Review of school-based interventions for children with ADHD

A systematic review published in Review of Education looks at the evidence from randomised controlled trials of the effectiveness of interventions for children with attention-deficit hyperactivity disorder (ADHD) in school settings.

Twenty-eight studies were included in the review and were sorted into eight categories of school-based intervention for ADHD. They were analysed for effectiveness according to a range of different ADHD symptoms, difficulties and school outcomes. The eight categories of intervention were: combined/multiple component; cognitive training; daily report card; neuro-feedback; relaxation; self-monitoring; study and organisation skills training; and task modification.

The strongest evidence of beneficial effects was found for interventions that combine multiple components. There was a large effect size (+0.79) for improved ADHD symptoms rated by teachers and parents, and a small effect size (+0.30) for parent- and teacher-rated academic outcomes.

Interventions involving daily report cards also showed some promise for academic outcomes (effect size = +0.68). There was a beneficial effect on academic outcomes for neuro-feedback interventions, and mixed findings for relaxation and self-monitoring interventions.

Source: School‐based interventions for attention‐deficit/hyperactivity disorder: A systematic review with multiple synthesis methods (October 2018), Review of Education Volume 6, Issue 3

Classroom-based intervention for pupils with autism

Findings from a cluster randomised trial published in the Journal of Consulting and Clinical Psychology suggest that classroom teachers can effectively deliver a programme for young pupils with Autistic Spectrum Disorder (ASD) that results in better outcomes relative to usual school-based education.

Lindee Morgan and colleagues conducted a trial of the Social, Communication, Emotional Regulation and Transactional Support (SCERTS) intervention – a classroom-based, teacher-implemented intervention aimed at improving active engagement, adaptive communication, social skills, executive functioning and problem behaviour in elementary (primary) school pupils with ASD – to assess what improvement pupils in the intervention group made across a variety of measures compared to pupils in the control group. Sixty schools from three US states were randomly assigned to either the intervention or control groups. Teachers in the intervention group were trained in how to deliver the SCERTS programme and received coaching throughout the school year.

Results showed better outcomes for the intervention group than the control group on observed measures of classroom active engagement with respect to social interaction. The intervention group also had better outcomes on measures of adaptive communication, social skills and executive functioning (effect sizes ranged from +0.31 to +0.45).

Source: Cluster randomized trial of the classroom SCERTS intervention for elementary students with autism spectrum disorder (July 2018), Journal of Consulting and Clinical Psychology, Volume 86(7)

Do physically active lessons improve pupil engagement?

A study published in Health Education and Behavior looks at the effects of introducing physically active lessons into primary school classes. Emma Norris and colleagues used the Virtual Traveller (VT) intervention to evaluate whether physically active lessons had any effect on pupil engagement, physical activity and on-task behaviour.

Virtual Traveller is a programme of pre-prepared physically active lesson sessions delivered using classroom interactive whiteboards during regular lessons. A total of 219 children aged 8- to 9-years-old from 10 schools in Greater London took part in the cluster-randomised controlled trial. Children in the intervention schools received 10-minute VT sessions three times a week, for six weeks, during maths and English lessons. To assess the effectiveness of VT, pupils’ physical activity levels, on-task behaviour and engagement were measured at baseline (T0), at weeks two (T1) and four  (T2) of the six-week intervention, and at one week (T3) and three months (T4) post-intervention.

Pupils in the intervention group showed more on-task behaviour than those in the control at T1 and T2, but this was not maintained post-intervention. No difference in pupil engagement between the control and intervention groups was observed at any time point. VT was found to increase physical activity, but only during lesson time.

Source: Physically active lessons improve lesson activity and on-task behavior: a cluster-randomized controlled trial of the “Virtual Traveller” intervention (March 2018), Health Education & Behavior DOI: 10.1177/1090198118762106

School-based mental health services for primary children

School-based services delivered by teachers and other school-based professionals can help reduce mental health problems in primary-age children, reports a study published in the Journal of the American Academy of Child and Adolescent Psychiatry.

The findings are based on a meta-analysis of 43 controlled trials involving almost 50,000 primary school children. The study examined the overall effectiveness of school-based mental health services, as well as the relative effectiveness of various school-based intervention models that differed according to treatment target, format and intensity.

Overall, school-based services had a small to medium effect (effect size = +0.39) in reducing mental health problems. Interventions that targeted child behaviour problems demonstrated the largest effect sizes (+0.76). Interventions that were implemented multiple times per week were found to be more than twice as effective as those that were only implemented on a weekly (or less) basis.

Source: The effectiveness of school-based mental health services for elementary-aged children: A meta-analysis (March 2018), Journal of the American Academy of Child & Adolescent Psychiatry, Volume 57, Issue 3

Examining the research on charter schools

The What Works Clearinghouse (WWC) has released a new topic area that focuses on the impact of charter schools on pupil achievement and other outcomes. As part of the launch, the WWC released three intervention reports, which review available research on an intervention or programme to determine if there is strong evidence that it has a positive impact on pupil outcomes.

The intervention reports examine the following three programmes:

  • Knowledge is Power Program (KIPP), a non-profit network of more than 200 US public charter schools educating early childhood, elementary, middle and high school pupils. According to the WWC intervention report, research shows that KIPP had positive effects on mathematics achievement and English language achievement, and potentially positive effects on science achievement and social studies achievement for middle and high school pupils (Years 7 to 13), and no discernible effects on pupil progression (eg, high school graduation within four years of grade 9 (Year 10) entry) for high school pupils.
  • Green Dot Public Schools, a non-profit organisation that operates more than 20 public charter middle and high schools in California, Tennessee and Washington. The WWC reports that Green Dot Public Schools had potentially positive effects on mathematics achievement, pupil progression, school attendance and English language achievement for high school pupils (Years 10 to 13).
  • Harlem Children’s Zone (HCZ) Promise Academy Charter Schools, a non-profit organisation designed to serve low-income children and families living in Harlem in New York City. According to the intervention report, the WWC is unable to draw any conclusions based on available research about the effectiveness or ineffectiveness of the HCZ Promise Academy Charter Schools on elementary, middle and high school pupils. Research that meets WWC design standards is needed to determine the effectiveness or ineffectiveness of this intervention.

Source:  Charter Schools, What Works Clearinghouse

Interventions can reduce school exclusion but the effect is temporary

This Campbell Systematic Review examined the impact of interventions to reduce exclusion from school. School exclusion, also known as suspension, involves the removal of pupils from regular teaching for a period during which they are not allowed to be present at school. In some extreme cases, the pupil is not allowed to come back to the same school (expulsion).

The review summarised 37 studies, reporting 38 interventions’ effect sizes. Most studies were from the US (n=33) and the UK (n=3). All of them were randomised controlled trials.

The evidence suggested that school-based interventions are effective at reducing school exclusion during the first six months after the intervention (effect size =+0.30), but that this effect is not sustained. Some specific types of interventions showed more promising results than others. Of the nine different types of school-based interventions included in the review, four types (enhancement of academic skills, counselling, mentoring/monitoring and skills training for teachers) showed positive results in reducing exclusion. However, based on the number of studies involved, the researchers suggest that results must be treated with caution.

Source: School-based interventions for reducing disciplinary school exclusion: a systematic review (January 2018), A Campbell Systematic Review 2018:1, Campbell Collaboration Crime and Justice Coordinating Group