A Cluster Randomized Trial of Promoting Alternative Thinking Strategies (PATHS®) With Swedish Preschool Children.

Lilianne Eninger,Hanna Ginner Hau,Mara Westling Allodi,Kyle Eichas,Laura Ferrer-Wreder,Birgitta Herkner,Mina Sedem,Tina M Olsson,Ann-Charlotte Smedler,Ingela Clausén Gull

doi:10.3389/fpsyg.2021.695288

Lilianne Eninger, Hanna Ginner Hau + Show 8 more

Open Access

https://doi.org/10.3389/fpsyg.2021.695288

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Abstract

The preschool edition of Promoting Alternative THinking Strategies (PATHS®) is a school-based, teacher implemented universal intervention developed in the United States designed to promote social emotional competence (SEC) in children as a foundation for improved mental health. PATHS is delivered as a curriculum and it is based on theories and research regarding SEC, brain development, and optimal school environments. A majority of children in Sweden attend preschool, which is government-subsidized and follows a national curriculum focusing on both academic and social emotional learning. However, there is not so much focus on formal instruction nor manual-based lessons. The purpose of this study was to assess the short-term (pre- to post-test) effects of PATHS in the Swedish preschool setting. Using a two-wave cluster randomized trial with multi-method and informant assessment (N = 285 4 and 5-year-old Swedish children; n = 145 wait-list control; n = 140 intervention; K = 26 preschools; k = 13 intervention; k = 13 control) we assessed changes in child emotional knowledge, emotional awareness, social problem solving, prosocial play, inhibitory control, and working memory using structural equation modeling (SEM). We included schools with at least one classroom of 4–5-year-old children from three municipalities. We excluded open preschools, parent cooperative preschools, and family day homes. After random assignment, schools were informed of condition assignment. Research team members were not blind to assignment. We hypothesized that relative to children in control schools, children in intervention schools would evidence improvements in social emotional competence as well as other outcomes. Children in PATHS, relative to children in the control, evidenced improvements in working memory and prosocial play, but also showed an increase in hyperactive behaviors. Girls in PATHS, relative to girls in the control, showed improvement in emotional knowledge and reduced anxiety. These results are considered in light of efforts to promote positive development and mental health. The trial registration number at ClinicalTrials.gov is NCT04512157. Main funding was from Swedish Council for Working Life and Social Research, the Swedish Research Council, Formas, and VINNOVA (dnr: 259-2012-71).

Highlights

This study concerns the effects of the preschool edition of Promoting Alternative THinking Strategies (PATHS R ) in a sample of Swedish children and this is the first systematic test of this intervention in Scandinavia
Social and emotional learning (SEL) unites what have historically been separate theories and research fields dedicated to the understanding of the complexity of emotions, executive functioning, and other developmental processes that relate to a wide range of competencies that allow for adaptive functioning in relationships and school (Tolan et al, 2016)
We evaluated the pre to post-test effects of preschool PATHS by specifying outcome models for each of the outcome variables and used them to examine covariate-adjusted change (Rausch et al, 2003)

Summary

Introduction

This study concerns the effects of the preschool edition of Promoting Alternative THinking Strategies (PATHS R ) in a sample of Swedish children and this is the first systematic test of this intervention in Scandinavia. PATHS was originally developed in the United States (U.S.) It is a universal social and emotional learning (SEL) intervention designed to promote social emotional competence (SEC; Domitrovich et al, 2007) which is a protective factor against the later development of mental ill-health including a range of internalizing and externalizing problems (e.g., Durlak et al, 2011). SEL unites what have historically been separate theories and research fields dedicated to the understanding of the complexity of emotions, executive functioning, and other developmental processes that relate to a wide range of competencies that allow for adaptive functioning in relationships and school (Tolan et al, 2016)

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