Promising Effects of Socioemotional Skills Training in Bilingual Children With Attention and Behavioral Concerns

Abstract

<h3>Research Objectives</h3> Bilingualism is present in every country of the world, class of society, and age group. Yet, monolingual-focused health practices, policies, and research dominate delivery of care, contributing to health disparities. To investigate the role of language in treatment delivery, the present study examined the effect of second language use on socioemotional skills in bilingual children with attention and behavioral concerns. <h3>Design</h3> A two-level (students, schools) cluster randomized controlled design accounted for treatment [Collaborative Life Skills (CLS) versus control] across 23 elementary schools. In addition, four schools received treatment in Spanish (parent group) and combination of Spanish and English (child skills training, classroom intervention). <h3>Setting</h3> The CLS program integrates empirically-supported treatments (parent training, classroom intervention, and child skills training) in school settings to encourage accessibility and sustainability. <h3>Participants</h3> Students were referred to the program by school staff for substantial inattention, hyperactivity/impulsivity, and/or related academic/social problems. We conducted secondary data analyses on 120 monolingual and 37 bilingual children (Grades 2-5, Mage=8.32, SDage = 1.08, 28% girls, 35% Latinx, 23% White, 18% Asian, 17% multiracial, 8% Black). <h3>Interventions</h3> Mental health professionals led nine 40-minute child group sessions during school hours. Modules targeted social functioning (e.g., self-control, friendship making, assertion) and independence (e.g., homework skills, routines). Socioemotional skills were taught through didactic instruction, behavioral rehearsal, and in-vivo practice. A reward-based contingency management program was used to manage behaviors and reinforce new skills. <h3>Main Outcome Measures</h3> ADHD symptoms, ADHD impairment. <h3>Results</h3> A mixed effects model revealed a treatment (CLS, control) by language status (bilingual, monolingual) interaction. A greater reduction in parent-reported impairment was found for bilingual children compared to monolingual children. <h3>Conclusions</h3> Socioemotional skills appear to especially benefit bilingual children with attentional and behavioral concerns. Future studies to understand mechanisms are warranted. Receiving socioemotional skills training in second language may help to down-regulate negative emotions, which may be conducive to learning socioemotional skills in clinical settings. <h3>Author(s) Disclosures</h3> No conflicts of interest to disclose.