Reducing Behavior Problems in the
Elementary School Classroom

Appendix D:
Technical Information on the Studies

Recommendation 1:
Identify the specifics of the problem behavior and the conditions that prompt and reinforce it

Level of evidence: Moderate

The panel judged the level of evidence supporting this recommendation to be moderate. A number of single-subject research studies demonstrate the effectiveness of behavioral interventions that are designed to address and modify what prompts and reinforces the problem behaviors of special and general education elementary school students.(1) Three recent single-subject studies examined the effectiveness of interventions chosen for individual students after teachers gathered data on the antecedents and consequences of students' problem behaviors, as opposed to interventions selected without attention to these factors.(2) Findings demonstrated greater success in reducing inappropriate behaviors through the use of approaches based on the gathered data. An emerging literature provides further evidence that general educators can play a key role in this information-gathering process by identifying the context of a problem behavior and selecting appropriate strategies that meet students' needs. But more research is needed to determine whether consistent results can be obtained when the strategies are implemented by the teacher without professional consultation.(3)

Research suggests that identifying a problem behavior's specific antecedents and consequences and then tailoring an approach to address the distinct needs of the individual student in the classroom context are more likely to yield positive outcomes than an intervention applied without attention to the factors prompting and reinforcing it.(4) In fact, strategies not linked to the specific context of the misbehavior demonstrate increases in the occurrence of the problem behavior, perhaps because strategies used to address it inadvertently reinforce the misbehavior.(5)

For example, in one single-subject study, researchers compared the outcomes of two interventions designed for three general education elementary students with aggressive and off-task behaviors.(6) One approach was based on assessment information gathered about each student's specific behavioral context and reinforcement (antecedents and consequences), contrasted with an approach based on general classroom management principles to address the topography of the problem behavior (that is, what the behavior problem looks like versus the underlying cause). Using an alternating-treatment, multiple-baseline design across participants, the researchers found that assessment-based interventions were more effective in decreasing problem behavior. In fact, data showed higher levels of problem behavior with the non-assessment-based approach than with the baseline condition. One potential limitation of the study, however, was that in all three cases the non-assessment-based interventions preceded the assessment-based interventions, so the study did not control for treatment effect order.

In a follow-up study, researchers measured the effectiveness of assessment-based interventions with two middle school students in general education classrooms.(7) The investigators controlled for treatment order effects by counterbalancing the two intervention approaches between the two students. Similar to the earlier findings, the single-subject withdrawal design demonstrated that the assessment-based interventions were more effective in lowering the number of problem behaviors.

Recently, investigators extended the research of these previous studies by examining the efficacy of assessment-based versus non-assessment-based interventions.(8) Results of their multi-treatment single-subject design involving four elementary school students demonstrated clear and immediate decreases in problem behavior with the introduction of assessment-based interventions and strong increases in problem behavior with each introduction of non-assessment-based intervention.

Examples of classroom studies that demonstrate the feasibility and effectiveness of general education teachers applying assessment-based approaches

Three single-subject research studies have demonstrated the success of an approach that specifically identifies and modifies what is prompting and reinforcing the problem behaviors in general education settings, with general education teachers taking substantive roles in the data gathering, design, and implementation of behavioral strategies. One research group successfully trained general education elementary school teachers to manipulate teacher and peer attention to problematic off-task and disruptive behaviors while fulfilling regular classroom responsibilities and routines.(9) In another study, investigators trained teachers to respond effectively to inappropriate behaviors by following a reinforcement protocol developed for each student exhibiting problem behaviors.(10) Recently, researchers used a collaborative process (including graduate school students who acted as project liaisons and consultants) with general education teachers as the primary interventionists and assessors, finding that the teachers consistently implemented assessment-based interventions that resulted in decreases in problematic behaviors.(11) However, these studies do not provide enough evidence to conclude that these practices will be effective for all students or in all settings. The studies differ in data collection methods (using a variety of both direct and indirect assessment measures, such as observations and interviews), in the extent of assistance from behavioral consultants, and in the methods used to select interventions and strategies on the basis of accumulated knowledge about the problem behavior.

As a result, some researchers have called for additional studies to be conducted with a variety of target behaviors across different settings because of concerns regarding inconsistencies when the approach involves different types of students, school-based personnel, and assessment methods.(12) For example, in one study investigators selected staff members from four elementary schools who had been trained in how to use the outcomes of a comprehensive assessment process to develop assessment-based intervention plans.(13) They then formed school-based intervention teams and served as facilitators for a total of 31 cases. The same cases also were distributed to three national experts who selected interventions based on the identified contextual data for each case. Comparisons between team and expert intervention strategy selection revealed that school-based personnel were more likely to select punitive and exclusionary strategies, regardless of the contextual information. Thus, in real-world school settings the link between a problem behavior's antecedents and consequences and the selection of an appropriate intervention is more complex than has been recognized in the literature.

One additional limitation of the literature is that no studies to date have experimentally examined the effects of general education teachers alone identifying the antecedents and consequences of problem behaviors and selecting suitable strategies to intervene with the problem behavior on the basis of that information. All studies employed some amount of behavioral consultation in the process. However, the panel believes that because research shows a strong link between understanding a problem behavior's context and applying an effective remedy, teachers should try to acquire the skills, experience, and confidence needed to carry out this information-gathering process and seek out their colleagues and the student's family for additional help and guidance in addressing behavior problems in their classrooms when necessary.

Recommendation 2:
Modify the classroom environment to decrease problem behavior

Level of evidence: Strong

The panel rated the level of evidence for this recommendation as strong. This recommendation reflects best practices in elementary classroom management and pedagogy, as defined and articulated by experts in the field since the early 1970s.(14) Research across decades has demonstrated that consistent implementation and reinforcement of well defined classroom rules is associated with positive student behavior in both the classroom and other school settings, such as the playground and hallways.(15) More recently, three randomized controlled trials,(16) one quasi-experimental design,(17) and six single-subject research studies (18) demonstrate empirical support for

• preventative classroom management, with particular emphasis on teachers' attention to specific environmental variables that evoke problem behaviors;(19) and for
• direct and differentiated instructional strategies to increase student engagement and decrease problem behaviors.(20)

Examples of studies that demonstrate the effectiveness of modifying the classroom environment

Research dating back almost four decades has demonstrated the effectiveness of group contingency programs (where students work in teams in which each individual is responsible to the rest of the group) in both preventing and intervening with behavior problems. Upon introducing these programs to students, teachers identify specific inappropriate behaviors (for example, verbal and physical disruptions or noncompliance) that, if displayed, will result in a team's receiving a checkmark. By the end of the lesson, teams that have not exceeded the maximum number of marks are rewarded, for example with a preferred activity or privilege, whereas teams that exceed the behavioral standard receive no rewards. Eventually, the teacher begins the game with no warning and at different periods during the day so students are encouraged to monitor their behavior continuously and strive to meet expectations. Researchers first documented the effects of such a program in an investigation of the Good Behavior Game, which demonstrated a reduction in the disruptive out-of-seat and talking behaviors of 24 4th-grade students in a general education classroom.(21)

Since then, classroom-based contingency programs modeled on the Good Behavior Game have been applied to other behaviors (for example, aggression or shyness), grade levels, and settings, and its impacts have been demonstrated both immediately following the intervention (at the end of 1st grade) and longitudinally (five years after the intervention) with hundreds of children.(22) Data demonstrated fewer aggressive and shy behaviors at the end of 1st grade and positive outcomes at 6th grade, especially for males displaying early aggressive behavior. Two randomized controlled trials were conducted with a sample of 678 students entering 1st grade in nine Baltimore City public elementary schools.(23) Using a randomized block design, three 1st grade classrooms in each of nine schools were randomly assigned to either a classroom-centered intervention using the Good Behavior Game or a family-school partnership intervention, or to a control condition. Findings revealed that in 6th grade, students who had been in the Good Behavior Game condition in 1st grade were significantly less likely than students in the control condition to be diagnosed with conduct disorders or to have been suspended from school. Participants in both the Good Behavior Game and family-school partnership interventions received significantly better ratings from their teachers for conduct problems than students in the control group.

Two randomized controlled trials evaluated the effectiveness of training teachers to use comprehensive classroom management approaches with the goals of reducing students' time off task and disruptive behaviors in the classroom.(24) Participants in the programs were trained to create and maintain well-organized classrooms and to use the instructional and skill-building strategies as prescribed, but findings were mixed regarding the impact of these approaches on students' task engagement and academic success.

One randomized controlled trial conducted with teachers from two school districts investigated the effectiveness of a classroom management program called COMP (Classroom Organization and Management Program).(25) COMP guides teachers in creating a well-organized classroom, establishing positive management policies, and maintaining these procedures throughout the year. The experimental study included 14 elementary school teachers assigned to the COMP intervention and 15 assigned to the control group. The COMP teachers received two 1-day workshops in the fall, with control group teachers receiving the same training at the end of the year. Observational data indicated that COMP teachers exceeded the control group in the use of key management principles, and their students showed statistically significantly greater task engagement and academic success and fewer inappropriate behaviors in the classroom.

However, another experimental study examining the effectiveness of a teacher training series that emphasized similar classroom management skills, reinforcement contingencies, and instructional and skill-building strategies showed less definitive results. Researchers examined the Incredible Years Training for Teachers Series in a randomized controlled group evaluation.(26) The teacher training series focused on the effective use of teacher attention, praise, and encouragement; how to manage inappropriate classroom behaviors; the importance of building positive relationships with students; and how to teach empathy, social skills, and problem-solving. Observational data indicated increases in teachers' use of praise and encouragement and reduced use of criticism and harsh discipline. But effects on concomitant student outcomes (for example increases in positive interactions with teachers and peers, improved task engagement, and reduction in aggression), although reported as statistically significant by the study's authors, could not be independently confirmed.(27)

In a series of four single-subject studies, student choice as an intervention also has been empirically demonstrated to be effective in decreasing inappropriate behaviors of students with emotional and behavioral disorders. Student choice includes many variations, such as choosing the specific task to complete,(28) materials to be used,(29) and sequence of activities.(30) For example, researchers investigated the effects of choice on the academic engagement of elementary school students with emotional and behavioral challenges using a multi-phased, single-subject design.(31) In the first analysis, two participants were given choices from menus of academic tasks that were pertinent to their educational objectives in English and spelling. Reversal designs showed that the choice condition increased task engagement and reduced disruptive behavior for both students. An additional analysis was performed with a third student in an effort to further distinguish the effects of choice from preference. In this study, one of the no-choice phases was yoked to a previous choice condition. This analysis demonstrated that the choice condition was superior to baseline and yoked-control phases, as determined by levels of task engagement and disruptive behavior.

Examples of studies that demonstrate the effectiveness of modifying classroom and individual instructional strategies

Reviews of research and retrospective observations of students who exhibit problem behaviors have concluded that these students are also likely to have poor academic performance,(32) although the direction of relationship between academics and behavior remains unclear.(33) Three single-subject studies have shown that curricular variables, such as assigning work that exceeds a student's skill level (34) or attention span, using a single and constant learning task (for example, written assignments or workbook pages) rather than a variety of activities, and delivering instruction at a slow pace or without sufficient interactive practice, can set the occasion for or exacerbate problem behaviors in the classroom.(35)

Another single-subject investigation examining the techniques of direct instruction suggested that lessons delivered in small steps, at the appropriate level of difficulty, and with ample opportunities for practice result in higher levels of on-task behavior and student engagement.(36) Single-subject research data also support the practice of increasing the number of opportunities that students have to respond to academic or social prompts, thereby increasing academic engaged time and fluency with the material and reducing inappropriate behavior. In one study researchers increased the number of teacher-presented opportunities to respond from 1.7 per minute during a baseline phase to 3.5 during an intervention phase in a class of nine students (ages 8 through 12) with emotional and behavioral disorders. The increase in opportunities to respond was associated with higher correct responding, fewer disruptive behaviors, and increased on-task behavior.(37)

There also is evidence that using effective instructional principles positively impacts students' academic and social behaviors. In one alternating-treatment design study researchers compared the effects of instruction incorporating modeling, guided practice, and student independent practice (that is, direct instruction, following guidelines derived from the literature)(38) with two other types of instruction: cooperative learning, where students participated in teams of one target student and two or three classmates, and independent learning, where participants were given individual folders detailing the lesson for the day.(39) Findings demonstrated higher rates of on-task behavior and lower rates of disruptive behavior among four elementary school students with emotional disorders in a self-contained classroom who were in the direct instruction group, relative to their performance in the other two conditions. The independent learning approach resulted in increased levels of disruptive behavior and decreased levels of on-task behavior relative to the direct instruction approach. The authors concluded that the instructional system underlying direct instruction practices reduced the disruptive behavior of students, and that certain instructional methods can serve as aversive stimuli in classrooms.

Finally, peer tutoring is an instructional strategy in which students work in pairs (or groups) as a tutor and tutee(s). The goals are to improve academic learning, develop cooperative work habits, and increase positive social interactions among students. Using both experimental group and single-subject research designs, researchers have demonstrated the effectiveness of peer tutoring as an instructional strategy for students with behavior problems.(40) One randomized controlled trial examined the effects of peer tutoring and parent involvement interventions on mathematics achievement of 84 academically at-risk 4th and 5th graders. The findings demonstrated that students who participated in the peer tutoring intervention groups (with or without parent involvement) displayed higher levels of accurate mathematics computations, and both groups also showed significant behavioral improvements in the classroom (decreases in acting out behaviors and increases in task engagement, as rated by their teachers) compared with control students.(41) Additionally, a single-subject research study investigated the effects of class-wide peer tutoring on the classroom behavior and academic performance of students with and without attention deficits.(42) The study included 18 students with attention problems (as reported by their parents and teachers) and 10 typically developing classmates in 1st-5th grades across schools in two districts. During the treatment condition, tutoring pairs worked with each other for about 20 minutes a day for 3 to 4 days a week on specific academic skills, switching roles (from tutor to tutee) every 10 minutes. The intervention was associated with significant increases in active engagement in academic tasks for both students with and without attention deficits, reductions in off-task behaviors for most study participants, and improvements in academic performance.

Recommendation 3:
Teach and reinforce new skills to increase appropriate behavior and preserve a positive classroom climate

Level of evidence: Strong

The panel rated the level of evidence for this recommendation as strong. This recommendation is based on five randomized controlled trials (43) and three single-subject research studies (44) examining the effectiveness of teaching and reinforcing new appropriate behaviors to students with problem behaviors. These studies have shown success in teaching students replacement behaviors (such as appropriate attention-seeking, social skills, problem-solving, self-management skills, and self-control strategies) and, as a result, in reducing inappropriate behaviors such as disruption and aggression. Furthermore, studies that span almost half a century demonstrate that positive reinforcement is associated with initial and long-term academic benefits and with increases in the frequency of appropriate behaviors among general education students.(45)

Examples of studies that demonstrate the effectiveness of teaching new skills to increase appropriate behaviors

Studies of classroom-based interventions for students with behavior problems have focused on enhancing skills, such as appropriate attention-seeking, social skills, problem-solving, self-management skills, and self-control strategies. One randomized controlled trial (46) and two single-subject research studies (47) have demonstrated that reductions in inappropriate behaviors, such as disruption and aggression, and increases in academic engagement are associated with skill-building instruction and reinforcement of positive behavior.

For example, one recent randomized controlled trial involving 165 students in 4th and 5th grades demonstrated that teaching students problem-solving skills useful in anger-provoking situations can improve teacher-reported behavior, including self-control and aggression.(48) Teachers delivered the class-wide intervention to all students (both those identified with behavior problems and their typical peers) twice a week for 10 weeks, rated the social skills curriculum positively, and reported that behavior was significantly improved relative to comparison students and maintained over several months.

Two other groups of investigators, using single-subject research designs, have shown that self-monitoring interventions with older elementary school students lead to increases in academic engagement and decreases in off-task behaviors.(49) Researchers examined the relationship between self-monitoring of on-task behavior, overall teacher perceptions of student performance, task completion, and frequency of teacher praise. The single-subject multiple-baseline design was employed across class periods for one 4th grade student with learning disabilities and problem behavior in a general education classroom. Eight male students were randomly selected from a pool of 16 to serve as comparison students. Results indicate that implementation of the self-management technique resulted in a decrease in the frequency of problem behaviors and an increase in on-task behavior and task completion. In addition, the intervention was associated with increased positive teacher perceptions of student performance.

Recently, another group of investigators examined whether a self-monitoring strategy, coupled with a student-teacher matching strategy (assessing if students' behavior ratings on a four-point scale were matched within one point to teachers' ratings), would improve the classroom social skills of five inner-city middle school students who were at risk for school failure.(50) Using a multiple-probe design across students and class periods, the researchers found that self-monitoring and student-teacher matching led to increases in appropriate social skills and decreases in off-task behavior for all five students across all class periods. Data suggested that self-monitoring is an effective procedure to promote the use of appropriate social skills across multiple general education settings, but improvements were more dramatic and consistent when a matching strategy also was used.

Additional studies, including one randomized controlled trial and one single-subject design, have demonstrated the effects of a specific classroom-based early intervention program, First Step to Success, designed to reduce antisocial behaviors by modeling and teaching appropriate replacement skills and behaviors and rewarding students when those behaviors are used.(51) First Step consists of three interconnected modules: proactive, universal screening of students for emotional and behavioral risks; a classroom-based intervention involving the teacher, peers, and the target child; and a home-based module of parent or caregiver education to support the student's school adjustment. The classroom strategy capitalizes on a brief consultative relationship established between the teacher and a behavioral coach who works with teachers for 10 days to model strategies to teach students appropriate replacement behaviors and reward students when those behaviors are used. During the school day the teacher gives the student visual cues (showing a green or red card) to indicate whether the student is on task and using appropriate behaviors. Throughout the day the student accrues points toward his or her behavioral goal. A student who makes the daily goal may choose an enjoyable activity for the whole class.(52) Using a cohort design with random assignment of 46 kindergartners to intervention or wait-list control conditions, students in the First Step program showed statistically significant increases in adaptive and on-task behaviors and decreases in maladaptive behaviors relative to control group students and maintained gains into the primary grades. In addition, teachers using the program in their classrooms expressed a high degree of satisfaction, remarking that it was easy to learn and implement and had favorable results with their students.(53)

The most recent study conducted by Beard and Sugai (2004) examined the effects of First Step on rates of problem behavior and academic engagement for six kindergarten students who were identified by their teachers as having high rates of problem behaviors. Half of the students received the classroom-based, teacher-directed intervention and the other half received the classroom- and home-based components. Using a single-subject design across students and classrooms, results showed a decrease in problem behaviors and an increase in academic engagement for all six children during the intervention phase, with effects persisting for four of the six students for 5 months after the end of the intervention.

One limitation to the collective research on First Step, however, is uncertainty regarding the impact of the home-based component of the dual intervention. Research to date has not been able to determine whether there is added benefit to the subscribed model of parent involvement when implemented with fidelity (6 weeks of meetings between the coach and parents or guardians).

Researchers also have examined the long-term effectiveness of the PATHS (Promoting Alternative THinking Strategies) curriculum, which focuses on developing students' self-control, emotional awareness, peer relations, and problem-solving skills. PATHS is a component of the Fast Track project, a multi-site intervention designed to prevent serious antisocial behavior and related problems in children at high risk when entering 1st grade.(54) Cohorts of participants were recruited to Fast Track from 1991-93, yielding a total sample of nearly 900 children. One randomized controlled trial involved 198 intervention and 180 comparison classrooms, with 1st grade teachers delivering the PATHS curriculum. Findings from classroom observations and peer ratings indicated significant reductions in students' levels of aggression and disruptive behavior.

Similarly, researchers have investigated the impact of Second Step, a violence-prevention, social and emotional learning program designed to reduce impulsive and aggressive behavior in elementary school students by increasing their social competence. The multi-lesson curriculum is designed for classroom teachers to deliver once or twice a week, and it includes discussion questions, modeling, coaching, and practice. At least a dozen evaluations have been conducted on Second Step, with two of the most rigorous studies described in more detail here. In one randomized trial, researchers used 6 pairs of matched schools, involving 790 2nd and 3rd grade students.(55) Aggressive and pro-social behavior changes were measured two weeks and six months after participation in the curriculum by teacher reports and by observation of a random subsample of 588 students in classroom, playground, and cafeteria settings. Although behavior observations collected by trained researchers revealed an overall decrease in physical aggression two weeks after the intervention and an increase in appropriate behaviors in the intervention group, with most effects persisting six months later, changes in teacher-reported behavior did not differ significantly between the intervention and comparison schools after adjusting for students' demographic differences.(56)

The most recent evaluation of Second Step involved 1,235 students from 15 elementary schools in 3 cities in Washington State.(57) The findings demonstrated that students who participated in Second Step were more likely to prefer pro-social goals, require less adult intervention, behave less aggressively, and (among girls) behave more cooperatively. Teacher ratings also showed increases in their students' social competence and decreases in antisocial behaviors in the first year of the program. But these impacts did not persist into the second year, when the students' new teachers failed to notice continued improvement in students' behavior.

One limitation of this body of research on class-wide social skill-building interventions, however, is that many studies examined the collective effects of multiple components of comprehensive intervention packages, making it difficult to determine the value-added effects of specific components, such as parent involvement modules.

Examples of classroom studies that demonstrate the effectiveness of positive reinforcement

As early as the 1960s, research studies demonstrated that positive reinforcement increased the task engagement and reduced disruptive (or "dawdling") behavior of students in general education classrooms.(58) Since then, however, the use of rewards in education has been veiled in some controversy, primarily due to a perceived negative effect on student's intrinsic motivation. The concerns are based on studies conducted since the 1970s, leading some researchers and educators to issue warnings against the use of praise and extrinsic rewards in schools (for example, a concern that "token economies will produce token learners").(59)

To address these concerns, a number of researchers have examined the large body of empirical studies on positive reinforcement to determine overarching findings. The earliest meta-analysis reviewed 128 studies to examine the overall effects of extrinsic rewards on students' intrinsic motivation and interest in activities.(60) Findings revealed that several types of rewards -- engagement-contingent rewards given for engaging in a task regardless of completion, completion-contingent rewards given for completing one or more tasks, and performance-contingent rewards given for performing up to a specific standard -- significantly undermined students' return to and persistence in a target activity during a free choice period ("free-choice intrinsic motivation"), and their self-reported interest in the target activity. Positive feedback, however, enhanced both free-choice behavior and self-reported interest.

The results from two other meta-analyses ran counter to this earlier study and concluded that little detrimental effect was found with the use of external reinforcement in educational settings; in fact, rewards following and linked to appropriate behavior were related to both initial and long-term academic engagement and social success.(61) The first set of researchers reviewed more than 100 experimental studies conducted over the previous 30 years.(62) Results suggested that rewards given for low-interest tasks enhanced free-choice intrinsic motivation. On high-interest tasks, verbal rewards produced positive effects on free-choice motivation and self-reported task interest. Negative effects were found on high-interest tasks when the rewards were tangible, expected (offered beforehand), and loosely tied to level of performance. When rewards were linked to level of performance, measures of intrinsic motivation increased or did not differ from a non-rewarded control group.

More recently, the researchers examined the extrinsic-intrinsic dichotomy debate using a meta-analytic approach that drew on evidence from cognitive and behavioral literatures.(63) From this review, it was concluded that little detrimental effect was found with the use of external reinforcement. Specific recommendations on the appropriate use of reinforcement programs in educational settings were offered to counteract inadvertent negative effects when rewards were not delivered with vigilance -- namely linking rewards to specific behaviors, delivering rewards frequently and immediately after the behavior, and gradually fading away rewards for appropriate behavior.

Recommendation 4:
Draw on relationships with professional colleagues and students' families for continued guidance and support

Level of evidence: Moderate

The panel rated the level of evidence supporting this recommendation as moderate. One quasi-experimental (64) study and one single-subject study (65) examined the effects of peer teacher relationships in improving social relationships among students or increasing student engagement in the classroom. Additionally, one randomized controlled trial (66) confirmed the effectiveness of teachers' consulting with behavioral experts in reducing behavior problems among students who exhibit inattentive and disruptive behaviors. Finally, two randomized controlled trials (67) evaluated interventions specifically aimed at establishing positive teacher-parent relationships, with one study demonstrating decreases in problem behaviors. Although components of recommendation 4 are supported by two randomized controlled trials, one study focused on teachers consulting with experts on particular problem behaviors of students identified with attention deficit/hyperactivity disorder, and the other on a specific teacher-parent education and activity program. The other studies supporting the recommendation include one quasi-experimental study and one single subject study. Consequently, the panel believes that the overall level of evidence for this recommendation is moderate.

Examples of studies in which relationships with professional colleagues affect students' social relations and student engagement

A quasi-experimental study considered a comprehensive school reform model that included a relationship-building component for teachers consisting of peer coaching, classroom observations, and teacher collaborations.(68) Findings indicate that students from the comprehensive school reform programs substantially increased the number of peer social relationships relative to students in comparison schools, though it is unclear if the teacher relationship component alone was effective in establishing this outcome.

A single-subject study reported on the effects of peer coaching for four teachers representing various grade levels, content areas, and levels of teaching experience.(69) A veteran elementary teacher with experience in coaching served as their peer coach and provided the teacher participants with an all-day in-service where they were trained on a new instructional technique and curriculum. The peer coach's involvement also included seven collaborative sessions with each teacher and in-class support during these lessons. The results from this study revealed high levels of student engagement and participation for the lessons where teachers were taught and supported by a peer coach.

Example of one study in which consultation with behavioral experts reduces behavior problems

One randomized controlled trial that examined teacher partnerships with behavioral consultants revealed strong evidence that consultations with behavioral experts can reduce behavior problems in the classroom.(70) The researchers explored the effects of having teachers whose students were identified with significant inattentive or hyperactive disorder participate in several behavioral consultation sessions that were structured to help the teacher identify and analyze problem behaviors and design and implement a behavior plan. Findings reveal that, compared with teachers with no consultation, those who collaborated with a behavioral consultant reported a significant reduction in their students' hyperactivity and in the incidence of behavior severity below clinical levels.

Examples of studies in which relationships with families reduce behavior problems

Researchers conducted a randomized controlled trial that assessed the effects of two universal 1st grade preventive interventions on several student outcomes, including early risk behaviors for conduct disorders such as disruptive and aggressive behavior.(71) One of the two interventions explored family-school partnerships, which consisted of a combination of trainings for teachers on effective parent-teacher partnership building and communication, along with weekly home-school activities and parent workshops aimed to increase parental involvement in their child's classroom activities. The study revealed that over the course of 1st and 2nd grades, both boys and girls in the intervention had significantly fewer behavior problems by the spring of 2nd grade relative to the comparison group.

Another randomized controlled trial examined the effects of The Incredible Years, a parent-teacher-child training program, on social competence and conduct problems among 4- to 8-year-old children who met criteria for oppositional defiant disorder.(72) Parental involvement was the cornerstone of the parent training condition in this study, with parents attending weekly clinic visits where they participated in programs aimed to strengthen positive interactions with their children. More relevant to the recommendation on teacher relationship building, however, was the teacher training component where a constant theme was to encourage positive communication with parents and strengthen parent-teacher collaborations.(73) The study's authors reported that comparisons between the treatment groups (including the treatment groups where teachers received training) and control groups showed statistically significant reductions in conduct problems after six months of the intervention. However, when the What Works Clearinghouse reviewers applied a multiple comparison adjustment to the analyses, the findings showed no statistically significant differences in child conduct problems between the intervention and comparison students.

Recommendation 5:
Assess whether school-wide behavior problems warrant adopting school-wide strategies or programs and, if so, implement ones shown to reduce negative and foster positive interactions

Level of evidence: Moderate

The panel judged the level of evidence supporting this recommendation to be moderate. One quasi-experimental study investigated the impact of school-wide changes in structure, organization, and practices and determined that these changes increased the number of social relationships among students.(74) In addition, four randomized controlled trials (75) and one single-subject (76) study examined the impact of specific school-wide intervention programs, each study finding statistically significant positive effects for several of its behavioral outcomes. Although there are several randomized controlled trials to support one component of recommendation 5 (specific school-wide intervention programs), other components of the recommendation (such as changes to the overall structure and organization of the school, and peer mediation programs implemented outside the classroom) are supported by quasi-experimental or single-subject studies that have moderate levels of evidence. Consequently, the panel believes that a moderate designation is appropriate for the overall level of evidence for this recommendation.

Example of one study that demonstrates the effectiveness of school-wide strategies

A quasi-experimental study was conducted on a sample of more than 1,000 2nd-6th grade students in five elementary schools to evaluate the effects of a cooperative elementary school, in which the concept of cooperation was embedded in the reorganization of the school's environment and learning processes.(77) Elements of this restructured school-wide program included widespread use of cooperative learning and inclusion of students with learning disabilities in regular education classrooms; regular opportunities for teacher coaching and collaborative support; a building-level steering committee comprised of administrators, teachers, special services, and other faculty to develop goals for the school and act as an open forum for discussion of school management and policy issues; and numerous opportunities to encourage active family involvement at the classroom and school-wide levels.

In addition to evaluating the academic outcomes of this school-wide program, the researchers also considered behavioral outcomes by assessing the number of social relationships established by students. The findings indicate that the social relationships among students had greatly increased after the program was implemented relative to students in comparison schools. In addition, there appeared to be greater social acceptance of students with learning disabilities in intervention schools after the program had been implemented.

Examples of school-wide interventions that demonstrate a reduction in behavior problems

A number of studies evaluated the effects of classroom-based curricula aimed at promoting positive outcomes in school-wide behaviors and social competency (see recommendation 3 for a detailed description of several studies implemented in classrooms). One example involves a randomized controlled trial that explored the impact of a preventive intervention program for 1st graders at high risk for long-term antisocial behavior.(78) This program consisted of several components, such as social skills training and academic tutoring sessions that occurred during two hours of extracurricular enrichment programs provided to students and families. One of the components of the program was PATHS (Promoting Alternative THinking Strategies), a school-wide curriculum that was implemented by teachers in an average of two to three lessons a week during the school year. Lessons from the curriculum addressed four domains of skills: emotional understanding and communication, friendship, self-control, and social problem-solving. The study found that by the end of 1st grade, significantly fewer aggressive and disruptive behavior problems were found among students in the intervention schools compared with those who did not receive the intervention.

One single-subject study considered an intervention that targeted behavior problems occurring on school playgrounds.(79) Fifth grade students were trained in a conflict resolution program and were involved in peer mediation teams that intervened within 10 seconds of the start of a conflict. The study found that the peer mediators successfully resolved approximately 90 percent of the playground conflicts in which they intervened and that physically aggressive playground incidents were reduced by 51-65 percent when the mediation program was implemented.

Go to Appendix D:
Technical Information on the Studies