Brief Behavioral Teacher Training for Behavioral Difficulties
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age4-13
SponsorAccare
About this trial
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.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
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)).
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.
Disqualifiers
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).
Trial design
Design model
Parallel
Treatments tested in this trial
Brief behavioral teacher training
BehavioralA brief behavioral teacher training program that combines 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.
Practice as usual only (PAU)
BehavioralPAU 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.
Treatment groups
60 Participants
are divided into 2 treatment groupsGroup A: Brief behavioral teacher training and optional practice as usualExperimental treatment 1 intervention
Group B: Practice as usual only (PAU)Active comparator 1 intervention
Trial outcomes
Primary outcomes
1
Severity of four daily rated target behaviors in specific classroom situations
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.
Time frame
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)Secondary outcomes
1
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)
To investigate whether the four target behaviors improve in other situations, we will ask teachers during the daily phone calls if these behaviors occurred in any of the other situations of the SSQ-R (DuPaul \& Barkley, 1992) (yes/no) in the last day the teacher had contact with the child. Items scored as 'yes' will be rated on a 5-point Likert scale ranging from 1 (not severe) to 5 (extremely severe).
Time frame
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)2
Teacher-reported severity of behavioral difficulties of the child in the classroom
Severity of children's behavioral difficulties in the classroom will be measured with the Intensity scale of the Dutch version of the Sutter-Eyberg Student Behavior Inventory-Revised (SESBI-R; Eyberg \& Pincus, 1999). On 38 items, teachers have to rate the frequency of the child's behavioral difficulties on a 7-point Likert scale, ranging from 1 (never) to 7 (always).
Time frame
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)3
Teacher-reported number of child behavioral difficulties in the classroom that the teacher considers troublesome
The number of children's behavioral difficulties in the classroom which the teacher considers troublesome will be measured with the Problem subscale of the Dutch version of the Sutter-Eyberg Student Behavior Inventory-Revised (SESBI-R; (Eyberg \& Pincus, 1999)). On 38 items, teachers have to indicate if the behavioral difficulties are problem for them by answering yes (0) or no (1).
Time frame
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)4
Teacher-reported child impairment at school associated with behavioral difficulties
Children's impairment associated with behavioral difficulties at school will be measured with a slightly adapted (i.e., we asked the teachers to specifically link the impairment to the behavioral difficulties) version of the Dutch version of the impairment rating scale - Teacher (IRS-T; Fabiano et al., 2006). On 6 items, teachers have to rate the impairment of the child on a 7-point Likert scale, ranging from no problem (0) to extreme problem (6).
Time frame
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)Other outcomes
1
Teacher/school-reported history of mental healthcare/support.
A self-developed questionnaire will be used to measure the history of mental healthcare/support for the behavioral difficulties of the considering child (including teacher support/training and programs for all children in the classroom)
Time frame
Before randomization (T0)2
Teacher/school-reported use of mental health care or support for behavioral difficulties of the child in the classroom
A self-developed questionnaire will be used to assess the use of mental health care or support for of the child in the classroom (including teacher support/training and programs for all children in the classroom) in the period between T0 and T1.
Time frame
One week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1)3
Caregiver-reported history of mental healthcare/support
A self-developed questionnaire will be used to measure the history of mental healthcare/support (except care/support provided at school) for the behavioral difficulties of the child.
Time frame
Before randomization (T0)4
Caregiver-reported use of mental health care for behavioral difficulties of the child at home.
A self-developed questionnaire will be used to assess the use of mental health care/support (except health care/support provided at school) for behavioral difficulties displayed by the child in the period between T0 and T1.
Time frame
One week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1). Source ClinicalTrials.gov