Dosage Results of a Randomized Control Trial of a Self-Monitoring Intervention for Elementary Students

Background and Purpose: Disruptive and challenging behaviors are the most common reason students are removed from class—interrupting instruction and exacerbating academic difficulties (Gresham et al., 2000; Nelson et al., 2007). Systematic reviews suggest instruction in SEL skills improve student behavioral and academic performance. The SMARTS intervention was developed to target and intervene with students with challenging behaviors and consists of three phases: (1) nine scripted lessons in goal development and SEL skills, (2) student self- and teacher-ratings on goals, and (3) weekly data processing sessions to discuss and revise goals. The study was a randomized control effectiveness trial conducted with natural implementors and wide-ranging dosages of students randomized to the intervention. The purpose of this study was to examine effects of an intent-to-treat (ITT) dosage model on prosocial behaviors and emotional regulation compared to students in an active control condition.

Method: Fifth grade student participants (n=334) over four cohorts in 19 elementary schools were screened for challenging behaviors before being randomized into an active control condition (CICO=180) or into the Self-Management Training And Regulation Strategy (SMARTS=154)—both interventions delivered by school counselors (n = 23). An ITT dosage variable was modelled from counselor-reported attendance of students in training, self-monitoring, and data reviews. HLM models were used to examine if the SMARTS ITT dosage variable predicted improvements teacher-rated emotional regulation, disruptive behavior, and prosocial behavior. Time 1 scores were included as a covariate, as well as sex, income status, and race.

Results: SMARTS students were exposed to range of the intervention elements, from 0% (n = 41) to 96% (n = 67). HLM models show an increase in dosage of the intervention significantly (p < .001) predicted positive increases in emotional regulation as measured by the TOCA, which was reverse coded (ß = -.58) and as measured by the TCOMP (ß = .96). Additionally, an increase in the dosage of SMARTS significantly (p < .001) predicted reduced disruptive behavior (ß = -.65), and significantly (p < .001) predicted increases in prosocial behavior as measured by the TOCA (ß = 3.75) and the TCOMP (ß = .93).

Conclusion and Implications: The SMARTS intervention not only teaches students at risk for behavior disorders social emotional and goal setting skills but puts the learning into practice through self-monitoring and processing with school counselors. The combination of the three phases of the intervention is crucial to seeing improvements in disruptive behavior, prosocial behaviors, and emotional regulation. Not only do students need to participate in all three phases, but consistent participation within each phase is crucial to the intervention effectiveness.