Dealing with Jimmy the "Terror"—How an Intensive Intervention Works
By Hill M. Walker, Elizabeth Ramsey, and Frank M. Gresham
To grasp the importance of a "selected" intervention, meet Jimmy. Jimmy was commonly referred to as a "terror" soon after entering kindergarten; he had a short attention span and was agitated much of the time—going off at the drop of a hat. Academic tasks and appropriate group behavior (e.g., participating in circle time and listening to the teacher in small groups) were extremely difficult for Jimmy. He could not seem to keep his hands off others and was constantly pestering his classmates.
Jimmy's peer relationships were a disaster. He was aggressive, controlling, and bullying in his peer-related social behavior—and his peers went to extraordinary lengths to avoid him. Based on peer popularity ratings, he was the most disliked student in his class.
Ratings of Jimmy's behavior on the aggression subscale of the Achenbach Child Behavior Checklist showed that he scored in the 99th percentile for boys his age. Observations of his playground and classroom behavior revealed a high rate of rule infractions and aggressive social behavior, as well as low levels of academic engagement. Jimmy's school used First Step to Success as its selected intervention and enrolled him in it.
First Step is an intervention that works to prevent and offset emerging antisocial behavior patterns among K-3 students (see Walker, Kavanagh, Stiller, Golly, Severson, and Feil, 1997). The program consists of three components: (1) a universal screening (similar to the Systematic Screening for Behavior Disorders described on page 12) to identify students in need of an intensive intervention; (2) a parent program called Homebase that teaches parents how to reward good behavior at home; and, (3) a school-based program called CLASS (Contingencies for Learning Academic and Social Skills) that targets and systematically rewards identified students for appropriate behavior and making friends.
For Homebase, a consultant (called the behavior coach) conducts six weekly sessions with parents at home, supported with a midweek call home. Each week the coach prepares parents to teach their children a new skill, such as cooperating or gaining self-control, by explaining the skill's importance and reviewing activity cards and other instructional materials that parents will use during the week.
In school, CLASS is a 30-day program that uses three of the techniques described in the accompanying article: individual and group reinforcement contingencies, response costs, and adult praise. Initially, the behavior coach explains the program to the teacher, parents, and target student, all of whom must agree to participate. Next, the coach takes about 30 minutes to teach the child expected, good behavior; throughout the program, follow-up sessions on good behavior are provided as needed. Once the coach and student are ready to begin, the coach explains the program to the rest of the class.
The intervention begins with a point system in which the student can earn a group activity reward (as well as rewards at home and occasional surprises) by behaving appropriately. For set blocks of time each day, the behavior coach provides feedback to the child by holding up a red (stop and think) card for bad behavior and a green (keep doing what you're doing) card for good behavior. If, at a specified interval, the green card is up, then the student earns a point. (For example, when the program begins, the first block of time is 20 minutes and the interval for earning points is every 30 seconds.) To receive a reward, the student must earn 80 percent of the possible points in each block of time. Over the course of the program the blocks of time and the intervals for earning points become longer, making it more difficult to earn rewards. If the student fails to earn a reward in a certain block of time, that block is repeated. So even though the program consists of 30 planned days, some students do need to repeat a few blocks and, therefore, may extend completion of the program past 30 school days.
The first five days are very intensive and would be nearly impossible for a teacher to do alone. During this time the behavior coach administers the point system. The teacher takes over on day six, but the coach is still available for support. Over the next 15 days, the point system is slowly faded out, with the student having to behave appropriately for longer blocks of time to earn a reward. The final 10 days rely on teacher (and parent) praise to motivate good behavior; though time-out is also used as needed to deal with aggression and defiance. Typically, the coach coordinates CLASS and Homebase so that there are connections between the skills that students are learning at home and at school (and so that the teacher is not overly diverted from his or her class responsibilities).
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When the First Step coach conducted a home visit to explain the program and the parent's role in it, Jimmy's mother said he could participate in the school intervention, but she wanted no part of Homebase. The behavior coach agreed to implement the school intervention part of First Step, but asked Jimmy's mother to provide home privileges and rewards, as the CLASS program requires, and to monitor his school performance. She agreed.
The First Step coach explained CLASS to Jimmy, his teacher, and his peers. Jimmy's classmates were somewhat skeptical about the program's ability to improve his behavior—as was his kindergarten teacher Mr. Spira. However, three months into the school year, Mr. Spira was willing to try almost anything to improve Jimmy's daily school behavior.
On day 1 of the program, Jimmy made the reward criterion for the morning session, but failed to make the second session's reward criterion. Thus, he earned an activity award for himself and his classmates after the morning session, but missed the afternoon reward opportunity and home privileges for that day. He came to school in a sullen, agitated state on day 2 and failed to achieve the criterion for both sessions. As a result, the next day the procedures for day 2 were repeated. Jimmy said that he did not think the program's available reward options were attractive enough and he was not sure he wanted to continue with it.
The First Step coach agreed to review the list of school and home rewards and to add options that were of greater interest to Jimmy, but she refused to increase their magnitude as Jimmy originally wanted. Jimmy seemed pleased with this compromise and agreed to continue the program. He made the daily reward criterion for all sessions for program days 3-5. On day 6, Mr. Spira assumed control of the program under the coach's supervision. Jimmy had some difficulty with this transition, failing to make the criterion for that day. However, he did well on days 7-10 when, according to the First Step protocol, the program was extended to the playground, lunchroom, and gym.
On days 10-15, Jimmy had to repeat, several times, program blocks that are required in this part of CLASS in order to meet the reward criterion. However, he negotiated the subsequent, more difficult five-day program block (days 15-20) on the first try and did quite well in the process. He earned nearly all the available points for this five-day period and seemed to enjoy the recognition and praise he received from his peers, teacher, and mother. During the maintenance phase of CLASS (days 21-30), Jimmy was working for teacher and parent praise only. His performance was somewhat irregular over this 10-day period, but his overall level of good behavior was still substantially above his preintervention level.
Once CLASS ended, the First Step coach strongly encouraged Mr. Spira to continue praising Jimmy as much as possible for good academic work, appropriate classroom behavior, and positive social behavior toward peers. Mr. Spira agreed and also decided to provide a weekly review and debriefing for Jimmy regarding his social behavior and academic performance. The First Step coach arranged with Jimmy's mother to make a surprise home privilege available from time to time when the reports of Jimmy's school performance were positive.
Mr. Spira was asked to rate Jimmy's behavior on the Achenbach Aggression Subscale after CLASS ended. His ratings indicated that Jimmy's overall level of aggression was reduced from the 99th percentile to the 70th percentile. An analysis of archival school records for Jimmy showed that the number of discipline contacts with the principal's office averaged nearly 4.0 per week in the month immediately preceding CLASS; discipline contacts averaged 0.3 per week in the month following the program.
With a fuller implementation of the First Step home component, Jimmy's results would have been better. The most rigorous evaluation of First Step to date was a randomized trial involving 46 kindergartners and a waitlist of kindergartners serving as the control group (see Walker, Kavanagh, Stiller, Golly, Severson, and Feil, 1998). The program's developers found that First Step led to increases in adaptive behavior and academic engaged time, as well as decreases in aggression and other forms of maladaptive behavior. The average effect size was .86, which researchers considered to be robust. A follow-up study, when the children were in grades five and six, found that the initial behavioral improvements seen in kindergarten were still evident (see Epstein and Walker, 2002).
First Step is available through Sopris West. To order the program, or request a free preview video, go to www.sopriswest.com/swstore/product.asp?sku=159.
Hill M. Walker is founder and co-director of the Institute on Violence and Destructive Behavior at the University of Oregon, where he has been a professor since 1967. Walker has published hundreds of articles; in 1993 he received the Outstanding Research Award from the Council for Exceptional Children and in 2000 he became the only faculty member to receive the University of Oregon's Presidential Medal. Elizabeth Ramsey is a school counselor at Kopachuck Middle School in Gig Harbor, Wash., and a co-author of the Second Step program. Frank M. Gresham is distinguished professor and director of the School Psychology Program at the University of California-Riverside. He is co-author of the Social Skills Rating System and co-principal investigator for Project REACH. The Division of School Psychology in the American Psychological Association selected him for the Senior Scientist Award. Together, Walker, Ramsey, and Gresham wrote Antisocial Behavior in School: Evidence-Based Practices, on which this article is based.