Archive for the 'Acting out' Category

First Step supported by WWC

Published on 14 March 2012 in Acting in, Acting out, Administration, News, Policy, Prevention, Research, The press and Treatment. 1 Comment Tags: , , , , , , , , .

The US What Works Clearinghouse (WWC) reviewed research about First Step to Success, an early intervention program for K-3 children who are at risk of developing antisocial behavior, and identified it as having positive effects on ratings of student behavior and potentially positive effects on ratings of emotions, social skills, and academic outcomes. The WWC based its review on two studies by the developers of First Step, Hill Walker and colleagues—alert readers of EBD Blog will recognize one of them (see “First Step Takes Off“).

What Works—which some folks have taken to calling “what doesn’t work,” because they say it rarely identifies practices that are effective—gave the research undergirding First Step a strong review:

The WWC review of interventions for Children Classified as Having an Emotional Disturbance addresses student outcomes in seven domains: external behavior, emotional/internal behavior, social outcomes, reading achievement/ literacy, math achievement, school attendance, and other academic performance. The two studies that contribute to the effectiveness rating in this report cover five domains: external behavior, emotional/internal behavior, social outcomes, reading achievement/literacy, and other academic performance. The findings below present the authors’ estimates and WWC-calculated estimates of the size and statistical significance of the effects of First Step to Success on children classified as having an emotional disturbance….

Two studies reported findings in the external behavior domain.

Walker et al. (1998) found, and the WWC confirmed, four positive and statistically significant differences between treatment and comparison groups on academic engaged time, the Child Behavior Checklist–Teacher Report Forms (CBCL-TRF) Aggression Subscale, the Early Screening Project (ESP) Adaptive Behavior Subscale, and the ESP Maladaptive Behavior Subscale.

Walker et al. (2009) found, and the WWC confirmed, four positive and statistically significant differences between treatment and comparison groups on academic engaged time, the Social Skills Rating System (SSRS) Problem Behavior Subscale for Parents, the SSRS Problem Behavior Subscale for Teachers, and the SSBD Maladaptive Behavior Index. Although the overall design of the Walker et al. (2009) study meets evidence standards, there was high attrition on one outcome: the SSRS Problem Behavior Subscale for Parents outcome. The authors established equivalence for the analytic sample for this outcome; thus, this finding meets evidence standards with reservations.

The mean effect size from the four outcomes in Walker et al. (1998) and the mean effect size from the four out- comes in Walker et al. (2009) were both statistically significant. Thus, for the external behavior domain, two studies with strong designs showed statistically significant positive effects. This results in an intervention rating of positive effects for the domain, with a small extent of evidence.

Walker, H. M., Kavanagh, K., Stiller, B., Golly, A., Severson, H., & Feil, E. (1998). First Step to Success. An early intervention approach for preventing school antisocial behavior. Journal of Emotional and Behavioral Disorders, 6, 66–80.

Walker, H. M., Seeley, J. R., Small, J., Severson, H. H, Graham, B. A., Feil, E. G., . . . Forness, S. R. (2009). A randomized controlled trial of the First Step to Success early intervention: Demonstration of program efficacy outcomes in a diverse, urban school district. Journal of Emotional and Behavioral Disorders, 17, 197–212.

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Webinar on FBA and positive behavior support plans

Published on 13 October 2011 in Acting out, Administration, Behavior management, News, Professsional development, The press and Treatment. 0 Comments Tags: , , , , , , .


Tim Lewis

If you and your colleagues need to obtain a good foundation on the use of functional behavioral assessment and positive behavior support plans, there is an opportunity coming to satisfy that need.Tim Lewis will present another Webinar under the auspices of the Council for Exceptional Children (CEC), and this one is entitled “Designing Individual Student Positive Behavior Support Plans Through Functional Behavioral Assessment.” It is scheduled for Tuesday 25 October 2011 from 4:00 to 5:00 PM (Eastern Time, US).

Professor Lewis is among the leaders in the area of Emotional and Behavioral Disorders and positive behavior interventions and supports (PBIS). He co-edits the journal Behavioral Disorders and co-directs major projects on PBIS. Follow this link to learn more about the event and how to register for it; it is the third in a series of Webinars on the topic of PBIS that Professor Lewis is providing via CEC. (I don’t have a financial interest in them; I’m just shilling for them for free here.)

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Addressing bullying via PBIS

Published on 7 October 2011 in Acting out, Administration, Behavior management, Bullying, News, Professsional development, The press and Treatment. 0 Comments Tags: , , , , , , , , .


Tim Lewis

Do you want to learn how to do something about bullying in schools? Here’s a way to get started.

Under the auspices of the Council for Exceptional Children (CEC), Tim Lewis will present an online seminar (“Webinar”) entitled “Addressing Bullying Behavior Through Schoolwide Positive Behavior Supports” on Thursday 20 October 2011 from 4:00 to 5:00 PM (Eastern Time, US). Professor Lewis, who teaches and conducts research at the University of Missouri, has a wealth of experience and expertise in the area of Emotional and Behavioral Disorders and positive behavior interventions and supports (PBIS), so this an excellent opportunity to get a good grounding in how to use the features of PBIS to help a school manage bullying problems. Follow this link to learn more about the event and how to register for it; it is one in a series of Webinars on the topic of PBIS that Professor Lewis is providing via CEC. (I don’t have a financial interest in them.)

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Cog mod for PTSD

Published on 6 July 2011 in Acting in, Acting out, Mental health, News, Research, The press and Treatment. 2 Comments Tags: , , , , , , , , , , .

In the Journal of Behavior Therapy and Experimental Psychiatry, Joanna Kowalik and colleagues reported that their review of studies on the use of cognitivie behavioral therapy for treating posttraumatic stress disorder (PTSD) revealed that cog-mod appears effective in changing raters’ responses on some of the widely used scales of the Child Behavior Checklist. However, the results of their literature review are not as powerful as one might hope, given the small number of studies and substantial variability in the studies themselves.

Abstract

Background and objectives There is no clear gold standard treatment for childhood posttraumatic stress disorder (PTSD). An annotated bibliography and meta-analysis were used to examine the efficacy of cognitive behavioral therapy (CBT) in the treatment of pediatric PTSD as measured by outcome data from the Child Behavior Checklist (CBCL).

Method A literature search produced 21 studies; of these, 10 utilized the CBCL but only eight were both 1) randomized; and 2) reported pre- and post-intervention scores.

Results The annotated bibliography revealed efficacy in general of CBT for pediatric PTSD. Using four indices of the CBCL, the meta-analysis identified statistically significant effect sizes for three of the four scales: Total Problems (TP; ?.327; p = .003), Internalizing (INT; ?.314; p = .001), and Externalizing (EXT; ?.192; p = .040). The results for TP and INT were reliable as indicated by the fail-safe N and rank correlation tests. The effect size for the Total Competence (TCOMP; ?.054; p = .620) index did not reach statistical significance.

Limitations Limitations included methodological inconsistencies across studies and lack of a randomized control group design, yielding few studies for meta-analysis.

Conclusions The efficacy of CBT in the treatment of pediatric PTSD was supported by the annotated bibliography and meta-analysis, contributing to best practices data. CBT addressed internalizing signs and symptoms (as measured by the CBCL) such as anxiety and depression more robustly than it did externalizing symptoms such as aggression and rule-breaking behavior, consistent with its purpose as a therapeutic intervention.

Because they are integrating so few studies it is very difficult to have a sensitive meta-analysis in this case. However, that Professor Kowalik and her collaborators found differences at all is encouraging. I hope they’ll continue to follow this literature. Also, I hope researchers will be using other measures of outcomes and that those other measures will be examined in future integrative literature reviews, too.

Kowalik, J., Weller, J., Venter, J., & Drachman, D. (2011). Cognitive behavioral therapy for the treatment of pediatric posttraumatic stress disorder: A review and meta-analysis. Journal of Behavior Therapy and Experimental Psychiatry, 42, 405-413. doi:10.1016/j.jbtep.2011.02.002

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Follow up of Fast Track

Published on 7 February 2011 in Acting out, News, Prevention, Research, The press and Treatment. 0 Comments Tags: , , , , , , , , , , , , .

These are the lead researchers in the Conduct Problems Prevention Research Group with their current universities (over the years, some have changed affiliations):

The Conduct Problems Prevention Research Group, a team of composed of seven of the most eminent US scholars studying the development of childhood behavior disorders, published another in its series of papers tracking the outcomes of the children it has been following in a long-term study about preventing acting out disorders. In this longer-term follow-up analysis, the team found that the effects were still present for the children who showed the most risk of having behavior disorders in the first place.

This project and these folks are the big time. The work has been conducted very carefully and cannot be represented as an example of over-hyped findings.
Continue reading ‘Follow up of Fast Track’

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Another photo for fun

Published on 14 September 2010 in Acting in, Acting out, ADHD, Administration, Assessment, Autism, Behavior management, Bi-polar, Bullying, Conduct disorder, Delinquency, Depression, Families, Photos, Policy, Prevention, Professsional development, Research, Schizophrenia and Treatment. 0 Comments Tags: , , , .

I was moving some materials from one office to another when I came across this photo of some friends. Believe it or not, I took this with a film camera. Yes, it is from the 1990s, even before 1997 or so, I think.

I suspect it was at one of the annual meetings in Tempe (AZ, US) of the Teacher Educators of Children with Behavior Disorders, as these are some of the usual suspects who attended those meetings. A casual search on any of these folks’ names will reveal that they are prominent contributors to the literature about improving the lives of children and youths with Emotional and Behavioral Disorders, the families of those children and youths, other students who do and do not have disabilities, their teachers and administrators, and on and on. Students who studied just these people’s writing in detail would get quite a valuable education.

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What do educators need to know?

Published on 11 August 2010 in Acting in, Acting out, ADHD, Administration, Assessment, Behavior management, Conduct disorder, Policy, Professsional development, Research and Treatment. 18 Comments

I’m asking readers of EBD Blog to help me identify important research questions about interventions for students with Emotional and Behavioral Disorders. As I noted in a parallel post on LD Blog, these need to be BIG IDEA questions. What do teachers and parents need to know about how to help students with EBD?

Examples (just for provoking discussion): Continue reading ‘What do educators need to know?’

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ABAI on restraint and seclusion

Published on 5 August 2010 in Acting out, Behavior management, News, Policy, The press and Treatment. 1 Comment Tags: , , , , , , , , , , , , .

Based on the work of a task force composed of highly qualified individuals, the Association for Behavior Analysis International (ABAI) has issued position statement about the use of restraint and seclusion in treatment. Members of the task force, which was appointed by the executive board, include Jon S. Bailey, Michael F. Dorsey, Louis P. Hagopian, Gregory P. Hanley, David B. Lennox, Mary M. Riordan, Scott Spreat, and Timothy R. Vollmer (chair).

The Association for Behavior Analysis International (ABAI) and its members strongly oppose the inappropriate and/or unnecessary use of seclusion, restraint, or other intrusive interventions. Although many persons with severe behavior problems can be effectively treated without the use of any restrictive interventions, restraint may be necessary on some rare occasions with meticulous clinical oversight and controls. In addition, a carefully planned and monitored use of timeout from reinforcement can be acceptable under restricted circumstances. Seclusion is sometimes necessary or needed, but behavior analysts would support only the most highly monitored and ethical practices associated with such use, to be detailed below.

In the “below,” the document goes on to present in detail the a set of guiding principles and specific recommendations about the use of seclusion and restraint. Read the statement, “ABAI Statement on Restraint and Seculsion” from the ABAI Website.

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Bipolar or temper dysregulation disorder with dysphoria?

Published on 17 May 2010 in Acting in, Acting out, Assessment, Bi-polar, News and The press. 2 Comments Tags: , , , , .

Under the headline “Time to reexamine bipolar diagnosis in children,” Brendan Borrell reports on proposed changes in the American Psychiatric Association
s Diagnostic and Statistical Manual for the identification of bipolar disorder. In addition to presenting the basic information, Mr. Borrell has alternative views by Dr. Gabrielle Carlson and Dr. David Axelson.

Psychiatrists in favor of a new label, temper dysregulation disorder, cite a spike in bipolar diagnoses. But others worry it will add uncertainty to the treatment of an already confusing condition.

I wonder which side the psychiatrists who were concerned about the change from “manic depressive” to “bipolar” are on with this newest change. Will I have to change the category label in EBD Blog?

Link to Mr. Borrell’s story. Use the short link for this entry: http://wp.me/peQI7-iw

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Virginia Campaign for Children’s Mental Health

Published on 15 December 2009 in Acting in, Acting out, Assessment, Autism, Bi-polar, Causes, Conduct disorder, Delinquency, Depression, Families, Musings, News, Policy, Prevention, Research, Schizophrenia, The press and Treatment. 0 Comments Tags: , , , , , , , , , , , , , , , , , , , , , , , .

Twelve key children’s services for community services boards
  1. specialized children’s emergency services;
  2. crisis stabilization;
  3. evaluations for Comprehensive Services Act services;
  4. psychiatric/medication;
  5. office-based mental health therapy;
  6. office-based substance abuse therapy;
  7. mental health case management;
  8. intellectual disabilities case management;
  9. substance abuse case management;
  10. home-based behavioral treatment and support for families;
  11. school-based day treatment; and
  12. local residential services.

Right here in my home commonwealth of Virginia last week, Mira Signe, Vicki Hardy-Murrell, John Morgan, and Margaret Nimmo Crowe explained why it is important that government and private organizations attend to and address issues in children’s mental health. By explaining that Virginia has inadequate services and that one in every five children or youths experience mental health problems at some time during their lives, they made the point that that there is a tremendous need for public focus on these issues. This was the kick-off event for the Campaign for Children’s Mental Health.

The Campaign for Children’s Mental Health is a 3-year sustained effort to make mental health services more available and accessible to Virginia children in need. It will strongly endorse Governor-elect McDonnell’s call for system improvements; urge the General Assembly and state and local government to work collaboratively with the administration to address system deficiencies; and conduct a high-profile three-year advocacy and education drive to build public and political support for improved mental health services for children.

Only about one in 20 of Virginia’s children have access to the key services listed in the accompanying box. So, four out of five children who need these services do not have access to them.

No, Virginia, this is not an acceptable way to treat our children. Let’s do better.

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First Step takes off

Published on 8 December 2009 in Acting out, Behavior management, Bullying, Conduct disorder, Delinquency, Families, News, Prevention, Research, The press and Treatment. 1 Comment Tags: , , , , , , , .

Hill Walker and colleagues reported that the First Step to Success program benefitted young children at risk for developing emotional or behavioral disorders. In a longitudinal study of the three-year program conducted in Albuquerque (NM, US), the researchers found substantial reductions in disruptive behavior and improvements in social functioning.

In a press release, Professor Walker said, “Albuquerque was the first opportunity we had to mount a large-scale study of the program using a randomized control group, the gold standard for research. First Step has been implemented widely, but not [studied] in this way.”
Continue reading ‘First Step takes off’

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Hold Me Tight, Let Me Go

Published on 21 July 2009 in Acting out, News, The press and Treatment. 0 Comments Tags: , , , , .

“Hold Me Tight, Let Me Go,” a movie about a UK school for children with Emotional and Behavioral Disorders, will air on US television 28 July 2009 on P.O.V. The film, made by Kim Longinotto (pictured at right), features the children and staff at Mulberry Bush School in the Oxfordshire village of Standlake. P.O.V. (Point of View) provides “documentaries with a point of view.”

Variety describes it as a film “mixing ferocity with tenderness, delicacy with tenacity”–exactly like the unusual school it explores. In Hold Me Tight, Let Me Go, one of Britain’s leading documentary filmmakers takes a verité look at Oxford’s Mulberry Bush School for emotionally disturbed children. Mulberry’s heroically forbearing staff greets extreme, sometimes violent behavior with only consolation and gentle restraint. Kim Longinotto’s unblinking camera captures an arduous process and a nearly unhinged environment, but it also records the daily dramas of troubled kids trying to survive and the moments of hope they achieve with Mulberry’s clear-eyed staff.

Watch on YouTube

Link to the US PBS site, where one can learn when the entire film will be available in different areas. Visit the Mulberry Bush organization’s Web site. See the UK’s Office for Standards in Education, Children’s Services and Skills (Ofsted) listing for the Mulberry Bush School. Link to an extended piece, “Inside the home for angry infants: It costs £123,000 a year to send a child to this special school — because nobody else will have them,” by Caroline Scott in the Times Online (11 May 2009). Learn about other P.O.V. shows.

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