Effects of a universal classroom behavior management program in first and second grades on young adult behavioral, psychiatric, and social outcomes

Abstract

Background-The Good Behavior Game (GBG), a method of classroom behavior management used by teachers, was tested in first-and second-grade classrooms in 19 Baltimore City Public * Supplementary data on Cohort 2 and additional information on the Good Behavior Game intervention are available with the online version of this paper at http://dx.doi.org by entering doi: xxxxxxxx.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Schools beginning in the 1985-1986 school year. The intervention was directed at the classroom as a whole to socialize children to the student role and reduce aggressive, disruptive behaviors, confirmed antecedents of later substance abuse and dependence disorders, smoking, and antisocial personality disorder. This article reports on impact to age 19-21. NIH Public AccessMethods-In five poor to lower-middle class, mainly African American urban areas, three or four schools were matched and within each set randomly assigned to one of three conditions: 1) GBG, 2) a curriculum-and-instruction program directed at reading achievement, or 3) the standard program. Balanced assignment of children to classrooms was made, and then, within intervention schools, classrooms and teachers were randomly assigned to intervention or control.Results-By young adulthood significant impact was found among males, particularly those in first grade who were more aggressive, disruptive, in reduced drug and alcohol abuse/dependence disorders, regular smoking, and antisocial personality disorder. These results underline the value of a first-grade universal prevention intervention.Replication-A replication was implemented with the next cohort of first-grade children with the same teachers during the following school year, but with diminished mentoring and monitoring of teachers. The results showed significant GBG impact for males on drug abuse/dependence disorders with some variation. For other outcomes the effects were generally smaller but in the same direction.

Methods for testing theory and evaluating impact in randomized field trials: Intent-to-treat analyses for integrating the perspectives of person, place, and time

“…One or more of these higher levels also serve as units of assignment of the intervention. For example, the First Generation Baltimore Prevention Program trial, described in the second row of Table 1, involved 41 first-grade classrooms in 19 elementary schools (Brown et al, 2007a;Kellam et al, 2008). Thus, defining a denominator for an ITT analysis first requires defining which of these first-grade classrooms should be included in the analysis, then which students should be included based on their assignment to these classrooms.…”

“…Prior to starting this trial, we selected 19 elementary schools from five diverse urban areas in Baltimore City with the help of city planners and school administrators. Our goal was to ensure ethnic and social class diversity across schools, to ensure that we would have sufficient classrooms to permit balancing the intervention assignments in these schools, and to ensure that none of these schools would be closed, divided, or otherwise reorganized during the trial (Brown et al, 2007a;Kellam et al, 2008). Schools were also chosen so that they had either two or three first-grade classrooms.…”

“…Thus if a classroom were assigned to the GBG but the teacher never performed the GBG or performed it poorly then the ITT analysis would still assign this classroom to the GBG condition. True to this definition, the GBG impact analyses in Kellam et al (2008) and Poduska et al (2008) were based on the combined GBG classrooms, the internal GBG control classrooms, all external control classrooms, and internal ML controls classrooms in the ML schools. Only the ML classrooms were excluded because they provided no information about the GBG impact nor could they be used as controls because of ML's own potential impact.…”

“…To protect against this, in evaluating the Good Behavior Game in the First Generation BPP trial, the appropriate individual level denominator consists of all first graders who were assigned to any of the GBG classrooms and all controls, excluding late entrants and program dropouts/late entrants. Balance across intervention conditions is provided by randomization at the classroom level, as demonstrated by nonsignificant differences in baseline characteristics by intervention condition in multilevel models that account for the group level of randomization (i.e., Section 2.4 of Kellam et al, 2008). Because this denominator is formed from the population that is present before the intervention occurs, it is not subject to treatment dropout.…”

“…However, the imputation model can use additional information on other variables measured across the study to help assess intervention impact. In our analyses reported in Kellam et al (2008), we included self-report measures of depressive symptoms in the imputation model and concluded that the effect was stronger using multiple imputation compared to the traditional FIML model.…”