Purpose: Researchers evaluated the efficacy of a small group social-emotional and behavioral intervention, the Incredible Years Dina Dinosaur Treatment Program (IY-Dina), for helping early elementary school students with social-emotional and behavioral difficulties. Many children with these difficulties do not respond adequately to universal interventions. As a result, they are at risk for discipline referrals, academic underachievement, and conflict with peers and teachers that interferes with learning for themselves and other students. The research team examined the following specific research questions:� 1) How efficacious is IY Dina for early elementary students with self-regulation difficulties? 2) Are there follow up effects during the next school year? 3) Does program efficacy vary by student characteristics including challenging behavior, gender, and parent education? and 4) How is implementation fidelity related to student outcomes?

Project Activities: The research team used a two-phase screening process to identify 1st and 2nd graders with self-regulation difficulties across three years and randomly assigned students within classrooms to IY-Dina or Business-as-Usual (BAU). IY-Dina was delivered in 17 small groups across three cohorts. Researchers collected multi-method data pre- and post-intervention and at a six month follow up during the next school year. Measures included teacher reports, classroom observations, direct child assessments, and school records (grades, office discipline referrals) to assess change in targeted outcomes.

Key Outcomes: The main findings of this study are as follows:

• With significant support, a school-based adaptation of the IY small group Dina program can be delivered with fidelity. However, there are numerous implementation challenges that must be addressed for successful delivery.
• Additional information about key outcomes and study findings will be reported as more peer reviewed publications are available.

Structured Abstract

Setting: This study took place in 11 public elementary schools in the central region of North Carolina. Schools were drawn from both urban and rural communities with considerable socio-demographic diversity.

Sample: A total of 172 1st and 2nd graders identified by their teachers as having self-regulation difficulties (based on a Total Difficulties score >12 on the Strengths and Difficulties Questionnaire) participated; 138 of these contributed results to outcome analyses. The sample was racially-ethnically diverse (56 percent Black, 23 percent White, 14 percent Latinx, and 7 percent Multiracial). Most students received free or reduced lunch (73 percent) and were male (67 percent). Students diagnosed with Autism Spectrum Disorder, significant intellectual or physical disabilities, or who were placed full-time in special education classes or were not proficient in English based upon school staff report were not included, as the intervention was not designed for such students.

Intervention: The Incredible Years Dina Dinosaur Treatment Program (IY-child) is a small-group (4 to 6 children), mixed-age pullout program that was adapted to implement in a school context for this study. A clinical therapist who was a member of the research team and a school-based counselor co-led 36 sessions of about 45 minutes in duration twice weekly over a six-month period. During the group sessions, participating children viewed brief video vignettes of same-age children in different situations where social-emotional skills and self-regulation were modeled. Children also participated in discussions facilitated by life-sized puppets and engaged in role-play practices and small group activities. Group leaders provided individual consultation to teachers of participating students and prompted use of skills during recess. Parents and their child were invited to attend three meetings in the evenings at the school to reinforce skills support.

Research Design and Methods: The researchers used a blocked randomization design such that, for classrooms in which two or more children were enrolled, randomization occurred at the level of individual children within classrooms. All remaining children (who were the only enrolled child in their respective classroom) were combined into a single block and randomization occurred at the level of individual children. Students were observed and assessed at three time points by research assistants (RAs) masked to treatment condition and systematically trained to pre-defined competency standards with ongoing reliability review. Pretest and posttest assessments occurred prior to randomization and at the end of active treatment (approximately September and April). A six-month follow-up visit was conducted in the subsequent school year. Individual child assessments were completed during 45-minute pull-out sessions with trained RAs at school who were blind to randomization status.

Control Condition: Students randomized to the BAU control group were able to receive any other services provided by their schools or families. Descriptive data suggest that approximately 30 percent of those students took medication to help with mood or behavior and a similar number received counseling outside of school, a rate that was approximately twice that of intervention students.

Key Measures: Researchers assessed student's inhibitory control, social-emotional skills, disruptive behavior, and academic and social-emotional competence via multiple measures including teacher report (such as the Emotion Regulation Checklist, the Strengths and Weaknesses of ADHD and Normal behavior, and the Impairment Rating Scale), direct student assessment (such as the Puzzle Box Task, Head Toes Knees Shoulders, Puzzle Task, Wally's Social Problem Solving Task), classroom observation (such as the Coder Observation of Child Adaptation-Revised and the REDSOCS), and school records (report card grades, discipline referrals, and special education referrals and service use). The team assessed teacher classroom management style using the Adapted Teacher Style Rating Scale (an observational measure). The research team also collected fidelity measures of small group content and quality.

Data Analytic Strategy: The research team initially created several composite constructs for data reduction purposes. Outcome analyses utilized a general HLM modeling approach to accommodate the nesting of children within schools using two-level HLM analyses to allow for the estimation of a random effect for school, with classroom included as a fixed effect. They estimated a series of intent-to-treat (ITT) models, in which each outcome was regressed on a pretest score and a treatment indicator. These ITT models were subsequently re-estimated three times to determine if treatment effects varied as a function of child characteristics (child gender, child risk for oppositional defiance disorder, and parent education). They also conducted a sensitivity analysis to address fidelity, examining effects for students who received an adequate "dosage" of the intervention. They explored whether effects varied as a function of group session quality.

Related IES Projects: Effects of the Incredible Years Dinosaur Classroom Prevention Program on Preschool Children's Executive Functioning and Academic Achievement (R305A150431)

Products and Publications

ERIC Citations:�Find available citations in ERIC for this award here.

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Journal articles

Kurian, J., Murray, D. W., Kuhn, L., & LaForett, D. R. (2022). Examining frequency and modality of parent engagement in an elementary school mental health intervention. Journal of Applied School Psychology, 38(1), 74–93.

LaForett, D. R., Murray, D. W., Reed, J. J., Kurian, J., Mills-Brantley, R., & Webster-Stratton, C. (2019). Delivering the Incredible Years® Dina treatment program in schools for early elementary students with self-regulation difficulties. Evidence-Based Practice in Child and Adolescent Mental Health, 4(3), 254–272. doi.org/10.1080/23794925.2019.1631723 Full text

Murray, D. W., Kuhn, L. J., Willoughby, M. T., LaForett, D. R., & Cavanaugh, A. M. (2021). Outcomes of a small group program for early elementary students with self-regulation difficulties: Limitations of transportability from clinic to school.School Mental Health, 1–19. Full text

Murray, D.W., Lawrence, J.R., & LaForett, D.R. (2018). The Incredible Years� Programs for ADHD in young children: A critical review of the evidence. Journal of Emotional and Behavioral Disorders, 26(4), 195–208. Full text

Willoughby, M. T., Murray, D., Kuhn, L. J., Cavanaugh, A. M., & LaForett, D. R. (2022). Incorporating callous–unemotional behaviors into school-based research.School Psychology.