Health knowledge made personal
Join this community!
› Share page:
Go
Search posts:

First Step takes off

Posted Dec 08 2009 3:21am

Hill Walker and colleagues reported that the First Step to Success program benefitted young children at risk for developing emotional or behavioral disorders. In a longitudinal study of the three-year program conducted in Albuquerque (NM, US), the researchers found substantial reductions in disruptive behavior and improvements in social functioning.

In a press release, Professor Walker said, “Albuquerque was the first opportunity we had to mount a large-scale study of the program using a randomized control group, the gold standard for research. First Step has been implemented widely, but not [studied] in this way.”

This is the abstract from a report in Journal of Emotional and Behavioral Disorders of the full study in Albuquerque.

This article reports on a randomized controlled trial of the First Step to Success early intervention that was conducted over a 4-year period in Albuquerque Public Schools. First Step is a selected intervention for students in Grades 1 through 3 with externalizing behavior problems, and it addresses secondary prevention goals and objectives. It consists of three modular components (screening, school intervention, parent training); lasts approximately 3 months; and is initially set up, delivered, and coordinated by a behavioral coach (e.g., school counselor, behavior specialist, social worker). Project Year 1 of this efficacy trial was devoted to gearing-up activities (e.g., hiring, training, planning, logistical arrangements); Years 2 and 3 each involved implementing First Step with approximately 100 behaviorally at-risk students. Students, teachers, and classrooms were randomly assigned to either intervention or usual care comparison conditions. Year 4 activities focused on conducting long-term, follow-up assessments and implementing sustainability procedures to preserve achieved gains. Pre-post teacher and parent ratings of student behavior and social skills showed moderately robust effect sizes, ranging from .54 to .87, that favored the intervention group. Direct measures of academic performance (oral reading fluency, letter—word identification) were not sensitive to the intervention. The implications and limitations of the study are discussed.

In separate analyses, the researchers found salutary improvements in disruptive behavior, social functioning, and academic performance. Those results were reported by John Seeley and collagues in an article that appeared in School Mental Health: A Multidisciplinary Research and Practice Journal. Here’s that abstract:

Abstract This study evaluated the efficacy of the First Step to Success early intervention for students meeting criteria for attention-deficit/hyperactivity disorder (ADHD). First Step is a targeted intervention for students in grades K-3 with externalizing behavior problems, and addresses secondary prevention goals and objectives. As part of a larger randomized controlled trial conducted within the Albuquerque Public School system, the efficacy of the First Step program was evaluated on a subsample of 42 students meeting DSM-IV criteria for ADHD who were randomly assigned to either the intervention group or a usual care control group. The First Step program was found to have significant and moderate-to-large post-intervention effects on school-based measures of ADHD and disruptive behavior symptoms, social functioning, and academic functioning. The intervention effects on the home-based assessments of problem behaviors and social skills were less robust and nonsignificant. Implications and limitations of the study are discussed.

Read more about First Step in this earlier article:

Walker, H., Golly, A., McLane, J., & Kimmich, M. (2005). The Oregon First Step to Success replication initiative: Statewide results of an evaluation of the program’s impact. Journal of Emotional and Behavioral Disorders, 13, 163-172.

Seeley, J. R., Small, J. W., Walker, H. M., Feil, E. G., Severson, H. H., Golly, A. M., & Forness, S. R. (2009). Efficacy of the First Step to Success intervention for students with Attention-Deficit/Hyperactivity Disorder. School Mental Health: A Multidisciplinary Research and Practice Journal, 1, 37-48.

Walker, H. M., Seeley, J. R., Small, J., Severson, H. H., Graham, B., Feil, E. G., et al. (2009). A randomized control trial of the First Step to Success early intervention: Demonstration of program efficacy outcomes within a diverse, urban school district. Journal of Emotional and Behavioral Disorders, 17, 197-212. DOI: 10.1177/1063426609341645

Visit the Institute on Violence and Destructive Behavior (IVDB) where First Step was developed or see video about First Step: YouTube resources: general overview of First Step to Success, summary of First Step in Albuquerque, and a little about ADHD in the study.

Post a comment
Write a comment:

Related Searches