Pyramid Model Feedback Survey

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

Pyramid Model feedback survey for Grant Recipients_Sept 2022_9.20.22

Pyramid Model Feedback Survey

OMB: 0970-0401

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OMB #: 0970-0401

Expiration Date: June 30, 2024

Feedback Survey of Pyramid Model Implementation and Impact


Survey Introduction

We are interested to learn about your experience with the Pyramid Model. This survey should take about 10 minutes of your time and will provide important feedback about the trainings, tools, and supports you have received. We hope to understand what has been helpful in implementing the Pyramid Model and what additional or continued supports you may need. Data from this survey will be used internally by the NCHBHS and ACF for planning purposes only; no information will be reported back to programs.

Thank you for your time and valuable feedback,

The Evaluation Team for the National Center for Health, Behavioral Health, and Safety (NCHBHS)

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PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to determine the success of TTA offerings, to improve the responsiveness of TTA offerings to group needs, and to inform continuous quality improvement of future TTA efforts. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0401 and the expiration date is 06/30/2024. If you have any comments on this collection of information, please contact Nancy Topping-Tailby, Project Director, NCHBHS.

National Center on Health, Behavioral Health, and Safety





Program Setting and Role

  1. Which region do you work in?

    1. Region 8 [go to pull down menu in Q2]

    2. Region 9 [go to pull down menu in Q3]

  2. Which program do you work at? (select from pull down menu)

    1. Sweetwater County School District #1 Head Start

    2. Sioux Falls Independent School District Head Start Program

    3. Bear River Head Start

    4. Utah Community Action

    5. Ogden-Weber Community Action Partnership, Inc

    6. Absaroka INC.

    7. Lincoln Unita Child Development Association

    8. Southern Utah University Head Start

    9. Aware Early Head Start

    10. Central Montana Head Start

    11. Carbon County Child development Center

    12. Lake County School District-The Center

    13. Opportunities, INC. Head Start Prenatal to 5

    14. OJC Child Development Services

    15. Mayville State University Child Development Programs

  3. Which program do you work at? (select from pull down menu)

    1. Urban Strategies, LLC

    2. North Coast Opportunities, Inc.

    3. Kidango, Inc.

    4. Los Angeles Education Partnership

    5. Options for Learning

    6. Pacific Clinics

    7. Regents of the University of California, Los Angeles

    8. Sunrise Children's Foundation

    9. Honolulu Community Action Program

    10. Kai Ming, Inc.

    11. Wu Yee Children's Services

    12. E Center

    13. Montebello Unified School District

    14. Baldwin Park Unified School District

    15. Colusa County Office of Education

    16. Community Action Partnership of San Luis Obispo County, Inc.

    17. Hacienda-La Puente Unified School District

    18. Stanislaus County Office Of Education

    19. Community Action Commission Of Santa Barbara County

    20. Volunteers of America of Los Angeles

    21. Madera County Board of Supervisors/CAPMC

  4. Are you the Team Leader (Program Contact) for the Pyramid Leadership Team for your program?

    1. Yes

    2. No

  5. What is your role? (select the option that most closely describes your role)

    1. Administrator/Director

    2. Program Manager (Site Coordinator/Education Manager/Disability Coordinator)

    3. Coach

    4. Mental Health Consultant

    5. Family Service Worker

    6. Frontline Staff, which includes:

  • Home visitors

  • Teachers, aides, and assistants

  • Family child care providers

  • Family engagement staff

  • Bus staff

  • Health and nutrition services staff

  • Facilities staff

    1. Other (please specify): ________________

  1. How long have you been working in a Head Start or other early care and education (ECE) program?

    1. Less than one year

    2. 1-3 years

    3. 4-6 years

    4. 7-10 years

    5. 11 or more years

    6. Not applicable (N/A)

Trainings and Tools

  1. Which of the following Pyramid Model Practices modules and trainings have you found to be most effective? (select all that apply)

    1. Module 1 – Relationships

    2. Module 2 – Targeted Strategies/SE Teaching Strategies

    3. Module 3 – Individualized Intervention

    4. Practice Based Coaching (PBC)

    5. PBC in a Group

    6. Teaching Pyramid Observation Tool (TPOT)

    7. Teaching Pyramid Infant-Toddler Observation Scale (TPITOS)

    8. Prevent, Teach, Reinforce - Young Children (PTR-YC)

    9. Prevent, Teach, Reinforce - for Families (PTR-F)

    10. Behavior Incident Report System (BIRs)

    11. Positive Solutions for Families

    12. Trauma Informed Care and the Pyramid Model

    13. Implicit Bias

    14. Equity

    15. Leadership Launch

    16. E-modules

    17. Training delivered by external coaches

    18. Training delivered by internal coach or other district/program staff

    19. None of the above - Not yet!

    20. Not sure

    21. Other (please specify): ___________

  2. Which of the following tools have you used? (select all that apply)

    1. Classroom Coaching Log or Early Intervention Practitioner Coaching Log

    2. Teaching Pyramid Observation Tool (TPOT)

    3. Teaching Pyramid Infant-Toddler Observation Scale (TPITOS)

    4. Behavior Incident Report System (BIRs)

    5. Prevent, Teach, Reinforce - Young Children (PTR-YC)

    6. Prevent, Teach, Reinforce - for Families (PTR-F)

    7. None of the above – Not yet!

    8. Not sure

    9. Other (please specify): _______________

  3. What helped you determine which tools to use?

Progress with Implementation [Q10 only displayed for Site Leaders]

  1. Thinking back to last Summer/Fall (2021), how would you describe your program’s progress with the following aspects of Pyramid Model implementation?




Lost some ground

No or minimal progress

Moderate progress

Significant progress

Increasing internal coach capacity for supporting teacher implementation of Pyramid Model practices





Increasing fidelity of implementation at the program level as it aligns with the Benchmarks of Quality (BoQ)





Increasing teachers' fidelity of implementation as it aligns with the Teaching Pyramid Observation Tool (TPOT) or The Pyramid Infant Toddler Observation Scale (TPITOS)





Broadening the use of culturally responsive practices to address equity, disproportionality, and implicit bias





Increasing family engagement





Increasing the use of data for program planning and improvement







    1. Please describe the extent of progress for any aspect above, including why some may have progressed more than others:

External Coach Support

  1. To what extent do you believe the Regional Training and Technical Assistance (TTA) team is providing the supports needed for your Leadership Team to implement the Pyramid Model successfully?

    1. The Regional TTA team provides all the support necessary to help the leadership team and staff implement the Pyramid Model successfully.

    2. The Regional TTA provides much of the support that is needed to help implement successfully, but we would like further support in some areas.

    3. The Regional TTA team provides some support, but much more is needed.

    4. The Regional TTA team is providing no or minimal support at this point.

    5. Our program does not need support from the Regional TTA team.

  2. [If b or c] Please describe the additional supports you would like to receive from your Regional TTA team: ___

  3. [If d] Please describe barriers that may be impeding efforts of the Regional TTA team to provide support: ___

  4. [If e] Please select any explanations that address why your program does not need support from the Regional TTA team:

    1. Our program is implementing adequately without the support of the Regional TTA team.

    2. Implementing the Pyramid Model is not a high priority for our program currently.

    3. We do not believe support from the Regional TTA team would be beneficial to our programs.

    4. Other: ___________

Benefits and Sustainability

  1. As a result of implementing Pyramid Model strategies, to what extent have these efforts benefited children and their families?




Not at all

Small extent

Moderate extent

Great extent

Not sure

Children are demonstrating improved social emotional competencies.






Children with IFSPs or IEPs receiving Special Education services are demonstrating improved social emotional competencies.






The rate of sending children to another class or home for the day due to challenging behavior has decreased.






Children are making greater cognitive and academic progress overall.






Relationships between school practitioners and families have been strengthened.






Families have gained skills and strategies for interacting with their children to support social emotional development.








    1. Please describe the extent of progress for any aspect above, including why some may have made more progress than others:



  1. How would you describe your program’s progress toward sustainability across the following elements of implementation?




Not in place

Partially in place

In place: Sustainable with support from external coach

In place: Sustainable without external coach support

Not sure

A Leadership Team that meets regularly






Internal coach(es) supporting teachers (i.e., practice-based coaching, supporting use of Pyramid Model practices toward fidelity)






Using procedures for responding to challenging behaviors in the classroom and with families (Tier 3 strategies)






Building and supporting systems to support staff in Pyramid Model implementation and practices






Using data effectively, including program, classroom, and child-level data






Implementing family engagement strategies








    1. Please describe the extent of progress for any aspect above, including why some may have made more progress than others:



  1. As a result of Pyramid Model training and implementation, to what extent do you feel you have gained competence or confidence in the following areas?




Not at all

Small extent

Moderate extent

Great extent

Supporting children’s social and emotional competencies





Addressing children’s challenging behaviors





Teaching children social emotional skills





Supporting families







    1. Please explain what contributes to any competency or confidence gains above, or what you need to strengthen them:

Next Steps

  1. What does your program need to support continued Pyramid Model implementation efforts? (select all that apply)

    1. Practice-based coaching to assist classroom staff with implementing Pyramid Model practices with fidelity

    2. A professional development and staff support plan (this may include a needs assessment, classroom observation tool, and individualized professional development plan for teachers)

    3. Procedures for responding to challenging behavior

    4. Skills in data use and reporting for monitoring implementation and outcomes

    5. Training for new Leadership Team members

    6. Training for new staff in Pyramid Model

    7. Additional trainings in specific areas

      1. Please specify: ___________

    8. Staff buy-in

    9. Family engagement/involvement

    10. Other: ________________

  2. In your own words, what supports are needed at the program and classroom levels to continue to sustain and scale implementation of Pyramid Model with fidelity?

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