WWC review of this study

The Early Risers longitudinal prevention trial: Examination of 3-year outcomes in aggressive children with intent-to-treat and as-intended analyses.

August, G. J., Hektner, J. M., Egan, E. A., Realmuto, G. M., & Bloomquist, M. L. (2002). Psychology of Addictive Behaviors, 16(4, Suppl), S27–S39.

  • Randomized controlled trial
     examining 
    199
     Students
    , grades
    K-2

Reviewed: June 2012

No statistically significant positive
findings
Meets WWC standards without reservations
Academic achievement outcomes—Statistically significant positive effect found for the domain
Outcome
measure
Comparison Period Sample Intervention
mean
Comparison
mean
Significant? Improvement
    index
Evidence
tier

Academic Achievement Composite

Early Risers vs. None

after 3 yrs of ER

Grade 3;
199 students

N/A

N/A

No

--

Concentration Problems Composite

Early Risers vs. None

after 3 yrs of ER

Grade 3;
199 students

N/A

N/A

No

--
External behavior outcomes—Indeterminate effect found for the domain
Outcome
measure
Comparison Period Sample Intervention
mean
Comparison
mean
Significant? Improvement
    index
Evidence
tier

Aggression Composite

Early Risers vs. None

after 3 yrs of ER

Grade 3;
199 students

N/A

N/A

No

--

Impulsivity Composite

Early Risers vs. None

after 3 yrs of ER

Grade 3;
199 students

N/A

N/A

No

--

Hyperactivity Composite

Early Risers vs. None

after 3 yrs of ER

Grade 3;
199 students

N/A

N/A

No

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

Social Skills Composite

Early Risers vs. None

after 3 yrs of ER

Grade 3;
199 students

N/A

N/A

No

--

Adaptability Composite

Early Risers vs. None

after 3 yrs of ER

Grade 3;
199 students

N/A

N/A

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: 31%
    Male: 69%

  • Rural
    • B
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    Minnesota
  • Race
    White
    89%

Setting

The study was conducted in two semirural sites in Minnesota, characterized by families of low and middle socioeconomic status.

Study sample

The sample consisted of students from 20 schools that were randomly assigned to either the Early Risers condition (n = 10 schools) or the comparison condition (n = 10 schools). Within these schools, 95% of kindergarten students were screened using teacher ratings of aggressive- disruptive behavior on the 25-item Aggression Scale of the Child Behavior Checklist– Teacher Rating Form (Achenbach, 1991). Children who obtained a t-score greater than 58 on the Aggression Scale (using gender-specific norms) or who were at or above the 85th percentile relative to all kindergarten students in their school without dropping below a t-score of 55 were eligible. Students were excluded from the study if their IQ was less than 80 or if they had a pervasive developmental disorder that required special education placement. Using these criteria, 341 children were screened in as potential participants; this initial sample consisted of 173 students in intervention schools and 168 students in comparison schools. During the baseline year, all students were in kindergarten. Intervention effects were measured after students in the Early Risers group had received two and three years of implementation. The analysis sample after three years of implementation included 199 students: Early Risers group (n = 100) and comparison group (n = 99). Gender information was not available for the analysis sample. Of the sample of children who received initial parental consent prior to assignment (n = 245), 69% were boys and 31% were girls. Race and ethnicity information for the study sample was not presented.

Intervention Group

The current report focuses on impacts after two (Appendix D) and three (Appendix C) years of implementation. The Child Skills component included a Monitoring and Mentoring School Consultation Program during the school year and an annual six-week, full-day summer school program. The Monitoring and Mentoring School Consultation Program consisted of teacher consultation and student mentoring. The summer school program began in the summer following kindergarten and included academic learning centers; training in social skills, art, drama, and sports; largegroup recreation; lunch; recess; and the use of peer mentors. A structured behavior modification program was implemented across all daily activities. The Family Program consisted of separate but concurrent parent and child sessions held on evenings or weekends from October through May. During the first three years, parent sessions addressed topics such as use of praise and discipline, involvement in schoolwork and learning at home, self-control and problem solving, communication skills, stress management, and social support. The child sessions focused on emotion regulation, conflict resolution, social skills, and understanding school rules. Session content was delivered using video modeling, fantasy play, and role-plays. Home visits, modeled after home-based wraparound mental health service programs, also were used to meet family goals.

Comparison Group

Children in the comparison condition did not participate in any aspect of the Early Risers program.

Outcome descriptions

This study included measures of social skills, adaptability, academic achievement, aggression, hyperactivity, and impulsivity after two and three years of implementation. For a more detailed description of these outcome measures, see Appendix B.

Support for implementation

Staff members were required to participate in a formal program of education and training prior to the implementation of each intervention component. Intervention manuals were obtained from the original program developers, who also served as project consultants. Staff members, who received ongoing supervision during the implementation phase, were required to demonstrate mastery of content and delivery methods.

In the case of multiple manuscripts that report on one study, the WWC selects one manuscript as the primary citation and lists other manuscripts that describe the study as additional sources.

  • August, G. J., Egan, E. A., Realmuto, G. M., Hektner, J. M., & Haaga, D. A. F. (2003). Four years of the Early Risers early-age-targeted preventive intervention: Effects on aggressive children’s peer relations. Behavior Therapy, 34(4), 453–470.

  • Bernat, D. H., August, G. J., Hektner, J. M., & Bloomquist, M. L. (2007). The Early Risers preventive intervention: Testing for six-year outcomes and mediational processes. Journal of Abnormal Child Psychology,35(4), 605–617.

  • Endicott, L. G. (2003). Reducing risk for antisocial behavior via protective factor development: The Early Risers prevention trial. Dissertation Abstracts International, 64(04B), 89-1924.

  • August, G. J., Realmuto, G. M., Hektner, J. M., & Bloomquist, M. L. (2001). An integrated components preventive intervention for aggressive elementary school children: The Early Risers program. Journal of Consulting & Clinical Psychology, 69(4), 614–626.

 

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