Positive School-wide Behavior System

What is Tertiary Prevention?

Tertiary Prevention was originally designed to focus on the needs of individuals who exhibited patterns of problem behavior. Research has demonstrated the effectiveness of PBS in addressing the challenges of behaviors that are dangerous, highly disruptive, and/or impede learning and result in social or educational exclusion. PBS has been used to support the behavioral adaptation of students (and other individuals) with a wide range of characteristics, including developmental disabilities, autism, emotional and behavioral disorders, and even students with no diagnostic label.

Tertiary Prevention is most effective when there are positive primary (school-wide) and secondary (classroom) systems in place. In addition, the design and implementation of individualized supports are best executed when they are conducted in a comprehensive and collaborative manner. The process should include the individual with behavioral challenges and people who know him/her best all working together to promote positive change all working as a behavioral support team (BST). Support should be tailored to people's specific needs and circumstances. It should involve a comprehensive approach to understanding and intervening with the behavior, and should use multi-element interventions. The goal of Tertiary Prevention is to diminish problem behavior and, also, to increase the student's adaptive skills and opportunities for an enhanced quality of life.

Tertiary Prevention involves a process of functional behavioral assessment (FBA) and a support plan comprised of individualized, assessment-based intervention strategies, including a wide range of options such as: (1) guidance or instruction for the student to use new skills as a replacement for problem behaviors, (2) some rearrangement of the antecedent environment so that problems can be prevented and desirable behaviors can be encouraged, and (3) procedures for monitoring, evaluating, and reassessing of the plan as necessary. In some cases, the plan may also include emergency procedures to ensure safety and rapid de-escalation of severe episodes (this is required when the target behavior is dangerous to the student or others), or major ecological changes, such as changes in school placements, in cases where more substantive environmental changes are needed.

What differentiates tertiary (individual) intervention from other systems of positive behavior support?

The main difference between tertiary and other levels of positive behavior support is the focus of the interventions. The defining features of Tertiary Prevention (i.e., identification of goals, data collection and analysis, summary statements, multi-element plans, and a monitoring system) address the needs of individual children. It is support that is focused on meeting individual needs; and the characteristics of individual students and specific circumstances related to them (e.g., differences in the severity of behavior, complexity of environment) dictate a flexible, focused, personalized approach. This means that Tertiary Prevention allows teams to vary features of the process (e.g., data collection tools used, breadth of information gathered, specificity and number of hypotheses generated, extent of the behavioral support plan, and degree of monitoring) to provide the most individualized behavior support possible.

School-wide Behavior > Primary prevention > Seconday prevention > Tertiary prevention