Transcript PowerPoint - The Incredible Years
Slide 1
nd
K-2
School-based Intervention for
Graders with Disruptive Behavior
Disorders
Jacob Venter, MD; Anne Marie Cardinal, LCSW; Melissa Shaw, LPC; Linda
Wiskerchen, LCSW; Sara DeSimone, LCSW and Alicia Ledesma, LPC.
District Medical Group, Inc.
An NIH/National Center on Minority Health and Health
Disparities Center of Excellence
The Incredible Years – “Dinosaur School”
Small Group Therapy Program
Research Questions
Introduction
The Incredible Years, Dinosaur Small Group Therapy Program, is an
evidence-based program that can be delivered in a school setting. The
program was developed by Dr. Carolyn Webster-Stratton of the University of
Washington Parent Clinic. It is a SAMHSA Model Program that was awarded
exemplary best practices by the Office of Juvenile Justice & Delinquency
Prevention.
The current intervention used the small group program developed for children
known as “Dinosaur School” with a blend of cognitive, affective and behavioral
components. A friendly cadre of puppets assist in the delivery, which brings
elements of play therapy into the intervention. “Dina” is the Dinosaur Principal
of the program who visit regularly to engage the children in the intervention
and provide opportunities for children to be noticed for good behavior by a
Principal with distinction. Dina also encourages children in role playing
activities, an important opportunity for behavioral rehearsal. Two other main
puppets are the child-sized siblings Wally and Molly. Children identify with
their friends who have similar problems with academics and behavior. They
learn by teaching the puppets when they are overwhelmed by problems.
Major program segments of Dinosaur School include emotions, problemsolving, anger management, friendship, and school success skills. Each
meeting consists of welcome and review of previous skills, video vignettes
demonstrating new skills, role play rehearsal, descriptive play, an activity, chip
trade-in, homework, and closing song.
Assess changes in pro-social and antisocial behaviors in response to an intensive, school-based early intervention for students with classroom disruptive behaviors
Test the effectiveness of a research-based intervention in a primarily minority population of students with significant behavioral problems
Methods
Teachers or parents referred K-3rd graders due to difficult to manage, disruptive
classroom behavior. Prior to the program and at completion, teachers rated
behavior with the School Social Behavior Scales (3 subscales measure “social
competence” and 3 subscales measure “antisocial behavior”).
The one-school year intervention consisted of the “Dinosaur School” Child Training
Programs (Small Group Therapy) component of The Incredible Years, implemented
by Master’s level therapists.
Teachers had 3 weeks with students to get to know them, then completed pre-tests
after which the intervention began. Data were analyzed using paired t-tests to
examine differences in mean scores before and after the intervention.
Each group had 6 students, one Master’s level therapist, and one MSW intern.
Groups met twice a week for 65 minutes. Each group had review time, a vignette
presenting new skills, role play, descriptive play activity, and reward time. Songs
and opportunities to interact with puppets were important parts of engagement.
Therapists sent video tapes to the Incredible Years for review.
Conclusions
The Small Group Therapy module of The Incredible Years program reduced disruptive
behavior and increased pro-social behavior in children from K-3rd grades.
Although behaviors as measured by both scales improved, those assessed by two of
the Antisocial Behavior subscales benefited less robustly or possibly needed longer
intervention length for response. Further studies might focus on the effect of parent and
teacher ability to change adult responses to children’s negative and defiant behaviors
so as not to continue a cycle of reinforcement of these patterns.
This intervention was implemented in a school district of typically underserved children.
The data was analyzed in two stages: 1) to assess for significant changes in pro-social
and antisocial behaviors from pre- to post-intervention, and
2) with isolation of demographic variables including age, gender, and ethnicity.
When these results were broken down, intervention outcomes were the same.
This program proved effective with a population of primarily minority children in a school
district where 85% of the students are eligible for free and reduced lunch.
Results
Data Source
Dinosaur School was implemented in the Osborn School District, which
serves an inner city, low income, multi-cultural, multi-lingual population.
School demographics included 63% Hispanic,13% non-Hispanic Caucasian,
10% Native American/Alaskan Native, 11% African American, and 1%
Asian/Pacific Islanders. Of these, 25% were considered limited in English or
“English Language Learners.”
The school district consists of five elementary schools and one middle school
in central Phoenix. Teachers provided pre- and post-intervention data by
completing the School Social Behavior Scales.
Participants by Ethnicity
Percentage
44.3
45
40
35
30
25
20
15
10
5
0
Eighty-eight participants completed the study. Scores on all pro-social scales
improved significantly (p<.001). Scores on all antisocial scales decreased
significantly. Scores on the Antisocial Behavior and Defiant/Disruptive subscales
decreased to a more significant degree (p<.001) than did scores on the
Hostile/Irritable and Antisocial/Aggressive subscales (p<.01).
Scale A: Social Competence Scale
Scale B: Antisocial Behavior Scale
higher scores = higher social competence
lower scores = lower antisocial behavior
PR: Peer Relations Subscale
HI: Hostile/Irritable Subscale
SM: Self-Management/Compliance Subscale
AA: Antisocial/Aggressive Subscale
AcB: Academic Behavior Subscale
DD: Defiant/Disruptive Subscale
Time Scale A*
PR*
SM*
AcB*
Scale B**
HI***
AA***
19.3
10.2
2.3
Hispanic
Black
White
Native American
Asian
Pre-
79.7
35.1
25.2
19.5
91.5
38.5
25.6
27.3
Post-
93.2
40.6
29.2
23.5
81.5
35.3
23.0
23.3
Ethnicity
Student participants (N=88) were from grades K-3, between 5 and 8 years of
age, and mostly male (n=72).
Participant ethnicity was largely minority: 2.3% Asian, 19.3% Black, 44.3%
Hispanic; 10.2% Native American, and 23.9% White.
When minority and non-minority ethnicity scores were compared, no significant
differences were observed. Nonetheless, overall scale scores for each subgroup
showed significant changes.
Time
Pre-test
Minority
Pre-test
White
Post-test
Minority
Post-test
White
Scale A*
PR*
SM**
AcB*
Scale B***
HI
AA
DD****
78.8
34.8
24.9
19.1
91.7
38.9
25.5
27.3
82.7
35.9
26.1
20.7
91.0
37.5
26.0
27.5
93.1
40.5
29.4
23.2
79.7
34.8
22.3
22.7
93.6.
40.7
28.6
24.3
87.3
36.7
25.4
25.2
• *Post-test scores significantly greater than Pre- (p<.0005)
• **Post- significantly greater than Pre (p=.001)
The benefits of this school-based intervention support its implementation for
disruptive behavior in schools. This model of intervention also provides effective
ways to meet the needs of an underserved population. Children with significant
needs for behavioral and social/emotional intervention can be treated in the same
environment where the need is greatest: the community school. They can also
receive the level of intensity of treatment needed to change patterns of behavior
because the commitment to treatment is built into the
commitment to education.
DD**
• Post-test scores significantly greater than Pre (p<.0005), ** Post-test significantly lower than Pre-test
(p<.0005), *** Post-test significantly lower than Pre-test (p=.002)
23.9
Discussion
*** Post- significantly lower than Pre- (p=.015)
**** Post- significantly lower than Pre- (p=.004)
The intervention has proven successful across diverse
participants, as demonstrated by a separate analysis with age,
gender, and ethnicity as variables.
Special appreciation to David Drachman, Ph.D. and Gilbert
Ramos, MA for their contributions with data management,
preparation, and analysis.
This intervention, funded through a US Dept. of Education Elementary
School Counseling Initiative, was a collaboration with the Osborn
Elementary School District and District Medical Group of Arizona, Inc.
SIRC is funded by a Center of
Excellence grant from the
National Center on Minority
Health and Health Disparities
NIH(P20MD002316-05).
nd
K-2
School-based Intervention for
Graders with Disruptive Behavior
Disorders
Jacob Venter, MD; Anne Marie Cardinal, LCSW; Melissa Shaw, LPC; Linda
Wiskerchen, LCSW; Sara DeSimone, LCSW and Alicia Ledesma, LPC.
District Medical Group, Inc.
An NIH/National Center on Minority Health and Health
Disparities Center of Excellence
The Incredible Years – “Dinosaur School”
Small Group Therapy Program
Research Questions
Introduction
The Incredible Years, Dinosaur Small Group Therapy Program, is an
evidence-based program that can be delivered in a school setting. The
program was developed by Dr. Carolyn Webster-Stratton of the University of
Washington Parent Clinic. It is a SAMHSA Model Program that was awarded
exemplary best practices by the Office of Juvenile Justice & Delinquency
Prevention.
The current intervention used the small group program developed for children
known as “Dinosaur School” with a blend of cognitive, affective and behavioral
components. A friendly cadre of puppets assist in the delivery, which brings
elements of play therapy into the intervention. “Dina” is the Dinosaur Principal
of the program who visit regularly to engage the children in the intervention
and provide opportunities for children to be noticed for good behavior by a
Principal with distinction. Dina also encourages children in role playing
activities, an important opportunity for behavioral rehearsal. Two other main
puppets are the child-sized siblings Wally and Molly. Children identify with
their friends who have similar problems with academics and behavior. They
learn by teaching the puppets when they are overwhelmed by problems.
Major program segments of Dinosaur School include emotions, problemsolving, anger management, friendship, and school success skills. Each
meeting consists of welcome and review of previous skills, video vignettes
demonstrating new skills, role play rehearsal, descriptive play, an activity, chip
trade-in, homework, and closing song.
Assess changes in pro-social and antisocial behaviors in response to an intensive, school-based early intervention for students with classroom disruptive behaviors
Test the effectiveness of a research-based intervention in a primarily minority population of students with significant behavioral problems
Methods
Teachers or parents referred K-3rd graders due to difficult to manage, disruptive
classroom behavior. Prior to the program and at completion, teachers rated
behavior with the School Social Behavior Scales (3 subscales measure “social
competence” and 3 subscales measure “antisocial behavior”).
The one-school year intervention consisted of the “Dinosaur School” Child Training
Programs (Small Group Therapy) component of The Incredible Years, implemented
by Master’s level therapists.
Teachers had 3 weeks with students to get to know them, then completed pre-tests
after which the intervention began. Data were analyzed using paired t-tests to
examine differences in mean scores before and after the intervention.
Each group had 6 students, one Master’s level therapist, and one MSW intern.
Groups met twice a week for 65 minutes. Each group had review time, a vignette
presenting new skills, role play, descriptive play activity, and reward time. Songs
and opportunities to interact with puppets were important parts of engagement.
Therapists sent video tapes to the Incredible Years for review.
Conclusions
The Small Group Therapy module of The Incredible Years program reduced disruptive
behavior and increased pro-social behavior in children from K-3rd grades.
Although behaviors as measured by both scales improved, those assessed by two of
the Antisocial Behavior subscales benefited less robustly or possibly needed longer
intervention length for response. Further studies might focus on the effect of parent and
teacher ability to change adult responses to children’s negative and defiant behaviors
so as not to continue a cycle of reinforcement of these patterns.
This intervention was implemented in a school district of typically underserved children.
The data was analyzed in two stages: 1) to assess for significant changes in pro-social
and antisocial behaviors from pre- to post-intervention, and
2) with isolation of demographic variables including age, gender, and ethnicity.
When these results were broken down, intervention outcomes were the same.
This program proved effective with a population of primarily minority children in a school
district where 85% of the students are eligible for free and reduced lunch.
Results
Data Source
Dinosaur School was implemented in the Osborn School District, which
serves an inner city, low income, multi-cultural, multi-lingual population.
School demographics included 63% Hispanic,13% non-Hispanic Caucasian,
10% Native American/Alaskan Native, 11% African American, and 1%
Asian/Pacific Islanders. Of these, 25% were considered limited in English or
“English Language Learners.”
The school district consists of five elementary schools and one middle school
in central Phoenix. Teachers provided pre- and post-intervention data by
completing the School Social Behavior Scales.
Participants by Ethnicity
Percentage
44.3
45
40
35
30
25
20
15
10
5
0
Eighty-eight participants completed the study. Scores on all pro-social scales
improved significantly (p<.001). Scores on all antisocial scales decreased
significantly. Scores on the Antisocial Behavior and Defiant/Disruptive subscales
decreased to a more significant degree (p<.001) than did scores on the
Hostile/Irritable and Antisocial/Aggressive subscales (p<.01).
Scale A: Social Competence Scale
Scale B: Antisocial Behavior Scale
higher scores = higher social competence
lower scores = lower antisocial behavior
PR: Peer Relations Subscale
HI: Hostile/Irritable Subscale
SM: Self-Management/Compliance Subscale
AA: Antisocial/Aggressive Subscale
AcB: Academic Behavior Subscale
DD: Defiant/Disruptive Subscale
Time Scale A*
PR*
SM*
AcB*
Scale B**
HI***
AA***
19.3
10.2
2.3
Hispanic
Black
White
Native American
Asian
Pre-
79.7
35.1
25.2
19.5
91.5
38.5
25.6
27.3
Post-
93.2
40.6
29.2
23.5
81.5
35.3
23.0
23.3
Ethnicity
Student participants (N=88) were from grades K-3, between 5 and 8 years of
age, and mostly male (n=72).
Participant ethnicity was largely minority: 2.3% Asian, 19.3% Black, 44.3%
Hispanic; 10.2% Native American, and 23.9% White.
When minority and non-minority ethnicity scores were compared, no significant
differences were observed. Nonetheless, overall scale scores for each subgroup
showed significant changes.
Time
Pre-test
Minority
Pre-test
White
Post-test
Minority
Post-test
White
Scale A*
PR*
SM**
AcB*
Scale B***
HI
AA
DD****
78.8
34.8
24.9
19.1
91.7
38.9
25.5
27.3
82.7
35.9
26.1
20.7
91.0
37.5
26.0
27.5
93.1
40.5
29.4
23.2
79.7
34.8
22.3
22.7
93.6.
40.7
28.6
24.3
87.3
36.7
25.4
25.2
• *Post-test scores significantly greater than Pre- (p<.0005)
• **Post- significantly greater than Pre (p=.001)
The benefits of this school-based intervention support its implementation for
disruptive behavior in schools. This model of intervention also provides effective
ways to meet the needs of an underserved population. Children with significant
needs for behavioral and social/emotional intervention can be treated in the same
environment where the need is greatest: the community school. They can also
receive the level of intensity of treatment needed to change patterns of behavior
because the commitment to treatment is built into the
commitment to education.
DD**
• Post-test scores significantly greater than Pre (p<.0005), ** Post-test significantly lower than Pre-test
(p<.0005), *** Post-test significantly lower than Pre-test (p=.002)
23.9
Discussion
*** Post- significantly lower than Pre- (p=.015)
**** Post- significantly lower than Pre- (p=.004)
The intervention has proven successful across diverse
participants, as demonstrated by a separate analysis with age,
gender, and ethnicity as variables.
Special appreciation to David Drachman, Ph.D. and Gilbert
Ramos, MA for their contributions with data management,
preparation, and analysis.
This intervention, funded through a US Dept. of Education Elementary
School Counseling Initiative, was a collaboration with the Osborn
Elementary School District and District Medical Group of Arizona, Inc.
SIRC is funded by a Center of
Excellence grant from the
National Center on Minority
Health and Health Disparities
NIH(P20MD002316-05).