Effects of a School-Wide SACD Intervention on Children with Disruptive Behavior Problems
William E. Pelham, Jr., Greta M. Massetti,
& Daniel A. Waschbusch
University at Buffalo, SUNY
Presentation at the 2005 SRCD Conference, Atlanta
Background: Violence and Aggression
NCLB legislates use of evidence-based programs in violence prevention and character education
Little scientific evidence on effective practices for 1. Building character and social competence,
and
2. Reducing violence, disruptive behavior, and aggression
Disruptive Behavior Problems
Most common referral for Mental Health services
Referrals to Special Education Burden on resources Area of concern for classroom
teachers Impairment for classroom settings
(disruption, aggression, interferes with learning)
Disruptive Behavior: Domains of Interest
Behavioral domains Aggression Bullying Noncompliance/defiance Classroom disruption
Psychiatric diagnoses ADHD ODD CD/Conduct problems/Delinquency
Rates of Behavior Problems in School
Settings
Behavior problems/disruptive behaviors: higher prevalence
Varies by school district Lower rates for psychiatric
diagnoses
Prevalence of Disruptive Behavior
Disorders Prevalence: 3-5% for APA Most epidemiological studies report
higher rates (6-16%) Teacher survey: nationally
representative sample (Fabiano et al., 2004)
6% identified as ADHD in elementary school setting
Additional 6% teachers rated as not identified Lower rates for middle school
Refractory Nature of Disruptive Behavior
Strongest predictors of poor outcomes in adolescence: Behavior problems Poor academic achievement
2/3 of children with disruptive behavior have moderate to poor outcomes
Social Competence
Ecological and social validity Stability of problems with DB and
antisocial, aggressive behavior Social competence as protective
factor Correlates of problems with social
competence Negative outcomes of
adolescence/adulthood
Social Skills Interventions for Children with DB
Problems Data on positive short-term effects Problems:
Long-term effectiveness Generalizability Magnitude of effects
At-risk and identified children Interventions must be
comprehensive and target multiple areas of functioning
Key Principles of Intervention for Disruptive
Behavior Disruptive/aggressive behaviors are
chronic conditions Focus on functional impairment,
deficient adaptive skills Focus on teaching skills to parents,
teachers, and children Parenting skills Classroom management Behavioral control, social competencies,
academic skills
Key Principles
Requires systems redesign (linking families, schools)
Palatability and feasibility of interventions for families, teachers
Early intervention is key Interventions need to be evidence-
based
Levels of Intervention in Comprehensive Programs
Universal Targeted/At risk Indicated/Identified
Rarely combined in programs Must be effective for both average
child and higher-risk children
Universal Prevention Programs
Comprehensive coverage of population
Consistency of implementation Teaches skills to non-problem
children Target populations at risk
BUT Often limited effects with highest-
risk and identified children
The ABC Program
School-Wide program with multiple components
Additional intervention for identified children
Standard framework adapted at each school Training for all teachers on classroom
management Behavioral consultants assigned to schools
to facilitate implementation and coordinate behavioral consultation
ABC Program Components: Universal Components
School-wide behavior managementClassroom managementSchool-wide rulesConsequences for rule following/violations: Daily
Positive Notes, Fun Friday, Honor Roll, Time OutHomework components
School-wide teacher-led social skills training
School-wide peer tutoring for academic skills
ABC Program Components: Targeted
Components Individual consultation services Individualized programming After-school program Parent workshops
Methodology
12 Schools: 8 Buffalo Public Schools (PK-8) 2 Charter schools (PK-9) 2 Suburban schools (K-5)
Urban, high-risk populations Matched and randomly assigned
Data Collection
Two cohorts:1st graders in year 1 (Younger cohort)3rd graders in year 1 (Older cohort)
Fall and Spring assessments for both cohorts
Classroom observations: 3 per year per classroom
Teacher, parent, and school measures
Hypotheses and Research Question
#1
Evaluate rates of behavior problems, and effect of
intervention on identified behavior problems (e.g., ADHD,
ODD)
Measures for Question #1
Child psychopathology Evaluate effects of intervention on
development, course of psychopathology Disruptive Behavior Disorder Rating Scale (Pelham et al.,
1992)
DB Problems as mediatorsEvaluate role of DB Problems (e.g., ADHD)
in mediating outcomesEvaluate trajectories for highest risk
children compared to non-problem children
Hypotheses and Research Question
#2
Evaluate the effects of the ABC Program: Children with
Disruptive Behavior Problems
Measures for Question #2: Child-level Effects
Impairment/adaptive skills Evaluate effects of intervention for
children with impaired daily life functioning
Impairment Rating Scale (Fabiano et al., 1999)
Peer functioning Peer acceptance/rejection for children
with disruptive behavior Dishion Social Acceptance Scale (Dishion, 1990)
Measures for Question #2: Child-level Effects
Home functioning Evaluate the burden of care placed
on parents of children with disruptive behavior problems
Caregiver Strain Questionnaire (Brannan, Heflinger, & Bickman, 1992)
Measures for Question #2: School-level Effects
Discipline and behavior problems Evaluate influence of individual-level
effects on school-level indicators School-level indicators: office referrals,
suspensions, ISST referrals, truancy, rule violations (observations)
Achievement Evaluate academic progress of
children with Disruptive Behavior Problems
Hypotheses and Research Question
#3
Examine cohort effects: Younger cohort (G1-3) and Older cohort
(G3-5), multiple years of intervention
Procedure for Question #3
Developmental influences Comparison of Younger & Older cohorts on yearly
outcome measures Evaluate effects of ABC Program on
prevention of DB Problems in younger cohort
Effects of multi-year intervention Comparison of Younger cohort in grade 3 to Older
cohort in grade 3 Evaluate impact of ABC Program on
trajectories and functioning for at-risk children
Hypotheses and Research Question
#4
Evaluate effects of intervention on use of mental health services and
psychoactive medication
Measures for Question #4
Special education Evaluate influence of intervention on
referrals to special education services
Mental health services & psychoactive medication Evaluate influence of intervention on
use of medication, MH service usage
Hypotheses and Research Question
#5
Evaluate potential mediators and moderators to effects of
intervention
Measures for Question #5
Child functioning Aggression/bullying, impairment,
psychopathology School climate
Neighborhood/community factors Risk factors, crime, delinquency
Program fidelity Classroom observations, ratings
Progress, Problems, and Prospects
Challenges School selection/recruitment Fidelity of implementation School perception of intervention Data collection burden
Currently: Year 1 2 new schools in Sept. 3-year intervention, follow-up
THANK YOU
Contact Information
Greta Massetti
William Pelham
http://Wings.buffalo.edu/adhd/