Vol.:(0123456789) 1 3 School Mental Health https://doi.org/10.1007/s12310-019-09321-5 ORIGINAL PAPER Efcacy of a Combined Approach to Tier 2 Social‑Emotional and Behavioral Intervention and the Moderating Efects of Function Katie Eklund 1  · Stephen P. Kilgus 1  · Crystal Taylor 2  · Amanda Allen 2  · Lauren Meyer 1  · Jared Izumi 2  · Megan Beardmore 3  · Sara Frye 3  · Deija McLean 2  · Fedra Calderon 3  · Kayla Kilpatrick 2 © Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Systematic literature reviews have supported the efectiveness of behavioral Tier 2 interventions, with research being par- ticularly plentiful in relation to Check-In/Check-Out (CICO) and social skills training (SST). Though fndings indicate either approach is efective in isolation, a recent study suggested these approaches might be particularly efective when integrated. The purpose of the current study was to build upon this initial single-case design study with a larger sample within a ran- domized controlled trial. Participants included 91 elementary students who had been identifed as being at risk of social- emotional and behavioral difculties. Students were randomized into three intervention conditions: CICO only, SST only, and CICO + SST. Prior to intervention, information was collected regarding the function of student problem behavior and the extent of social skill defcits. Systematic direct observation data were then completed at pre- and post-test regarding student positive and negative social engagement. Multivariate general linear models were then conducted, with pre-test scores serving as covariates and intervention group and behavioral function serving as fxed factors. Results indicated that implementation of CICO, SST, and a combined CICO + SST was functionally related to a reduction in negative social engagement. Follow- up post hoc tests indicated that after adjusting for pre-test responding, the diference between conditions in efectiveness was moderated by behavioral function. Specifcally, SST was less efective for students whose behavior functioned to escape social and academic situations. No such diferences were noted between students whose behavior functioned to attain adult or peer attention. Implications for practice, methodological limitations, and directions for future research are reviewed. Keywords Targeted intervention · Tier 2 intervention · Check-In/Check-Out · Social skills · Function-based assessment Introduction Approximately 15–20% of children experience signifcant behavioral and emotional problems that present as barri- ers to learning in the school setting (Costello, Mustillo, Erkanli, Keeler, & Angold, 2003; Skiba et al., 2011). These children are at a higher risk of many negative outcomes, including school failure, substance abuse, and employment difculties (Lee, Humphreys, Flory, Liu, & Glass, 2011; Reid, Gonzalez, Nordness, Trout, & Epstein, 2004). In an efort to provide a prevention-oriented approach to address- ing student behavioral concerns, schools across the country use multi-tiered systems to support students with varying levels of need (Greenwood, Horner, & Kratochwill, 2008; Tilly, 2008). These behavioral support frameworks typically involve three tiers of intervention. Tier 1 (universal) supports are implemented throughout the school with a focus on the prevention of problem behavior and development of proso- cial behavior. Tier 1 may consist of the development and explicit instruction of expected behavior and the application of consistent consequences for appropriate and inappropriate behaviors. Tier 2 (targeted) interventions are implemented with students who do not respond to Tier 1 support. For schools utilizing a multi-tiered approach, Tier 2 conforms to a standard protocol approach, wherein all students requir- ing targeted support receive the same intervention (Hanni- gan & Hannigan, 2018). Such interventions are intended to * Katie Eklund katie.eklund@wisc.edu 1 Department of Educational Psychology, University of Wisconsin-Madison, 1025 W. Johnson Street, Madison, WI 53706, USA 2 University of Missouri, Columbia, MO, USA 3 University of Arizona, Tucson, AZ, USA