The Effectiveness and Micro-costing Analysis of a Universal, School-Based, Social–Emotional Learning Programme in the UK: A Cluster-Randomised Controlled Trial

There are a growing number of school-based interventions designed to promote children’s social and emotional learning. One such intervention, PATHS (Promoting Alternative Thinking Strategies), was evaluated in a randomised controlled trial involving 5074 pupils aged 4–6 years at baseline in 56 primary schools across a large city in the UK. The programme was implemented for two academic years. The primary outcome measure was the teacher-rated Strengths and Difficulties Questionnaire (SDQ). A secondary measure was the PATHS Teacher Rating Scale (PTRS). Observations of child and teacher behaviours were undertaken in a third of intervention and control schools using the Teacher–Pupil Observation Tool (T-POT). Regarding fidelity, dose and adherence were measured via weekly logs completed by teachers, and a semi-structured questionnaire completed by PATHS coaches was used as a global measure of fidelity (capturing adherence, dose and quality). A cost-consequence analysis examined programme costs from a multi-agency public sector perspective. At 1 year post-baseline, there were no statistically significant differences between the programme and control groups on the SDQ subscales or the SDQ total difficulties and impact scores. There were statistically significant differences favouring the programme group for six out of 11 subscales on the secondary outcome measure (PTRS). At 2 years post-baseline, there were no statistically significant differences between the groups on either measure. Fidelity, according to the global measure, was relatively strong, and there was no relationship between fidelity and treatment effects. The average cost of PATHS was £12,666 per school or £139 per child. The study, which was fully powered and independent of the programme developer, shows no statistically significant effect of the programme on child behaviour or emotional well-being. Trial registration site and number: www.controlled-trials.com: ISRCTN 32534848

Coaching Models of School-Based Prevention and Promotion Programmes: A Qualitative Exploration of UK Teachers' Perceptions

There has been increased interest in recent years regarding the utility of imported universal prevention and promotion (P&P) programmes in UK schools, many of which have a coaching model attached. However, there have been relatively few studies exploring the cultural transferability and social validity of these models, even though evidence suggests that these factors are important to the successful implementation of the programmes, and thus the achievement of the intended outcomes. The aim of the current study was to explore the coaching practices that teachers report experiencing, and to further understanding of the perceived benefts of these coaching practices to teachers. The sample consisted of 33 teachers implementing one of two universal, school-based P&P programmes, Good Behavior Game and Promoting Alternative Thinking Strategies as part of large-scale, randomised controlled trials. Qualitative, semi-structured interviews were conducted, and data were analysed thematically utilising a hybrid approach. Teachers typically reported engaging in six distinct practices with their coaches. While the majority of these practices were in line with coaching literature, there were some discrepancies between intended coaching practices and teachers’ reports. The coaching practices were generally perceived to be acceptable to teachers. Two unanticipated practices, validation and motivation, appeared to be of particular value to teachers, although these are not currently a prominent feature in existing coaching models. The fndings provide implications for improving the development of socially valid coaching models for UK schools

School Outcomes of Aggressive-Disruptive Children: Prediction From Kindergarten Risk Factors and Impact of the Fast Track Prevention Program

A multi-gate screening process identified 891 children with aggressive-disruptive behavior problems at school entry. Fast Track provided a multi-component preventive intervention in the context of a randomized-controlled design. In addition to psychosocial support and skill training for parents and children, the intervention included intensive reading tutoring in first grade, behavioral management consultation with teachers, and the provision of homework support (as needed) through tenth grade. This study examined the impact of the intervention, as well as the impact of the child's initial aggressive-disruptive behaviors and associated school readiness skills (cognitive ability, reading readiness, attention problems) on academic progress and educational placements during elementary school (Grades 1–4) and during the secondary school years (Grades 7–10), as well as high school graduation. Child behavior problems and skills at school entry predicted school difficulties (low grades, grade retention, placement in a self-contained classroom, behavior disorder classification, and failure to graduate). Disappointingly, intervention did not significantly improve these long-term school outcomes

Can Genetics Predict Response to Complex Behavioral Interventions? Evidence from a Genetic Analysis of the Fast Track Randomized Control Trial

Early interventions are a preferred method for addressing behavioral problems in high-risk children, but often have only modest effects. Identifying sources of variation in intervention effects can suggest means to improve efficiency. One potential source of such variation is the genome. We conducted a genetic analysis of the Fast Track randomized control trial, a 10-year-long intervention to prevent high-risk kindergarteners from developing adult externalizing problems including substance abuse and antisocial behavior. We tested whether variants of the glucocorticoid receptor gene NR3C1 were associated with differences in response to the Fast Track intervention. We found that in European-American children, a variant of NR3C1 identified by the single-nucleotide polymorphism rs10482672 was associated with increased risk for externalizing psychopathology in control group children and decreased risk for externalizing psychopathology in intervention group children. Variation in NR3C1 measured in this study was not associated with differential intervention response in African-American children. We discuss implications for efforts to prevent externalizing problems in high-risk children and for public policy in the genomic era