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SchoolSchool--Based Prevention: Based Prevention: Current Status and Future Current Status and Future Current Status and Future Current Status and Future

ChallengesChallengesgg

Mark T. GreenbergMark T. GreenbergPrevention Research CenterPrevention Research Center

Penn State UniversityPenn State Universitywww.prevention.psu.eduwww.prevention.psu.edu

““Even though our society does not emphasize this, the most important use of knowledge and education is to help to understand the importance of engaging in more help to understand the importance of engaging in more wholesome actions and bringing about the discipline within our minds.

The proper utilization of our intelligence and knowledge is to effect changes from within that develop a good heart.”

HIS HOLINESS THE DALAI LAMA (1998)

What I will Discuss

R Fi di S i l d E i l R Fi di S i l d E i l •• Recent Findings on Social and Emotional Recent Findings on Social and Emotional

LearningLearninggg

•• Why the Role of Schools is EssentialWhy the Role of Schools is Essential

•• 3 Current and Future Research Challenges in 3 Current and Future Research Challenges in

SchoolSchool--Based PreventionBased Prevention

Why is SchoolWhy is School--Based Prevention Critical to Based Prevention Critical to Community WellCommunity Well--Being?Being?

•• Treatment (even when effective) will not substantially Treatment (even when effective) will not substantially d th b f “ ”d th b f “ ”

Community WellCommunity Well--Being?Being?

reduce the number of new “cases”reduce the number of new “cases”•• Schools are the primary setting in which problems arise Schools are the primary setting in which problems arise

and can be preventedand can be preventedand can be preventedand can be prevented•• Building protective factors to promote good mental Building protective factors to promote good mental

health reduces the burden on multiple forms of later health reduces the burden on multiple forms of later health reduces the burden on multiple forms of later health reduces the burden on multiple forms of later disease/poor outcomesdisease/poor outcomes

•• SchoolSchool--based prevention have been shown to impact not based prevention have been shown to impact not p pp ponly mental health but also academic outcomesonly mental health but also academic outcomes

SchoolSchool--Based PreventionBased PreventionWh h b A li h d i 1994Wh h b A li h d i 1994What has been Accomplished since 1994:What has been Accomplished since 1994:

•• The number of evidenceThe number of evidence--based interventions (EBIs) has based interventions (EBIs) has The number of evidenceThe number of evidence based interventions (EBIs) has based interventions (EBIs) has grown substantiallygrown substantially

•• RCTs have been crucial in legitimizing prevention RCTs have been crucial in legitimizing prevention effortseffortseffortsefforts

•• Most still require independent replicationMost still require independent replication•• Reviews of these programs are now widely availableReviews of these programs are now widely available•• Reviews of these programs are now widely availableReviews of these programs are now widely available

–– Campbell Collaboration Campbell Collaboration –– CDC CDC –– 2007 2007 –– Universal Programs and ViolenceUniversal Programs and Violence–– CDC CDC –– 2007 2007 –– Universal Programs and ViolenceUniversal Programs and ViolenceBut still little focus on promoting positive But still little focus on promoting positive

development, citizenship, healthy behaviorsdevelopment, citizenship, healthy behaviors•• The easy work is done!The easy work is done!

Effective Universal ProgramsEffective Universal ProgramsEffective Universal ProgramsEffective Universal Programs

•• Social/Emotional Social/Emotional C iti Vi lC iti Vi l

•• Family Focused InterventionFamily Focused InterventionCognitive Violence Cognitive Violence PreventionPrevention–– Responding in Peaceful and Responding in Peaceful and

Positive WaysPositive WaysI l C i iI l C i i

–– Triple PTriple P–– Strengthening Families: 10Strengthening Families: 10--14 14 ––IowaIowa

•• EcologicalEcological–– Interpersonal Cognitive Interpersonal Cognitive Problem SolvingProblem Solving

–– Promoting Alternative Thinking Promoting Alternative Thinking Strategies (PATHS)Strategies (PATHS)

–– Increased SocialIncreased Social

•• EcologicalEcological–– School Transition ProjectSchool Transition Project–– Child Development ProjectChild Development Project–– Good Behavior Game/Mastery Good Behavior Game/Mastery Increased Social Increased Social

Awareness/Social Problem Awareness/Social Problem SolvingSolving

–– Responsive ClassroomResponsive Classroom

/ y/ yLearningLearning

•• MultiMulti--DomainDomainLi ki h I f F ili dLi ki h I f F ili d•• Drug/Alcohol Drug/Alcohol

PreventionPrevention–– Life Skills TrainingLife Skills Training–– All StarsAll Stars

–– Linking the Interests of Families and Linking the Interests of Families and TeachersTeachers

–– Seattle Social Development ProjectSeattle Social Development Project–– Incredible YearsIncredible YearsAll StarsAll Stars

Prevention and Improving the

Undesired Related Undesired Related Underlying Shared Underlying Shared

Public Health

Poor School AchievementPoor School Achievement Impulsive Action

OutcomesOutcomesy gy g

ConstraintsConstraints

Poor School AchievementPoor School AchievementPoor Mental HealthPoor Mental HealthAggression/ViolenceAggression/Violence

Impulsive Action

Emotion DysregulationAggression/ViolenceAggression/ViolenceEarly Substance UseEarly Substance Use

Insecure Relations w/ Parent, Teachers, Peers

D N i hb h dDangerous Neighborhoods

Nurturing ResilienceNurturing Resilience

SelfSelf Control/Emotion RegulationControl/Emotion Regulation

Nurturing ResilienceNurturing Resilience

SelfSelf--Control/Emotion RegulationControl/Emotion RegulationCognitive Abilities Cognitive Abilities –– Problem Solving SkillsProblem Solving SkillsBuilding Attention and Learning CapacityBuilding Attention and Learning CapacityHealthy relations Healthy relations with with yy

peers peers and and adultsadultsSafe, Welcoming, CaringSafe, Welcoming, Caringf , W m g, gf , W m g, g

ClassroomsClassrooms

Three Research ChallengesThree Research Challenges

1 M i f Effi Eff i

Three Research ChallengesThree Research Challenges

1. Moving from Efficacy or Effectiveness

2 S i bili2. Sustainability

3 Continue Development and Refinement of 3. Continue Development and Refinement of Programs and Models

Types of ResearchTypes of Research

T p 1 t a lati al Type 2 translational Type 1 translational research applies basic science

discoveries to intervention development.

Type 2 translational research investigates factors,

models, and processes associated with the adoption,

i l t ti dp

The typical endpoint for Type 1 research is testing of

promising new models of prevention to reduce risk and

implementation, and sustainability of tested and

effective prevention programs, policies, and practices in

prevention to reduce risk and improve health and well-being.

communities, services settings, and populations.

Translation 2 DefinedTranslation 2 Defined

Type Type Two TranslationTwo Translation is research on factors associated with the is research on factors associated with the adoption, maintenance and sustainability of scientifically adoption, maintenance and sustainability of scientifically adop o , a e a ce a d sus a ab y o sc e ca y adop o , a e a ce a d sus a ab y o sc e ca y validated interventions validated interventions by service systems under controlled, by service systems under controlled, uncontrolled or uncontrollable conditions, i.e., services research.uncontrolled or uncontrollable conditions, i.e., services research.

It is PostIt is Post--efficacy and efficacy and --effectiveness research that leads to effectiveness research that leads to adoption, maintenance and sustainability of scienceadoption, maintenance and sustainability of science--based based interventions at the practice level.interventions at the practice level.pp

In In the real world, the real world, translation of sciencetranslation of science--based practicesbased practices, , stumble, largely unguided, toward uneven, incomplete and stumble, largely unguided, toward uneven, incomplete and stumble, largely unguided, toward uneven, incomplete and stumble, largely unguided, toward uneven, incomplete and socially disappointing outcomes. Put simply T2 can be simple socially disappointing outcomes. Put simply T2 can be simple stated as “we need effective distribution system for effective stated as “we need effective distribution system for effective products.”products.”

T2 research requires new research skills T2 research requires new research skills regarding“ implementation science”: regarding“ implementation science”:

–– Fielding and evaluating interventions in real world Fielding and evaluating interventions in real world settings settings Understanding the factors that affect engagement Understanding the factors that affect engagement –– Understanding the factors that affect engagement Understanding the factors that affect engagement or reach of interventions and policiesor reach of interventions and policies

–– Understand what factors affect implementation Understand what factors affect implementation ppquality quality

–– Understanding the factors that influence the Understanding the factors that influence the sustained quality use of programs and policiessustained quality use of programs and policies

–– What factors in management, organization, What factors in management, organization, financing training lead to effective outcomes?financing training lead to effective outcomes?financing, training lead to effective outcomes?financing, training lead to effective outcomes?

Challenge #1 Challenge #1 Challenge #1 Challenge #1 ImplementationImplementation

An effective intervention is one An effective intervention is one thing Implementation of an effective thing Implementation of an effective thing………Implementation of an effective thing………Implementation of an effective

intervention is a very different thingintervention is a very different thing

Implementation 0f SEL ProgramsImplementation 0f SEL ProgramsImplementation 0f SEL ProgramsImplementation 0f SEL Programs

•• Why focus on implementation?Why focus on implementation?y f mp my f mp m

–– Programs will likely show no effect when Programs will likely show no effect when i l d li l d limplemented poorlyimplemented poorly

–– It is so important to build the right context It is so important to build the right context It is so important to build the right context It is so important to build the right context to effectively implement programsto effectively implement programs

Hi h lit i l t ti Hi h lit i l t ti h ld h ld t t –– High quality implementation High quality implementation should should support support sustainabilitysustainability

“In theory there is no difference “In theory there is no difference between theory and practice; inbetween theory and practice; inbetween theory and practice; in between theory and practice; in

practice, there is.”practice, there is.”Yogi Berra

MACRO-LEVEL

AGENCY-LEVEL

AdministrativeMission/Policy

Policies Financing

INDIVIDUAL-LEVEL

ProfessionalCharacteristics

Intervention Perceptions and 

Leadership

Agency Culture

Mission/PolicyAlignment

ResourcesCharacteristics Perceptions and 

Attitudes

IQIntervention Model Support System

Agency ClimateDecision 

IQIntervention Model Support System

Psychological Characteristicsg y

AgencyCharacteristics

StructureOrganizational 

Health

MPP: Effects of Fidelity of Implemetation: Marijuana Used y p jin Last Month (N=42 Schools*)

12%ana

9.1% 9.9%

5.4%4 2%6%

8%10%12%

ed M

ariju

4.2% 4.1%3.1%

0%2%4%6%

rcen

t Use Baseline

Year One

0%

Contro

l

ementatio

n

ementatio

n

Per

Low Im

plem

High Implem

*Approximately 5,000 6th and 7th grade students @ baseline and follow-uppp y g @ p

Data from Pentz, Trebow, Hansen, MacKinnon, Dwyer, Johnson, Flay, Daniels, & Cormack

®

Essential Components for PATHSEssential Components for PATHS

•• Skill Building for Both Students and TeachersSkill Building for Both Students and Teachersgg

•• Generalization: Create opportunities to use these skills Generalization: Create opportunities to use these skills throughout the daythroughout the dayg yg y

•• Provide sufficient Technical Support to teachersProvide sufficient Technical Support to teachers

I i h A d i S bjI i h A d i S bj•• Integrate into other Academic SubjectsIntegrate into other Academic Subjects

•• Involve ParentsInvolve Parents

What is Necessary for Quality What is Necessary for Quality What is Necessary for Quality What is Necessary for Quality Implementation?Implementation?

Initial Training Initial Training –– 2 day workshop2 day workshop

A S C ( C)A S C ( C) PATHS Coach (PC) regularly visits each classPATHS Coach (PC) regularly visits each class

PC receives ongoing technical assistance from PC receives ongoing technical assistance from PC receives ongoing technical assistance from PC receives ongoing technical assistance from PATHS TrainerPATHS Trainer

Teachers use PATHS 2Teachers use PATHS 2 3X/week for 203X/week for 20 30 minutes30 minutes Teachers use PATHS 2Teachers use PATHS 2--3X/week for 203X/week for 20--30 minutes30 minutes

CLASSROOM LEVELSCHOOL LEVEL

•Administrative stabilityPlanned Intervention

Program ModelQuality of Delivery

•Teacher characteristics and behaviors

•Classroom climate

Administrative stabilityleadership/support

•School Goals & Climate

Program as Implemented

Pl d I l t ti Planned Implementation Support

Pre-planningQuality of Technical

Support

DISTRICT LEVEL•Administrative leadership and support

•District GoalsC i ti ith

COMMUNITY LEVEL•School-Community Relations

•School-Family Relationsupp •Communication with schools

y•Community Readiness

The Study of ImplementationThe Study of ImplementationThe Study of ImplementationThe Study of Implementation

Three Illustrations from Research with Three Illustrations from Research with PATHSPATHSPATHSPATHS

Study #1Study #1yyPATHS CurriculumPATHS Curriculum

Implementation QualityImplementation Qualityp Q yp Q y(Fast Track Project(Fast Track Project))

Teacher’s skill in teaching PATHS related to:Teacher’s skill in teaching PATHS related to:

Teacher Teacher -- rated behavior of students (TOCArated behavior of students (TOCA--R)R)

Concentration/Attention Concentration/Attention

A / hA / h Aggressive/Disruptive BehaviorsAggressive/Disruptive Behaviors

Social CompetenceSocial CompetenceSocial CompetenceSocial Competence

Study #2Study #2

Effectiveness StudyEffectiveness Study-- Harrisburg City Schools (PA)Harrisburg City Schools (PA)

•• Distressed school district Distressed school district •• Distressed school district Distressed school district

•• Low AchievementLow Achievement

•• High Dropout RateHigh Dropout Rate

•• Effectiveness trial of the PATHS Curriculum in a real Effectiveness trial of the PATHS Curriculum in a real world settingworld setting

Evaluation DesignEvaluation Design

•• PrePre--post, quasipost, quasi--experimental designexperimental design

•• 3 intervention and 3 control schools (24 classrooms: 3 intervention and 3 control schools (24 classrooms: 13 intervention and 11 control)13 intervention and 11 control)

•• 350 students ( 41.74% males; 79.42% African 350 students ( 41.74% males; 79.42% African A i )A i )American)American)

Fig 1. Differences in PATHS Effects in the Three Intervention Schools compared to the Comparison

0.00

nSchools

-0.15

-0.10

-0.05

ent A

ggre

ssio

n

-0.30

-0.25

-0.20

crea

se in

Stu

de

-0.45

-0.40

-0.35Dec

-0.50

Sch 1 - Avg. Control Sch 2 - Avg. Control Sch 3 - Avg. Control

What Explained Differences Between What Explained Differences Between What Explained Differences Between What Explained Differences Between The Schools in Outcome??The Schools in Outcome??

•• Significant Implementation X Principal Significant Implementation X Principal Support InteractionSupport Interaction

•• Schools with High Principal Support and Schools with High Principal Support and High Teacher Quality had less aggression High Teacher Quality had less aggression g y ggg y ggand higher social competenceand higher social competence

Th Eff t f L d hi D l t d Th Eff t f L d hi D l t d The Effects of Leadership Development and The Effects of Leadership Development and Support on SEL Practices and Student OutcomesSupport on SEL Practices and Student Outcomes

StudentStudent outcomes:

•Academic performance

Professional development

and support of school

Leadership competencies School and

classroom effects:Leadership

ti performance•SEL

competencies•Reduced risk

behaviors

school leadership

teams •Programming•Climate•Partnerships

Leadership relationships

practices

behaviors

PATHS Implementation StudyPATHS Implementation StudySix SchoolsSix SchoolsSix SchoolsSix Schools

Simultaneous Simultaneous Multilevel Data CollectionMultilevel Data Collection

•• Building Level MeasureBuilding Level Measure–– Climate survey of all professional staffClimate survey of all professional staff

•• Classroom Level MeasureClassroom Level Measure–– Observer ratings of implementation qualityObserver ratings of implementation quality

•• Individual Level MeasureIndividual Level Measure–– Teacher report of child behaviorTeacher report of child behavior

Climate Climate Implementation Implementation QualityQualityAll School Climate Measures were significantly

related to implementation quality.

ClimateClimate PATHS ImplementationPATHS Implementation

r at to mp m ntat on qua ty.

TeacherTeacher--Teacher TrustTeacher Trust 1.521.52**

Orientation to Innovation Orientation to Innovation 3.013.01**

Commitment to CommunityCommitment to Community 2.022.02##

C ll ti R ibilitC ll ti R ibilit 1 471 47**Collective ResponsibilityCollective Responsibility 1.471.47

Focus on LearningFocus on Learning 2.672.67**

Study DesignStudy DesignStudy DesignStudy Design

6 Buildings in an Urban District6 Buildings in an Urban District

3 d G d

Year 1 Year 2

3rd Grade Social-

Emotional Functioning

4th Grade Academic

FunctioningFunctioning

3rd Grade Teachers i l t d th New teachers ratedimplemented the

PATHS Curriculum bi-weekly

New teachers rated student functioning

Children who showed improved attention during d d h d hPATHS in 3rd grade showed greater teacher-

rated achievement in 4th grade.

4th grade outcomes

3rd grade GrowthSocial-Emotional

Engagement in Learning

Achievement

SkillBehavioral Dysregulation

-.24** -.20*y g

Attention .32** .30**

*p < .05, **p < .01

Better Quality PATHS Implementation is Q y prelated to Improved Attention and Social

Competence (across 6 urban schools)

Aggression Attention Social-Competence

Quality of Implementation

-.01 .44** .32*

*p < .05, **p < .01

End of Grade 3

Attention.35** .28*

EngagementPATHS .32*

.22ns

Engagement in Learning

PATHS Implementation

Grade 3 Grade 4 Teacher Rating of Academic

Functioningg

The Role of Teacher The Role of Teacher Characteristics and Characteristics and i li lEnvironmental SupportsEnvironmental Supports

•• Buss and Hughes Buss and Hughes Buss and Hughes Buss and Hughes Teacher with Higher MetaTeacher with Higher Meta--Emotion Scores (more Emotion Scores (more positive view of teaching re emotions) showed better positive view of teaching re emotions) showed better p g )p g )lesson adherence and more positive ratings by PATHS lesson adherence and more positive ratings by PATHS consultantsconsultants

•• Ransford et al. Ransford et al.

Principal support and quality of the school Principal support and quality of the school p pp q yp pp q yenvironment predict teachers report of implementation environment predict teachers report of implementation quality of PATHSquality of PATHS

Central Research Questions Central Research Questions Ch ll # 1Ch ll # 1Challenges # 1Challenges # 1

We need a broadened “science of implementation”We need a broadened “science of implementation”

How effective are EBI programs under “realHow effective are EBI programs under “real--world world di i ( i i )di i ( i i )conditions? (requires comparison groups)conditions? (requires comparison groups)

How does implementation quality affect outcome?How does implementation quality affect outcome?

What factors influence the quality of What factors influence the quality of implementation (Implementation quality IS the implementation (Implementation quality IS the outcome!)?outcome!)?outcome!)?outcome!)?

Research Challenge #2Research Challenge #2gg

Developing Effective and Sustainable Developing Effective and Sustainable Prevention Programming and Policies

i A i S h lin American Schools

Schools, Structure and Prevention SuccessPrevention Success

Almost all programs that are provided through schools fail to be sustained and effective.

Implementation needs to occur not only at the level Implementation needs to occur not only at the level of the classroom, but at the organizational level of of the classroom, but at the organizational level of the school and the districtthe school and the districtthe school and the districtthe school and the district

This is a new and different business for education and schools have not developed the infrastructure necessary to plan implement monitor evaluate necessary to plan, implement, monitor, evaluate, and sustain quality programs.

What Changes in Management, O i ti Fi i d T h i l Organization, Financing, and Technical

Assistance are necessary?

There is a need for a new structure in public school systems – An “Office of Social and Emotional Development”.

This office is focused on curriculum and policy and is NOT located with psychologists, counselors, social workers, and p y gspecial educators, but in the central mission of schools –Curriculum. It involves both teacher training in quality teaching processes as well as specific curriculum.g p p

Continuing to invest funding in prevention programs without investing in this infrastructure will lead to the inevitable nvest ng n th s nfrastructure w ll lead to the nev table problem of prevention being marginalized in schools and showing low quality and sustainability.

Research Challenge #2This challenge truly requires a change in approach and This challenge truly requires a change in approach and philosophy from previous research paradigmsphilosophy from previous research paradigms..

The questions is not how do we get schools to test the The questions is not how do we get schools to test the ff f b d h ff f b d h effectiveness of our exciting programs, but instead what effectiveness of our exciting programs, but instead what

supports and structures are necessary to implement supports and structures are necessary to implement with quality and create sustainable change in school with quality and create sustainable change in school q y gq y gprevention programmingprevention programming

Engaging Schools in an Intentional Process Engaging Schools in an Intentional Process ––The CASEL Rubric The CASEL Rubric The CASEL Rubric The CASEL Rubric

SEL Implementation and Sustainability ProcessA. Provide ongoing

professionaldevelopmentdevelopment

B. Monitor and

evaluate for continuous

2. Engage stakeholders

d f

F. Communicatew/stakeholders

(marketing)improvement

4. Conduct needs and

3. Develop and articulateshared vision

10. Continue cycle of

and form steering

committee

1. Principal commits

to school-wide SEL

needs and resources

assessment

9. Expand

cycle of implementing and improving

Leadership

E Nurture

5. Develop action plan

6. Select 8 Launch SEL

instruction and integrate SEL school-

wide

E. Nurturepartnerships

with families &communities

C. Develop infrastructure

to support SEL

evidence-based

program

7. Conduct initial staff

development

8. Launch SEL instruction in classrooms

D. Integrate SEL

framework school-wide

Central Research Questions Central Research Questions Ch ll # Ch ll # 22Challenge # Challenge # 22

•• Wh t f t i fl th t i bilit f idWh t f t i fl th t i bilit f id•• What factors influence the sustainability of evidenceWhat factors influence the sustainability of evidence--based SEL in schools?based SEL in schools?

•• H D SEL P b t l t f lH D SEL P b t l t f l•• How Do SEL Programs become a central part of longHow Do SEL Programs become a central part of long--term district operations? Alignment, Standards, term district operations? Alignment, Standards, Measurement SystemsMeasurement Systemsyy

•• What factors in management, financing, training, and What factors in management, financing, training, and technical assistance lead to sustained use?technical assistance lead to sustained use?

•• What types of diffusion networks and TA most What types of diffusion networks and TA most effectively support sustainability?effectively support sustainability?y pp yy pp y

Research Designs for Ch ll # 2Challenge # 2

Naturalistic/descriptive studies of the longerNaturalistic/descriptive studies of the longer--term term outcome of EBI programs and partnerships in outcome of EBI programs and partnerships in communitiescommunities

Experimental trials that vary important features of Experimental trials that vary important features of Experimental trials that vary important features of Experimental trials that vary important features of systems development, training, financing, etc. to systems development, training, financing, etc. to examine how variations in such factors influence examine how variations in such factors influence sustainability sustainability

Research Challenge # 3Research Challenge # 3Research Challenge # 3Research Challenge # 3Type 1 ResearchType 1 Research

Continuing Development and Refinement Continuing Development and Refinement of Preventive Intervention Programs of Preventive Intervention Programs

and Modelsand Models• Developing New Modelsp g

• Combining already known effective models across contexts and time (PATHS X PAX)across contexts and time (PATHS X PAX)

• Understanding the mediational “causal” processesprocesses

Developing New ModelsDeveloping New ModelsDeveloping New ModelsDeveloping New Models

•• Greater attention to interventions with Greater attention to interventions with Greater attention to interventions with Greater attention to interventions with Middle and High School StudentsMiddle and High School Students

•• Innovations in SchoolInnovations in School Family Partnership Family Partnership •• Innovations in SchoolInnovations in School--Family Partnership Family Partnership InterventionsInterventions

U i B i f I t ti (MI Attit d U i B i f I t ti (MI Attit d •• Using Brief Interventions (MI, Attitude Using Brief Interventions (MI, Attitude Change)Change)

•• Developing Mindfulness for Children and Developing Mindfulness for Children and Youth (Stress Reduction and SelfYouth (Stress Reduction and Self--awareness)awareness)

Integrating EBI ModelsIntegrating EBI ModelsIntegrating EBI ModelsIntegrating EBI Models

•• Combining behavioral/ecological and/or policy Combining behavioral/ecological and/or policy Combining behavioral/ecological and/or policy Combining behavioral/ecological and/or policy models with SEL modelsmodels with SEL models

•• Combining intervention focused on teacher’s Combining intervention focused on teacher’s awareness and development with high quality awareness and development with high quality awareness and development with high quality awareness and development with high quality SEL curriculum modelsSEL curriculum models

The Big Picture : Supporting Effective Social and Emotional Development

Teacher Well-Being and Awareness

Social andEff i Social and Emotional

Skill Development

Effective Conditions

for Learning

Understanding Causal ProcessesUnderstanding Causal ProcessesUnderstanding Causal ProcessesUnderstanding Causal ProcessesHow do EBI effects occur?How do EBI effects occur?

Inside the Child Inside the Child –– Inside the Child Inside the Child •• SocialSocial--EmotionalEmotional•• CognitiveCognitive•• NeuroNeuro--physiological Changephysiological Change

–– Classroom Level Classroom Level T h B h iT h B h i•• Teacher BehaviorTeacher Behavior

•• Classroom Atmosphere ContextClassroom Atmosphere Context–– Intervention Support System (Indirect Effects)Intervention Support System (Indirect Effects)Intervent on Support System (Ind rect Effects)Intervent on Support System (Ind rect Effects)

–– Effects of TAEffects of TA–– School LeadershipSchool Leadership

Neurobiological AssessmentsNeurobiological AssessmentsNeurobiological AssessmentsNeurobiological Assessments

Central Research IssuesCentral Research IssuesCh ll # 3Ch ll # 3Challenge # 3Challenge # 3

Will require experimental designsWill require experimental designsWill require experimental designsWill require experimental designsThere is no longer a “true” control group:There is no longer a “true” control group:

need to carefully study the experiences and need to carefully study the experiences and need to carefully study the experiences and need to carefully study the experiences and interventions received by “controls”interventions received by “controls”

Innovation is hampered by the strictures of Innovation is hampered by the strictures of Innovation is hampered by the strictures of Innovation is hampered by the strictures of using group randomized trials (increased costs, using group randomized trials (increased costs, reduced innovation, hampering new investigators)reduced innovation, hampering new investigators)

RCTs that are comparisons RCTs that are comparisons betweenbetween programsprograms

CrossCross--Cutting IssuesCutting Issuesgg

Systems Integration Across:Systems Integration Across:Systems Integration Across:Systems Integration Across:

Developmental StageDevelopmental StageDevelopmental StageDevelopmental StagePreKPreK--12 Coordinated Programming12 Coordinated Programming

Levels of Care Levels of Care Levels of Care Levels of Care Universal, Selective, TreatmentUniversal, Selective, Treatment

Institutional StructuresInstitutional StructuresInstitutional StructuresInstitutional StructuresSchools, Families, Community ServicesSchools, Families, Community Services

Bottom Line:Bottom Line: EvidenceEvidence--Based Prevention Programs are being Broadly Based Prevention Programs are being Broadly

Disseminated.Disseminated.

i M d l i b d b d d i M d l i b d b d d Innovative Models exist but need to be nurtured and Innovative Models exist but need to be nurtured and supported to fully develop and mature.supported to fully develop and mature.

W h t b t fl d li “ i f i l t ti ” i W h t b t fl d li “ i f i l t ti ” i We have at best a fledgling “science of implementation” in We have at best a fledgling “science of implementation” in schoolschool--based preventionbased prevention

We need a much fuller and differentiated understanding We need a much fuller and differentiated understanding We need a much fuller and differentiated understanding We need a much fuller and differentiated understanding of the goals of educators. We need fuller partnerships of the goals of educators. We need fuller partnerships with educational leaders to create better alignment of with educational leaders to create better alignment of ggprogramming. programming.

ThanksThanksThanksThanks

•• ColleaguesColleaguesKaren Karen BiermamBiermam Celene DomitrovichCelene DomitrovichCarol Kusche Christa Carol Kusche Christa TurskmaTurskma

•• Numerous Funding Numerous Funding AgenciesAgencies

NIMHNIMHKuKu u mu mDorothy Morelli ChiDorothy Morelli Chi--Ming Kam Ming Kam Rebecca Cortes Becky Rebecca Cortes Becky DeRoussieDeRoussieElizabeth Cook Julie Elizabeth Cook Julie QuammaQuamma

NIMHNIMHNIDANIDANICHHDNICHHDOCYF OCYF –– Head StartHead StartElizabeth Cook Julie Elizabeth Cook Julie QuammaQuamma

Rob Nix Janet WelshRob Nix Janet WelshSandy Stewart Julie MastersonSandy Stewart Julie Masterson

El B El B

OCYF OCYF Head StartHead StartW.T. Grant FoundationW.T. Grant Foundation

Kerry Kerry WeissmannWeissmann Elaine Berrena Elaine Berrena Howard Rosen Alison RosenHoward Rosen Alison RosenJudy NussJudy Nuss Meg SmallMeg SmallMichael Cleveland Michael Cleveland