Co-Principal Investigators: Mitchell, Barbara; Wills, Howard; Kilgus, Stephen

Purpose: The purpose of this study is to evaluate the efficacy of Check-in/Check-out (CICO) for improving social, emotional, and academic behavior of elementary school students at risk for emotional and behavioral disorders (EBD). CICO is a manualized Tier 2 behavioral intervention commonly implemented within a multi-tiered framework and designed to improve the social and behavioral performance of students with emerging problem behavior. Research has indicated that CICO is a promising intervention for improving student outcomes, has high acceptability ratings from participants, and has shown feasibility of implementation in elementary school settings. However, evaluations of CICO have primarily used single-case research designs and high quality, group design studies are lacking. This study will examine the efficacy of CICO for improving teacher instructional practices; student social, emotional, and academic behaviors; and parent perceptions of school partnership, and potential mediators or moderators of those effects. In addition, the cost and cost-effectiveness of the intervention will be examined.

Project Activities: The research team will evaluate the efficacy of CICO using a randomized controlled trial. Schools will be recruited and randomly assigned to CICO or a services-as-usual comparison condition. Within each school, students in grades 1-5 will be screened to identify those at risk for EBD who are eligible to participate in CICO. Data will be collected before, during, and after the intervention and analyzed to determine the effects of CICO on teacher, student, and family outcomes; mediators and moderators; and the costs and cost-effectiveness of the intervention.

Products: This project will provide evidence of the efficacy of CICO for improving teacher instructional practices; student social, emotional, and academic behaviors; and parent perceptions of school partnership. This project will result in a final dataset to be shared, peer-reviewed publications and presentations, and additional dissemination products that reach education stakeholders such as practitioners and policymakers.

Structured Abstract

Setting: The research will take place in diverse urban and suburban elementary schools that are implementing a multi-tiered framework of behavioral support in Missouri, Kansas, Wisconsin, and Illinois.

Sample: Participants will include 480 students in grades 1-5 who are identified as at risk for EBD, and their parents or guardians. In addition, 48 classroom teachers and school personnel (2 per school) designated as CICO facilitators will participate.

Intervention: CICO is an 8 to 12-week Tier 2 intervention designed for students at risk for behavioral concerns and/or those students who do not respond to universal supports alone within a multi-tiered framework. CICO has the following components. First, students "check-in" with an intervention facilitator each morning and receive a Daily Progress Report (DPR) form that lists their daily behavioral goals as well as reminders for meeting these goals. Second, using the DPR, teachers provide specific feedback to students about their behavior (positive, specific praise for behavioral expectations that were met and specific error corrections for any expectations that were not met) throughout the day and rate their performance using a predetermined point system. Third, at the end of each day, students return to the intervention facilitator for "check-out," which includes entering points earned on the DPR in a data-collection system. Fourth, the intervention facilitator provides a copy of the completed DPR for the student to take home and receive additional feedback and a signature from a parent or guardian. After meeting specified targets, students are taught to evaluate and record their own behavior while the intervention components are gradually faded out.

Research Design and Methods: This study will use a cluster randomized controlled trial to test the efficacy of CICO. A total of 6 schools will be recruited each year across the first 4 project years. Schools will be randomly assigned to CICO or a services-as-usual comparison condition. Within each school, all students will be screened to identify a sample of at-risk students in grades 1-5. Classroom teachers and school personnel designated as CICO facilitators will be trained to implement CICO with at-risk students. Data will be collected at 6 timepoints, including baseline, at weeks 4, 8, and 12 post-baseline, and weeks 16 and 20 to examine maintenance of effects Ongoing implementation fidelity checks (multiple checks during the initial week and weekly for the remainder of the project) will also be conducted by the research team. The research team will analyze data to examine the efficacy of the intervention as well as variables that may mediate (such as classroom environment and home-school communication), or moderate (such as function of problem behavior and student demographics) intervention effects. The research team will also conduct cost and cost-effectiveness analyses to help schools and districts understand the monetary costs of implementing CICO, including the costs relative to observed student outcomes.

Control Condition: Students in the control condition will receive the usual services that schools provide.

Key Measures: Students will be screened for EBD risk with the Behavioral and Emotional Screening System. Student social-emotional, behavioral, and academic outcomes will be assessed with the Behavior Assessment System for Children-Third Edition and the Multiple Option Observation System for Experimental Studies (MOOSES). The MOOSES will also be used tomeasure change in teacher behavior. Family and parenting relationships and parent perceptions of school supports will be measured with the Parenting Relationship Questionnaire-Child and Adolescent. Student function of behavior will be identified using a semi-structured interview and checklist for teachers/school staff. Data on teacher and student classroom interactions will be gathered using the Brief Classroom Interaction Observation Revised. Home-school communication about the student's social/emotional or behavioral performance will be tracked. A number of measures will be used to assess implementation fidelity including a review of permanent records, self-reports, and direct observation checklists. Social validity will be measured using the Intervention Rating Profile-15. Demographic information will be obtained through questionnaires, and school-level data such as number of suspensions and rates of attendance will be gathered from school records.

Data Analytic Strategy: A series of multilevel growth models will be used to determine the impact of CICO on teacher, parent, and student outcomes, and examine potential mediators and moderators. Growth models will be used determine if there is a change in the trajectory of student and teacher outcomes at the maintenance timepoints. Descriptive analyses will be used to assess the social validity data. The research team will use the Cost Out tool kit to estimate intervention costs and cost-effectiveness will be analyzed using the Incremental Cost-Effectiveness Ratio.