Archive for the 'Prevention' Category

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First Step supported by WWC

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.

Follow up of Fast Track

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.
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Another photo for fun

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.

Fish oil and adolescent psychosis

During the 40 weeks after receiving a brief course of ω-3 (“omega three”) polyunsaturated fatty acids, adolescents at risk for psychotic disorders were less likely to progress to psychotic status than similar peers who did not receive the supplement. In the study by G. Paul Amminger and colleagues, the youths in the treated group also had fewer positive, negative, and general symptoms of psychosis and improved overall functioning than those in the control group.

The youths in the treated group received a supplement of two fish-oil capsules twice a day for 12 weeks, and the controls received a placebo of coconut-oil capsules. The researchers then monitored their status and symptoms for the following 40 weeks.
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US legislators consider law for preventing abusive restraint and seclusion

The US Congress is considering legislation to prevent abusive restraint and seclusion of students in schools. This is a welcome consequence of the highly visible reports about terrible abuses of students’ right to be free from harm. However, as much as I support this initiative, it is important to make clear that the laws (and regulations resulting from them) must be crafted carefully.

Here’s some text from the press efforts by the US House of Representatives about this important legislation. I follow it with a cautious support of the law.
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UK action on children’s mental health

Lord Jones of Cheltenham, a member of the the UK Parliament, has formally asked “what measures are planned to improve services for (a) children with serious emotional disturbance, and (b) adults with mental health illnesses.” The request is in response to recent UK report, Keeping Children and Young People in Mind – Full Government Response to the CAMHS Review that, in turn (and as the title shows), was a response to the government-sponsored review of child and adolescent mental health services (CAMHS).

Keeping Children and Young People in Mind calls for a system of universal services, targeted services, and specialist services accompanied by support for them from local and national government agencies. Get a copy of Keeping children and young people in mind: the Government’s full response to the independent review of CAMHS and visit the Web site of the UK Department of Children, Schools, and Families for more about “services supporting the emotional wellbeing and mental health of children and young people.”

See the Parliamentary records for a written version of the request by Lord Jones.

Virginia Campaign for Children’s Mental Health

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.

First Step takes off

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.”
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