Cited by 87Behavioral and Psychological StudiesSchool Health and Nursing EducationEarly Childhood Education and Development

Getting “SMART” about implementing multi-tiered systems of support to promote school mental health

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August, Gerald J., Piehler, Timothy F., Miller, Faith G.·2018·Journal of School Psychology

Abstract

With the growing adoption and implementation of multi-tiered systems of support (MTSS) in school settings, there is increasing need for rigorous evaluations of adaptive-sequential interventions. That is, MTSS specify universal, selected, and indicated interventions to be delivered at each tier of support, yet few investigations have empirically examined the continuum of supports that are provided to students both within and across tiers. This need is compounded by a variety of prevention approaches that have been developed with distinct theoretical foundations (e.g., Positive Behavioral Interventions and Supports, Social-Emotional Learning) that are available within and across tiers. As evidence-based interventions continue to flourish, school-based practitioners greatly need evaluations regarding optimal treatment sequencing. To this end, we describe adaptive treatment strategies as a natural fit within the MTSS framework. Specifically, sequential multiple assignment randomized trials (SMART) offer a promising empirical approach to rigorously develop and compare adaptive treatment regimens within this framework.

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  • The comprehensive, empirical, sustainable, and efficient nature of MTSS is designed to optimize limited resources and is thus becoming widely adopted in school settings.

    “The comprehensive, empirical, sustainable, and efficient nature of MTSS is designed to optimize limited resources and is thus becoming widely adopted in school settings (McIntosh et al., 2010; August et al., 2018).”

    From Reconciling Contemporary Approaches to School Attendance and School Absenteeism: Toward Promotion and Nimble Response, Global Policy Review and Implementation, and Future Adaptability (Part 1) (2019) · cites this paper as August et al., 2018

    The Abstract (page unavailable) describes MTSS as layered and empirically driven and says its implementation is proliferating in educational settings. It does not establish that MTSS is sustainable or already optimizes limited resources; instead, it calls maintaining efficiency and feasibility a challenge. The Conclusion (page unavailable) presents reduced cost as a potential benefit of adding SMART designs, not an established property of MTSS. (LLM, conf=0.86)

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Research works printed but not linked: 5

  1. Crone D Hawken L Horner R 2010 Responding to problem behavior in schools: The behavior education program 2nd New York Guilford Press
  2. Dishion TJ Stormshak EA Kavanagh K 2011 Everyday Parenting: A professional’s guide to building family management skills Champaign, IL Research Press
  3. Guerra NG Williams KR Tolan PH Modeski Kl 2008 Theoretical and research advances in understanding the causes of juvenile offending Hoge RD Guerra NG Boxer P Treating the profile offender 33 53 New York, NY Guilford Press
  4. Kratochwill TR Bergan JR 1990 Behavioral consultation in applied settings: An individual guide New York Plenum Press
  5. Reynolds CR Kamphaus RW 2004 Behavioral Assessment System for Children 2nd Edition: Manual Circle Pines, MN American Guidance Services

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Authors
August, G. J., Piehler, T. F., & Miller, F. G.
Affiliations
University of Minnesota (US)
Corresponding author
Piehler, Timothy F.
Venue
Journal of School Psychology
Publisher
Elsevier BV
Published
2018-02
Volume
66
Pages
85-96
ISSN
0022-4405 (ISSN-L)
OpenAlex
W2765592309
Cited by
87
References
75
Citations by year
2026: 8 · 2025: 14 · 2024: 14 · 2023: 12 · 2022: 15 · 2021: 7 · 2020: 7 · 2019: 6 · 2018: 2 · 2017: 2
FWCI
9.41
Type
journal article
Language
en
Open access
Locations
  • Journal of School Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
NIMH (P20 MH085987, R34 MH097832)
Topics
  • Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
  • Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
  • Social Sciences › Education › Early Childhood Education and Development
Keywords
multi-tiered systems of support, school mental health, adaptive treatment strategies, sequential multiple assignment randomized trial, treatment sequencing, prevention, Positive Behavioral Interventions and Supports, social-emotional learning, evidence-based interventions, implementation evaluation
MeSH terms
Health Promotion, Humans, Mental Health, Mental Health Services, School Health Services, Schools, Students

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