On this episodes of Meeting Midway we talk with Nicole Jones, Director of Risk Prevention at the Missouri Department of Mental Health – Division of Developmental Disabilities. Our topic centers around Enriched Environments. We first dive into what is an enriched environments and evidences that supports this intervention. We then explore how teams can set up an enriched environment and things that they need to consider when doing so. Several show notes have been shared on this topics below. 

Show Notes: 
-  Competing stimulus assessments: A systematic review (J. Haddock & L. Hagopian): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8151254/
-  The effects of an environmental “enrichment” program on the behavior of institutionalized profoundly retarded children. (R. Horner): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1308151/
-Environmental Enrichment as a Positive Behavioral Intervention Across the Lifespan (P. Sampedro-Piquero & A. Begega): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5543669/
-  Environmental Enrichment May Help Treat Autism – and Help Us All (M. Leon): https://www.scientificamerican.com/article/environmental-enrichment-may-help-treat-autism-and-help-us-all/
-  The Benefits of an Enriched Environment: What it is and how to implement it (Home ABA): https://www.caymanaba.com/blog/2020/5/26/the-benefits-of-an-enriched-environment-what-it-is-and-how-to-implement-it

For any questions on Enriched Environment please contact us Tier2@dmh.mo.gov 

Additional Resources…
-  DMH Tier 2 Webpage: https://dmh.mo.gov/dev-disabilities/tiered-supports/tier-2 
-  Missouri Department of Mental Health - https://dmh.mo.gov/ 
-  Missouri Department of Mental Health Facebook - https://www.facebook.com/MODivisionDD 
-  Missouri Division of Developmental Disabilities Facebook - https://www.facebook.com/MODivisionDD 
-  X - https://twitter.com/MentalHealthMO 
-  Missouri Department of Mental Health Youtube - https://www.youtube.com/channel/UCPsFpAHi-lN5sEaf_pbhEWg 
-  Missouri Division of Developmental Disabilities Youtube - https://www.youtube.com/@modivisionofdevelopmentald1632

Enriched Environments Ep 15

On this episode of Meeting Midway we are talking with Melinda Kubisa, CEO, & Wendy Pettifer, Executive Manager, with Community Living Options Inc. in Adelaide, South Australia. Melinda and Wendy recently presented at the 2024 Association for Positive Behavior Support conference in Chicago, IL. Their presentation was titled "Evidenced Based Positive Behavior Support for Quality of Life and A Home In the Community". Melinda and Wendy discuss a residential service program they developed in South Australia to help individuals with complex needs and co-occurring diagnoses (behavioral health and IDD) transition out forensic treatment settings or institutional settings into the community through the use of a Positive Behavioral Support (PBS) and a Multi Tiered System of Support (MTSS) model. The success of their program has shown the power and effectiveness of PBS and MTSS as they have seen zero recidivism for the population they support, but most importantly an increase in autonomy, personal liberty, and quality of life. Our discussion centers around this program while providing context around funding with Australia's National Disability Insurance Scheme (NDIS). Please see additional below…

Show Notes: 
Community Living Options: https://www.clo.org.au/ 
NDIS Quality and Safeguards Commission: https://www.ndiscommission.gov.au/sites/default/files/2022-10/Compendium%20of%20Resources%20for%20Positive%20Behaviour%20Support%20%20%20A%20guide%20for%20behaviour%20support%20practitioners%20-%20March%202019.docx 
ARMIDILO-S Manual: https://www.armidilo.net/files/Web-Version-1-1-2013-Intro-Manual.pdf 
ARMIDILO: https://www.armidilo.net/ 
Good Lives Model: https://www.goodlivesmodel.com/ 
La Trobe University: https://www.latrobe.edu.au/ 

Additional Show Notes:
Missouri Department of Mental Health: https://dmh.mo.gov/
Missouri Department of Mental Health Facebook: https://www.facebook.com/MODivisionDD
Missouri Division of Developmental Disabilities Facebook: https://www.facebook.com/MODivisionDD
X - https://twitter.com/MentalHealthMO
Missouri Department of Mental Health Youtube: https://www.youtube.com/channel/UCPsFpAHi-lN5sEaf_pbhEWg
Missouri Division of Developmental Disabilities Youtube: https://www.youtube.com/@modivisionofdevelopmentald1632

EP 20. From Forensic Settings to Thriving in the Community: Australian Tiered Supports

On this episode of Meeting Midway we're talking with Bob Putnam, Chelsea Salvatore and Emily Baton from the May Institute about their most recent presentation at the 2024 Association for Positive Behavior Supports conference. The title of their presentation was "Beyond Data Collection: Using Data to Make a Difference in IDD Settings". Our discussion centers around their presentation and the fidelity tools they reviewed and discussed. Two tool mentioned in their presentation were the Agency Systems Support Evaluation Tool aka ASSET with Missouri and the Tiered Onsite Evaluation Tool aka TOET with Minnesota. Our discussion then leads into a third fidelity tool the May Institute in Massachusetts is developing. From here we discuss several other tools and resources that listeners might find helpful in addition to goals and dreams for Bob, Chelsea and Emily on where they would like to see these tools in the future. If you're interested in learning about these tools please see the show notes below for further information. 

Show Resources: 
	- May Institute: https://www.mayinstitute.org/
	- Missouri's DMH ASSET: https://dmh.mo.gov/media/pdf/asset
	- University of Minnesota Twin Cities - Person Centered PBS Strategies / Tiered Onsite Evaluation Tool: https://publications.ici.umn.edu/dhs/universal-person-centered-pbs-strategies/tiered-onsite-evaluation-tool
	- Quality of Universal Implementation Checklist - https://www.mayinstitute.org/pdfs/presentations/*23-PBIS-F3C%20-%20QUIC-Quality-of-Universal-Implementation-Checklist.pdf
	- Massachusetts Department of Developmental Services - Guidance for Providers Implementing Positive Behavior Supports (Tiered Fidelity Inventory - TIF, pg 6): https://www.mass.gov/doc/pbs-guidance-universal-tier-of-supports-guidance-for-providers/download
       - Meeting Midway EP 18 TSSET: https://open.spotify.com/episode/09mgPULF0JSJW5WIqHxIta?si=XK595eCiS-yNVcMJD-_D3A

Additional Resources 
	- Missouri Department of Mental Health - https://dmh.mo.gov/
	- Missouri Department of Mental Health Facebook - https://www.facebook.com/MODivisionDD
	- Missouri Division of Developmental Disabilities Facebook - https://www.facebook.com/MODivisionDD
	- X - https://twitter.com/MentalHealthMO
	- Missouri Department of Mental Health Youtube - https://www.youtube.com/channel/UCPsFpAHi-lN5sEaf_pbhEWg
Missouri Division of Developmental Disabilities Youtube - https://www.youtube.com/@modivisionofdevelopmentald1632

Ep 21 - Tiered Fidelity Tools

On this epsidoes we discuss Tier 2 Readiness. What does this mean? How do we know when we’re ready for Tier 2? And why should we use Tier 2? These questions and more are answered in this episode. If you have questions about Tier 2 or how the Missouri Department of Mental Health is using the MTSS framework to enhance the lives of its residence and provider network, please contact us at Tier2@dmh.mo.gov. 

Show Resources
Tier 2 DMH page - https://dmh.mo.gov/dev-disabilities/tiered-supports/tier-2
Tier 2 Readiness Action Plan - https://dmh.mo.gov/media/55756/download
DMH Tier Supports main page - https://dmh.mo.gov/dev-disabilities/tiered-supports
APBS – What is Positive Behavior Supports - https://apbs.org/pbs/
Ep 14 Tier 2 Risk Screening - https://open.spotify.com/episode/3apFVeOsaOsuPNSMMXrINE?si=iQ1MVSpCQomdJ0Miyeayyg
Ep 15  Enriched Environments - https://open.spotify.com/episode/71URtfIAVJuiGnIZjA0XxJ?si=PcepBZVVQ-OQ7Zk25RQwUQ
Ep 12  Check-In, Check-Out - https://open.spotify.com/episode/1M83grp9ksITCijqSSPx3d?si=L0JChp-5SaSE0yd_Uu8EiQ
Ep 8 Crisis Safety Plans - https://open.spotify.com/episode/3eOzaETcLuWuJDDaBfnwrW?si=By-I40tJTyelpNlTtER0iw 

Additional Resources 
Missouri Department of Mental Health - https://dmh.mo.gov/
Missouri Department of Mental Health Facebook - https://www.facebook.com/MODivisionDD
Missouri Division of Developmental Disabilities Facebook - https://www.facebook.com/MODivisionDD
X - https://twitter.com/MentalHealthMO
Missouri Department of Mental Health Youtube - https://www.youtube.com/channel/UCPsFpAHi-lN5sEaf_pbhEWg
Missouri Division of Developmental Disabilities Youtube - https://www.youtube.com/@modivisionofdevelopmentald1632


Ep 24. Are you ready for Tier 2?

Happy New Year from Meeting Midway! 🎉

In this special year-in-review episode, we reflect on the journey so far, recap the exciting episodes we’ve released in 2024, and shine a spotlight on the incredible guests who joined us. We also share a sneak peek of what’s coming in 2025!

Since launching Meeting Midway in 2022, we’ve created 25 episodes (including this one) and delivered over 13 hours of content. Our mission has been to empower listeners with practical knowledge and tools to enhance Tier 2 systems and gain a deeper understanding of the Multi-Tiered System of Support (MTSS).

Join us as we revisit highlights, celebrate milestones, and look forward to an exciting year ahead. Don’t forget to let us know what topics or guests you’d like to hear about in future episodes—your feedback shapes our show!

Show Notes
Association for Positive Behavior Support Conference 2025 - https://apbs.org/conference/ 
Missouri Department of Mental Health - Multi Tiered System of Supports - https://dmh.mo.gov/dev-disabilities/tiered-supports/mtss
Missouri Department of Mental Health - Tiered Supports - https://dmh.mo.gov/dev-disabilities/tiered-supports
Ep 14 – Tier 2 Risk Screening (https://open.spotify.com/episode/3apFVeOsaOsuPNSMMXrINE?si=o3Yr9DrfSSu86Q0EzU5ZJA 
Ep 15 – Enriched Environments (https://open.spotify.com/episode/71URtfIAVJuiGnIZjA0XxJ?si=I8RHpeUnTEeQggMHevN80g) 
Ep 16 – Remote Supports (https://open.spotify.com/episode/12VUOJNyYMfDzzKqUiQuoP?si=ZQ-Q0OGYRS6RE5nH_XiFPA) 
Ep 17 – APBS 2024 Conference (https://open.spotify.com/episode/12VUOJNyYMfDzzKqUiQuoP?si=ZQ-Q0OGYRS6RE5nH_XiFPA) 
Ep 18 – TSSET (https://open.spotify.com/episode/09mgPULF0JSJW5WIqHxIta?si=yqmNTHe5QzuVFE54J5tqMQ) 
Ep 19 – Communication and Health Advocacy Training (CHAT) (https://open.spotify.com/episode/6fPAQzGDOo9cm0wW1REfwx?si=QpZml7QsS3KiBofyAvM4Lw) 
Ep 20 – From Forensic Settings to Thriving in the Community: Australian Tiered Supports (https://open.spotify.com/episode/5e3EuOQajy9AmWGfjowiKg?si=77t3Mq8jQsWWYybrTLvKqg) 
Ep 21 – Tiered Fidelity Tools (https://open.spotify.com/episode/2nkj9ULg7Wy5fv4R3JKQDy?si=1xsoX8sPRDOVI2IuxBEHuw) 
Ep 22 - Do you have data? (https://open.spotify.com/episode/275ixwjZ8sucmVy7A6r1uE?si=gudsXbI_SRWHPSk3pl-lsQ) 
Ep 23 – Do you know about fading? (https://open.spotify.com/episode/3ZnPxgUwSWVe4Hwh6Jo1dq?si=oFMRmPDISWagZielvcSbBQ) 
Ep 24 – Are you ready for Tier 2? (https://open.spotify.com/episode/5dvRTBxdbwW4R0bxpxeHGw?si=4LCX6pesTNKrkljTbz2XjA) 

Additional Resources 
Missouri Department of Mental Health - https://dmh.mo.gov/
Missouri Department of Mental Health Facebook - https://www.facebook.com/MODivisionDD
Missouri Division of Developmental Disabilities Facebook - https://www.facebook.com/MODivisionDD
X - https://twitter.com/MentalHealthMO
Missouri Department of Mental Health Youtube - https://www.youtube.com/channel/UCPsFpAHi-lN5sEaf_pbhEWg
Missouri Division of Developmental Disabilities Youtube - https://www.youtube.com/@modivisionofdevelopmentald1632



Ep 25. A year in in review 🎉

Welcome to this episode of meeting Midway. In this episode, we’re joined by Nicole Kanaman, who recently presented at the 2024 Tiered Supports Summit in Missouri, sharing insights on “An Agency-Wide Approach: Getting DSPs to Use Healthy Behavioral Practices.” Nicole discusses the key points of her presentation, focusing on the multi-tiered (MTSS) approach her agency implemented to improve DSP training and behavior practices. 

Nicole discusses the barriers faced not only by individuals receiving services but also by providers themselves—challenges that are often overlooked but are critical to understanding the broader scope of support needed in the field. She shares how her agency worked to overcome these challenges, leveraging technology to support their initiatives.

Nicole discusses the pyramidal model and outlines four foundational practices for promoting healthy behavior among DSPs. She provides a quick overview of these practices and how they align with the Tier 1 universal supports in the multi-tiered system of supports (MTSS). 

Nicole also dives into the importance of Behavioral Skills Training (BST), explaining how it formed the foundation for healthy behavioral practices and contributed to her agency's success. The conversation covers how training and maintenance plans were integrated to ensure DSPs retained the knowledge gained through their training, which played a significant role in sustaining the long-term success of the initiative.

Nicole shares results from the implementation and how these outcomes reflect the overall effectiveness of their agency-wide strategy. She also elaborates on the Tier 2 approach featuring a Behavior Specialist Curriculum. 

Finally, for other providers considering implementing a similar multi-tiered system, Nicole offers valuable advice and shares key lessons learned from her experience.

Tune in to hear Nicole’s expert insights on improving DSP practices and fostering better outcomes for individuals receiving services.

Show Resources: 
GoodLife Innovations - https://mygoodlife.org/
Tiered Support Summit - https://dmh.mo.gov/dev-disabilities/tiered-support-summit/2024

Additional Resources 
Missouri Department of Mental Health - https://dmh.mo.gov/
Missouri Department of Mental Health Facebook - https://www.facebook.com/MODivisionDD
Missouri Division of Developmental Disabilities Facebook - https://www.facebook.com/MODivisionDD
X - https://twitter.com/MentalHealthMO
Missouri Department of Mental Health Youtube - https://www.youtube.com/channel/UCPsFpAHi-lN5sEaf_pbhEWg
Missouri Division of Developmental Disabilities Youtube - https://www.youtube.com/@modivisionofdevelopmentald1632



EP 27. Meeting Midway Tier 2 Prevention - DSPs and Healthy Behavioral Practices

In this episode, we explore the concept of systems—what they are, how they work, and how to build a sustainable system for your organization. We break down the key components of a system, including people, behaviors, and technology, and explains how these elements must work together to achieve a greater outcomes. The episode delves into the three essential characteristics of a successful system: it must be Alive, Written, and Sustainable. Practical steps are provided for creating and maintaining a system, from establishing written procedures to monitoring progress and ensuring long-term sustainability. The episode wraps up with a call to action for listeners to apply these insights in their own organizations, fostering efficient and effective systems.

Show Notes
Ep 14 - Meeting Midway - Risk Screening https://open.spotify.com/episode/3apFVeOsaOsuPNSMMXrINE?si=hLUCVLQoQCeM07ZZ361m5Q
MTSS  DMH - https://dmh.mo.gov/dev-disabilities/tiered-supports/mtss


Additional Resources 
Missouri Department of Mental Health - https://dmh.mo.gov/
Missouri Department of Mental Health Facebook - https://www.facebook.com/MODivisionDD
Missouri Division of Developmental Disabilities Facebook - https://www.facebook.com/MODivisionDD
X - https://twitter.com/MentalHealthMO
Missouri Department of Mental Health Youtube - https://www.youtube.com/channel/UCPsFpAHi-lN5sEaf_pbhEWg
Missouri Division of Developmental Disabilities Youtube - https://www.youtube.com/@modivisionofdevelopmentald1632


New tracks tagged #Positive Behavior Supports