CARE Team Meetings

The Role of the Team

The CARE Team’s primary function is routine, structured problem solving in conjunction with teachers requesting assistance, and the resolution of student-centered problems. Teams work effectively with other teachers and staff members, analyze student problems, and design interventions powerful enough to effect the desired change. The functions and services the teams provide vary with the needs of the individual schools.

Overview of the Process

When a student is not responding the Tier 2 interventions the team can refer to a CARE Team meeting to determine more tailored specific interventions the students should receive.

Problem Identification and Description

It is crucial to have an objective description of the academic and/or behavioral problem before the team can begin to assist the teacher. A concrete definition avoids confusion and ensures that everyone is talking about the same thing. It helps to eliminate negative labels such as “lazy,” “rude” or “insubordinate” that defy change, and do not allow for measurement of progress. There are five steps to problem identification:

Sometimes the intervention team will want to choose a problem that can be quickly or easily changed in order to gain momentum. To fully understand the behavior we must look at antecedents; when or under what conditions the behavior occurs. We are looking for setting variables, activities, or interactions with others that lead to the behavior of concern. Identify what happens immediately before the sleeping behavior occurs, e.g., teacher is beginning instruction and student puts head down on desk and goes to sleep. Also, look for a pattern of the behavior, e.g., sleeps during reading, writing and math, but does not sleep during music, P.E., art or computer lab.

Identify when the student argues with the teacher, e.g., when corrected, when requests are denied, etc.

It is also necessary to discover what consequences are currently at play; that is, what happens when the student behaves appropriately and what happens when the student misbehaves. Question such as the following will help to identify the consequences: “What does the teacher do when the student behaves appropriately?” The teacher expects the student to cooperate and therefore does not comment on appropriate behavior. “What does the teacher do when the student sleeps?” The teacher warns the student then ignores the behavior and lets the student sleep. “What happens immediately after the student argues with the teacher?” The teacher sends the student to the office.

Consider function of behavior. Awareness of consequences leads to functional thinking that establishes the purpose the behavior serves. In its simplest form, the function is determined by asking the questions “Why is he doing this?” or “What is the payoff for sleeping, or arguing?” All behavior has a function driving it. Students behave either to avoid or escape something; feelings of inadequacy, anxiety or discomfort or to gain or obtain something; attention, power, or revenge. Considering the function of the behavior also helps to clarify whether the student cannot do the work or will not do the work. Clearly interpreting the function will guide the selection of useful interventions. For example, a student throwing tantrums each time she is told to join her reading group is being sent to time out; once in time out she quiets down quickly. When questioned about the function of the behavior, the teacher can now see that the student is escaping reading instruction, which is difficult for the student. Continued use of the exclusionary interventions (such as timeout) is not appropriate.

Establish replacement behavior/desired outcomes. Once behaviors of concern have been pinpointed and antecedents identified, it is relatively easy to pair the behavior with the opposite, alternative, or replacement behavior. For the child that is out of his seat, the desired behavior is to remain in his seat or ask permission before leaving. For the child who argues with the teacher when corrected, the replacement behavior is accepting correction calmly. The question to ask is “What is the goal?”, “What do you want the child to do or achieve?”, or “What is the preferred behavior?” Alternative or replacement behaviors are always stated as the presence of the preferred or desirable behavior, not the absence of the problem behavior e.g., “accepting correction calmly” instead of “not arguing”.

A student that is bossy with others may have leadership potential that can be used and channeled to engage the student in positive behaviors. Interests can also be used to develop reinforcing activities. Questions to ask might include “What does this student do well?” or “What does he choose to do when s/he has free time?” Defining the problem succinctly in this way requires some skill and initially some time. It is therefore recommended that the case liaison and the teacher do this prior to the team meeting. This provides a non-threatening private setting for the teacher to respond to questions, uncovers the need for observation, and allows the case liaison to determine if Ancillary Team members will be needed. It also ensures efficient use of the team meeting time. At the team meeting, the case liaison can provide a succinct description, including all of the above variables, within 2-3 minutes. The team can then spend the majority of their time on solutions and planning for intervention.

Brainstorming, Evaluating, and Selecting Interventions

When the problem has been stated concisely and one or two desired outcomes have been chosen, the team is ready to recommend interventions using a collaborative process. One example is brainstorming. This process guarantees efficiency and that each person, including the requestor, will contribute. There are four steps to brainstorming:

1. Silent generation of ideas in writing.

Begin by asking the team to take a minute to write as many possible interventions as they can. This one-minute think-to-write time results in a broader range of intervention generation. The Team Leader or individual facilitating the meeting should set up this activity by reviewing the goal or desired behavior(s), the function of the behavior, and student strengths. This will provide focus and increase the likelihood that ideas generated will be relevant to the problem. It may be helpful to prompt the team to think of interventions that: 1) teach missing academic skills in conjunction with alternative behaviors, 2) recognize or encourage appropriate behavior, 3) intervene or provide consequences when the problem behavior occurs, as well as 4) strategies that deal with setting variables. The team should be encouraged to consider all possible solutions from simplest to complex, to more obvious or obscure. They can also be prompted to prioritize their ideas should they have time.

2. Round robin sharing and recording of ideas.

At the conclusion of the silent generation, the leader asks all present, in turn, to share an intervention, continuing to go around to each member until an exhaustive list is obtained. Teams easily generate as many as 8-12 strategies. All comments, judgments or discussion are deferred until the list of ideas is completed. Each idea is listed. The recorder may use the same graphic organizer found on the back of the Intervention Plan on an easel or whiteboard to record the ideas for all to see. The silent generation of ideas and round-robin sharing should take no more than 6-8 minutes.

3. Clarification and discussion.

The next step is to seek clarity on interventions, as needed, to eliminate any that might conflict with the nature and function of the problem, and to advocate for those perceived as workable and powerful. Preference should always be given to interventions that are instructional and positive in focus. In addition, some feasibility considerations include:

1) degree of disruption to classroom procedures and teacher routines,

2) possible side effects on the student or peers,

3) amount of support services required,

4) the difficulty of the strategy and prerequisite competencies required to implement, and

5) the power of the intervention and probability of success.

Six-eight minutes should be enough time for thorough consideration of intervention possibilities.

4. Decision.

The individual who has the primary responsibility for implementation (the requestor) should, in the end, select the interventions that are most desirable. If the teacher is not comfortable with the intervention(s), he or she may not implement it with fidelity. Final selection can be guided by the wisdom of the other team members. Sometimes 3-4 interventions may be identified, with some being very easy to implement (e.g., increase rate of positive feedback or change seating) and 1-2 that require more effort. The selected interventions are circled and dated on the brainstorming graphic organizer (on both the form and the easel). This list then be available at subsequent meetings should further intervention consideration occur, avoiding the need to retrace the team’s steps. The interventions to be implemented are entered on the front of the intervention plan form. Details about implementation do not need to be ironed out at this time, but addressed later at a personal planning meeting with the teacher.

Writing the CARE Team Intervention Plan

The recorder has been entering much of the information on the form as the meeting has progressed (e.g., Brief Summary of Presenting Problem, Target Skills/Behaviors and Replacement Skills or Goals, Function of Behavior, and Student Strengths). Now that interventions have been selected, the written plan can be finalized. For each intervention, data that will be used to determine effect is noted. After this notation has been made, the preparation, arrangements, and materials development needed for implementation occur. Minimally, this includes a team member with the required skills meeting with the teacher to plan and prepare. Finally, a specific time for a follow-up meeting with the entire team is set. Typically, two weeks is a reasonable interval for full implementation and a good indication of intervention impact.

How to Facilitate a CARE Team Meeting

As the facilitator, it is your job to remain neutral and move the meeting along. The goal of a CARE team meeting is to have the group figure out how to best help the student. If staff are struggling with certain behaviors or with academics, chances are the family has the same struggles with the student at home. Families should leave a CARE team feeling like their student is supported. The staff should leave the meeting feeling supported and with a plan for the student.

There are a few major areas of question during a CARE. In general, you will want to stick with this order:

Student Strengths

The meeting should begin with introductions, but then go straight into student strengths. The person who made the referral should have already listed some strengths and can share those. Elicit strengths from the family. It can be anything from sports, academics, does the student like to help around the house, what they like to play, any other interests they have, etc. Starting with the strengths of a student will help set the tone for the meeting and also help the parents feel more at ease.

Known Information/History

After discussing strengths it is important to talk about any history of the student that may help the team better understand what is going on. Did they attend preschool? Have they been held back? Attended many schools? Were there any complications during the pregnancy or birth? Did they meet all developmental milestones on time? Any medical issues we should know about? Any history in the family of similar problems (learning disabilities, mental health issues, medical, etc.) This is when you get as much information about past history that may be contributing to the current issues.

Concerns

What are the concerns that have brought everyone together for the meeting? Be sure to ask both the family and the teacher. If any other school staff or outside providers are present they should also be given the opportunity to speak during this time.

Interventions Tried

The teacher will have provided all of the interventions that have been tried in the classroom. Any other school staff (RST, reading support, counselor, etc.) can also discuss what they have tried. Make sure to ask the family what they have tried at home.

Next Steps/ Goals/ Who’s Responsible

What steps do the team agree should happen next? These should be specific with the person(s) who are responsible for each goal and a target date for when the goal will be met. The hope is that both school staff and the families have goals they will be working on. Make sure the goal dates that are set are realistic and allow enough time for each intervention.

After everyone has agreed to the next steps print the CARE Team Student Plan. Be sure to have everyone sign and date the master copy. Everyone present should be offered a copy of the plan.

Monitoring Implementation

Team participation in implementation and monitoring of outcomes is often overlooked by teams as they put their efforts into problem-solving meetings. The collaborative nature of the team must extend throughout the intervention phase and includes support to the teacher, and data collection. A team member arranges to get together with the teacher following the team meeting to help prepare for implementation. This might include reviewing and explaining the interventions, developing an implementation checklist, modeling or role-playing the instruction or strategy, arranging with other school staff, or creating materials. Ongoing encouragement should be provided during implementation. It might include observing, data collection, and coaching. The greatest success is realized when team members work collaboratively with teachers, to achieve positive outcomes.

Data collection

The behavior of concern should be monitored both prior to the intervention and after the intervention to measure its effectiveness. This may sound like a lot of work, but monitoring behavior does not have to be difficult or time-consuming. It is, however, something that initially may require some assistance from a team member. Perhaps the most commonly used data is the frequency of a behavior (e.g. times seatwork is completed, times out of seats, interruptions during class, etc.). Use of existing records such as attendance/absentee records, or number of assignments completed/turned in, or number of disciplinary referrals can also be useful. Schools using curriculum-based measures or direct daily measurement such as reading fluency provide a readily available source of achievement data. Collecting data is not an end, but a means to make clear decisions. Data is also used to report progress accurately to the students, to other teachers, parents, and administrators.

Resource: Timeline of a CARE Team Meeting