ERIC ED605568: A Critical Review of the Professional Development Literature for Paraprofessionals Supporting Students with Externalizing Behavior Disorders

2020·0.66 MB·English

by  ERIC

Received:17May2019 | Revised:8March2020 | Accepted:14March2020
DOI:10.1002/pits.22381
RESEARCH ARTICLE
Acriticalreviewoftheprofessionaldevelopment
literature for paraprofessionals supporting
students with externalizing behavior disorders
Linda A. Reddy | Alexander Alperin | Todd A. Glover
GraduateSchoolofAppliedandProfessional
Psychology,RutgersUniversity,Piscataway, Abstract
NewJersey
The present paper serves as the first systematic review
Correspondence ofthetraining,methodologies,andoutcomesreportedin
LindaA.Reddy,RutgersUniversity,152
the professional development (PD) literature for para-
FrelinghuysenRoad,Piscataway,
NJ08854‐8085. professionals working with students with or at risk
Email:[email protected]
for externalizing behavior disorders. A total of 16 in-
Fundinginformation vestigations including 332 paraprofessionals and
USDOEInstituteofEducationScience, 852 children and adolescents were reviewed and coded
Grant/AwardNumber:R324A170069
on 44 variables across four dimensions (i.e., PD compo-
nents, intervention components, methodologies used,
andoutcomesreported).Strengthsoftheliteraturewere
inclusion of multicomponent PD, training on im-
plementation,paraprofessionalcharacteristics,andinter‐
rater reliability estimates. All studies reported para-
professional and/or student outcomes; however, the de-
tails of PD components and interventions delivered
varied. The majority of the studies used single‐case de-
signs or descriptive case studies to evaluate effective-
ness. Weaknesses were lack of inclusion and exclusion
criteria, student characteristics, adult experiential learn-
ing methods, monitoring of implementation fidelity, and
use of statistical testing. Implications for research and
practiceareoffered.
KEYWORDS
externalizingbehavior,paraeducator,paraprofessional,
professionaldevelopment,teacheraide
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PsycholSchs.2020;1–22. wileyonlinelibrary.com/journal/pits ©2020WileyPeriodicals,Inc. 1
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2 REDDYETAL.
1 | INTRODUCTION
Withtheemphasisoninclusiveeducationofchildrenwithdisabilities,aswellaslegalmandatesforindividualized
services,thehiringofparaprofessionalsisexpectedtogrow8%by2026andhasincreasedby49%nationallyinthe
last decade (Chopra, Sandoval‐Lucero, & French, 2011; National Center for Educational Statistics, 2009; U.S.
BureauofLaborStatistics,2019).In2016,1,308,100paraprofessionalswereemployedinthenation(U.S.Bureau
ofLaborStatistics,2019).Paraprofessionalsoutnumberfull‐timespecialeducationteachersinschools,with76%of
specialeducationservicesdeliveredbyparaprofessionals(Giangreco,Suter,&Hurley,2013;U.S.Departmentof
Education,2012).
Paraprofessionalsprovidevitalsupporttoclassroomteachersbyofferingopportunitiesforstudentswithorat
risk fordisabilities ingeneraland specialeducationclassrooms to enhance skilldevelopment and academic and
behavior functioning (Chopra et al., 2011). For example, paraprofessionals prepare academic materials, provide
individual and whole‐group instruction, communicate with parents and caregivers, and serve as primary im-
plementers of classroom‐based behavioral interventions (e.g., Fisher & Pleasants, 2012; Hall, Grundon, Pope, &
Romero,2010;McKenzie&Lewis,2008;Riggs&Mueller,2001;Sobeck,2016).Inalargesurveyofover1,800
paraprofessionals, 87% reported their most frequent role was delivering individual or small group behavior and
socialsupportstostudents(Fisher&Pleasants,2012).Whiletherolesandresponsibilitiesvaryforthisposition,
trainingonevidence‐basedpracticesisneededtopromotestudentengagement,learning,andpositivebehaviors.
Likewise, training that enhances paraprofessional knowledge of learning and behavior difficulties, as well as ef-
fectivemethodsforcollaborationandcommunicationwithteachersandparentsisnecessaryforparaprofessionals
tobeeffectiveintheclassroom.
Given paraprofessionals’ increasing popularity in working with classroom teachers to address students’
learningandbehavioralneeds,theyareoftentheadultsinclassroomsmostlikelytoimplementandmonitorthe
interventionssuggestedbyschoolpsychologistsandotherschoolspecialists.Schoolpsychologistsoftenworkwith
classroom teachers and paraprofessionals to identify students’ academic and behavioral needs, determine ante-
cedent and environmental factors affecting learning, select interventions and support and monitor intervention
implementationacrosslearningcontexts.Thus,workingindividuallywithstudents,paraprofessionalsmaintainan
importantroleinaddressingtheresourcedemandsofaclassroom.
Despitetheirimportanceinsupportingthelearningandbehaviorofstudentswithoratriskfordisordersor
disabilities,paraprofessionalsreceiveinadequatesupervisionandlittletonotrainingorjob‐embeddedsupportsto
enhance their professional development (PD; Brock & Carter, 2013; Sobeck, 2016). Although Section 1,412 of
the2004IndividualswithDisabilitiesEducationImprovementAct(IDEIA)requiresthatdistrictsappropriatelytrain
andsuperviseparaprofessionalsandtheEveryStudentSucceedsAct(2015)encouragesschoolstoallocatefunds
for this purpose, districts have failed to provide paraprofessionals with adequate guidance (IDEIA, 2004;
Sobeck,2016).Forsometime,specialeducationscholarshaveraisedseriousconcernsabouttheextenttowhich
paraprofessionals are trained, utilized, and supervised (e.g., Broer, Doyle, & Giangreco, 2005; Giangreco
et al., 2013). In a recent survey of training, PD needs, and knowledge of best behavior management practices,
paraprofessionals reported limitedtraining and knowledge,as wellas significant PD needsin best teachingand
behavior management practices for supporting students with disorders or disabilities, especially students with
disruptive behaviors (Dudek, Reddy, & Glover, 2018). Consistent with previous research (e.g., French, 2001;
Giangreco,Suter,&Doyle,2010),thevastmajorityofparaprofessionalssurveyedinthisstudyreceivednoPDon
positive behavior managementinterventions and supports. Thus,the increased presenceof paraprofessionals in
educationalsettingswithlimitedinstructionalandbehaviormanagementtraininghasresultedinamajorvoidin
personnelpreparationandservicedeliveryforstudentswithdisabilities.
Giventhegapinparaprofessionaltraining,acomprehensiveappraisaloftheextantPDliteratureisurgently
needed.Todate,existingreviewshaveincludedparaprofessionalsamongmultipletypesofinterventionproviders
orhavebeenlimitedtoonlysupportforstudentswithsevereintellectualordevelopmentaldisabilities(e.g.,Brock
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&Carter,2013,2017;Douglas,2012;Garrote,Dessemontet,&Opitz,2017;Mrachko&Kaczmarek,2017;Rispoli,
Neely,Lang,&Ganz,2011;Walker&Smith,2015).Specificallysevenreviewshaveincludedstudiesinvestigating
trainingandsupportsforparaprofessionalsinprovidingservicestostudentswithsevereintellectualordevelop-
mental disorders or a broad range of disabilities, including core competencies and interventions and supports
neededtomeettheuniquelearningandsocialbehaviorneedsofthestudents.Findingsfromthepublishedreviews
areimportantforexaminingtheavailabilityofPDandeffectivenessofPDforimprovingparaprofessionals’skillsin
servingtheuniqueneedsofthesestudentpopulations.
Althoughexternalizingbehaviorsrepresentthemostcommonfociofreferralstochildstudyteamsandmental
healthclinics,andparaprofessionalsspendaconsiderableamountoftimeworkingwithstudentswithoratriskfor
externalizing disorders (Allen, 2016; Reddy, De Thomas, Newman, & Chun, 2009), no systematic reviews have
examined the efficacy of training and supports for paraprofessionals who support the needs of students in this
prevalentpopulationinschools.Givendifferencesintheoriginofexternalizingbehaviordisordersandtheneedfor
uniquebehaviorinterventionstosupportthisstudentpopulation,asystematicreviewfocusedonparaprofessional
PD to address externalizing behavior disorders is needed for bridging research to practice and forging new di-
rectionsforpersonnelpreparationtomeetstudents’needs.
1.1 | Needs of students with externalizing behavior disorders
Paraprofessionalsupportforstudentswithoratriskforexternalizingbehavioraldisordersiscritical.Externalizing
behaviors are the most common foci of referrals to child study teams and mental health clinics and constitute
approximately25%ofallspecialeducationservicesinschoolsinthenation(Allen,2016;Reddyetal.,2009;Reddy,
Newman,&Verdesco,2015).Supportforstudentswithoratriskforexternalizingbehavioraldisordersiscrucial
given the risk for negative outcomes for such students throughout their life span such as academic under-
achievement,schooldropout,interpersonaldifficulties(i.e.,familyandpeerrelationshipissues),drivingaccidents,
teenage pregnancy, substance abuse, suicide, unemployment, health problems, and incarceration (e.g., Barker,
Oliver, & Maughan, 2010; Hodgins, Cree, Alderton, & Mak, 2008; Reddy et al., 2009; Schutter, Van Bokhoven,
Vanderschuren, Lochman, & Matthys, 2011; Webster‐Stratton & Reid, 2010). If untreated, it is estimated that
studentswithexternalizingbehaviordisorderswillcostapproximately$3milliontosociety,whichismorethan
twicethecostforstudentswithoutdisabilities(Guevaraetal.,2003).Disruptivebehaviorsalsointerferewiththe
learning ofallstudents intheclassroom.Forexample,inasurvey ledbytheEducationAdvisory Board (2019),
1,400elementaryschoolgeneraleducationandspecialeducationteachersreported,onaverage,losingnearlytwo
andahalfhoursofinstructioneachweekduetoclassroomdisruptivebehaviors.Thisisconcerninggiventhatlost
instructionaltimehasanadverseimpactonthelearningandsocialdevelopmentofallstudentsandevenmoreso
forthosestudentswithdisabilities.Thus,targetedPDthattargetsschoolpersonnel(e.g.,paraprofessionals,tea-
chers) skills in implementing behavior interventions and supports early in school are needed to help curtail the
developmentofnegativeoutcomesforthispopulation(e.g.,Eyberg,Nelson,&Boggs,2008;Reddy,Cleary,Alperin,
&Verdesco,2018;Reddyetal.,2009;Wilson&Lipsey,2007).
1.2 | Purpose of study
Paraprofessionalsofferimportantinstructionalandbehaviormanagementsupportsforstudentswithoratriskfor
externalizingbehaviordisordersdespitereceivinglimitedPDtrainingandsupportsinschools.Further,theyare
oftenthosemostlikelytoimplementandmonitorthebehavioralinterventionssuggestedbyschoolpsychologists
and other school specialists. Given the need to take stock of the state of research and practice on PD for
paraprofessionals on behavioral supports, a systematic review is needed. To this end, we synthesized the PD
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literatureforparaprofessionalswhoworkwithstudentswithoratriskforexternalizingbehaviordisorders.This
articleconstitutesthefirstsystematicreviewthatexaminesPDtrainingavailableforparaprofessionalsworking
withstudentswithoratriskforexternalizingbehaviordisorders.Specifically,thisarticlesynthesizesthefollowing
forresearchonparaprofessionalPD:(a)componentsofthePDprocess,(b)componentsofinterventionsinwhich
paraprofessionalsaretrained,(c)researchmethodologiesusedininvestigatingPD,and(d)outcomesreportedin
thePDresearch.Basedonthefindings,strengthsandlimitationsoftheliteratureareidentifiedforbridgingPD
researchwithpracticeforthispopulation.
2 | METHOD
2.1 | Literature search approach
Weconductedacomprehensiveliteraturesearch(1979–2018)onstudiesusingthekeytermsofparaprofessional,
paraeducator, instructional assistant, educational assistant, teacher aide, classroom aide, instructional coach,
coaching,training,PD,development,andeducation.Thefollowingdatabaseswereused:Articles+,GoogleScholar,
andProQuest.Also,areviewofselectedpeer‐reviewedjournalsknowntopublishliteraturepertinenttothefields
ofspecialeducation,PD,andeducationwereconductedtoensureacomprehensiveliteraturesearch(e.g.,Reviewof
Education Research, Exceptional Children, Journal of Educational and Psychological Consultation, and Remedial and
SpecialEducation).
Becausesupportingstudentswithoratriskforexternalizingbehaviordisordersrepresentsalmost25%ofall
special education services and is paraprofessionals’ most frequent job responsibility (Carter, O’Rourke, Sisco, &
Pelsue,2009;Fisher&Pleasants,2012;Giangrecoetal.,2013),wechosetolimitoursearchtoresearchfocusedon
the effect of paraprofessional PD (e.g., workshop, educational materials, intervention training, coaching, etc.) on
behaviorsupportsforstudentswithoratriskforexternalizingbehaviordisorders.Studiespublishedbefore1979
conceptualizedparaprofessionalsasaidesworkinginahospitalsetting,counselingcenter,andsoforth.Initially,seven
published reviews were identified that included paraprofessionals, however the reviews included studies of para-
professionals among multiple types of intervention providers and/or were limited primarily to the provision of
supportsforstudentswithdisabilities(i.e.,Brock&Carter,2013,2017;Douglas,2012;Garroteetal.,2017;Mrachko
&Kaczmarek,2017;Rispolietal.,2011;Walker&Smith,2015).Thesesevenreviewsandthestudiesfoundinthe
aforementioneddatabasesandpeer‐reviewedjournalsyieldedatotalof108articles.Fromthe108articles,wethen
focusedourinclusioncriteriaonstudiesthatexaminedPDdesignedforschool‐basedparaprofessionalsthatsupport
Kindergartenthrough12th‐gradestudentswithoratriskforexternalizingbehavioraldisorders.Giventhefocuson
paraprofessionalPDwereviewedbehavioralsupportsforstudentswithoratriskforbehaviordisorders.Researchon
PDforsupportingstudentswithprimarydiagnosesofAutismSpectrumDisorder(ASD),PervasiveDevelopmental
Disorder(PDD),and/orIntellectualDevelopmentDisorder(IDD)wasexcluded.Thisresultedintheidentificationof
11publishedarticles.Thesearchwasexpandedtoincludeunpublisheddissertationsusingthesamesearchtermsand
inclusion/exclusion criteria via the ProQuest Dissertations & Theses Global Full Text databases. The final search
included5dissertationsand11peer‐reviewedstudies(seeTable1).
2.2 | Structured review coding system
Consistentwithpreviouspublicationsonchildrenandadolescents(e.g.,Reddyetal.,2018),asystematiccoding
procedure was designed to review the literature on four dimensions (44 variables): (a) components of the PD
process,(b)componentsofinterventionsinwhichparaprofessionalsaretrained,(c)researchmethodologiesusedin
investigatingPD,and(d)outcomesreportedintheresearch.Thedimensionsandspecificvariablesselectedforthis
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Outcome Studentsoftrainedparaprofessionalsshowed greaterreductionsin‐actingoutbehaviorandoverallmaladjustmentthanstudents ofuntrainedparaprofessionals. Resultsindicatedthattrainingpositivelyaffectedthree paraprofessionalteachingskillswithinfourorfivetraining sessions(sessionsrangedfromoneminutetotenminutes). (Continues)
disorders(n=16) ParaprofessionalPDtraining PrimaryMentalHealthProject;10‐weekly,1.5hrlecturediscussion sessionscoveringthetherapeutic relationship,thereflectivetechnique,characteristicsof childrenwhoactout,consequences‐ofactingoutbehavior,therapeutic interventionandlimitsetting,andadvancedconsiderations(e.g., handlingambivalence).Lectureswerefollowedby10weekly,1.5hr groupsupervisionusingvideotapesoftheparaprofessionals'workwith targetstudents.Duringtheprogram'ssecondyear, paraprofessionalsmetfor7additionalgroupsupervision sessions. Thetrainingpackageconsistedofdefiningandmodelingof paraprofessionalteachingskills:(a)verbalattention,including reinforcingcommentsfor‐appropriatebehaviorortimeout proceduresforinappropriate behavior;(b)verbalpreacademicinstructions;and(c)verbaland nonverbalbehaviorforcorrectingstudent'sincorrectresponses. Visualperformancefeedback(graphs)wasprovidedonthe
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externalizingbehavio Researchdesign ‐Quasiexperimentalgroupdesign(pre/ posttest) ‐Singlesubjectdesign,multiplebaseline AcrossBehaviors
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Outcome Findingsindicatethatcourse objectivesandcoursematerialswerehighlyratedby paraprofessionalsandcourseinstructors;Paraprofessionals gainednewknowledge,perspectives,andskillsthat assistedtheprovisionofspecialeducationservicesfor studentswithdisabilities. Resultsindicatedthatparaprofessionalscouldbe taughttoimplementbehaviormanagementtechniques,but thattheintensityoftrainingeffortsvariedacross participantsandbehaviors.Overall,theparaprofessionals demonstratedincreasesincorrectimplementationof behaviormanagementtechniques.Studentbehaviors didnotrevealchangesduring andfollowingtraining.Apossiblereasonforthisoverall findingisthatobservedstudentbehaviorwereneara ceilingfordesirablebehaviors. Ratesofpeerinteractionincreasedforallstudentparticipantsand
araprofessionalPDtraining frequencyofthethree paraprofessionalbehaviors. ‐wocourses:(a)ParaeducatorEntry LevelTrainingforSupportingStudentswithDisabilitiesand(b) SupportingStudentswithChallengingBehaviors:A ParaeducatorCurriculumweretaughttoparaprofessionals. araprofessionalreviewedwritten‐takehomemanual,summarycard (stepsorelementsandoperationaldefinitionsofbehaviormanagement skill),andmodelingvideotapeonthreebehaviormanagementskills:‐‐instructiongiving,praise,andtimeout.Performancefeedbackwas provided(e.g.,reviewofsteps,implementationdata,etc.).A writtentestwasadministeredbeforeandaftereachtraining phaseuntiltheparaprofessional demonstratedmasteryofknowledge. hreehoursofindividualparaprofessionaltrainingthat
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araprofessionalsample 13Paraprofessionalstook thecourseParaeducator‐EntryLevelTrainingfor SupportingStudentswithDisabilities;105ofthe 213tookthecourse“SupportingStudentswith ChallengingBehaviors:A”ParaeducatorCurriculum.
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Outcome ratesofparaprofessional facilitativebehaviorincreasedonlyslightly.Paraprofessionals usedfacilitativebehaviorofmodelingskillsmorethan otherstrategies. Specificpraiseincreasedfrom13%atbaselineto31%following‐groupbasedtraining.Grouptrainingplususeofthesignal deviceincreasedpraisefrom48%(baseline)to61% (posttest).Paraprofessionalknowledgeincreasedfrom77% (baseline)to92%(posttest). Resultsindicatedthatuseof‐tactilepromptsandselfmonitoringwithaccuracy feedbackimprovedtokeneconomyimplementationfor allparticipants. (Continues)
araprofessionalPDtraining focusedonenhancingperspectives, importanceofinteractions,andincreasingtheparaprofessional knowledgeofstrategiesforfacilitatingpeerinteraction. Strategiestaughtincludedfourfacilitativestrategies:(a)teaching ormodelinginteractionskills;(b)highlightingsimilaritiesbetween studentsorstrengthsofthetargetstudents;(c)interpretingpeer behaviorsforthetargetstudentor apeer;and(d)movingstudentstoworkinclosephysicalproximityto oneanother. araprofessionalgrouptrainingontypesofpraiseusingtheprogram EnhancingSkillsofParaeducators.Theyweretaughtspecificpraise throughlecture,homework,modeling,instructivefeedback,and trainingmaterials.Atactilesignalingdevicethatvibratedat 15sintervals,promptedparaprofessionalstogivespecific praise. ‐araprofessionalsprovidedbriefin servicetrainingonimplementingtokeneconomies(i.e.,managing disruptions,promptingappropriate‐studentbehavior,andbonuspoint delivery);tactileprompts;and
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Outcome Paraprofessionalsratedthe study,trainingandproceduresassociallyvalid. Paraprofessionaldemonstratedgoodfidelitywithfunctionalbehavior analysisandinterventiondevelopment;ratedintervention developmentashighlyacceptable.Studentdecreased inappropriatebehaviorsand‐increasedontaskbehaviors followingintervention. Resultsindicatedimprovedimplementationofstudent behaviorplansfollowingafewcoachingsessionswhileongoing coachingwasneededtomaintaininterventionintegrity.Despite evidencethattheimplementedinterventionshadpositively affectedthestudents'behavior,paraprofessionalsaffirmedthat factorsoutsidetheircontrolcausedthebehavioral improvements.Studentsrated likingthepositivesupportoffered. Paraprofessionalstookendofunit examsresultinginanoverallmeanscoreof95.5%. Paraprofessionalsindicated
araprofessionalPDtraining ‐selfmonitoringwithaccuracy performancefeedbackprovided. araprofessionalstrainingonfunctionalbehavioranalysisand‐functionbasedinterventiondevelopment. araprofessionalswereprovidedindividualcoachingfocusedon:(a) reflectingoninteractionswithstudentsandteachers,(b)analyzing possiblecauses(i.e.,antecedents,consequences)ofstudent behaviors,and(c)reviewingstrategyimplementationofthe student'sbehaviorsupportplans. heTeamApproachtoParaeducator/ SupervisorProfessionalDevelopment(TAPS)Modelwas usedtotrainparaprofessionals.This
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Outcome ‐increasesinknowledgeinself assessmentoftheirlearning.Paraprofessionalsand supervisorsratedtheTAPSModelhighly. Comparedtocontrols,CTRT teachersandparaprofessionalshadgreaterimprovementsin‐relationshipbuildingskills.StudentsintheCTRT treatmentgroupmadegreaterimprovementsinexternalizing problemsthanstudentsinthecontrolgroup.Negative correlationsbetweenteacher‐CTRTrelationshipbuilding skillsandstudentexternalizingbehaviorswerefound. Resultsindicatedthattrainingrelatedtoparaprofessional interventionfidelity.Groupcontingencyimplementation byparaprofessionalsimprovedratesof:(a)interactions betweenparaprofessionalsand (Continues)
ParaprofessionalPDtraining modelconsistsoffourcomponents: (a)assessmentoflearningneeds,(b)formationofanindividualized professionaldevelopmentplan,(c)‐participationinselfdirectedtraining usingtheTAPScurriculummaterials,and(d)feedbackandsupport providedbythesupervisor. ChildTeacherRelationshipTraining (CTRT)wasprovidedto6paraprofessionalandteacherdyads;‐anintensive2.5daytrainingoninterventionskills(e.g.,reflective listening,recognizingandrespondingtochildren'sfeelings) weretaught.CoachesmodeledCTRTskillswithstudentsand observedteacherandparaprofessionalsimplement interventions.Weeklysupervisionwasheld.Aclassroommanagement programandsocialemotionalcurriculumwasprovidestothe6 paraprofessionalandteacherdyadsinactivecontrolgroup. Trainingproceduresincluded(a)aninitialdidacticintroductiontothe groupcontingencyproceduresmodeledaftertheGoodBehavior Game,(b)modelingoftheinterventionprogramwithinthe classroomsetting,and(c)the
Researchdesign ‐Quasiexperimental repeatedmeasuresgroup design ‐Singlesubjectdesign:concurrent multiplebaselinedesign
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Outcome students,(b)teacher instruction,and(c)studentaggressivebehavior.Highrates ofsociallyvaliditywerereportedbyteachersand paraprofessionals. Paraprofessionalsreported increasedknowledgeofbehavioralmanagementand academicinstructionstrategies.Goalsforstrategyuseinthe classroomwerenotfullymet. Paraprofessionalreduceduseofreactivestrategiesfollowing trainingbutwasinconsistentwithuseofproactive strategies.Studentsengagedinfewerproblembehaviorsafter training,butimprovementsonotherstudentoutcome measures(e.g.,compliance)werenotconsistently observed.Socialvalidity measuresindicatedsomesatisfactionwiththetraining andreductionsinstaffstresslevelsrelatedtoclassroom management,butthetrainingdidnotreducestress associatedwith–teacherstudentrelationships.
ParaprofessionalPDtraining deliveryofperformancefeedback tosupportparaprofessionalsuseoftheinterventionprocedures(the protocolcomprised13stepsdesignedtosystematizethe deliveryofclassroomexpectationsandconsequencesforappropriate andinappropriatebehaviors). ‐Eight,30mintrainingsessionsfocused onbehaviormanagementandacademicinstruction. Teacherandparaprofessionalsweretrainedonreactiveandproactive approachestoclassroommanagement;Strategieswere discussedandmodeled.Inclasssupportincludedstrategymodeling, prompting,forecastingpossiblesituations,useofspecificpraise, andfeedback.
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