SocialEmotional Learning and Academic Funtioning

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Using a Public Health Approach to Promote Mental
Health in Preschool and Young Children Celene
Domitrovich, Ph.D. Penn State University Barnardo
ss Tomorrows Child Conference Dublin,
Ireland November 5, 2008
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Accomplishments in the Field of Prevention

• The number of empirically validated (EV)
  preventive interventions has grown substantially
• RCTs have been crucial in legitimizing efforts
  and creating a science of prevention
• Reviews of these programs are now widely available

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The Public Health Approach

• Based on the concept of risk and protective
  factors.
• Adolescent problems (e.g. mental disorders,
  substance abuse, delinquency) share common risk
  factors (equifinality).
• Risk factors increase the chance of a variety of
  behavioral and emotional disorders
  (multifinality).
• Protective factors help buffer the effects of
  risk factors.

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Example of Heart Disease HSEs Ireland Take
Heart
RISK FACTORS Increase the likelihood of
developing a disease or disorder
PROTECTIVE FACTORS Decrease the likelihood of
developing a disease or disorder
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Preventive Intervention Research Cycle
Feedback Loop
1. Identify problem or disorder (s) and review
information to determine its extent
2. With an emphasis on risk and protective
factors, review relevant information both from
fields outside prevention and from existing
prevention literature.
3. Design, conduct, and analyze pilot studies and
confirmatory and replication trials of the
preventive intervention program
4. Design, conduct, and analyze large-scale
trials of the preventive intervention program
5. Facilitate large-scale implementation
and on-going evaluation of the preventive
intervention program in the community
Institute of Medicine, 1994
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Community Risk Factors

• Economic Deprivation
• High Mobility
• High Crime
• Community Laws and Norms
• Availability of Drugs
• Low Neighborhood Attachment and Community
  Disorganization
• Limited Resources Supports

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Family Risk Factors

• Ineffective Parent Management
• Punitive Discipline
• Negative P-C Relationship
• Inadequate Home-School Communication

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School Risk Factors

• Crowded Classrooms
• High Rates of Negative Behavior
• Unstable Administration
• Low Achievement
• High Rates of School Dropout

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Individual Risk Factors

• Impulsivity
• Early Aggression Disruptive Behavior
• Low Cognitive Ability
• Academic Failure
• Poor Peer Relations
• Poor School Bonding

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EARLY STARTER PATHWAY TO ANTISOCIAL BEHAVIOR
Preschool Years
Early Education Years
Early Adolescence
School Entry

• Early child, family, and community risk factors

• Poor school readiness in cognitive, social, and
  emotional domains

• Academic failure
• Peer rejection
• Social coping deficits
• Adult support/
• supervision

• Deviant peers
• Poor adult monitoring
• Alienation/
• depression

Increased and Diversified Antisocial Behavior
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Intervention Model for Prevention of Conduct
Disorder
Intervention
Parenting Peer Relations Social
Cognition Academics
Early Starter
Conduct Disorder
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Elementary -Aged Intervention Components

• Parenting (weekly groups, bi-weekly home visits)
• Behavior management, warmth, monitoring
• Peer Relations (friendship groups, peer coaching)
• Behavioral and social skills, prosocial
  groups
• Social Cognition (universal classroom-based
  skills training)
• Problem solving and attributions
• Academics (tutoring, after-school groups)
• Reading and organization skills

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IMPLICATIONS OF THE DEVELOPMENTAL MODEL FOR
INTERVENTION DESIGN

• Multiple skill domains
• Multiple socialization support systems
• Sustained, well-integrated
• Developmentally and culturally informed

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Protective Factors that may be Targets of
Preventive Interventions
Person-Centered Focus Self-Regulation/Emotion
Regulation Cognitive Skills Social-Emotional
Skills Normative Beliefs Resistance
Skills Environmental Focus Supportive
Environments (home school) Positive Relations
with Peers and Adults Community Policies
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Core SEL Competencies
Recognizing ones emotions and values as well as
ones strengths and limitations
Making ethical, constructive choices about
personal and social behavior
Managing emotions and behaviors to achieve ones
goals
Forming and maintaining positive relationships,
working in teams, dealing effectively with
conflict
Showing understanding and empathy for others
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Key SEL Competencies

• Relationship Skills

• Responsible Decision-Making

• Managing Emotions
• Analyzing Situations
• Goal Setting
• Problem-Solving

• Communication
• Building Relationships
• Negotiation
• Refusal
• Help Seeking

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To Learn More About The Field of Social-Emotional
Learning Go To
The Collaborative for Academic,Social and
Emotional Learning
http//www.CASEL.org
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Elementary SEL Programming Key to Social
Academic Success
Evidence-Based SEL Programming
Teach SEL Competencies (Self awareness, Social
awareness, Self-management, Relationship skills,
Responsible decision making)
Greater Attachment, Engagement Commitment to
School
Fewer MH Problems Better Academic Performance
and Success in School and Life
Less Risky Behavior, More Assets, Positive
Development
Safe, Caring, Cooperative, Well-Managed Learning
Environments
Provide Opportunities Reinforcement for
Positive Behavior
CASEL, 2004 Hawkins Catalano, xxxx
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The PATHS Curriculum
Promoting Alternative THinking Strategies
Elementary Version Mark Greenberg Carol
Kusche in collaboration with Rosemary Calderon,
Ruth A. Gustafson, Lisa Anderson, and Christa
Turksma.
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PATHS Theoretical Model

• Developmental theory based on the integration of
  affect, behavior, cognition, and language.
• Neuro-cognitive model of regulatory function of
  language and emotional awareness for frontal Lobe
  control of behavior.
• Ecological model focused on building a caring
  school environment in addition to individual
  skills.

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Elementary Curriculum (Age 5-11)

• Twice Weekly Lessons
• Readiness Self-Control
• Feelings Unit
• Friendship and Manners
• Problem Solving Unit
• Generalization Activities
• Supplemental Activities

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Findings on the Effectiveness of The Elementary
PATHS Curriculum

• There have been four studies with randomized
  control groups 2 with regular education, 1 with
  special needs children, and 1 with
  deaf/hearing-impaired children.
• Findings
• Significant reductions in aggressive behavior by
  both teacher and child reports
• Significant reductions in child and teacher
  report of internalizing (anxiety and depressive
  symptoms)
• Significant improvements in children social
  competence by teachers reports of child behavior
• Significant improvement in childrens
  understanding of emotions and their ability to
  generate effective, peaceful solutions to
  everyday peer conflicts

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Promoting School Readiness
Key Competencies
Getting Along With Others
Engaging in Learning Tasks
High Quality Early Years Program
Following Rules
Anger Management
Managing conflicts Problem-solving
Universal Social-Emotional Curriculum
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Preschool SEL Programming Key to Social
Academic Success
Evidence-Based SEL Programming
Teach SEL Competencies (Emotion Knowledge, Self
Control, Social Problem Solving)
Greater Social Competence, Less Negative Behavior
Fewer MH Problems Better Academic Performance
and Success in School and Life
Safe, Caring, Cooperative, Well-Managed Learning
Environments
Greater Engagement in Learning
Promote Autonomy, Provide Opportunities
Reinforcement for Positive Behavior
Jenkins Greenberg, in press Bierman et al,
2008
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Preschool PATHS
Promoting Alternative THinking Strategies
Authors Celene Domitrovich, Mark Greenberg,
Carol Kusché, and Rebecca Cortes
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Preschool Curriculum (Age 3-5)

• Introduction (4 lessons)
• Feelings Units (22 lessons)
• Self-Control Unit (6 lessons)
• Friendship Skills (5 Lessons)
• Problem Solving Unit (3 lessons)
• Informal Formal Generalization Activities that
  integrate with the structure of most early
  childhood

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Findings on the Effectiveness of The Preschool
PATHS Curriculum

• There has been two randomized clinical trials of
  Preschool PATHS. In the first the program was
  evaluated as a stand-alone intervention and in
  the REDI project it was integrated with
  evidence-based language and literacy components.
• Findings
• Significant improvement in childrens
  understanding of emotions.
• Significant improvements in children social
  competence by teacher and parent report of child
  behavior.
• Significant reductions in social withdrawal by
  parent and teacher report.

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Why is Prevention Critical to Community Mental
Health with Children?

• Building protective factors that promote good
  mental health is an essential role of the mental
  health system.
• Protective factors that promote mental health
  also promote more general successful life
  outcomes (e.g. life skills, academic success)
• There is evidence-base that MH disorders can be
  prevented.
• Treatment (even when effective) will not have a
  substantial impact on new cases.
• Treating disorders at their outset leads to
  better prognosis.
• Cost-benefit analysis provides support that
  prevention is the most economic strategy.

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Best Practice Guidelines

• Theoretically-Based
• Empirically Evaluated
• Developmentally Appropriate
• Comprehensive/Multi-Level
• Integrated with Broader Systems
• Clear Implementation Guidelines
• Sustainable

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Prevention Challenges

• Systems Integration
• Implementation Quality and Sustainability

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Challenge 1

• Systems Integration to Achieve a Comprehensive
  Approach
• Levels of Care
• Developmental Stages and Theory
• Institutional Structures

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Interconnected Systems for Meeting the Needs of
All Children
Prevention and Positive Youth
Development Universal and Selective
Prevention (low end need/low cost per child)
Early Intervention Early-after-onset-Indicated (m
oderate need/cost per child)
Systems of Care Treatment of severe and chronic
problems (High end need/ cost per child)
Systemic collaboration is essential to establish
inter-program connections within and across
systems of prevention, early intervention, and
treatment
Adapted from Adelman et al.
(UCLA Center for Mental Health in the Schools)
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Building Systems Integration Across
Institutional Structures

• Develop Community Level Leadership across Schools
  and Agencies.
• Educate Leadership regarding Impact of Prevention
  and need for Cross-Institution Cooperation.
• Provide Training to Agency Staff, Teachers, and
  School Support Staff on Prevention Programming.
• Develop and Showcase Model Communities.

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Challenge 2
2. Implementing Evidence-based Practices with
Quality and Sustaining them over time
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General Definition of Implementation Quality
What a program consists of in practice and the
degree to which it was conducted as it was
originally intended (Durlak, 1995 Yeaton
Sechrest, 1981)
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Measurement of Evidence-Based Intervention
Implementation

• Fidelity
• Dosage
• Quality of Delivery
• Participant Responsiveness
• Program Differentiation

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Why monitor implementation?

• In community replications the quality of
  implementation varies considerably
• Dusenbury, Brannigan, Flaco, Hansen (2003)
• Gottfredson Gottfredson (2002)
• Ringwalt, Vincus, Ennett, Johnson, Rohrbach
  (2004)
• When monitored, quality of implementation has
  been found to be related to variation in
  outcomes
• Derzon, Sale, Springer Brounstein (2005)
• Durlak Weissberg (2005)
• Durlak Dupree (2008)

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A Model of Factors Influencing Program
Implementation
Support System
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Strategies to Ensure High Quality Implementation

• Pre planning
• Quality Training
• Ongoing Coaching
• Using Data to Monitor and Adapt the Intervention
• A Plan for Continuous Training and Improvement

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JOINING TOGETHER FOR WITH A COMMON GOAL

• I was taught that the world had a lot of
  problems that I could struggle and change them
  that intellectual and material gifts brought the
  privilege and responsibility of sharing with
  others less fortunate and that service is the
  rent each of us pays for living - it is the very
  purpose of life.
• Marian Wright Edleman