School-based Early Intervention Program Research Articles

The role of social support in differentiating trajectories of adolescent depressed mood

IntroductionThis study explored the extent to which disaggregated support from family, peers, close friendships, teachers, and schools predicted membership into identified, sex-specific trajectories of depressed mood in 3210 Australian adolescents (49% females) based on self-report data collected at four annual time points from school Grade 6 to 9 (ages 10–16). MethodsThe sample was initially split by sex. Group-Based Trajectory Modelling was used to identify the trajectory groups using a Censored Normal model, starting with a two-group model and increasing group size in increments of one, up to a six-group model. Overall model-fit and specific model-fit criteria were examined, and participants were allocated to best-fit groups. Multinomial Logistic Regression examined the associations between baseline social supports and allocated trajectory group membership. ResultsFor boys, four trajectory groups were identified which were given the qualitative labels; Low Stable, Moderate Stable, Moderate Decreasing, and High Stable. Regression analysis showed that higher rates of peer belonging were associated with membership in the low and moderate groups compared to the High Stable group. For girls, four trajectory groups were identified and labelled as Low Stable, Moderate Decreasing, Moderate Increasing and High Increasing. Regression analysis showed that higher rates of family support, school climate, and peer belonging were associated with membership in the low and moderate groups compared to the High Increasing group. ConclusionsImplications included the need for school-based early intervention programs to consider disaggregated supports and vary their interventions by sex. Limitations and directions for future research are discussed.

Socio-Emotional Learning among Low-Income Prekindergarteners: The Roles of Individual Factors and Early Intervention

ABSTRACT Research Findings: Previous research has indicated that low-income children are at increased risk for socio-emotional problems, which may contribute to socioeconomic disparities in wellbeing and academic achievement. The present study examines socio-emotional learning (SEL) across the prekindergarten year in a low-income, racially and ethnically diverse sample of Chicago Public School students (N = 2,630). The sample included participants of the Child-Parent Center early educational intervention program (N = 1,724) and a propensity-score matched comparison group (N = 906). At the beginning of the prekindergarten year, teachers rated boys and lower income participants as having relatively lower SEL skills, and CPC participants and older children as having slightly higher SEL skills. Over time, CPC participants exhibited significantly greater rates of SEL growth, ending the prekindergarten year with teacher-rated SEL scores that were an average 10.30% higher than control participants. There were no significant differences in SEL growth over time by sex or family income. Practice and Policy: Multicomponent, school-based early intervention programs (e.g., CPC) have the potential to promote SEL among at-risk populations.

Community Health Workers and Social Proximity: Implementation of a Parenting Program in Urban Poverty.

Community health workers (CHWs) offer a potential means through which to mitigate many of the barriers to mental health services faced by minority youth and their families. The primary aim of the present study was to better understand a core feature of CHWs: their shared community membership with the population served, or social proximity. We conducted qualitative semi-structured interviews with 16 CHWs implementing a school-based early intervention program in Latino and African American communities of urban poverty. The program promoted child and parent/caregiver engagement in schooling as a protective factor for children's mental health. Thematic analyses revealed three main themes defining social proximity: (a) experiences of parenthood or caring for children, (b) familiarity with and understanding of culture, and (c) experiences of life hardships and struggles. Additionally, the process of relating with parents/caregivers through shared experiences was the main theme to describe how CHWs leveraged their social proximity. CHWs' accounts illustrated how their experience of social proximity to the population served was central to how they engaged parents/caregivers in services, highlighting the importance of supporting and promoting CHWs' natural traits and lived experiences.

Outcomes of a School-Based Program for Young Children with Disruptive Behaviors

This article reports on outcomes of an Australian pilot school-based early intervention program called Got It! (Getting On Track In Time!). Findings contribute to evidence for the effectiveness of interventions for children with early-onset conduct problems. The Got It! program incorporates universal and targeted components for children ages five to eight years with emerging conduct problems, during their first three years of schooling (K–2). A mixed methods research design entailed pre- and postintervention measures of child behavior and of parenting practices for 60 families who completed the targeted intervention. In addition, qualitative data were gathered in parent and carer interviews. Significant improvements on outcome measures were supported by qualitative findings. Improved scores were maintained by 85 percent of children at the six- to eight-months follow-up. This early evaluation research indicates positive impacts from Got It! for many of the families participating in the targeted intervention. A partnership between health and education is fundamental to the program model. The school context for program delivery was found to support engagement with families who would not otherwise access services.

Engaging Families in Early Intervention for Child Conduct Concerns

Early intervention programs assist families to deal with emerging child behavioural difficulties that are likely to worsen over time. Identifying families suited to an early intervention program and then generating their interest in the program can be an uncertain and complex process. This paper describes the approach to family engagement in a school-based early intervention program for children with emerging conduct problems, calledGot It!, and presents some of the findings from an external evaluation of the program conducted by the authors for New South Wales (NSW) Ministry of Health. Child behaviour screening questionnaires were completed by parents/carers and teachers, and qualitative data were gathered through interviews with parents/carers, teachers and health staff. The views of families who participated in the targeted intervention and those who were exposed only to the universal intervention were sought. Results indicate that offering the specialised group intervention in the school, in the context of universal interventions and screening, supported engagement with families of children with identified conduct problems. Many parents said they would not otherwise have sought assistance. A partnership approach between schools and specialist child and adolescent mental health services is a central feature of program delivery. Factors that contribute to an effective partnership are discussed.

The Influence of Early Intervention Length on the Participation of Low Socioeconomic At-Risk Preschool Boys: A Two-Group Control Study

This study compared the effect of length—1 (shorter) versus 2 (longer) years—of a multi-model, multidisciplinary, school-based early intervention program on improving children's preschool participation, occupational performance, and performance skills both within activities and out of context (graphomotor, motor, and cognitive skills). Using a pre-post, two-group intervention design, low socioeconomic preschool boys, at risk for developmental delays, were assigned to a 2-year (n = 28) or a 1-year (n = 30) intervention program. While both group outcome measures improved following intervention, the outcome measures of the longer-group were significantly better than the shorter-group, except for performance skills out of context. Longer interventions appear to be more beneficial for at-risk preschool children.

A pilot study of a school‐based prevention and early intervention program to reduce oppositional defiant disorder/conduct disorder

Oppositional defiant disorder (ODD) or conduct disorder (CD) occurs when children's disruptive and antisocial behaviours start to interfere with their academic, emotional and/or social development. Recently, there has been a considerable investment to implement national school-based early intervention programs to help prevent the onset of ODD/CD. This paper describes the delivery of the Royal Children's Hospital, Child and Adolescent Mental Health Service and Schools Early Action Program: a whole school, multi-level, multidisciplinary approach to address emerging ODD/CD and pre- versus post-delivery assessment in 40 schools over a 4-year period (2007-2010). All children from preparatory to grade 3 (ages 4-10 years) were screened for conduct problems (n = 8546) using the Strengths and Difficulties Questionnaire. Universal, targeted and indicated interventions were delivered in school settings. In total, 304 children participated in the targeted group program where the Child Behaviour Checklist was used as a pre- and post-intervention measure. Cohen's d effect sizes and a reliability change index were calculated to determine clinical significance. Significant reductions in both parent- and teacher-reported internalizing and externalizing symptoms were noted. Parent, teacher and child feedback were very positive. A future randomized controlled trial of the program would address potential placebo and selection bias effects.

Effectiveness of a School-Based Indicated Early Intervention Program for Māori and Pacific Adolescents

This study set out to determine the efficacy of a school-based early intervention program (the Kiwi ACE program) with Māori and Pacific adolescents experiencing depressive symptoms. A large group ( N = 419) of Māori and Pacific students (average age 14 years) was screened for depressive symptoms and, from a pool of students scoring greater than 63 on the Children's Depression Inventory (CDI), 56 students were randomly assigned to either an intervention or control group. After attrition, the final sample constituted 24 young people after one year. The intervention comprised eight 90-minute sessions conducted in school time. Students were taught to more fully understand the relationships between thinking, feeling and behaviour, to challenge beliefs and to solve interpersonal problems. At immediate posttest ( p = .045) and at one-year follow-up ( p < .001) a significant effect for condition was obtained: the intervention group reported lower depressive symptoms. Efficacy of the intervention was supported by qualitative data obtained from focus groups. Further controlled trials on a larger scale are recommended to establish the durability and generalisability of the effects of program participation.

Early Intervention for Childhood Anxiety in a School Setting: Outcomes for an Economically Disadvantaged Population

To evaluate a school-based early intervention program for the reduction of anxious symptoms in at-risk children from low socioeconomic status neighborhoods. A total of 425 children (8-11 years old) from nine schools in low socioeconomic status areas were screened to identify children with high-level anxious symptoms. Ninety-one children were selected, and schools were assigned to either an eight-session active intervention or a waitlist control. Active intervention was conducted in small groups during school time by both school and health personnel. Parents of children in active intervention were offered two information sessions. Demographic data indicated a low socioeconomic status for the sample. Children assigned to active intervention demonstrated a significant reduction in symptoms of anxiety relative to children assigned to waitlist and differences were maintained 4 months after treatment according to both self-report (F287 = 6.73, p < 0.005, partial eta = 0.134) and teacher report (F 2,87 = 7.99, p = .001, partial eta = 0.155). Parents did not return sufficient data for meaningful statistical analysis. School-based early intervention appears to offer an effective means of reducing anxious symptomatology in economically disadvantaged populations. The school environment offers promise as a means of extending the reach of efficacious interventions for mental health to underserviced populations.

Short-term Effectiveness of a School-based Early Intervention Program for Adolescent Depression

This article reports on the effectiveness of an early intervention program, 'Adolescents Coping with Emotions' (ACE), for depression in girls. ACE was assessed in a short-term wait-list control trial. In 1999, 882 students (aged 13-16 years) were screened using the Children's Depression Inventory (CDI). One hundred and seventy-nine students (63% female) who scored above the CDI cutoff (of 18) were offered the program and 143 (65% female) agreed to participate. On a school basis, participants were allocated to the intervention group ( n= 76; 56% female) who commenced the program within one month, or to a wait-list control condition (control group, n= 50; 79% female) who commenced the ACE program after 10 weeks. Data analysis was conducted for 82 female participants. All students completed the CDI, Adolescent Coping Scale and Children's Automatic Thoughts Scale at pre-And post-intervention. The intervention group alsocompleted a 6-month follow-up. At post-intervention, female ACE participants reported significantly reduced depressive symptoms and significantly improved coping skills compared with the control group. Using cognitive-behavioural and interpersonal techniques, the ACE program diminished depressive symptoms and increased coping skills in girls screening at-risk for depression.

The Achieving, Behaving, Caring Project for Preventing ED: Two-Year Outcomes

Two-year outcomes are reported for a school-based early intervention program for 82 children identified as at risk for emotional disturbance (ED) by their kindergarten teachers. Matched pairs of children were randomly assigned to Parent-Teacher Action Research (PTAR) teams or to a control group for their first- and second-grade years. Teachers also provided social skills instruction to all participants, along with their classmates. At the end of the 2-year period, the PTAR group showed significantly greater reductions than the control group in teacher-reported internalizing problems and delinquent behavior; parent-reported total problems, externalizing, and delinquent behavior; and observed internalizing problems in the classroom. PTAR group parents also reported significantly greater increases in their children's cooperation, self-control, and total competence, as well as in their own feelings of empowerment in obtaining school-based services for their children. The findings demonstrate long-term incremental benefits of PTAR teams combined with whole-class social skills instruction for children at risk for ED.

Impact of an infection control program in a specialized preschool

Background: The purpose of this study was to design and implement a comprehensive infection control program and measure its effects on the number and types of infectious illnesses experienced by children attending a specialized preschool program. Methods: Participants in the study were children with Down syndrome enrolled in a school-based early intervention program. The ages of the children ranged from 6 weeks to 5 years. Through a series of parental questionnaires, the number and types of infections in the children were chronicled for a year before and a year after the implementation of an infection control intervention program. Interventions included infection control lectures, handouts, posters, and attention to environmental cleaning and disinfection, with an emphasis on toys. Compliance with these measures was monitored and recorded. Results: During the interventional year the median number of total illnesses/child/month decreased significantly from the baseline year (0.70 vs 0.53 p < 0.05), with a trend toward a decrease in the number of respiratory illnesses (0.67 vs 0.42, p < 0.07). Significantly decreases were also seen for the median number of physician visits (0.50 vs 0.33, p < 0.05), courses of antibiotics administered (0.33 vs 0.28, p < 0.05), and days of school missed as a result of respiratory illness (0.75 vs 0.40, p < 0.05). Conclusions: This study demonstrates a decrease in infection rates with the implementation of a comprehensive educational and environmental infection control program in a day care setting.