, teachers, and family members) to more distant (macrosystem, e.g., broader cultural norms, policies, and beliefs). For example, school refusal may be the result of a young person experiencing bullying, an interaction within a young person’s microsystem. Government policy at the macrosystem level, such as increased supports for youth mental health can result in improved attendance for students who may not have had access to that support previously.
Tier 1
At Tier 1 universal supports may include academic supports such as individualised learning plans and social-emotional skill development. Schools would monitor data systems to identify students at risk for attendance problems. Schools would invest in school wide positive behaviour for learning to address bullying and school climate.
Tier 2
At Tier 2 the school may focus on cohorts or individuals at risk of school drop out through individualised tutoring programs, mentoring and cognitive behavioural intervention initiatives. At a parent and family level supports may include family outreach, home visits and relationship building initiatives for members of the school community identified at risk. The school may also consider flexible learning models and incentives for students who regularly engage.
Tier 3
At a Tier 3 level more intensive and individual supports are afforded at the student level, family level and school level. For example, increased efforts may be made to ensure the young person remains engaged in community and education. This could include the student accessing a flexible learning centre part time or engaging in vocational courses and/or work experience. At a family level social supports may be provided through family therapy counselling, transport support and efforts may be made to respectfully optimise a families living conditions through providing food, clothing, furniture and uniforms.
Conclusion
From my viewpoint, there is still work to be done in established a shared understanding of multi-dimensional MTSS approaches. The ridged structures of service provision aligned to funding and resources inhibit the latitude required to provide a nuanced MTSS. Attendance problems have clearly demonstrated that the ‘one size fits all’ models with clearly defined measures of support are inadequate at addressing the breadth and depth of need presented by young people and their families.
Lastly, organisational structures that promote silo’s restrict movement towards the adoption of integrated MTSS. A key challenge is thus not so much in developing a multi-dimensional model but reshaping ways of working to ensure seamless integration of supports across multiple domains.