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Definitions and Concepts

One reason that healthy child development is often difficult to promote and sustain is that no consensus exists on a term to encompass the multiple facets of the work. These child development and prevention approaches may be referred to by a variety of terms, often named for a narrow program focus or desired short-term outcome, but their collective purpose is to improve outcomes for children and youth.

Schools and districts often work both internally and with community groups to implement a range of stand-alone programs to enhance students’ social skills, promote their mental health, and prevent negative outcomes. They often operate as distinct initiatives, disconnected from one another. Each may even have its own funding stream or budget line, advisory board oversight, indicators and outcomes, and agenda. For example, universal and comprehensive student supports and social and emotional learning and development may encompass these stand-alone elements:

  • Programs labeled positive school discipline, conflict resolution, and civic engagement.
  • Structural change approaches that build safe and supportive school environments, for example, Positive Behavioral Interventions and Supports (PBIS) or trauma-sensitive school initiatives.
  • Various prevention programs and curricula that depend on how they initially define a problem:
    • Substance use prevention
    • Violence prevention
    • Pregnancy prevention
    • Bullying prevention
    • Suicide prevention

The Action Guide takes a systems level view of these discrete programs, building on their similar goals. Rather than pursuing the sustainability of each program in a fragmented manner, it recommends bringing together similar efforts and organizing the varied school and community initiatives in a structured, three-tiered framework to create a comprehensive state or local approach that encompasses all child and youth development programs.

Viewing these often-disparate programs as the components of an overarching strategy for student success and well-being, rather than as competition for resources, will help not only with sustainability, but with leveraging the resources essential for effective and comprehensive student supports.

Using a Multi-tiered Framework

The interventions, programs, or actions should be seen in a comprehensive framework of differing levels of support. The concept of three tiers, sometimes called a Multi-Tiered Systems of Support (MTSS), is used in education, public health, and related fields to describe the availability of increasingly supportive interventions matched to the level of need:

  • Universal resources to promote or maintain health and learning for all, and prevent negative outcomes,
  • Early intervention resources for those showing some level of risk or emerging problems, and
  • Targeted resources for groups and individuals with identified need.

Universal supports (Tier 1) encompass initiatives that focus on all students. It includes school climate, behavioral interventions, and restorative justice programs to name a few. It can be a skill-building curriculum for all classes, training for all teachers on how traumatic events impact learning, or activities that foster a welcoming atmosphere such as teachers greeting every student when they enter the classroom.

Early intervention (Tier 2) is for students not responding to Tier 1 instruction or interventions, or have been identified as at risk for developing more serious problems. Such interventions could be supplemental instruction or behavioral services and typically occur in small group settings or as individualized plans. Examples include small group counseling, behavioral modification charts, parenting classes for those with students at risk, food banks or open closets for those who need them, or mentoring programs.

Tier 3 are the most intensive interventions and are put in place for those where Tiers 1 and 2 are currently not enough. Individual or family counseling, referrals for treatment, and intensive programs for substance abuse, could all be considered Tier 3.

The tiers build on each other, with each level providing more directed (and more specialized or resource-heavy) services. They work in tandem and provide a scaffold for determining the types of programs to implement and how they can best be coordinated. The key is having a progression of increasingly intensive and specific interventions to address individual challenges and a method of ascertaining when a student needs them. Therefore, a tiered approach must include screening and surveillance activities to help identify students at risk so they can be provided additional assistance. Together, a range of interventions provides a continuum of services that is effective and cost-efficient, making them easier to sustain, adjust, and maintain.

A focus on prevention and an understanding of the underlying determinants of health, behavior, and academic success, such as poor nutrition, lack of sleep, homelessness, and neighborhood violence is also essential since providing early intervention in these areas can help prevent future problems or address current undesirable behavior (chronic absenteeism, substance abuse, anxiety). It is also important to have information both on the challenges students face and on how well the programs currently being implemented are working to resolve universal, group, and individual problems.

By using a three- tiered strategy to review and coordinate student support systems, educators and stakeholders from throughout the community can better envision how youth development and wellness programs and services can be effectively coordinated so there is a seamless continuum of positive supports to collectively expand equity and improve student lives.

But to help cross-sector initiatives succeed, it is also essential to create a common understanding of terms and concepts. Different sectors may use different terms for similar concepts or the same term may be used for different concepts, so it is important for all to be aware of and respect these differences.

Updated May 2018