The Effectiveness of a Brief Behavioral Training for Teachers of Children With Behavioral Difficulties at School: a Randomized Controlled Trial.
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 60
- 试验地点
- 2
- 主要终点
- Severity of four daily rated target behaviors in specific classroom situations
研究概览
简要总结
The goal of this two-armed randomized controlled trial is to investigate the effectiveness of a new, individually tailored, brief behavioral training for teachers of children with behavioral difficulties at school.
The main questions the study aims to answer are:
- Does the brief teacher training reduce the severity of four daily rated target behaviors in specific classroom situations compared to practice as usual (PAU) on the short term?
- Does the brief teacher training program reduce the severity of the same four daily rated target behaviors in other classroom situations, behavioral difficulties of the child at school and at home, and the impairment of the child in the school situation and reduce the number of behavioral difficulties of the child at school judged as troublesome by the teacher, and improve the teacher-student relationship quality, teachers' sense of efficacy, and teachers' behavior management strategies compared to practice as usual (PAU) on the short term?
- Are short-term improvements maintained at 3 months follow-up?
Teachers will be randomly assigned (simple randomization) to (a) three sessions of brief teacher training with PAU, or (b) PAU only. The brief teacher training provides teachers with individually tailored stimulus control and contingency management techniques to treat children's behavioral difficulties in two (bi)weekly training sessions of two hours and a third session of one hour in which the training will be evaluated and maintenance training will be provided. PAU may include any support or treatment as regularly provided by mental health care centers, schools, school collaborations and/or other organizations, except from pharmacological treatment for children's behavioral difficulties and/or behavioral teacher training/support. PAU can also imply that there is no support or treatment.
详细描述
INTRODUCTION AND RATIONALE
Behavioral difficulties, such as inattentive, impulsive, hyperactive, oppositional and/or aggressive behaviors, are highly prevalent in children and adolescents and one of the most common reasons for referral to mental health care. When left untreated, problems may exacerbate, grow into disorders and put children at risk of subsequent adverse outcomes, such as school dropout, delinquency, substance use, and/or depression. Ideally, treatment should prevent the escalation of problems, reduce the need for long and intensive treatments (including antipsychotics or other medication), and lower societal costs.
Behavioral teacher training is a promising intervention to treat children's behavioral difficulties at school. In the Netherlands, there are currently no brief and individual teacher training interventions available for this group of children. Existing programs are either self-help interventions, long programs that are not tailored to the individual teacher's and child's needs, or programs that focus on peer-support. There is thus an urgent need for a brief, accessible, and individually tailored teacher training programs.
To address this need, the Investigators will evaluate a brief, individually-tailored behavioral teacher training program based on effective training elements identified in our earlier work. Our previous project showed that effects of a brief teacher training on behavioral difficulties were promising, while the dropout rates of teachers were low. Teachers were particularly positive about the short time span of the training and the program's focus on tailoring program content to the individual problems that teachers and/or the child experience.
OBJECTIVES
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
盲法说明
N/A The investigator will not perform any outcome assessments.
入排标准
- 年龄范围
- 4 Years 至 13 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •for the teachers will be:
- •The teacher works in regular elementary education, special elementary education or special education (in Dutch: cluster 4);
- •The teacher indicates that the child displays at least four behavioral difficulties in the classroom on a daily basis that the teacher wants to target in the training (using a list of target disruptive behaviors (Hornstra et al., 2021; Van den Hoofdakker et al., 2007)).
- •Exclusion criterion for the teachers will be:
- •The teacher has received behavioral training or behavioral support aimed at remediating behavioral difficulties of the concerned child within the past year;
- •The teacher already participates in the study with another child.
排除标准
- •for the children will be:
- •The child has a diagnosis of autism spectrum disorder (as reported by parents, we will not perform any measures to assess autism spectrum disorder);
- •The child currently receives pharmacological treatment for behavioral difficulties (e.g., methylphenidate).
研究组 & 干预措施
Brief behavioral teacher training and optional practice as usual
A brief, individualized, three-session teacher training that exists of two (bi)weekly individually tailored training sessions of 120 minutes, and a third session of 60 minutes. Teachers and children may receive practice as usual as well. The practice as usual may include any support or treatment as regularly provided by mental health care centers, schools, school collaborations and/or other organizations, except from pharmacological treatment for children's behavioral difficulties and/or behavioral teacher training/support. Practice as usual can also imply that there is no support or treatment.
干预措施: Brief behavioral teacher training (Behavioral)
Practice as usual only (PAU)
PAU may include any support or treatment as regularly provided by mental health care centers, schools, school collaborations and/or other organizations, except from pharmacological treatment for children's behavioral difficulties and/or behavioral teacher training/support. PAU can also imply that there is no support or treatment. There are no criteria for professionals providing PAU.
干预措施: Practice as usual only (PAU) (Behavioral)
结局指标
主要结局
Severity of four daily rated target behaviors in specific classroom situations
时间窗: Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only)
The primary outcome measure will be the severity of teacher-rated daily measured target behaviors in specific classroom situations. Teachers select four daily occurring behavioral difficulties of the child in the classroom (i.e., target behaviors of the intervention) and the specific situations. Target behaviors will be selected from an adapted version of a list (Hornstra et al., 2021; Van den Hoofdakker et al., 2007), with teachers indicating daily occurrence (yes/no) and rating severity on a 5-point Likert scale (1=not severe to 5=extremely severe). Specific classroom situations will be selected from the School Situation questionnaire (SSQ-R; DuPaul \& Barkley, 1992). Severity of the target behaviors in these specific situations will be measured with brief daily phone calls to teachers on four consecutive school days, by the researchers. Teachers report whether the four selected target behaviors occurred (yes/no) and rate their severity on a 5-point scale.
次要结局
- Teacher-reported child impairment at school associated with behavioral difficulties(Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only))
- Teacher-reported severity of behavioral difficulties of the child in the classroom(Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only))
- Teacher-reported quality of the teacher-student relationship(Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only)].)
- Caregiver-reported severity of child behavioral difficulties at home(Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only))
- Teacher-reported frequency of supportive and non-supportive management strategies(Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only)
- Severity of daily the same four daily rated target behaviors in other classroom situations than the specified situation which is used as primary outcome (see primary outcome measure for details on administration)(Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only))
- Teacher-reported number of child behavioral difficulties in the classroom that the teacher considers troublesome(Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only))
- Teacher's sense of self-efficacy(Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only))