Addressing Children’s Behavioral Health Needs
Extensive research supports that social, emotional, and behavioral competencies are necessary for effective life functioning and that these skills can be taught. It is also true that many students have, or are at risk for developing, significant social, behavioral, and/or emotional problems, to which many teachers and schools struggle to effectively respond and intervene (Reinke et al., 2011). The gap between students’ behavioral health needs and schools’ ability to effectively respond is concerning because students in the early grades who already demonstrate poor social and behavioral functioning are at significant risk for continued behavioral challenges, low academic achievement, school dropout, and compromised economic outcomes (Bradshaw et al., 2008), resulting in significant costs to these individuals and society at large (Walker, 2007). Unfortunately, this pattern is particularly evident for students of color from impoverished neighborhoods and/or low-income households, because these students are at the greatest risk of experiencing social-emotional and academic challenges that negatively affect their long-term development (Guyer et al., 2009). Compounding this issue, economically disadvantaged and ethnic minority children are also the least likely to receive needed preventative and early intervention behavioral and social-emotional programming (O’Connell, 2009). In the absence of intervention programming, low-income and minority children are often left to receive substandard behavioral health services through the juvenile justice or welfare systems (Alegria et al., 2000).
To address these gaps in services, there has been an increased focus on developing and implementing universal intervention programs that promote positive behavioral and social-emotional development for at-risk children, especially in under-resourced schools located in low-income neighborhoods (Daly et al., 2013). Delivering and evaluating these programs in schools situated within impoverished neighborhoods is especially critical given that socioeconomic status (SES) is a key factor in the behavioral and social outcomes of school-age children (Spencer et al., 2002). Some of the primary advantages of providing universal school-based prevention and intervention programming include increased accessibility to disadvantaged and vulnerable populations, improved teacher engagement in fostering the mental health of children, and enhanced opportunities for broad mental health promotion (see Weist et al., 2003).
Challenges Associated With Teaching in Urban Schools
Although much is known about successful classroom management strategies, many teachers report receiving inadequate training or support for learning effective methods for helping students with social, emotional, and behavioral problems in the classroom (Reinke et al., 2011). This gap in teacher training is particularly concerning because teachers report that 16% to 30% of students in their classrooms pose ongoing problems in terms of social, emotional, and behavioral difficulties (Raver & Knitze, 2002). When teachers spend a significant amount of time ineffectively dealing with challenging classroom behaviors, their ability to deliver quality academic instruction is compromised. For example, a survey of more than 800 members of the American Federation of Teachers Union revealed that 21% of teachers in urban areas said they lost four or more hours per week of instruction time due to disruptive student behavior (Walker et al., 2003). Teachers with poor classroom management skills tend to have higher levels of student aggression and peer rejection in their classrooms, which in turn may impede the development of appropriate self-regulatory and behavioral skills in students (Webster-Stratton & Reid, 2003). One important consequence is that many teachers, especially those working in urban schools, leave the profession due to challenges in managing student behavior and social and emotional skill deficits (Hinkel, 2009). Under-performing schools in high-poverty areas have the highest rates of teacher turnover and attrition (Simon & Johnson, 2013), and this educational instability contributes to poorer student performance (Terry & Kritsonis, 2008). African-American children are more than twice as likely as students from other racial and ethnic groups to encounter ineffective teachers, highlighting a notable challenge in educational equity faced by urban public schools (Darling-Hammond et al., 1999). High teacher turnover in urban schools can be reduced when teachers are provided with resources and training to manage student behavior, the area they find most challenging to address. Partnering with teachers in the delivery of universal interventions to enhance behavioral and social skills and competencies of youth can result in wide-ranging positive effects, including fewer disciplinary and special education referrals, increased student academic achievement, and an enhanced school climate of respect (Polirstok & Gottlieb, 2006).
Agents of Implementation
Early models of behavioral and social skills curricula for prevention and intervention programs for elementary school students were primarily designed to be delivered by clinical or specialist staff. This was considered a necessary element because of research findings supporting that intervention leaders’ qualifications significantly affected the impact of the intervention (Scheckner et al., 2002). However, Shucksmith and colleagues (2007) suggested that the use of specialist staff was both unsustainable in the short term and also not necessary for large-scale and universal interventions. The challenge of sustainability prompted more recent versions of universal behavioral and social skills programs to rely exclusively on teachers as interventionists. However, the evidence is mixed when comparing effectiveness of teachers relative to specialist staff in delivering behavioral and social skills interventions. For instance, findings from three reviews suggested that teachers are less effective than specialist staff when delivering interventions (Beelmann & Lösel, 2006; Wilson et al., 2003; Wilson & Lipsey, 2006a), but results from three other reviews indicated that teachers can be just as effective as specialists (Adi et al., 2007; Diekstra, 2008; Wilson & Lipsey, 2006b). There are additional concerns that teacher-implemented intervention programs in urban schools face significant challenges, including lack of time for training and problems with sustainability. For example, schools with limited resources and high turnover of teachers and school personnel may not be able to adequately train staff to deliver interventions with fidelity. In addition, many evidence-based programs require training from certified trainers, which may be cost-prohibitive for schools with limited financial resources, thus affecting long-term sustainability.
University-school partnerships represent a model that potentially addresses training concerns and sustainability challenges by combining specialist staff with teachers as dual interventionists. These partnerships use a program-delivery system in which students and faculty from universities partner with teachers and school staff to implement programs that focus on preventing problem behaviors and promoting prosocial behaviors (Blank et al., 2012; Freeman, 2011). Collaborative endeavors such as these are important because teachers working in urban schools and students from institutions of higher education receive practical training opportunities in delivering evidence-based programs to at-risk populations and low-income children attending schools with limited resources receive effective behavioral and mental health care services at no cost. The sections below briefly describe the process of adapting and modifying several evidence-based programs into a single curriculum that was co-delivered by classroom teachers and psychology students from several universities in proximity to the schools.
The Incredible Years Series: Classroom Dinosaur Curriculum (Classroom Dina) and Small Group Dinosaur Program Curriculum
Classroom Dina is a curriculum implemented by teachers as a prevention program for an entire classroom of students that can be used with students’ aged three to eight years (Webster-Stratton & Reid, 2003). Delivery of the curriculum occurs two to three times a week for 20 to 30 minutes during circle time lessons. Following the lessons, students participate in small group activities and teachers encourage students to use their skills throughout the school day. Lesson plans focus on topics such as doing your best in school, understanding and detecting feelings, problem solving, anger management, being friendly, and talking with friends.
The Small Group Dinosaur Program (Webster-Stratton & Reid, 2003) was designed to be delivered by specialists such as counselors, therapists, or special education teachers and utilizes a curriculum primarily focused on treatment. Students in these groups are usually screened in because they have challenges with conduct problems, attention deficit hyperactivity disorder, and/or internalizing problems. This program is implemented in two-hour weekly small group sessions for 18 to 22 weeks. Each lesson uses a variety of activities, including role plays, games, group discussions, and video vignettes to teach children about main program themes that include communicating feelings, having empathy for others, solving problems, being a good friend, and effectively managing anger (Webster-Stratton & Herman, 2010). The curriculum also emphasizes the development of academic skills, such as following classroom rules and listening to the teacher, which are honed through a reward system (Webster-Stratton, 2004).
Studies examining the efficacy of the Classroom Dina program have revealed positive impacts on child behavior, social competence, and classroom management. For example, children who receive the intervention demonstrated increased interest and enthusiasm for school (Baker-Henningham et al., 2009) and enhanced problem-solving and conflict management skills (Webster-Stratton et al., 2004). Positive outcomes associated with participation in Classroom Dina have been demonstrated in diverse populations, including children who are socioeconomically at risk and/or display early-onset conduct problems (Webster-Stratton & Reid, 2003), and Hispanic children (Barrera et al., 2002).
Findings from multiple randomized controlled trials of the Small Group Dinosaur Program reveal that children who participated in the program demonstrated more positive interactions with peers, improved problem-solving and friendship skills, and reductions in conduct problems (Drugli & Larsson, 2006; Webster-Stratton et al., 2008; 2011). For example, students who participated in the Small Group Dinosaur Program demonstrated significant reductions in the frequency and severity of problem behaviors and higher levels of social competence relative to control groups (Webster-Stratton et al., 2004) as indicated by independent observer and teacher ratings. This program also has demonstrated positive effects with diverse preschoolers from low-income homes (Brotman et al., 2003).
Description of the PHDEP Program and Study Objectives
The Promoting Healthy Development through Effective Practices (PHDEP) program was designed with the intent of using dual interventionists (teachers and psychology students). We primarily used the content from the Classroom Dinosaur Curriculum (Classroom Dina), which is intended to be delivered by teachers, but we also incorporated and adapted some activities from the Small Group Dinosaur Program Curriculum, which is typically delivered by specialists. Because our lesson plans were delivered in units spaced across two weeks, we used activities from the Small Group Dinosaur Program to supplement Classroom Dina activities that were used in the first week of each lesson plan.
The PHDEP program is unique in its emphasis on interdisciplinary collaboration, pairing psychology students with teachers to deliver and reinforce the prevention program, and adding consultants who help participating children and teachers generalize the skills learned through the program. The PHDEP program involved a total of 18 sessions and was administered one hour per week in each designated classroom. There are several notable differences between PHDEP and the Dinosaur programs. First, in the PHDEP program, we included three review weeks (weeks 5, 10, and 15) so that the students could continue to practice the skills learned in the lessons (see Table 1 for program content). We also added in some lesson plans that were requested by the teachers (i.e., conflict resolution, bullying prevention). Because the two schools in which the program was implemented would allot only one hour per week of nonacademic programming, we were limited to weekly sessions of 60 minutes duration. In terms of training, all group leaders (teachers and psychology students) received an initial three-hour training on the curriculum. Teacher participation was included in every aspect of the curriculum such as didactic teaching, role plays, small group activities, and larger group activities. We hypothesized that:
Table 1.
Overview of Curriculum
| Week | Topic |
|---|---|
| 1 | Introduction to school rules |
| 2 | Learning/following school rules |
| 3 | Detecting and understanding your feelings |
| 4 | Detecting and understanding others’ feelings |
| 5 | Review |
| 6 | Relaxation and emotion regulation I |
| 7 | Relaxation and emotion regulation II |
| 8 | Problem solving I |
| 9 | Problem solving II |
| 10 | Review |
| 11 | Positive play and friendship skills I |
| 12 | Positive play and friendship skills II |
| 13 | Conflict resolution I |
| 14 | Conflict resolution II |
| 15 | Review |
| 16 | Bullying Prevention I |
| 17 | Bullying Prevention II |
| 18 | Final review and graduation party |
Students who participated in the PHDEP intervention in their classrooms for 18 weeks would exhibit significantly better skills at post-test in two domains: behavioral self-regulation and social competence;
The majority of students participating in the intervention would demonstrate positive change scores at post-intervention; and that
Teachers who participated in PHDEP would report high levels of acceptability and satisfaction with the program.
Study Method and Sample
Participants in this study included 151 students (57% male, 43% female) from two public elementary schools in a large urban city in the Northeast. These schools were selected based on location in disadvantaged neighborhoods and characteristics of students in the schools. More specifically, both of the schools are located in neighborhoods primarily composed of minority, low-income children and families. For example, in School 1, approximately 65% of residents belong to a minority ethnic group, the median household income is $23,509, and nearly 40% of families live below the poverty line (U.S. Census, 2013). In School 2, approximately 65% of residents belong to a minority ethnic group, the median household income is $19,236, and nearly 53% of families live below the poverty line (U.S. Census, 2013). In terms of student characteristics, approximately 95% of children across both schools are from economically disadvantaged families, and the vast majority of students are African American.
The schools were recruited by contacting and then meeting with the principals at the respective schools. Both principals were enthusiastic about the program. The only condition requested by the principals was that the intervention be delivered to all classrooms in the different grade levels. Six classrooms and their respective teachers participated in the intervention program. The breakdown of classroom grades was two kindergarten classrooms (N = 42), two first-grade classrooms (N = 62), and two second-grade classrooms (N = 47). We secured university institutional review board approval, and both schools agreed to a waiver of active consent procedure (passive). No parents from either school requested that their child not participate in the program.
Study Procedures
The intervention lasted for 18 weeks from October 2015 through March 2016. The lessons were held on a weekly basis, except for school holidays. Graduate- and undergraduate-level psychology students from two large urban universities partnered with teachers to serve as group co-leaders for implementing this preventative intervention program. Four group leaders (one teacher and three students) and one consultant were assigned to each classroom. The consultant worked directly with teachers to ensure consistency in using positive behavior management strategies throughout the school day. The consultant also worked with the group leaders to problem solve any challenging behaviors exhibited by students. Formal supervision was provided weekly and off-site by a licensed psychologist. The supervision meetings focused on helping group leaders achieve a balance between treatment fidelity and flexibility to address the unique challenges and needs of students in the respective classrooms.
The intervention utilized a structured reward system. Group leaders were instructed to use labeled praise and stamps to reinforce students’ positive behaviors. This method helped build consistent skills and social norms across the classroom. At the beginning of each lesson group, leaders set a “magic stamp number” to encourage students to achieve the specified number of points so they could receive a reward. Students who earned the target number of stamps were awarded with prizes that were provided by the group leaders. The number of target stamps increased each week and/or became more difficult to earn as students progressed through the intervention. Review weeks were also built into the curriculum to allow students to rehearse and practice topics they had learned. Throughout the intervention, teachers were included in delivering the lessons by being given specific assignments, such as using labeled praise to promote a target behavior, and setting clear classroom rules and routines.
Study Measures
Outcome data included teacher ratings of students’ social, emotional, and behavioral functioning before and after completion of the program. We also assessed teacher satisfaction with the PHDEP program. Pre-test data were collected in early October of the academic year. October was selected (rather than August or September) to give teachers more time to get to know their students in order to more accurately rate their social, emotional, and behavioral competencies and needs. Post-intervention data were collected in April 2016.
Abbreviated Social Skills Rating Scale
The Abbreviated Social Skills Rating System-Teacher (ASSRS) is a shorter version of the Social Skills Rating System-Teacher (Gresham & Elliott, 1990). We chose the abbreviated version to reduce teacher burden in completing the assessment measures. The ASSRS contains 11 items and is completed by teachers to assess social skills and competing problem behaviors of students in the school setting. Domains of social skills on this measure include Cooperation (e.g., “volunteers to help peers”), Assertion (e.g., “accepts peers ideas”), Responsibility (e.g., “follows your directions”), and Self-control (e.g., “responds appropriately when he/she is hit or pushed by a peer”). The items on the scale are answered on a 3-point scale: Never/Rarely, Sometimes, Often/Always. Higher scores on this scale indicate more adaptive behaviors. Although reliability data are not available for the abbreviated version, the SSRS has demonstrated adequate internal consistency for reliability for the Total Social Skills (α = 0.93) and Total Problem Behaviors (α = 0.88) scales. Cronbach’s alpha reliability for our sample was excellent (α = 0.93).
Social Competence (Teacher Rating) Scale
At baseline and post-intervention, teachers individually rated students using a shorter version of the Teacher Social Competence (TSC) scale (Conduct Problems Prevention Research Group, 1995). The TSC used in the current study is a 12-item measure assessing several different dimensions of social behavior including prosocial behavior and emotional regulation. Each item asks teachers to rate behaviors on a 6-point scale ranging from 1 (Almost Never) to 6 (Almost Always). Higher scores indicate more prosocial behaviors and higher levels of emotional regulation. Although reliability data are not available for the abbreviated version, the TSC has demonstrated adequate internal consistency for reliability for Prosocial Behavior (α = 0.93), Emotion Regulations (α = 0.88), and the combined score from these scales (α = 0.95) (Gifford-Smith, 2000). Cronbach’s alpha reliability for our sample was adequate (α = 0.67).
ASSRS and TSC Behavior Change Scores
Teachers rated each student’s behavior change between pre- and post-intervention on the ASSRS and TSC. Each item on these scales allowed the teacher to rate improvement in social competence and behavior over the course of the 18-week intervention on a 7-point scale (ranging from “much worse” to “much improved”). The TSC change scale has demonstrated adequate internal consistency for reliability for Prosocial Behavior (α = 0.88), Emotion Regulations (α = 0.90), and the combined score from these scales (α = 0.93) (Gifford-Smith, 2000). No psychometric data exist for the ASSRS change scores. In our sample, Cronbach’s alpha reliability for the ASSRS change scale was excellent at 0.98, as was the TSC change scale at 0.99.
Behavior Intervention Rating Scale
Post-intervention, teachers rated their acceptability and satisfaction with the PHDEP intervention on the Behavior Intervention Rating Scale (BIRS; Von Brock & Elliott, 1987). This instrument assesses teachers’ perceptions of treatment acceptability and perceived effectiveness of classroom intervention. The BIRS comprises 18 items, which are rated on a 6-point Likert scale from 1 (Strongly Disagree) to 6 (Strongly Agree). In a study assessing the reliability and construct validity of the BIRS, Von Brock and Elliott (1987) reported α coefficient of 0.97 for the total score. Cronbach’s alpha reliability for our sample was excellent (α = 0.91).
Study Analyses and Results
In order to address our research questions, we ran paired sample t-tests with pre-and post-intervention total scores from the ASSRS and TSC. We examined descriptive statistics for the post-intervention change scores on the ASSRS and TSC, as well as for the BIRS, which is a measure of teacher acceptability and satisfaction with the intervention.
Results suggest that students’ prosocial behaviors and social competence skills improved over time, as demonstrated by teachers’ responses on the ASSRS and TSC rating scales. A paired-samples t-test was conducted to compare scores on both the ASSRS and the TSC measures. There was a significant difference between the baseline (M = 13.07, SD = 6.37) and post-intervention scores (M = 15.38, SD = 4.31) on the ASSRS; t(83) = −3.38, p = 0.001. There was also a significant difference on the TSC rating scale between baseline (M = 31.65, SD = 14.65) and post-intervention scores (M = 38.72, SD = 14.16); t(73) = −3.14, p = 0.002.
When reviewing descriptive statistics for teachers’ endorsement of change for all items on the ASSRS, the mean scores trended toward the response item of “a little improved.” These data are detailed in Table 2. Notably, on the ASSRS, teachers endorsed that 25% of the students were “much improved” on the item that asked about “overall behavior.” Teachers responded similarly on the TSC, the mean score ranging between “a little improved” to “somewhat improved.” These data are shown in Table 3.
Table 2.
Abbreviated Social Skills Rating System (ASSRS) Change Scores (N = 95)
| Itema | Min | Max | M | SD |
|---|---|---|---|---|
| Responds appropriately when hit or pushed by a peer | 0 | 6 | 3.81 | 1.58 |
| Follows your directions | 0 | 6 | 3.98 | 1.58 |
| Ignores peer distractions | 0 | 6 | 3.69 | 1.59 |
| Cooperates with peers | 0 | 6 | 3.92 | 1.52 |
| Gives compliments to peers | 0 | 6 | 3.91 | 1.41 |
| Joins ongoing activity or group | 0 | 6 | 3.88 | 1.49 |
| Volunteers to help peers | 0 | 6 | 3.96 | 1.42 |
| Accepts peers’ ideas | 0 | 6 | 3.92 | 1.42 |
| Disturbs ongoing activities | 0 | 6 | 3.82 | 1.50 |
| Is easily distracted | 0 | 6 | 3.67 | 1.48 |
| Argues with others | 0 | 6 | 3.77 | 1.57 |
All items were rated on a 6-point scale (0 = much worse; 1 = somewhat worse; 2 = a little worse; 3 = no change; 4 = a little improved; 5 = somewhat improved; 6 = much improved).
Table 3.
Teacher Rating of Social Competence (TSC) Change Scores (N = 101)
| Itema | Min | Max | M | SD |
|---|---|---|---|---|
| Show empathy and compassion for others’ feelings | 0 | 6 | 4.37 | 1.38 |
| Provide help, share materials, and act cooperatively with others | 1 | 6 | 4.41 | 1.35 |
| Take turns, play fair, and follow the rules | 0 | 6 | 4.39 | 1.36 |
| Listen carefully to others | 0 | 6 | 4.30 | 1.38 |
| Initiate interactions and join in with others in an appropriate and positive manner | 0 | 6 | 4.45 | 1.36 |
| Stop and calm down when excited or upset | 0 | 6 | 4.22 | 1.40 |
| Recognize and label his/her feelings and those of others appropriately | 0 | 6 | 4.29 | 1.37 |
| Handle disagreements in a positive manner | 0 | 6 | 4.24 | 1.42 |
| Get angry when provoked by other children | 0 | 6 | 4.14 | 1.44 |
| Easily get irritated when he/she has trouble with some task (e.g., reading, math, etc.) | 1 | 6 | 4.21 | 1.31 |
| Show verbal or physical aggression to other persons | 0 | 6 | 4.10 | 1.52 |
| Obey classroom rules and teachers’ directions | 0 | 6 | 4.25 | 1.48 |
All items were rated on a 6-point scale (0 = much worse; 1 = somewhat worse; 2 = a little worse; 3 = no change; 4 = a little improved; 5 = somewhat improved; 6 = much improved).
At post-intervention, teachers rated items on the BIRS intended to reflect their opinions about the acceptability and perceived effectiveness of the PHDEP and their satisfaction with it. Teacher satisfaction with the PHDEP was high. Findings reveal that the mean score for most items ranged from slightly agree to strongly agree that the PHDEP intervention was acceptable, feasible, and effective (see Table 4). Additionally, all teachers agreed or strongly agreed that they would suggest the use of the PHDEP to other teachers and that they would be willing to use the intervention again in their own classroom (all of these ratings are one of the two most favorable options on a 6-point scale).
Table 4.
Behavior Rating Intervention Scale (BIRS) Scores (N = 6)
| Itema | Min | Max | M | SD |
|---|---|---|---|---|
| Was an acceptable intervention for behavior problems in the classroom setting | 3 | 6 | 5.00 | 1.10 |
| Was an acceptable intervention for social skills/competence problems in the classroom setting | 4 | 6 | 5.33 | 0.82 |
| Was effective in reducing behavior problems in the classroom setting | 2 | 6 | 4.50 | 1.64 |
| Was effective in promoting social skills/competence in the classroom setting | 3 | 6 | 5.00 | 1.27 |
| Was appropriate for a variety of children | 5 | 6 | 5.33 | 0.52 |
| Quickly improved students’ behavior | 1 | 6 | 4.17 | 1.72 |
| Quickly improved students’ social skills/competence | 2 | 6 | 4.67 | 1.51 |
| Produced a lasting improvement in students’ behavior | 2 | 6 | 4.33 | 1.51 |
| Produced a lasting improvement in students’ social skills/competence | 2 | 6 | 4.33 | 1.51 |
| Improved behavior to the point that students who had behavior problems now do not noticeably deviate from their other classmates’ behavior | 1 | 6 | 4.00 | 1.79 |
| Not only improved students’ behavior in my classroom but also in other settings (e.g., other classrooms, home) | 1 | 5 | 3.50 | 1.52 |
| Produced enough improvement in students’ behavior such that this is no longer a problem in my classroom | 1 | 6 | 4.00 | 1.79 |
| I would suggest the use of Dino School to other teachers | 5 | 6 | 5.50 | 0.55 |
| Most teachers would find Dino School suitable for behavior problems in the classroom setting | 5 | 6 | 5.33 | 0.52 |
| I would be willing to use Dino School in the classroom setting in the future | 5 | 6 | 5.50 | 0.55 |
| I like the procedure and strategies used in Dino School | 5 | 6 | 5.50 | 0.55 |
| Other behaviors related to students’ problem behaviors were also improved by Dino School | 3 | 6 | 4.50 | 1.23 |
| Overall, Dino School was beneficial for my students | 2 | 6 | 4.67 | 1.51 |
All items were rated on a 6-point scale (1 = strongly disagree; 2 = disagree; 3 = slightly disagree; 4 = slightly agree; 5 = agree; 6 = strongly agree).
Discussion
There is a compelling need for effective prevention and early intervention efforts that support the development of social and emotional skills in at-risk children, thereby reducing the likelihood of long-term behavioral and academic problems. The PHDEP program specifically targeted students in kindergarten through second grade, because problems with behavioral and social functioning often begin in these early years. Moreover, children who live in poverty are more likely to have social and behavioral problems during the first two years of elementary school (Macmillan et al., 2004), including early and persistent peer rejection, mostly punitive contacts with teachers, and school failure (Center for Evidence-Based Practice, 2003). Conversely, children who are emotionally well-adjusted have greater likelihood of early school success (Raver, 2002). Therefore, the first and second grades are an ideal time to intervene by teaching effective strategies for promoting adaptive emotional, behavioral, and social skills. Results from this study are encouraging in that we found significant pre- to post-intervention improvements in prosocial behaviors and social competence per teacher report. Moreover, the mean for change scores on the ASSRS TSC obtained at post-intervention suggested improvement in behavior and social skills. Overall, our pattern of results are consistent with the extant literature on the benefits of early prevention and intervention programs for youth, but they extend the literature by providing support for the use of a dual-interventionist model in urban elementary schools with youth of color.
Another notable finding from the current study is that teacher acceptability and satisfaction with the PHDEP was high. Pairing graduate students with teachers as co-leaders has bi-directional benefit whereby psychology students learn how to intervene with a whole classroom and teachers learn specific behavior management strategies for their students. Having professionals across disciplines working together helps to create a full continuum of top-quality care including prevention, mental health promotion, and early intervention services that has the potential to prevent more severe behavioral problems during later childhood and adolescence.
Finally, the use of consultants can serve a crucial role because they can help group leaders promote the generalization of skills beyond the classroom.
Study Limitations
Several limitations of the current study should be noted. Most notably, because teachers who participated as group leaders in the intervention also completed the rating scales, we cannot rule out the possibility of positive bias when completing the outcome measures. Future studies can partially address this limitation by using trained independent observers to rate students’ behavior and prosocial behavior during class time.
In addition, some of the measures used in this study were abbreviated versions of longer psychometrically sound scales. The decision to use scales with fewer items was deliberate in an effort to reduce burden on teachers. However, a limitation of using the abbreviated scales in this study is that they lack estimates of internal reliability.
Another limitation is the lack of a control or comparison group for this study. One condition of being allowed to deliver this intervention in the respective schools was that all classrooms in a certain grade would receive the intervention. Therefore, it is possible that changes in student behavioral and social-emotional outcomes were due to other factors such as time, historical events in the schools, maturation, and/or nonspecific treatment effects rather than the PHDEP program. A randomized controlled trial testing the efficacy of the PHDEP against common school practices or other intervention approaches will be an important next step to evaluate this intervention.
Finally, this study did not examine any academic achievement or performance outcomes, a metric that is important for educators, parents, and students.
Practice, Research, and Policy Implications
Although the primary responsibility of schools and teachers is the education of students, schools also have essential roles to play in promoting children’s positive behaviors and prosocial skills. When teachers and specialist staff such as psychology graduate students work together as partners, they create important opportunities for children to develop the necessary behavioral and social competencies that promote optimal short-term and long-term developmental outcomes. There is an ongoing study funded by the Institute of Education Sciences (IES) (PI: M.K. Rosanbalm) that is evaluating the combined effects of the Dinosaur Classroom Prevention Program and the Teachers Classroom Management Program. However, in contrast to the current study, teachers are trained as the sole interventionists. In addition, the IES study is using full versions of the curriculum and professional development program. Our program adapted and reduced material. To the best of our knowledge, our study is the first to use a dual interventionist approach that adapted and combined material from the Classroom Dina and Small Group Dinosaur Program Curriculums.
In relation to practice, findings from the current study extend support for collaborating with teachers to deliver universal social-emotional programming for elementary school students of color attending school in an urban environment. The PHDEP program was associated with improvements in prosocial behaviors and social competence skills per teacher report. In addition, ratings for acceptability and satisfaction with the program were very high. Taken together, these results suggest that the use of a dual-interventionist model is acceptable and can produce positive effects.
Future research efforts should focus on designing studies that examine whether partnering with teachers as dual interventionists results in a positive impact on intervention outcomes. Much of the prior research that has looked at agents of implementation has focused on specialist staff or teachers as separate interventions and has not investigated the independent effects of combining them as group co-leaders.
Future studies are also needed to better understand the facilitators to and barriers against partnering with teachers for implementing universal programs designed to promote positive social behavioral skills.
From a policy perspective, our results found that the majority of teachers indicated that they would be willing to use this program in the classroom setting in the future. As is true with all university-school partnerships, coordination and support is needed for these types of programs at the school and district levels. One avenue of advocacy is to affirm how these types of programs are aligned with the Every Student Succeeds Act (ESSA) because they deliver social-emotional programming for struggling students and schools. ESSA is landmark legislation that governs the country’s K-12 education policy and replaces the No Child Left Behind Act. One of the main provisions in ESSA is a focus on implementation and evaluation of efforts to improve student academic and social and emotional behavioral functioning. Within this context, effective early intervention programs for young students, as explored in the current study, will be of critical importance (Darling-Hammond et al., 2016).
Contributor Information
Mina Ratkalkar, Doctoral student at Drexel University
Ke Ding, Master’s student at Drexel University
Margaret H. Clark, Clinical trial coordinator at Drexel University
Melissa Morrison, Doctoral student at Temple University
Janette Thames, BHRS clinical manager at Northern Children’s Services
Lila Elmished, Recent graduate of Drexel University
Brigid Garvin, School psychologist at Drexel University.
Jean Boyer, Clinical teaching faculty member at Temple University
Brian P. Daly, Associate professor at Drexel University
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