Effects of a universal classroom behavior management program in first and second grades on young adult behavioral, psychiatric, and social outcomes

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Abstract

Background

The Good Behavior Game (GBG), a method of classroom behavior management used by teachers, was tested in first- and second-grade classrooms in 19 Baltimore City Public Schools beginning in the 1985–1986 school year. The intervention was directed at the classroom as a whole to socialize children to the student role and reduce aggressive, disruptive behaviors, confirmed antecedents of later substance abuse and dependence disorders, smoking, and antisocial personality disorder. This article reports on impact to ages 19–21.

Methods

In five poor to lower-middle class, mainly African American urban areas, three or four schools were matched and within each set randomly assigned to one of three conditions: (1) GBG, (2) a curriculum-and-instruction program directed at reading achievement, or (3) the standard program. Balanced assignment of children to classrooms was made, and then, within intervention schools, classrooms and teachers were randomly assigned to intervention or control.

Results

By young adulthood significant impact was found among males, particularly those in first grade who were more aggressive, disruptive, in reduced drug and alcohol abuse/dependence disorders, regular smoking, and antisocial personality disorder. These results underline the value of a first-grade universal prevention intervention.

Replication

A replication was implemented with the next cohort of first-grade children with the same teachers during the following school year, but with diminished mentoring and monitoring of teachers. The results showed significant GBG impact for males on drug abuse/dependence disorders with some variation. For other outcomes the effects were generally smaller but in the predicted direction.

Introduction

This article reports on the cumulative impact in young adults (ages 19–21) of a universal preventive intervention classroom behavior management program carried out in first and second grades known as the Good Behavior Game (GBG; Barrish et al., 1969). Administered by the teacher classroom-wide, it is directed at socializing children to the role of student and reducing aggressive, disruptive behavior, a well-documented antecedent risk factor for later drug, alcohol, and antisocial behavioral disorders and other problem outcomes. We have conducted three generations of developmental epidemiology-based, randomized field trials involving the GBG in close partnership with the Baltimore City Public School System (BCPSS). In the first generation trial, the GBG was tested by itself, and a curriculum/instruction intervention called Mastery Learning (ML; Block and Burns, 1976) was tested separately in a parallel design. The GBG and a curriculum/instruction intervention were combined in the second-generation trial (Ialongo et al., 1999) and further combined with a family/classroom partnership in the ongoing third-generation trial. This paper is concerned solely with the outcomes in young adulthood of the first-generation trial of the GBG and is directed at three goals: (1) to report the overall effectiveness and the predicted variation in effectiveness of the GBG within and across outcomes; (2) to report evidence on the theoretically predicted etiological role of early aggressive, disruptive behavior on this profile of outcomes; (3) to report the utility of the prevention strategy of aiming an intervention at a single shared early antecedent of a set of later problem outcomes for the purpose of reducing the risk of the entire set of outcomes.

The Baltimore prevention intervention research and the Chicago/Woodlawn studies that preceded it are grounded in an integration of three scientific paradigms (Kellam and Ensminger, 1980, Kellam and Langevin, 2003, Kellam and Rebok, 1992, Kellam et al., 1999). The first paradigm is community epidemiology, which is concerned with understanding the sources of nonrandom distribution of health problems, behaviors, or related factors in a defined community. Community epidemiology provides control of selection bias and, when integrated with the second paradigm, life course development, allows the study of variation in developmental antecedents and paths. The third paradigm is the use of a randomized experiment to test preventive interventions directed at early antecedents of later problem outcomes to investigate the causal role, malleability, and mediating/moderating effects of risk factors on the course and prevention of behavioral, psychiatric, and social adaptation, and how the impact varies in relationship to a priori prediction. This prevention science strategy has guided our past research and guides the presentation of results and discussion in the present study (Brown and Liao, 1999, Kellam and Langevin, 2003, Kellam and Rebok, 1992, Kellam et al., 1999).

Our research is further grounded in a theoretical view of psychological, behavioral, and social health. Life course/social field theory (Kellam et al., 1975) is focused on two dimensions and their interrelationships: the levels of success and failure as defined by an external dimension (i.e. how an individual is viewed by the prevailing society) and an internal dimension (i.e. the psychological, psychiatric well-being of the individual) as well as on the potential reciprocal relationships between the two dimensions. Life course/social field theory is centered on the observation that in each stage of life there are a few main social fields, each with defined social task demands. The adequacy of an individual's responses to these specific social task demands is rated by natural raters, such as parents within the family, teachers in the classroom, significant peers in the peer group, or later in the life course, by partners in the intimate social field or supervisors in the work social field. This process of social task demands and behavioral responses to them is called social adaptation; the resulting ratings by the natural rater(s) are termed social adaptational status (SAS). In addition to the individual's performance, the natural rater, chance, and the fit of the individual in the social context play roles in an individual's SAS. Aggressive, disruptive behavior, academic problems, and other early antecedents to problem outcomes are viewed, therefore, not as residing merely in the individual but also reflecting the results of social interactions within and across social fields—between child and teacher, classmates/peers, family, and the broader community and societal context.

Life course/social field theory postulates that adapting or maladapting to earlier social task demands in specific social fields leads to later adaptation or maladaptation in the same field as well as in other social fields (Cicchetti and Schneider-Rosen, 1984). The theory also suggests that psychological well-being (PWB), the internal dimension that reflects the psychological status of an individual, may be an antecedent and/or a consequence of social maladaptation, since social maladaptation may be reciprocally related to PWB. For example, failure may make one feel depressed, and/or feeling depressed may make one more likely to fail. Finally, life course/social field theory proposes that improving SAS early in the life course is likely to improve later developmental outcomes.

For several decades, we have studied teachers’ social task demands of students in first grade classrooms (Kellam et al., 1975, Werthamer-Larsson et al., 1991). The first social task demand for students is engaging in behavior that is in keeping with classroom rules, to which one maladaptive response is aggressive, disruptive behavior. Other social task demands are that children participate in social interactions with classmates and the teacher and not be too shy or withdrawn, that they pay attention and remain focused, and that they learn the academic subjects. In prior publications we reported that directing interventions at the social adaptational process of social task demands and behavioral responses shows promise for improving both later SAS and PWB. For example, conducting the GBG in first-grade classrooms resulted in decreases in aggression (Dolan et al., 1993) and off-task behavior (Brown, 1993) by the end of first grade and lower levels of antisocial behavior and tobacco use by middle school (Kellam and Anthony, 1998, Kellam et al., 1994a). In addition, improving achievement (SAS) tends to improve depression (PWB) in girls and to reduce aggression (SAS) in boys (Kellam et al., 1994b, Kellam et al., 1998b) during the course of the first grade. Previous publications have addressed the immediate effects of the GBG by the end of first grade and the intermediate effects by middle school.1 This report, however, focuses on the long-term, young adult outcomes of the GBG intervention as predicted by life course/social field theory and further guided by earlier research on aggressive, disruptive behavior as a risk factor for long-term outcomes.

Aggressive, disruptive behavior repeatedly has been shown, as early as the first grade, to be an important maladaptive classroom behavioral antecedent of adolescent and adult illicit drug use, conduct disorders, antisocial personality disorder, criminal behavior, and school failure and dropout (Block et al., 1988, Dishion et al., 1996, Ensminger and Slusarcick, 1992, Ensminger et al., 1983, Farrington and Gunn, 1985, Farrington et al., 1988, Grant, 1991, Hans et al., 1992, Haskins et al., 1983, Kellam et al., 1975, Kellam et al., 1983, Kellam et al., 1991, Kellam et al., 1994a, Kershaw, 1992, Oakes and Lipton, 1990, Patterson et al., 1992, Pekarik et al., 1976, Robins, 1978, Sameroff, 1994, Schwartzman et al., 1985, Shedler and Block, 1991). During the preschool years, this early risk factor is most likely to be found in the interactions of children, their siblings, and their parents in the home setting. In particular, coercive, irritable, and ineffective parenting behaviors have been implicated consistently in the development of conduct problems throughout childhood (McCord, 1988, Patterson et al., 1992, Reid, 1993, Reid and Eddy, 1997) and as a precursor to illicit drug use (Hawkins et al., 1992). McNeil et al. (1991), Webster-Stratton, 1989, Webster-Stratton, 1998, and Patterson et al. (1982) showed that parent-training programs had intervention effects on antisocial behavior, supporting the strategy of directed interventions at these types of antecedents.

When children enter the school system this link between family processes and child outcomes becomes more complex. Preschool-age children who engage in oppositional and aggressive, disruptive behaviors with their parents are at high risk for engaging in aggressive, disruptive behaviors with classmates that not only accelerate the development of antisocial behaviors but also decrease children's ability to profit from positive educational and social opportunities (Reid, 1993). Furthermore, these students may become involved in coercive interactions with their teachers, who often are not trained in classroom behavior management and may inadvertently escalate negative behaviors in children leading to classrooms with higher levels of aggressive, disruptive behavior (Kellam et al., 1998a). These classrooms place children at higher risk of later problem behavior and outcomes, particularly those who themselves are more aggressive, disruptive in first grade (Kellam et al., 1994c, Kellam et al., 1998a). Such classrooms point to the need for interventions that provide teachers with better tools for socializing children into the role of student and for effective classroom behavior management.

The GBG was developed by Barrish et al. (1969). Before the Baltimore trials, as far as we can determine, no randomized field trials had been conducted of the GBG, but there are numerous scientific papers and dissertations describing positive results from the use of GBG in pre–post or fairly short-term ABAB designed studies with relatively small numbers of children.2 These observational studies led to the epidemiologically based randomized trial reported here. In a recently published review, Tingstrom et al. (2006) infer that the pre-randomized field trials and the Baltimore epidemiologically based randomized trials support the beneficial effects of GBG as a classroom behavior management tool. Embry (2002) even suggests the GBG as a possible “behavioral vaccine” to prevent subsequent problem behaviors, particularly given the earlier reported results of our randomized trials in Baltimore.

The purpose of the GBG is to create a classroom environment that is conducive to learning for all students. The focus is on the social context of the classroom; the function of GBG is to socialize children into the role of student and to teach them to regulate their own and their classmates’ behavior through a process of interdependent team behavior–contingent reinforcement (Tingstrom et al., 2006). The goal of the strategy is to reduce early aggressive, disruptive behavior at the classroom level and at the individual level, a frequently reported antecedent of later problem outcomes. This report is the longest follow-up study of GBG impact conducted yet, and it provides evidence regarding the effectiveness of GBG.

In the trial reported here, classrooms of first and second graders received the GBG intervention over the course of 2 years. GBG teachers initially received training and assigned children to one of three heterogeneous teams that contained equal numbers of boys and girls, equal numbers of aggressive, disruptive children, and equal numbers of shy, socially isolated children based on baseline measurements of classroom behavior. The teacher posted basic classroom rules of student behavior and teams were rewarded if the team members committed four or fewer infractions of these classroom rules. During a particular game period, all teams were eligible for the reward if they accumulated four or fewer infractions of acceptable student behavior. The GBG was played during those periods of the day when the classroom environment was less structured, such as when the teacher was working with one student or a small group while the rest of the class was instructed to work on assigned tasks independently.

During the first weeks of the intervention, the GBG was played three times each week for a period of 10 min. The duration of the game increased approximately 10 min per game period every 3 weeks, up to a maximum of 3 h. Initially, the teacher announced game periods, and the rewards were delivered immediately after the game. Later, the teacher initiated the game periods without announcement, and the rewards were delayed until the end of the school day or the end of the week. Over time, the game was played at different times of the day and during different activities. In this manner, the GBG evolved from a procedure that was highly predictable and visible, with a number of immediate rewards, to a procedure with an unpredictable occurrence and location, with deferred rewards.

We hypothesize that the GBG, directed at the interactive process of the classroom teacher's social task demands and the children's behavioral responses, will be effective overall but that its main impact will be for children who are maladapting to the classroom by aggressive, disruptive behavior, the specific target of GBG. Based on life course/social field theory and earlier results, we further hypothesize that the impact of the GBG will be found among those long-term outcomes predicted by early aggressive, disruptive behavior, generally the more externalizing behaviors. Life course/social field theory also posits that mastery enhances the likelihood of positive outcomes therefore protecting against maladaptive and/or poor psychological outcomes, and so a research question rather than a hypothesis is whether GBG protects children from becoming more at risk over the life course due to the mastery of social adaptation.

Section snippets

Epidemiologically based, randomized field trial design

Our trial design involved selecting five large urban areas within Baltimore City, matching sets of schools in each area, and randomly assigning which type of intervention would be tested in which elementary schools from these urban areas. We then assigned all of the children entering first grade to classrooms within these schools in a balanced manner, and then randomly assigned the classrooms/teachers to classroom intervention condition. This multilevel design encompassed a total of 19 schools,

Results

Formal analyses of GBG intervention against internal GBG controls were conducted as a series of parallel analyses, one for each young adult outcome. For each outcome, we begin by reporting simple cross-tabulations of outcome by intervention status to show the overall magnitude of the effect. These cross-tabulations compared the GBG against internal GBG controls as well as all controls (internal GBG, internal ML, and external controls). We also compared the group's rates for each outcome for

Discussion

To interpret our results in this trial in a way that is useful for policy makers, we present in Table 10 overall rates that we would expect to find if all subjects were in the GBG condition or alternatively in the control condition. The rates in this table are derived from the best fitting individual and classroom-level analytical models provided earlier, expressed as adjusted population rates rather than model parameters; all show statistically significant as well as meaningful reductions in

Conflict of Interest

The author and all of the co-authors declare that they have no conflict of interest.

Acknowledgments

Since 1984, with the strong support of Ms. Alice Pinderhughes, the much-respected superintendent during the early years of the study, the partnership between our research team and the BCPSS has made possible three generations of randomized field trials. This partnership has been a firm foundation for much research serving the mutual interests of the BCPSS and the prevention and education research fields. Dr. Leonard Wheeler, Area Superintendent, the school principals, and the teachers played

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    Supplementary data on Cohort 2 and additional information on the Good Behavior Game intervention is provided in the Supplementary data with the online version of this paper at http://dx.doi:org/10.1016/j.drugalcdep.2008.01.004.

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