Young Adult Outcomes from the Good Behavior Game: a classroom behavior management program applied in 1 st and 2 nd G

1. Young Adult Outcomes from the Good Behavior Game: a classroom behavior management program applied in 1st and 2nd Grades Sheppard G. Kellam, M.D. AIR Center for Integrating Education and Prevention Research in Schools Presentation at SREE December 11, 2006 Funding since 1984 by National Institutes of Health: NIDA, NIMH, NICHD

2. Co-Authors Sheppard G. Kellam, M.D. 1,4 C. Hendricks Brown, Ph.D. 2 Jeanne Poduska, Sc.D. 1 Carla Ford, Ph.D. 1 Amy Windham, Ph.D. 1 Natalie L. Keegan 1 John Reid, Ph.D. 3 Nicholas Ialongo, Ph.D. 4 Hanno Petras, Ph.D. 6 Bonnie Copeland, Ph.D. 5 Linda Chinnia, 5 1 American Institutes for Research, Center for Integrating Education and Prevention Research in Schools 2 University of South Florida, Prevention Science Methodology Group 3 Oregon Social Learning Center 4 Johns Hopkins University Bloomberg School of Public Health 5 Baltimore City Public School System 6University off Maryland

3. The Baltimore Education and Prevention Partnership • The Baltimore City Public School System (BCPSS) has collaborated in 3 generations of education and prevention epidemiologically-based randomized field trials. • Trials were directed at helping children master key social task demands in 1st and 2nd grade classrooms. • Interventions were tested separately, then together. • The 1st generation will be our main focus today, where the Good Behavior Game (GBG) was tested by itself and the children, now young adults, were recently followed to ages 19-21.

4. Developmental Epidemiological Randomized Preventive Trials • One of a set of current prevention research strategies • Intervention is directed at early risk factor to reduce risk and improve developmental paths • Defining population helps control selection bias • Allows study of means, but also variation in developmental paths and in impact—”who benefits and under what conditions” • Periodic follow-up to determine impact on paths and outcomes

5. Early Risk in Prevention and Education Research • Over the last four decades much has been learned about early risk factors and paths leading to behavioral, mental health, and school problems. • Most if not all are strongly related to academic failure, also a major risk factor for later school drop-out, delinquency, drug abuse, depression, and other problem outcomes. • Aggressive, disruptive behavior as early as 1st grade has been repeatedly found a risk factor for later school failure, delinquency, violence, drug abuse, and high risk behaviors.

6. Stancavage: Theory

7. Design of 1st Generation Baltimore Trial: Aimed at Aggressive Behavior and Poor Achievement Separately • 41 1st grade classrooms in 19 schools • Across schools: 3 or 4 schools in each of 5 low to low/mid SES urban areas were matched. 70% African American. Schools were randomly assigned either to the standard program (control); or to an enhanced curriculum (Mastery Learning--ML); or to a classroom behavior management program (Good Behavior Game--GBG). • Within intervention schools: Children were balanced across all 1st grade classrooms.1st grade classrooms and teachers were randomly assigned to standard program classrooms or to intervention classrooms.

8. Study Design cont. • In the 1st generation, the GBG trial was done over 1st and 2nd grades in 2 consecutive first grade cohorts. • 1st cohort with 40 hours of teacher training and support thru the year. This was the effectiveness trial, and will be our focus today. • 2nd cohort with same teachers with little training and support, tested the sustainability of results—the naïve trial.

9. 10 Mean = 1.85 Std. Dev. = .42 8 N = 40 6 Frequency of classrooms 4 2 0 1.00 2.00 Level of Classroom Aggression Classroom Levels of Aggressive, Disruptive Behavior 8-10 Weeks After Random Assignment in First Grade (control classrooms)

10. High Risk Children in Well vs Poorly-Managed Classrooms (control classrooms) • If the top 25% of all children on aggressive behavior were in disrupted classrooms, their risk of severe aggressive behavior problems by middle school was up to 59 times the average child’s. • If similar children were in well-managed classrooms, the risk was 2.7 times the average child’s. • Random assignment of children and teachers within schools allowed inferences re classroom effect.

11. Impact of Poorly Managed Classrooms on Teachers • The number-one reason for teacher burn-out is the inability to manage classrooms. • Teachers need tested tools to manage classrooms, i.e., to teach children how to be students. • A large portion of 1st grade teachers need such tools, e.g. ~50% in Baltimore.

12. Goals of the Good Behavior Game (GBG) • Provide teachers a classroom-wide method to socialize children into the role of student • Reduce classroom aggressive, disruptive behavior among children to enhance classroom teaching and learning • Prevent school failure, drug abuse, delinquency, and other problem outcomes

13. The History of the Good Behavior Game (GBG), a Classroom-wide Program • The GBG was originally developed by Barrish, Saunders, & Wolfe at the University of Kansas in the late 1960s • The GBG had been reported in over 20 scientific papers, none randomized field trials, prior to the Baltimore large scale epidemiologically based trials.

14. GBG Implementation • In Baltimore, the GBG consists of dividing the 1st grade class into 3 heterogeneous teams. • Teacher exhibits a large poster that states proper student behaviors, i.e., classroom rules. • Teams are rewarded for each child’s pro-social behavior, and not rewarded when a child is disruptive. It is “group contingent.”

15. GBG Implementation (cont’d) • Early in the year, the GBG was played systematically for ten minutes, 3 times a week, and the time extended over the year. • Rewards were more abstract as the year went on. It was carried out in first and second grades. Kellam: Framework

16. Measure of Early Classroom Aggressive, Disruptive Behavior For this presentation a sub-set of Teacher’s Observations of Classroom Adaptation (TOCA R), a measure of each child’s social adaptation to classroom rules for student behavior • Structured 2 hour interview with the teacher, not a checklist • Ratings were obtained for each child in the classroom in fall and spring of 1st and 2nd grades, and thereafter in spring of 3rd through 7th grades • TOCA Aggressive, Disruptive Items on 6 point scales: (1) breaks rules, (2) harms others and property, (3) breaks things, (4) takes others property, (5) fights, (6) lies, (7) teases classmates (8) yells at others, (9) stubborn, (10) trouble accepting authority

17. The Young Adult Follow-up Data • Ages 19-21 • 2 Hour (average) telephone interview with each respondent. • Developmental, psychological and psychiatric status, WHO version of the CIDI for diagnoses. • Juvenile court and school records. • Social adaptational status in social fields of parental family, school, work, intimate relations, marital family if any, peers.

18. GBG Impact vs All Controls on Any Service Use for Males

19. GBG Impact vs All Controls on Alcohol Abuse or Dependence Disorder for Males

20. GBG Impact vs All Controls on Drug Abuse or Dependence Disorder for Males

21. GBG Impact vs All Controls on Drug Abuse or Dependence Disorder for Females

22. GBG Impact vs All Controls on Antisocial Personality Disorder for Males

23. GBG Impact vs All Controls on Regular Smoking for Males

24. GBG Impact vs All Controls on Completed High School for Males

25. GBG Effectiveness trial vs. GBG Sustainability Trial • Although the results from the 1st generation’s 1st cohort were impressive, the results from the 2nd cohort-- the “sustainability trial”-- except for drug abuse and dependence disorder-- revealed less impact, but in the same direction. • Since the mid 1980s we have learned more about the problem of sustainability of practices and results over subsequent cohorts. • We are currently trying a model with BCPSS based on multi-level mentoring and continual monitoring.

26. Lessons Learned I • First-grade classrooms are of central importance to later academic, mental, and behavioral health. • A relatively simple universal method of classroom behavior management in 1st and 2nd grades, aimed at aggressive, disruptive behavior-- a risk factor shared by a set of long term outcomes-- appears to improve the set of long term outcomes. • Females are less responsive to GBG than are higher risk males. More research is needed re females.

27. Lessons Learned II • Without a system to mentor, model, and monitor teacher practices over time, GBG practices are prone to deteriorate. • Teachers need support from principals; principals from area leaders; area leaders from chief academic and executive officers.

28. Lessons Learned III • Randomized field trials (RFTs) are vital in testing what works, for which children, in what conditions. • Demographic epidemiology, analytic modeling, Pre-RFT observational studies—lead to testing with RFT designs • Partnerships among researchers and school districts are essential to support such studies, and dissemination.

29. Thankyou, The End

30. Had baseline TOCA Followed as young adult

31. 2nd Generation Ed/Prev Trial in Baltimore Schools • Combined curriculum/instruction (C&I) and GBG from 1st trial • New family/classroom partnership program (FCP) tested separately • Children, teachers, intervention condition all randomly assigned within 9 schools • 3 Classrooms randomly assigned within each school to: 1) C&I + GBG; 2) FCP alone; or 3) the standard program • Results: By middle school combined GBG and C&I improved both achievement and behavior • Family/classroom partnership by itself had modest impact

32. 3rd Generation Ed/Prev Trial in Baltimore Schools • Integrate 3 components into 1 Whole Day Program (WD): GBG+ C&I+ F/C partnership • 8 Development Schools helped design and refine interventions and measures • Within 12 trial schools, random assignment of all 1st grade children, teachers, and classrooms to WD or standard program • Children in 12 Whole Day 1st grade classrooms are compared to children in 12 Standard Program classrooms

33. Phases of Education and Prevention Trials

34. Baltimore analytic model Decreased Later Substance Abuse Decreased Aggressive, Disruptive Classrooms Decreased Individual Aggression Classroom Behavior Management Individual Classrooms Aggression Decreased Later Conduct & Anti- social Personality Disorders Teachers’ Effective Academic Instruction Increased Achievement Poor Poor Improved Reading Skills Reading Skills Achievement School Success & Decreased Drop-Out Decreased Depressive Symptoms Effective Family-Classroom Partnerships Depressive Symptoms Decreased Later Depressive Disorders • Other mediating or moderating variables: • Family and poverty • Deviant peers • School building • Community economic health, • resources, drugs, and violence Whole Day First Grade Education and Prevention Program Whole Day • • •

35. Prevention Research Strategies DEVELOPMENTAL EPIDEMIOLOGY: directed at early proximal targets COMMUNITY PREVENTION: directed at Community & School proximal targets MORE IMMEDIATE RISK: directed at more recent proximal targets COMMUNITY / SOCIETAL: directed at Policies & Laws as proximal targets Kellam: Framework