School Mental Health (2018) 10:202–213

https://doi.org/10.1007/s12310-017-9239-y

REVIEW PAPER

Using the Teaching Pyramid Observation Tool (TPOT) to Support

Implementation of Social–Emotional Teaching Practices
Mary Louise Hemmeter1 · Patricia Snyder2 · Lise Fox3

Published online: 30 December 2017

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Abstract
The emphasis on social–emotional competence and its importance to positive academic and nonacademic outcomes has led
to a focus on identifying and implementing effective practices for supporting young children’s social–emotional competence.
Our work to identify, validate, and support the fidelity of implementation of evidence-based practices to promote young chil-
dren’s social–emotional competence and to address challenging behavior has focused on the Pyramid Model for Promoting
Social–Emotional Competence in Infants and Young Children framework (Fox et al. in Infants Young Child 23:3–14, 2010;
Hemmeter et al. in Sch Psychol Rev 35:583–601, 2006; Hemmeter et al., in: Buysse, Peisner-Feinberg (eds) Handbook of
response-to-intervention in early childhood, Brookes, Baltimore, 2013). The implementation of the Pyramid Model practices
to provide effective intervention that leads to meaningful child outcomes will require that practitioners are able to imple-
ment the practices with fidelity. Implementation science provides guidance on the “drivers” or key components that must
be in place within a system to ensure the use of evidence-practices or interventions (Blase et al. in stages of implementation
analysis: where are we? FPG Child Development Institute, University of North Carolina, Chapel Hill, 2013; Metz et al. in
an integrated stage-based framework for implementation of early childhood programs and systems. OPRE Research Brief
OPRE 201548, 2015). In this paper, we address competency drivers by describing an instrument that has been developed,
validated, and used to measure the fidelity with which practitioners implement Pyramid Model practices. In addition, we
describe the professional development intervention we have used to support teachers to implement the practices with fidelity.
We focus on how a fidelity tool can be used to measure practice implementation as well as to guide professional development
focused on the practices.

Keywords Social–emotional competence · Challenging behavior · Fidelity · Professional development · Implementation

science

Social–emotional development is critically important to

children’s school readiness and has been identified in a
* Mary Louise Hemmeter number of national publications and policy statements as
[email protected] critical to children’s success in school and life. In a recent
Patricia Snyder report, Jones, Greenberg, and Crowley (2015) found signifi-
[email protected] cant positive relationships between children’s social–emo-
tional skills in kindergarten and their outcomes as young
1
Department of Special Education, Vanderbilt University, adults (e.g., higher levels of education, less criminal activ-
Box 228 GPC, Nashville, TN 37203, USA
ity, fewer mental health issues). In Neurons to Neighbor-
2
Anita Zucker Center for Excellence in Early Childhood hoods, Shonkoff and Phillips (2000) identified three areas
Studies, School of Special Education, School Psychology,
and Early Childhood Studies, University of Florida, PO of children’s development that reflect social and emotional
Box 117050, Gainesville, FL 32611, USA competence: (1) learning to regulate one’s own emotions,
3
Florida Center for Inclusive Communities, Department behaviors, and attention; (2) learning language, reasoning,
of Child and Family Studies, College of Behavioral and problem solving; and (3) learning how to get along with
and Community Sciences, University of South Florida, others and develop friendships.
MHC 2113A, 13301 Bruce B. Downs Blvd., Tampa,
FL 33612‑3807, USA

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The importance of social–emotional competence during a social-emotional curriculum such as Preschool PATHS
the early childhood years is emphasized in federal- and state- (Domitrovich, Greenberg, Kusche, & Cortes, 2004) or
level early care and education programs. The Head Start Second Step (Committee for Children, 1991), as part of an
Early Learning Outcomes Framework includes social and instructional framework such as embedded instruction for
emotional development as a domain for infants, toddlers, and early learning (Snyder et al., 2017b), or some combination
preschoolers noting that it is a critical foundation for devel- of these. Although the teaching practices reflected in each of
opment and learning throughout life (Office of Head Start, these might differ in intensity, delivery mode, organization,
2015). The Office of Child Care has a priority to increase the and other characteristics, across them there is a focus on
number of states that are implementing early learning guide- high quality, developmentally appropriate, intentional teach-
lines that include social and emotional development, noting ing practices (Copple & Bredekamp, 2009).
that almost all states and territories have social–emotional Our work to identify, validate, and support the fidelity
guidelines for infants and toddlers (National Center on Early of implementation of evidence-based practices to promote
Childhood Quality Assurance, 2016; Scott-Little, Kagan, all young children’s social–emotional competence and to
Reid, Sumrall, & Fox, 2014). The Office of Special Educa- address challenging behavior has focused on the Pyramid
tion Programs (OSEP) requires states to report data on child Model for Promoting Social–Emotional Competence in
and family outcomes in early intervention (Part C of IDEA) Infants and Young Children framework (Fig. 1; Fox, Carta,
and early childhood special education (Part B, Section 619 Strain, Dunlap, & Hemmeter, 2010; Hemmeter, Fox, & Sny-
of IDEA) on three outcomes: (1) positive social–emotional der, 2013; Hemmeter, Ostrosky, & Fox, 2006). The Pyra-
skills, (2) acquiring and using knowledge and skills, and (3) mid Model is a multi-tiered system of support framework of
taking appropriate actions to meet needs. evidence-based practices for promoting the social–emotional
competence of all children; addressing the social, emotional,
and behavioral needs of children who are at-risk; and devel-
Supporting Children’s Social–Emotional oping, implementing, and evaluating individualized posi-
Competence Through Evidence‑Based tive behavior supports for children with persistent social,
Teaching Practices emotional, or behavioral challenges. The Pyramid Model
practices were identified through a review of the research
The emphasis on social–emotional competence and its on promotion, prevention, and intervention practices that
importance to positive academic and nonacademic outcomes have been associated with positive social–emotional out-
has led to a focus on identifying and implementing effective comes for young children and decreases in their challenging
environmental, interactional, and instructional practices for behavior (Hemmeter et al., 2013). In the present paper, we
supporting young children’s social–emotional competence. describe the development and use of an instrument designed
Without early intervention, social–emotional challenges may to measure the extent to which Pyramid Model practices are
persist or worsen and lead to negative outcomes (Brennan, implemented with fidelity by practitioners in early childhood
Shaw, Dishion, & Wilson, 2012; Bulotsky-Shearer & Fan- classrooms.
tuzzo, 2011; Hauser-Cram & Woodman, 2015). Over the last
decade, there has been an increased emphasis on identifying
evidence-based curricula as well as evidence-based practices Describing Pyramid Model Practices Across
that early childhood educators and families can use to pro- Tiers
mote children’s social–emotional competence and address
challenging behaviors (e.g., Conroy et al., 2015; Domitro- The universal tier of the Pyramid Model refers to promotion
vich, Moore, & Greenberg, 2012; Domitrovich et al., 2009; practices related to responsive and supportive interactions
Hemmeter, Snyder, Fox, & Algina, 2016; Webster-Stratton, such as supporting children’s play, ongoing and extended
Reid, & Stoolmiller, 2008). conversations, and positive feedback and encouragement of
In addition to being evidence-based, the curricula or appropriate behavior (e.g., Burchinal, Vandergrift, Pianta,
teaching practices used by early childhood educators and & Mashburn, 2010; Chien et al., 2010; National Research
family members must be developmentally appropriate; Council, 2001; Peisner-Feinberg et al., 2000). It also
feasible and acceptable; and designed to meet the range of includes practices related to teaming, family engagement,
social, emotional, and behavioral needs of children in inclu- communication with families, and family engagement. These
sive early childhood classrooms. In early childhood settings, practices are considered essential to the provision of high
social–emotional teaching practices may be addressed using quality, developmentally appropriate programs for young
a comprehensive preschool curriculum such as the Crea- children (Copple & Bredekamp, 2009; Division for Early
tive Curriculum (Dodge et al., 2016) or Connect4Learning Childhood, 2014).
(Sarama, Brenneman, Clements, Duke, & Hemmeter, 2016),

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Fig. 1  Pyramid Model for

promoting social–emotional
competence in infants and
young children

The universal promotion tier also includes practices and supporting self-regulation; teaching and supporting chil-
related to high-quality supportive environments that have dren’s use of strategies for handling difficult emotions (e.g.,
been shown to promote children’s engagement in develop- anger and disappointment); teaching and supporting social
mentally appropriate learning activities. These practices problem solving; teaching and supporting friendship skills;
include providing adequate and appropriate materials in teaching and supporting collaboration with peers; and pro-
learning centers, defining the boundaries of learning centers, viding individualized instruction for children who need addi-
offering a balanced schedule of activities with length and tional support (Brown et al., 2001; Denham & Burton, 1996;
type matched to developmental needs of children (large and National Research Council, 2001; Webster-Stratton, Reid, &
small group), structuring transitions, providing clear direc- Hammond, 2004). For children who have social–emotional
tions to all children and individualized directions to chil- delays or instructional support needs, specific social skills or
dren who need additional support, teaching and promoting a emotional competencies are targeted and a systematic plan
small number of classroom rules, and actively promoting the is designed to ensure that adequate learning opportunities
engagement of children (e.g., Chien et al., 2010; Jolivette, are embedded within meaningful activities (Snyder et al.,
Wehby, Canale, & Massey, 2001; National Research Coun- 2017b).
cil, 2001; Peisner-Feinberg et al., 2000). At the individualized intervention (tertiary) tier of the
The secondary prevention tier involves providing sys- Pyramid Model, early childhood educators are part of a
tematic instruction on social skills to all children in the team that develops and supports the implementation and
classroom and systematic instruction for small groups or evaluation of an assessment-based, individualized behav-
individual children who are at-risk of challenging behavior ior support plan that includes prevention practices, targeted
and emotional/behavioral disorders or have social–emo- instruction and responding strategies (Dunlap & Fox, 2011;
tional skill deficits. Within the Pyramid Model, social skills Dunlap, Wilson, Strain, & Lee, 2013; Dunlap et al., 2017).
instruction is delivered for all children but varies in form These individualized behavior support plans include system-
and intensity depending on the individual needs of each atic instruction on individualized social–emotional targets
child (Brown, Odom, & Conroy, 2001; Snyder, Bishop, & described at the secondary level. Progress monitoring is
McLauglin, 2017a). Secondary prevention practices include frequent and ongoing and tracks both reductions in chal-
teaching children to identify and express emotions; teaching lenging behavior and the use of replacement skills. In the
Pyramid Model, each tier builds upon the previous tier, and
tier 2 and 3 practices are reliant on the previous tiers for the

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implementation of practices that are critical to promoting implementation than self- or implementer-reported meas-
social–emotional outcomes. ures (Abry, Hulleman, & Rimm-Kaufman, 2015).
Implementation science provides guidance on the “driv-
ers” or key components that must be in place to ensure
Importance of Measuring Fidelity the use of evidence-practices or interventions (Blase, Van
of Implementation of Evidence‑Based Dyke, & Fixsen, 2013; Metz, Naoom, Halle, & Bartley,
Social–Emotional Teaching and Behavioral 2015). These drivers include: a) competency drivers, (b)
Support Practices organization drivers, and (c) leadership drivers (Fixsen
et al., 2005; Metz et al., 2013). Competency drivers are
In the development of the Pyramid Model, we identified the structures needed to establish or improve and sustain
the tiers of evidence-based practices to address the range practitioners’ use of evidence-based practices. These
of social, emotional, and behavioral intervention needs of structures include the use of a practice fidelity assessment
young children within a program or classroom. The imple- tool; implementation materials; the provision of robust
mentation of these practices to provide effective intervention and ongoing professional development, including coach-
that leads to meaningful child outcomes requires that prac- ing to ensure fidelity of implementation; and the training
titioners are able to implement the practices with fidelity. of leadership personnel who support implementation by
Assessment of fidelity is critical for linking practice practitioners.
implementation to child outcomes and for establishing In the remainder of this paper, we describe an instrument
the efficacy of interventions used in educational settings that has been developed, validated, and used in research to
(Hagermoser Sanetti, Dobey, & Gritter, 2012; Horner measure the fidelity with which practitioners implement
et al., 2005; Lloyd, Supplee, & Mattera, 2013; O’Donnell, Pyramid Model practices. In addition, we address compe-
2008). A meta-analytic review of over 200 social–emo- tency drivers by describing the professional development
tional learning school-based interventions compared approach we have used to support teachers to implement
outcomes for programs that were well implemented ver- Pyramid Model practices with fidelity. We focus on how a
sus those that had implementation fidelity issues. Find- fidelity tool can be used to measure practice implementation
ings showed better outcomes for programs that were well as well as to guide professional development focused on the
implemented, with student academic gains twice as high practices.
and reductions in conduct problems almost twice as large
when programs were well implemented versus when they Teaching Pyramid Observation Tool
had implementation fidelity issues (Durlak, Weissberg,
Dymnicki, Taylor, & Schellinger, 2011). The Teaching Pyramid Observation Tool (TPOT; Hem-
Given the important relationship between fidelity of meter, Fox, & Snyder, 2014) is an instrument designed to
practice implementation and desired outcomes, measuring measure practitioners’ implementation of the environmental,
fidelity of practice implementation has received renewed interactional, and instructional practices associated with the
attention, particularly with the growing interest in the sci- Pyramid Model. It was developed to measure the fidelity
ence of implementation. Implementation science focuses with which preschool teachers implement Pyramid Model
on the study of what supports and processes are necessary teaching practices. Consistent with the Pyramid Model
for programs, practices, or interventions that have promis- framework, the practices included on the TPOT are univer-
ing research evidence to be implemented on a larger scale sal practices (i.e., nurturing and responsive relationships and
and in authentic settings (Fixsen, Naoom, Blase, Fried- environments that promote young children’s social and emo-
man, & Wallace, 2005; Metz, Halle, Bartley, & Blasberg, tional competence and prevent challenging behavior), tar-
2013). Information about the fidelity of practice imple- geted practices (i.e., explicit social–emotional and behavior
mentation permits nuanced understanding of the mecha- support teaching practices such as teaching children friend-
nisms by which interventions impact outcomes and aids in ship skills or teaching children to express emotions), and
replication or diffusion activities (LoCasale-Crouch, Wil- practices that demonstrate teachers’ capacity to implement
liford, Whittaker, DeCoster, & Alamos, 2017). Measures individualized practices (i.e., social–emotional or behavio-
that provide information about the extent to which specific ral support interventions for children with persistent social,
evidence-based practices are implemented with fidelity emotional, or behavioral challenges).
have been identified as preferable to those that focus on The TPOT has three subscales: (1) key teaching practices
general model components (Hullerman & Corrday, 2009). (14 items), (2) red flags (17 items), and (3) effective strate-
In addition, direct observation fidelity measures have been gies for responding to challenging behavior (3 items). For
identified as providing less biased reports of practice the key teaching practices items, observable practice indi-
cators are organized under each key practice. The number

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Table 1  Teaching pyramid Key practices item Number of

observation tool key practices observable indi-
items and number of observable cators
indicators associated with each
item Schedules, routines, and ­activitiesa 10
Transitions between ­activitiesa 8
Supportive ­conversationsa 10
Promoting children’s ­engagementa 9
Providing ­directionsa 7
Collaborative ­teaminga 9
Teaching behavior ­expectationsa 7
Teaching social skills and emotional ­competenciesa 8
Teaching children to express e­ motionsb 8
Teaching problem-solvingb 9
Teaching friendship ­skillsb 9
Interventions for children with persistent challenging ­behaviorc 5
Connecting with f­ amiliesc 8
Supporting family use of Pyramid Model ­practicesc
a
Scored via observation
b
Scored via observation or interview
c
Scored primarily via interview

of indicators associated with each item varies from 5 to 10 Development of the TPOT
for a total of 114 practice indicators related to key teaching
practices. Table 1 illustrates the 14 key practice items and The TPOT was initially developed as part of a development
the number of indicators associated with each item. Red flag and innovation (Goal 2) study funded the Institute of Educa-
items are environmental or interactional practices that con- tion Sciences to measure the fidelity with which preschool
flict with or impede the implementation of Pyramid Model teachers were implementing Pyramid Model practices before
practices (e.g., children are reprimanded for expressing emo- and after their participation in a professional development
tions, learning centers do not have clear boundaries). The (PD) intervention that involved workshops, implementation
strategies for responding to challenging behavior item have guides, materials to support practice implementation, and
three essential practices that teachers should use to respond controlled doses of practice-based coaching (Hemmeter
to any incident of challenging behavior. et al., 2016). We also used the measure to evaluate imple-
The TPOT is completed following a 2-h observation in mentation of Pyramid Model practices in comparison group
a preschool classroom. Assessors observe both teacher- classrooms. Through measurement of the TPOT key prac-
directed (e.g., circle time, small group) and child-initiated tices items and associated indicators, we wanted to quantify
activities (e.g., free play, center time), as well as transitions several aspects of fidelity of Pyramid Model practice imple-
between activities. The observation is followed by a 15- to mentation by teachers: adherence, quality of delivery, and
20-min interview with the teacher. Eight of the key teaching program differentiation (cf. Carroll et al., 2007; O’Donnell,
practices indicators are scored based solely on the asses- 2008). Development of the pilot version of the TPOT began
sor’s observation. The indicators associated with three key in 2005. The content of the pilot version was informed by
teaching practices are scored based on the observation and generating a list of potential items (e.g., teaching children
interview. The remaining three key teaching practices are to express emotions, promoting children’s engagement) that
scored based on interview only (see Table 1). All but three of reflected key Pyramid Model practice elements based on
the red flags are scored based on the assessor’s observation. a thorough review and synthesis of the literature. We then
The remaining red flags are scored based on observation generated a definition for each practice element that would
and interview (2 items) or interview (1 item). The effective become a TPOT item and specified a list of observable indi-
strategies for responding to challenging behavior practices cators associated with each key practice element to reflect
are scored each time an incident of challenging behavior adherence, quality of delivery, or program differentiation.
occurs during the observation. To help inform the development of observable indicators,
we used the Inventory of Practices (Center on the Social
and Emotional Foundations for Early Learning, 2003).

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The Inventory of Practices was associated with Pyramid occasions. SID stability coefficients were highest for key
Model work conducted under the auspices of the Center on practices related to schedules, routines, and activities, and
the Social and Emotional Foundations for Early Learning lowest for collaborative teaming and connecting with fami-
(CSEFEL). We developed additional indicators that were lies. The finding that SID stability coefficients were low-
identified as important based on reviews of the literature est for collaborative teaming and connecting with families
but that did not appear on the Inventory of Practices. We might relate to variations in the need to implement these
also developed additional practice elements when practices specific practices over measurement occasions relative to
from the Inventory of Practices did not fit into one of the the other TPOT practices such as predictable schedules,
prespecified practice elements. After these content develop- routines, and activities. Overall, SID stability coefficients
ment steps, further development of the pilot version of the for occasions 1 and 2 ranged from .43 to .85, from .48 to .79
TPOT involved iterative processes of content validation by for occasions 2 and 3, and from .41 to .75 for occasions 1
experts and field testing in preschool classrooms (Hemmeter and 3. Across all 14 key practices, SID stability coefficients
et al., 2014). were .91 for occasions 1 and 2, .87 for occasions 2 and 3,
The pilot version of the TPOT had 14 key practices items and .85 for occasions 1 and 3. Red flag stability was .69 for
with multiple practice indicators associated with each item, occasions 1 and 2, .80 for occasions 2 and 3, and .67 for
seven items related to environmental arrangements in class- occasions 1 and 3.
rooms, one item focused on whether challenging behavior For SOMOM, average percentage scores for each key
occurred and strategies used to respond to the challenging practices item were generally very stable across time. Over
behavior, and 16 red flag items. Based on psychometric data the three occasions of measurement, without professional
for the pilot version of the TPOT and feedback from users, development being provided on Pyramid Model practices,
revisions were made, which resulted in the current Research implementation percentage scores on the TPOT remained
Edition of the TPOT (Hemmeter et al., 2014). stable or showed slight declines. Average percentage scores
show that across each measurement occasion, most indica-
tors associated with key practices items were not scored as
Score Reliability and Validity Evidence “yes” (i.e., implemented based on criteria specified for the
for TPOT indicator). Percentage scores ranged from 11.4% (collabora-
tive teaming) to 67% (connecting with families) on occasion
A number of studies have been conducted to examine TPOT 1, from 9.1 to 61.8% on occasion 2 for the same two items,
score reliability and validity with samples of preschool and from 8.0 to 61.3% on occasion 3 for the same two items.
teachers and classrooms (Hemmeter et al., 2014). Some of Average percentage scores for the all indicators associated
the psychometric evidence is based on studies conducted with the 14 key practices items were 41.9% on occasion 1,
using the pilot version of the TPOT (Fox, Hemmeter, & Sny- 38.9% on occasion 2, and 36.4% on occasion 3. Red flags
der, 2008; Fox, Hemmeter, & Snyder, 2009). Other data are percentage scores were 16.4% on occasion 1, 20.1% on occa-
from studies in which the Research Edition of the TPOT was sion 2, and 19.9% on occasion 3.
used. The characteristics of the teachers and classrooms in The stability data described above show that without
which TPOT psychometric integrity evidence was gathered explicit professional development or training focused on
are described in Hemmeter et al. (2014). the Pyramid Model, teachers’ fidelity of implementation of
Of particular relevance to the present paper, we have practices associated with the observable indicators on the
examined TPOT score stability and interrater reliability and TPOT generally was low and did not change appreciably
agreement. For the former, we have explored the stability across three occasions of measurement separated by at least
of individual differences (SID) and stability of means over 2–3 weeks. Based on the psychometric data presented in
occasions of measurement (SOMOM) for TPOT scores by this paper and elsewhere (Hemmeter et al., 2014), the TPOT
having two trained raters conduct three observations in 50 appears to be a promising tool to quantify the adherence
preschool classrooms when no professional development or and quality of baseline implementation of Pyramid Model
training was being provided on the Pyramid Model (Hem- practices.
meter et al., 2014). Because the TPOT is designed to be completed by
SID was assessed by examining correlation coefficients trained assessors and it is a judgment-based instrument
for scores collected at different occasions when the profes- that is scored following an observation and interview, it is
sional development intervention was not delivered. Results important to have evidence of interrater score reliability or
showed that teachers whose implementation of key prac- agreement. Assessors are trained during a 2-day workshop
tices resulted in high or low scores on the first measurement in which they learn to score the tool and practice scoring
occasion also engaged in practices that resulted in relatively individual items. During the second day of the workshop,
high or low scores on the second and third measurement the assessors watch a 2-h video and 30-min interview and

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score the entire TPOT. Their scores are compared to “gold PD focused on the Pyramid Model practices, implementa-
standard” scores and must achieve 80% agreement to achieve tion of practices as measured by the TPOT was, on average,
reliability. They then practice the tool using live observa- below 42%.
tions and achieve reliability with gold standard observers. From a practical perspective, these data are significant
For three studies in which the pilot version and research given they were implemented across early childhood service
edition of the TPOT was used (Hemmeter et al., 2014), gen- delivery systems (e.g., child care, Head Start, public school
eralizability coefficients were computed based on classroom, Pre-k) and regardless of setting, the average scores are below
rater, and error facets. Maximum likelihood estimates of the the levels of implementation that would be needed to affect
variance components were calculated. Each generalizability change in children’s social skills and problem behavior. Fur-
coefficient used the variance components due to classrooms ther, given that many Pyramid Model practices on the TPOT
as the numerator and the sum of the variance components reflect developmentally appropriate (Copple & Bredekamp,
as the denominator. As noted by Hemmeter et al. (2014, 2009) and recommended practices in early intervention/early
p. 98), “This is a conservative generalizability coefficient childhood special education (Division for Early Childhood,
because it assumes that in routine use of the TPOT, data 2014), the low implementation fidelity data were troubling.
will be collected using a different rater for each classroom, With respect to the utility of the TPOT as a measure
whereas typically raters are the same in all or in subsets of of fidelity of practice implementation in both treatment
classrooms.” Findings from the analyses showed interrater and control conditions, we have evidence that improved
score reliability and agreement were very good to excellent implementation of Pyramid Model practices is associated
for the key practices subscale (≥ 0.89) and ≥ 0.84 for the red with improved child social and behavior outcomes. In our
flags subscale. For each key practices item, interrater coeffi- research, improvements in ratings of children’s behavior
cients generally were good across each of three measurement and social skills were associated with teachers who received
occasions (range for occasion 1 = .51 to .78, range for occa- coaching and training related to the Pyramid Model and
sion 2 = .43 to .78, and range for occasion 3 = .55 to .81). whose growth in implementation of Pyramid Model prac-
tices as measured on the TPOT by blind observers changed
to a statistically significant and noteworthy extent across
Comparability of Baseline TPOT Scores three measurement occasions (Hemmeter et al., 2016, 2017).
Across Studies In these studies, mean implementation fidelity percentages
for teachers in the control groups remained relatively stable
As the evidence presented above demonstrates, TPOT scores across time and their TPOT implementation fidelity scores
remain relatively stable in the absence of a PD intervention were not associated with statistically significant or notewor-
focused on Pyramid Model practices. In a series of three thy changes in children’s behavior and social skills.
studies, we have also found relative comparability across
studies in the average practice implementation percentage Professional Development and the Measurement
scores prior to PD intervention or without intervention (i.e., of Practice Implementation Change
baseline TPOT scores; Hemmeter et al., 2016; Hemmeter,
Snyder, Fox, & Algina, 2017; Snyder, Hemmeter, Fox, The TPOT has been used to guide the organization of a pro-
Bishop, & Miller, 2013). Table 2 shows data from these fessional development intervention that includes workshops,
three studies and the average percentage implementation implementation guides, materials, and practice-based coach-
(and range of percentage implementation) for the 114 indica- ing of classroom teachers in several research studies (Hem-
tors associated with the TPOT key practices items. Average meter, Hardy, Schnitz, Adams, & Kinder, 2015; Hemmeter
percentage implementation at baseline for the three studies et al., 2016) and within states engaged in scaling up imple-
was 39.1, 38.24, and 48.27%, respectively. For red flags, the mentation of the Pyramid Model (e.g., Johnson, 2017, Vinh,
mean number of red flags in the three studies was 3.0, 3.75, Strain, Davidon, & Smith, 2016). Coaching is a professional
and 3.23, respectively. These data show in the absence of development strategy that is used to guide practitioners to

Table 2  Average percentage and Snyder et al. (2013, N = 50) Hemmeter et al. (2016, Hemmeter et al.
range of TPOT key practices N = 40) (2017, N = 92)
items and number and range of
red flags implemented during Key teaching practices 39.1% (14–73%) 38.24% (16–74%) 48.27% (19–86%)
baseline across three studies (v = 114)
Red flags (v = 17) 3.0 (0–11) 3.75 (1–10) 3.23 (0–11)

v = number of indicators (key teaching practices) or items (red flags)

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implement and sustain the use of evidence-based practices the coach and teacher collaboratively identify the practice
as intended (Metz et al., 2013; Snyder, Hemmeter, & Fox, goals that will be listed on the action plan. After defining
2015). An important aspect of effective coaching is the the action plan, the PBC process is used in repeated cycles
explicit identification of the practices that are the focus of of focused observation (i.e., observing the implementation
coaching and the use of repeated cycles of observation and of practices identified on the action plan) and debriefing
feedback on the implementation of the targeted practices. from the observation by guiding reflection and providing
Coaching that uses these and other elements (i.e., explicit set feedback. The coach might continue to use the TPOT infor-
of practices, cyclical process of coaching support, reflection) mally, as a progress monitoring checklist, to identify teacher
has been shown to be effective in several research studies growth in practices and then re-administer the TPOT to for-
related to social–emotional teaching practices (e.g., Art- mally assess teacher growth in practice implementation.
man-Meeker & Hemmeter, 2013; Fox, Hemmeter, Snyder, The use of the TPOT within PBC allows for precision
Binder, & Clarke, 2011), behavior support (Conroy et al., in the delivery of coaching that is targeted and efficiently
2015), and embedded instruction practices (Snyder et al., delivered. Using TPOT data, the coaches are able to target
2017b), and early childhood literacy practices (McCollum, practices needed for growth and identify any red flags that
Hemmeter, & Hsieh, 2013). need to be addressed as a priority. In addition, the TPOT
Using the TPOT as an instrument to support practice provides an assessment of growth in teacher practices as an
implementation was carried out within a defined coaching outcome from coaching efforts.
framework known as practice-based coaching (PBC). PBC We have used the TPOT as a component of PBC delivery
has been described as “a cyclical process for supporting in two randomized trials with notable fidelity of practice
preschool practitioners’ use of effective teaching practices implementation outcomes. Table 3 shows comparative data
that leads to positive outcomes for children” (Snyder et al., across conditions and studies (Hemmeter et al., 2016, 2017)
2015, p. 2). PBC is implemented through a collaborative and suggest TPOT scores are sensitive to detecting change
partnership with the coachee and is focused on a defined set in preschool teachers’ implementation of Pyramid Model
of effective teaching practices. The cyclical process involves practices following a PD intervention.
the development of shared goals and an action plan, the use Both studies focused on teachers’ implementation of the
of focused observation of targeted practices, and the use of Pyramid Model practices and examined associated outcomes
reflection and feedback. for children in the classroom. In the first study, 40 public
When using PBC to support fidelity of implementation of school classroom preschool teachers in Florida and Ten-
Pyramid Model practices, the coach and teacher use TPOT nessee were randomly assigned to two conditions with one
data to assess a teacher’s current level of implementation of group receiving workshop training, implementation guides,
the Pyramid Model practices (i.e., implementation strengths materials, and practice-based coaching and the other group
and needs) and to guide the collaborative development of receiving training only after we had collected Pyramid
an action plan. At the initial meeting, the teacher shares the Model implementation fidelity data over an academic year
priorities for implementation and the coach shares the TPOT (Hemmeter et al., 2016). The teachers in the experimental
results and describes the practices that could be pivotal for condition received workshop training in Pyramid Model
the teacher to focus on for the action plan. After review- practices, implementation guides and classroom materi-
ing the teacher’s preferences and the data from the TPOT, als, and between 7 and 17 sessions of PBC (mean of 13.4

Table 3  Comparison of TPOT mean percentage key practices implementation data for intervention and BAU conditions over the course of a
study across two studies
Study Mean percentage (SD) TPOT key practices implementation
Wave 1 (preintervention) Wave 2 (during intervention) Wave 3 (during intervention) Wave 4 (post-intervention)
I BAU I BAU I BAU I BAU

Hemmeter 37.0 (13.9) 45.6 (14.8) 43.2 (13.3) 41.3 (11.3) 56.3 (18.9) 44.6 (13.4) 69.9 (17.5) 44.2 (14.8)
et al.
(2016,
N = 40)
Hemmeter 47.79 (15.77) 49.37 (14.77) 54.07 (14.67) 47.30 (17.35) 60.62 (17.32) 47.00 (17.63) 59.33 (17.57) 47.84 (17.10)
et al.
(2017,
N = 92)

I = Pyramid Model professional development intervention, BAU = business-as-usual professional development

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210 School Mental Health (2018) 10:202–213

sessions) that were scheduled to occur on a weekly basis. to Pyramid Model practices or the quality of their practice
We had four measurement waves where the TPOT was used delivery.
to assess implementation of the Pyramid Model practices Further, our data indicate that the TPOT may be used as
with the first administration occurring before training and an instrument to provide actionable information about practi-
coaching. The first TPOT measure was used as a covariate tioners’ competence with respect to a defined set of interven-
in the examination of differences between teachers in the tion practices. Data from the TPOT can be used formatively
experimental and control conditions. For each of the three to inform PD, including practice-based coaching (Snyder
subsequent administrations of the TPOT over the academic et al., 2015). Data from the TPOT can be used to identify
year, there were statistically significant and noteworthy dif- strengths and needs related to practice implementation and
ferences between teachers who received PBC following inform the development of individualized goals and action
workshop training and teachers in the control condition. plans used by coaches and those being coached to enhance
Teachers who received PBC implemented more practices or refine practice implementation. TPOT data can also be
with fidelity (Hemmeter et al., 2016). used for summative purposes to characterize the adherence,
The second study was conducted in classrooms in Florida quality, and differentiation of delivery of Pyramid Model
and Tennessee and involved 92 preschool classroom teach- practice implementation for an individual teacher, for a set of
ers within public schools. They were randomly assigned to classrooms, for a program, or for a group of programs or to
receive workshop training, implementation guides, mate- examine changes in levels or trends of implementation over
rials, and practice-based coaching or to receive workshop time following PD that includes practice-based coaching.
training and implementation guides and materials at the end At the program level, the TPOT can be used to examine
of the academic year following data collection. In this study, the implementation of practices across teachers. When the
each of the 45 teachers in the intervention condition received TPOT is used in this manner, data on practice implemen-
16 sessions of PBC. We used the TPOT to examine teaching tation are summarized across teachers to provide average
practices at four points in time over the first year of coaching scores on key practice areas. School or program person-
and have analyzed these data using a single-level multivari- nel can use these data to (a) identify key practice areas to
ate ANCOVA with the first measurement point score (gath- address in professional development activities, (b) provide
ered prior to training and coaching) as the covariate. At each guidance related to curriculum or lesson planning, and (c)
measurement point, we found that teachers who received design other professional development strategies or supports
training and PBC showed significant and noteworthy dif- (e.g., community of practice, book study). For example, a
ferences in practice implementation when compared with program or school might use TPOT scores to determine
teachers in the control conditions with moderate to large which teachers need the most intensive form of support (e.g.,
effect sizes (Hemmeter et al., 2017). individual, intensive delivery of practice-based coaching)
versus teachers who might benefit from less intensive forms
of support (e.g., group coaching).
Discussion In programs or schools that are implementing Multi-
Tiered Systems of Supports, the TPOT provides an essential
The information presented in this article demonstrates the tool for assessing the implementation of universal social,
utility of the TPOT for use as a tool for measuring fidelity emotional, and behavioral teaching practices and teachers’
of practice implementation and changes in teacher practice capacity to implement explicitly designed tier 2 and tier 3
implementation. In addition, the TPOT can be used in pro- interventions for small groups or individual children. Data
fessional development to guide coaches in their work with from the TPOT can be used by the MTSS implementation
teachers. Consistent with tenets of implementation science team to assess current capacity and growth in the imple-
about the importance of the competency drivers for support- mentation of social, emotional, and behavioral teaching
ing implementation of evidence-based practices, our findings practices.
show a professional development intervention that includes States and local regions have also identified the TPOT
workshops/training, implementation guides and materials, as a valuable measure for examining classroom quality. In
and practice-based coaching increased teachers’ implemen- several states and local communities, the TPOT is used as a
tation of social–emotional teaching practices as measured classroom quality measure that contributes to the evaluation
by the TPOT. TPOT scores over the course of the studies of overall quality of a program within a quality rating sys-
demonstrated teachers in the intervention condition made tem. When the TPOT is used in this manner, it provides an
progress toward implementation benchmarks (defined as incentive to early care and education programs to focus on
≥ 60% fidelity of practice implementation). Teachers in the the implementation supports needed to strengthen classroom
BAU condition, on average, did not grow in their adherence implementation of the Pyramid Model.

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School Mental Health (2018) 10:202–213 211

Although the TPOT has been used primarily to meas- Informed Consent Informed consent was obtained from all individual
ure the implementation of Pyramid Model practices in early participants included in the study.
childhood classrooms, it could be used to measure changes Animal Rights This article does not contain any studies with animals
in classroom practices as a result of professional develop- performed by any of the authors.
ment on other sets of social–emotional teaching practices or
as a measure of the implementation of universal social–emo-
tional curricula. As described earlier, the Pyramid Model
reflects high-quality developmentally appropriate practices References
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