WWC review of this study

First Step Next and homeBase: A Comparative Efficacy Study of Children with Disruptive Behavior [First Step Next and homeBase vs. Business-as-usual]

Frey, Andy J.; Small, Jason W.; Seeley, John R.; Walker, Hill M.; Feil, Edward G.; Lee, Jon; Lissman, Dana Cohen; Crosby, Shantel; Forness, Steven R. (2022). Exceptional Children, v88 n2 p205-222 . Retrieved from: https://eric.ed.gov/?id=EJ1323804

  • Randomized Controlled Trial
     examining 
    171
     Students
    , grades
    K-3

Reviewed: February 2024

At least one finding shows promising evidence of effectiveness
At least one statistically significant positive finding
Meets WWC standards without reservations
Academic achievement outcomes—Indeterminate effect found for the domain
Outcome
measure
Comparison Period Sample Intervention
mean
Comparison
mean
Significant? Improvement
    index
Evidence
tier

Social Skills Improvement System - Teacher Form - Academic Competency

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
169 students

90.25

88.35

No

--
Student Behavior outcomes—Statistically significant positive effect found for the domain
Outcome
measure
Comparison Period Sample Intervention
mean
Comparison
mean
Significant? Improvement
    index
Evidence
tier

Systematic Screening for Behavior Disorders: Academic Engaged Time

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
158 students

71.71

60.46

Yes

 
 
24
 

Child Behavior Checklist: Attention Deficit/Hyperactivity Problems Scale: Teacher Report

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
161 students

66.90

73.58

Yes

 
 
23
 

Social Skills Improvement System (SSIS) Rating Scales Social Skills: teacher-reported

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
170 students

83.26

76.13

Yes

 
 
22
 

Social Skills Improvement System (SSIS) Rating Scales Problem Behavior: teacher-reported

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
167 students

124.98

132.88

Yes

 
 
20
 

Child Behavior Checklist: Conduct Problems Scale: Teacher Report

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
144 students

67.13

71.99

Yes

 
 
17
 

Systematic Screening for Behavior Disorders: Maladaptive Behavior Index

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
171 students

32.57

35.95

Yes

 
 
15
 

Child Behavior Checklist: Oppositional Defiant Problems Scale: Teacher Report

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
169 students

65.48

68.37

Yes

 
 
15
 

Systematic Screening for Behavior Disorders: Adaptive Behavior Index

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
171 students

33.29

30.68

No

--

Student Teacher Relationship Scale (STRS): Child-Teacher Conflict

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
171 students

33.02

36.31

No

--

Social Skills Improvement System (SSIS) Rating Scales Social Skills: parent-reported

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
155 students

87.09

83.71

No

--

Child Behavior Checklist: Oppositional Defiant Problems Scale: Parent Report

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
152 students

64.53

64.44

No

--

Child Behavior Checklist: Attention Deficit/Hyperactivity Problems Scale: Parent Report

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
150 students

65.43

64.73

No

--

Social Skills Improvement System (SSIS) Rating Scales Problem Behavior: parent-reported

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
155 students

127.94

126.14

No

--

Child Behavior Checklist: Conduct Problems Scale: Parent Report

First Step Next and homeBase vs. Business as usual

0 Days

Full sample;
151 students

65.57

64.46

No

--


Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.

Characteristics of study sample as reported by study author.


  • Female: 26%
    Male: 74%
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    Indiana, Kentucky
  • Race
    Black
    53%
    Other or unknown
    10%
    White
    37%
  • Ethnicity
    Other or unknown    
    100%
  • Eligible for Free and Reduced Price Lunch
    Free or reduced price lunch (FRPL)    
    72%
    No FRPL    
    28%

Setting

The study took place in 100 elementary schools in five school districts in Kentucky and Indiana. The First Step Next (FSN) intervention was administered in traditional classroom settings. The homeBase (HB) intervention was administered in the homes of students over several months. No elements of the HB intervention took place in the child’s school.

Study sample

Across five school years, the researchers randomly assigned 94 students to the FSN only condition, 96 students to the HB only condition, 94 students to the FSN and HB combined condition, and 95 students to the business-as-usual condition. Students were taught by 379 teachers in 100 schools. Students who were identified as having behavioral challenges were recruited to participate in the study. This review assesses the contrast between students in the FSN and HB combined condition and the business-as-usual condition. A total of 171 students from kindergarten to grade 3 were included in this analysis. Among students in the analytic sample, approximately 26% of the students were female, 72% were eligible for free or reduced-price lunch, and 24% had an Individualized Education Plan. Fifty-three percent were African American, 37% were White, and the rest had unknown race. The study did not report student ethnicities.

Intervention Group

First Step Next (FSN) draws upon support for multiple stakeholders, such as parents, teachers, and peers. The intervention includes in-school activities as well as home-school communication strategies to engage parents. The primary components of the intervention are direct social skills instruction, the green card game, and home-school connections. The intervention was administered individually to students in whole class settings. A group of 29 trained FSN coaches were tasked with implementing the intervention activities with participating teachers and students. The intervention, which took place over 30 days, also included facilitation with parents. The homeBase (HB) is a home-visiting intervention that seeks to improve the outcomes of young children by providing home-based support to their caregivers. The intervention consists of three to six 60-minute home visits over several months. During sessions, parents or caregivers are encouraged to align their parenting practices consistent with one or more of the five universal principles of behavioral support: establishing clear expectations, directly teaching expectations, reinforcing the display of expectations, minimizing attention for minor inappropriate behavior, and establishing clear consequences for unacceptable behavior. HB sessions are delivered within a multi-step process for increasing intrinsic motivation to adopt and implement an evidence-based practice with integrity. The four steps are: (1) engage in values discovery (2) assess current practices (3) share performance feedback (4) offer extended consultation, education, and support. During each step, HB coaches use motivational interviewing to guide and strengthen the parent/caregiver’s engagement with and commitment to behavioral change.

Comparison Group

Students in the comparison condition received business-as-usual instruction. These students did not have contact with the trained FSN coaches and did not receive caregiver support in their homes.

Support for implementation

There were 29 coaches affiliated with the University of Louisville who served as FSN coaches and assisted in implementing interventions. Project research staff trained all coaches using role playing activities where they practiced implementing FSN to all students and teachers. FSN behavioral coaches were trained via a 2-day workshop where they were introduced to the intervention material, reflected on videos of the intervention being implemented correctly, and role-played several of the procedures. These coaches then practiced implementing the intervention with at least one child who was not enrolled in the study under the supervision of an experienced implementer. Coaches also participated in weekly supervision meetings led by an experienced implementer with other coaches to troubleshoot during the study. The HB coaches who participated in this study were also university employees. In total, 25 coaches participated in HB implementation. Research staff from the Motivational Interviewing Training and Assessment System provided training to all participating HB coaches. This training involved 12 hours of didactic workshops and simulated practice sessions with an experienced implementer. Coaches also participated in weekly supervision meetings led by an experienced implementer with other coaches to troubleshoot any problems during the study.

 

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