BASIS-T Strategy for Childhood Behavior Challenges

(BASIS-T Trial)

Overseen By Mike Pullmann, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Washington

Disqualifiers: PGD training past 5 years

Compensation: Varies

Number of Visits: Unknown

276 Participants Needed

Trial Summary

What is the purpose of this trial?

For the approximately one in five children with social, emotional, and behavioral (SEB) challenges, accessible evidence-based prevention practices (EBPPs) are critical. In the United States, schools are the primary service setting for children's SEB service delivery but EBPPs are rarely adopted or implemented by educators (e.g., teachers) with sufficient fidelity to see effects. Given that individual behavior change is ultimately required for successful implementation, focusing on individual-level processes holds promise as a parsimonious approach to enhance adoption. Beliefs and Attitudes for Successful Implementation in Schools for Teachers (BASIS-T) is a pragmatic, multifaceted pre-implementation strategy targeting volitional and motivational mechanisms of educators' behavior change to enhance implementation and student SEB outcomes. This study protocol describes a hybrid type 3 effectiveness-implementation trial designed to evaluate the main effects, mediators, and moderators of the BASIS-T implementation strategy in the context of Positive Greetings at the Door (PGD), a universal school-based EBPP previously demonstrated to reduce student disruptive behavior and increase academic engagement.

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the BASIS-T treatment for childhood behavior challenges?

The BASIS-T treatment, which involves teacher training and support, may be effective for childhood behavior challenges as similar school-based mental health programs have shown success. For example, a study found that a school-based behavioral treatment package led to significant improvements in children's behavior and peer relationships, suggesting that structured interventions in educational settings can be beneficial. ^{1 2 3 4 5}

How is the BASIS-T treatment different from other treatments for childhood behavior challenges?

BASIS-T is unique because it focuses on changing teachers' beliefs and attitudes to improve the implementation of behavioral interventions in schools, addressing barriers like stress and competing demands, which are often overlooked in other treatments. ^{4 6 7 8 9}

Research Team

Aaron Lyon, PhD

Principal Investigator

University of Washington

Eligibility Criteria

This trial is for K-5th grade teachers at elementary or K-8 schools who haven't been trained or supervised in Positive Greetings at the Door (PGD) in the past 5 years. Special education-only classroom teachers are not eligible.

Inclusion Criteria

I am a teacher for grades K-5 in a regular classroom, not special education.

Exclusion Criteria

I have been trained or supervised in PGD within the last 5 years.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Preparation/Adoption

BASIS-T is delivered to address behavioral components and enhance motivation prior to EBPP training

2-4 weeks

Virtual sessions

Active Implementation

Teachers implement Positive Greetings at the Door (PGD) with ongoing fidelity observations

9 months

Monthly self-report and observation

Follow-up

Participants are monitored for fidelity and sustainment of PGD practices

6 months

Monthly self-report

Treatment Details

Interventions

• Attention Control (ACC)
• BASIS-T

Trial Overview The BASIS-T efficacy trial is testing a strategy called BASIS-T, designed to help teachers adopt and implement school-based practices to improve student social, emotional, and behavioral outcomes. It's compared with an Attention Control group.

Participant Groups

Group I: BASIS-T Experimental Treatment 1 Intervention

BASIS-T is designed to address the behavioral components often missing from standard EBPP training and consultation that relate to motivation prior to receiving EBPP training, and volition after EBPP training. It is an EBPP-agnostic implementation strategy designed to be delivered within the Preparation/Adoption phase, immediately prior to Active Implementation (CITE EPIS). BASIS-T targets behavioral intentions via improvement in attitudes, subjective norms, and self-efficacy.

Group II: Attention Control Placebo Group 1 Intervention

Teachers assigned to the ACC will receive pre- and post-training experiences designed to mirror those received in the BASIS-T condition. These training experiences will be virtual, delivered by the same interventionist, and be approximately the same length as the BASIS-T experiences, but will not contain any of the BASIS-T content or mechanisms of change. The ACC pre-training experience will define, describe, and advocate for EBP implementation in schools. Content will be didactic, as is typical in professional development training for teachers.

Who Is Running the Clinical Trial?

University of Washington

Lead Sponsor

Trials

1,858

Recruited

2,023,000+

Institute of Education Sciences

Collaborator

Trials

10

Recruited

3,200+

Findings from Research

Clinicians believe that the success of parent-directed behavioral therapy (PDT) for disruptive behavior disorders in children is significantly influenced by appointment attendance and the primary caregiver's commitment to the treatment approach.

Additional factors affecting PDT effectiveness include the caregiver's support system, emotional and physical well-being, the complexity of the child's behavior, and the home environment, suggesting that improving these areas could enhance treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinician-Identified Factors in Success of Parent-Directed Behavioral Therapy for Children's Tantrums. Yu-Lefler, HF., Lindauer, S., Riley, AW.[2022]

A review of 11 studies focused on task sequencing interventions for children with emotional and/or behavioral disorders (EBD) found that these strategies can effectively improve academic outcomes in educational settings.

The study highlights the need for more comprehensive research on the application of task sequencing methods, such as high-probability and task interspersal interventions, to better support students with EBD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Task sequencing for students with emotional and behavioral disorders: a systematic review. Knowles, C., Meng, P., Machalicek, W.[2018]

The feasibility study involving 23 children with ADHD demonstrated that the Pay Attention! intervention is both practical to implement and well-received by participants, indicating its potential for clinical use.

Post-intervention evaluations showed significant reductions in ADHD symptoms and improvements in executive functions, including fluid reasoning, cognitive flexibility, and working memory, suggesting that further randomized clinical trials are needed to explore its effectiveness as a treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attention training for school-aged children with ADHD: results of an open trial. Tamm, L., Hughes, C., Ames, L., et al.[2010]

A school-based mental health program using a behavioral treatment package significantly reduced hyperactive, impulsive, and aggressive behaviors in children, as reported by parents, with 30 children receiving treatment compared to 12 in a waitlist control group.

Teachers also noted improvements in inattention, academic performance, and student-teacher relationships, highlighting the effectiveness of integrating mental health services into schools.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

School-based mental health programming for children with inattentive and disruptive behavior problems: first-year treatment outcome. Owens, JS., Richerson, L., Beilstein, EA., et al.[2015]

A study involving 26 agency staff and 452 parents and youth identified key barriers to implementing the STAND program for ADHD, including practical issues like transportation and scheduling, as well as the need for better engagement with parents and youth.

Eighteen effective implementation strategies were proposed, focusing on training stakeholders, engaging consumers, providing interactive assistance, and using evaluative methods, which will be tested in a pilot trial to improve the STAND service delivery model.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Stakeholder-Generated Implementation Strategies to Promote Evidence-Based ADHD Treatment in Community Mental Health. Sibley, MH., Ortiz, M., Rios-Davis, A., et al.[2022]

Teachers face significant barriers to implementing behavioral classroom interventions for students with ADHD, including distractions from competing demands and feelings of stress or burnout, which can hinder their motivation and execution of these strategies.

Facilitators that enhance the use of these interventions include strong student-teacher relationships and the development of habitual practices, suggesting that targeted support in these areas could improve the effectiveness of behavioral interventions in classrooms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Barriers and Facilitators to Teachers' Use of Behavioral Classroom Interventions. Lawson, GM., Owens, JS., Mandell, DS., et al.[2022]

A cognitive training program focused on self-instruction and self-management significantly improved math accuracy for all three hyperactive children aged 7 to 8 years, indicating its efficacy in enhancing academic performance.

The training also led to improvements in on-task behavior for two of the children and showed evidence of generalization to other untrained behaviors, such as self-correction during oral reading.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of cognitive training on academic and on-task behavior of hyperactive children. Cameron, MI., Robinson, VM.[2019]

In a study involving 77 first graders, both Computerized Attention Training (CAT) and Computer Assisted Instruction (CAI) were effective in reducing attention problems as rated by teachers, compared to a control group.

CAI not only improved attention but also led to gains in reading fluency and overall academic performance, suggesting that these interventions could be beneficial for children struggling with attention issues, especially those with more severe symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized trial of two promising computer-based interventions for students with attention difficulties. Rabiner, DL., Murray, DW., Skinner, AT., et al.[2022]

The enhanced choice model of skill-based treatment (ECM-SBT) was successfully implemented with 3 children in a public special day school, leading to increased positive behaviors like communication and cooperation while reducing precursor problem behaviors.

Participants showed a strong preference for ECM-SBT over other activities, suggesting that this treatment is not only effective but also engaging for children with emotional and behavioral disorders in school settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of an enhanced choice model of skill-based treatment for students with emotional/behavioral disorders. Staubitz, JL., Staubitz, JE., Pollack, MS., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Clinician-Identified Factors in Success of Parent-Directed Behavioral Therapy for Children's Tantrums. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Task sequencing for students with emotional and behavioral disorders: a systematic review. [2018]

3. United States pubmed.ncbi.nlm.nih.gov

Attention training for school-aged children with ADHD: results of an open trial. [2010]

4. United States pubmed.ncbi.nlm.nih.gov

School-based mental health programming for children with inattentive and disruptive behavior problems: first-year treatment outcome. [2015]

5. United States pubmed.ncbi.nlm.nih.gov

Stakeholder-Generated Implementation Strategies to Promote Evidence-Based ADHD Treatment in Community Mental Health. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Barriers and Facilitators to Teachers' Use of Behavioral Classroom Interventions. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Effects of cognitive training on academic and on-task behavior of hyperactive children. [2019]

8. United States pubmed.ncbi.nlm.nih.gov

A randomized trial of two promising computer-based interventions for students with attention difficulties. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Effects of an enhanced choice model of skill-based treatment for students with emotional/behavioral disorders. [2022]