# Presentation: 476309

## Emotion Regulation, Communication, Inhibitory Control and Social Competence  

**Intervening Early: Progress and Opportunities in Child Service Settings**
**Mark T. Greenberg**
- Prevention Research Center, Penn State University
- www.prevention.psu.edu

## What I will discuss

- Developmental Model of Integrated Development Across Cognition, Emotion and Behavior
- The Importance of Language and Regulation for Learning and Social Outcomes
- Intervention Trial Findings with the PATHS Curriculum on School Age and Preschool Children

## Poor School Achievement
Poor Mental Health
Aggression/Violence
Substance Use/Abuse

- Poor Mental Health
- Aggression/Violence
- Substance Use/Abuse

- Impulsive Action
- Emotion Dysregulation
- Insecure Relations

- Undesired Related Outcomes

- Underlying Shared Constraints

- The Big Picture: Public Health Outcomes

## 
Cognitive Abilities
Self-Control/Emotion    Regulation
Relations with peers and    adults

- Cognitive Abilities
- Self-Control/Emotion    Regulation
- Relations with peers and    adults

**Resilience Factors that may be Targets of Preventive Interventions**

## Pre Frontal Functions

**REGULATIVE  (Self-Control)**
**	****   ****INHIBIT AND MODULATE ATTENTION**
**EXECUTIVE  (Problem Solving)**
**        ****PLANNING AND GOAL-SETTING    ****	****  (Working Memory)**
**SOCIAL (Effective Action in Context)**
**        ****INTEGRATION OF EMOTION AND**
**        ****REASON FOR SOCIAL DECISION-MAKING**

## On Impulse and Mediation

- 	The first effect of every mediation of an impulse is to check or arrest that impulse.  Reflection means postponement; it is delayed action.  Through this delay the impulse is brought into connection with other impulses, habits, and experiences.  Now that a due balance is kept, the result is that the original impulse is harmonized with the self, and, when expressed, it realizes not only its partial nature but that of the whole self (p.244).
- John Dewey, 1894

## ABCD Model(Affective-Behavioral-Cognitive-Developmental)

_**Stages of Developmental Integration**_

**1.  Infancy:****  ****(Birth to 18 months)**
-       *** Emotion = Communication      **
**      ***** Arousal & Desire = Behavior**

**2.  Toddlerhood:**** ****  ****(18 months to 36 months)**
-      *** Language supplements Emotion = Communication**
**     ***** Very initial development of emotional labeling**
**     ***** Arousal and Desire = Behavior**

**  ****3.  Preschool Years:****  ****(3 to 6 years)**
-        *** Language develops powerful role**
**       ***** Child can recognize/label basic emotions**
**       ***** Arousal & desire > symbolic mediation > behavior**
**       ***** Development of role-taking abilities**
**       ***** Beginning of reflective social planning & problem-solving **

-    Words provide a moment of recognition and delay in which discomfort over feeling might have a chance of being handled in ways other than denial or immediate discharge through action.  Words facilitate coping-emotions that are identifiable, known to and shared by others.
- 		Fred  Pine (1985)

## Self-Regulation Requires

**Self-Regulation Requires**

- Horizontal Neural Development
- Strong Interconnections between left and right    hemispheres – Role of Language
- Vertical Neural Control
- Decision-making and motor control in which the Pre-frontal Areas (including ACC, Dorso-lateral Prefrontal and Orbital) that
- regulate impulse
- consider context
- delay and make appropriate decisions
- control motor response

-    The parent who labels feelings for the child brings them into the region of social communication--they are shared, the child is not unique and alone with them, they are capable of being understood, the power of words and the psychological achievement words facilitate can be applied to them.
- John Dewey (1894)

## What is Social and Emotional Learning ?

**The process of acquiring the competencies to:**
- Recognize and manage emotions
- develop caring and concern for others
- make responsible decisions
- establish and maintain positive relationships
- handle challenging situations effectively
- ALL REQUIRE SELF-REFLECTIVE FUNCTIONS
- 	Language/Communication
-    Inhibition/Self Control
- 	Problem- Solving

## ®

**®**

## The PATHS Curriculum

**Five Central Goals**
- The conscious awareness of emotional states in oneself and others
- The ability to put these feelings into words
- The ability to calm oneself down when feeling highly emotionally aroused
- The ability to plan ahead and consider the effects of your behavior on others
- Developing greater empathy/compassion for others

## Essential Components for PATHS

- Skill Building for Both Students and Teachers
- Very explicit materials
- Specific time for skills development
- Provide Sufficient Technical Support to Teachers
- See other teachers doing it well
- Coaching
- Generalization: Create Opportunities to Use these Skills Throughout the Day
- Provide Students Feedback and Recognition for Performance
- Integrate into other Academic Subjects
- Involve Parents

## Problem-Solving Outline

- When you notice upset feelings:

-  	1.  _STOP_ and think.
-  	2.  Identify the _PROBLEM_.  (collect lots of information)
- 	 3.  Identify the _FEELINGS_.  (your own and other peoples')
-  	4.  Decide on a _GOAL_.
-  	5.  Think of lots of _SOLUTIONS_.
-  	6.  Think about what _MIGHT_ happen next.
- ER
- 	 7.  Choose the _BEST_ solution.  (evaluate all the alternatives)
-  	8.  Make a _PLAN_.  (think about possible obstacles)
-  	9.  _TRY_ your plan.
- 	10.  _SEE_ what happens.  (evaluate the outcome)
- 	11.  _TRY_ another plan or solution if your first one doesn't
-        		work.

## Learning to Calm Down

- The Turtle Story and the 3 Steps for Calming Down

## Slide 17

## Slide 18

## Slide 19

## Study Designs

- There have been seven randomized clinical trials with preschool and elementary school-aged children
- Some are quite large (over 6000 children) and others are small (100 children)
- Populations include:
- Typically Developing Children
- Children with Learning and Behavioral Disorders
- Children who are Deaf/Hard of Hearing
- Both Urban and Rural Populations – Multiple Ethnicities
- Three RCTS done completely independent of myself:
- Netherlands – Oborio DeCastro (Univ. of Utrecht)
- Switzerland – Manuel EisNer (Cambridge Univ.)
- US – Deb Johnson and Hugh Crean (U. of Rochester)

## Research Question #1

- Can we promote greater social-emotional competence (SEC)?
**Grades 1-4**
- Improvements in teacher ratings of frustration tolerance
- PATHS Classrooms show improvements in peer rated prosociality
**Preschool**EC
- 	1.   Improvements in teacher ratings of S
- 	2.   Improvements in parent ratings of SEC

## Research Question #2

- Can we reduce problem behaviors and symptoms of psychopathology?
**Grades 2-5**
- Improvements in teacher ratings of externalizing and internalizing problems (CBCL – Achenbach)
- PATHS Classrooms show improvements in peer rated aggression and hyperactive-disruptive behavior
- Children report lower rates of depressive symptoms

## PATHS Universal Intervention End of First Grade (1 Year of Intervention)		

- PATHS Universal Intervention End of First Grade (1 Year of Intervention)

- Children who receive PATHS rate their classmates as significantly less aggressive than do children in randomized comparison classes

- Fast Track Study – 378 Classrooms – 6715 children
- CPPRG, 1999 – Journal of Consulting and Clinical Psychology

## PATHS Universal Intervention  	1 Year of Intervention	Child Depression Inventory

**Students Receiving PATHS in Grade 2 and 3 significantly decline in self-report of symptoms of depression and sadness**

- Kam, Greenberg & Kusche 2004

## Does the Intervention alter Executive Function?
		Stroop – (Inhibition)
		Verbal Fluency (Working Memory)

Do changes in Executive Function mediates the relation between intervention and decreased aggression or internalizing problems?

- 		Stroop – (Inhibition)
- 		Verbal Fluency (Working Memory)
- Do changes in Executive Function mediates the relation between intervention and decreased aggression or internalizing problems?

- Research Question #3

## Slide 26

## Stroop Test – Part 1

## Stroop Test – Part 2 – Inhibitory Control

## Pretest

_**9-mo post**_

_**1-yr follow-up**_

**Hypothesized PATHS Mediational Model**

**PATHS**

- Inhibitory
- Control

**Externalizing **
**Internalizing **
**Behaviors**

- α

- β

- γ

**0**

**Riggs, et al. (in press)**

## Participants

- 318 regular education students in the Seattle School District.
- Random assignment of four schools
- Mean age = 8 years (2nd and 3rd grade students).
- 55% White, 33% African-American, & 12% Asian-American, Native American, or “Other.”

**0**

**Notes:**
Original efficacy trial of PATHS

## Pretest

_**9-mo post**_

_**1-yr follow-up**_

**Test of PATHS Mediational Model****Externalizing**

**PATHS**

**Inhibitory**
**Control**

**Externalizing **
**Behavior**

- .15**

- -.17***

**0**

- -.14**

- ns

- ** = p < .01; *** = p < .001

**Sobel Test for Indirect Effects z = 2.06, p < .05**

**Notes:**
Standard betas for first to regressions

## Pretest

_**9-mo post**_

_**1-yr follow-up**_

**Test of PATHS Mediational Model****Internalizing**

**PATHS**

- Inhibitory
- Control

**Internalizing **
**Behavior**

- .15**

- -.14**

**0**

- -.15**

- n.s.

- ** = p < .01

**Sobel Test for Indirect Effects z = 2.07, p < .05**

## Preschool PATHS: Promoting Social and Emotional Competence in Young Children

**Celene E. Domitrovich, Rebecca Cortes, **
**& Mark T. Greenberg **
**Penn State Prevention Research Center**

## Slide 34

## Overview of PATHS Unit Lessons

- Creating a Positive Classroom Climate
- Basic Feelings I
- Basic Feelings II
- The Turtle Technique: Teaching Children Self Control

- Sharing, Caring & Friendship
- Basic Problem Solving
- Intermediate Feelings
- Ending & Transitions

## Curriculum Overview – Unit 4

**Curriculum Overview – Unit 4**

**Doing Turtle: ****Self Control, Anger Management and Signaling Distress**
*Twiggle Learns**to Do Turtle*
- Turtle Technique Review
- Appropriate Turtles
- Calm or Relaxed

## Teaching Self-Control with the Turtle Technique

**Funded by NICHD grants HD046064 & HD43763**

- Promoting Academic and Social-emotional School Readiness: The Head Start REDI Program

## REDI Logic Model

- _Teaching Strategies_
- Rich, sensitive, expansive teacher-child communication
- Positive guidance, emotion coaching, & social support

- _Child Competencies_
- Oral language & emergent literacy skills
- Social-emotional competencies

**INTERVENTION ****(Curriculum & Teacher Mentoring)**

**Readiness for Transition into School**

**Adjustment and Academic Success**

-                   _ __Intervention Targets_     _Proximal Outcomes_          _ Distal Outcomes_

- Parent Involvement & Support of Child

## Intervention Components:

*Social-Emotional Competencies*
_**PATHS Curriculum**_
- Prosocial Skills
- Emotional Competence
- Self Control
- Social Problem Solving

*Language/Literacy Skills*
_**Interactive Reading**_
_**Sound Games**_
_**Print Center**_
- Vocabulary
- Syntax
- Phonological Sensitivity
- Print Awareness

- Major Emphasis on Hands-On, Proactive Teacher Coaching

## Emotional Understanding and Social Problem-Solving Skills

- P<.06

- P<.03

- P<.04

- P<.01

## Teacher Ratings ofSocial Competence, Aggression, Learning Engagement

- P<.10

- P<.05

## Parent Ratings of Attention Problems, Communication, Reading Involvement

- P<.06

- P<.02

- P<.07

## Direct Effects on Executive Functions
Dimension Change Card Sort (WM, Inhib Control, Set Shifting ) – Intervention Effect p.=06
Peg-Tapping (Inhibitory Control) – no effect
Backward Digits (Working Memory) – no effect
Observed Sustained Task Orientation – p<.02
Moderation of Outcomes by EF Skills
Students with Lower Initial EF Skills showed the most gains in Intervention on Social-Emotional Outcomes
Students with Higher Initial EF Skills showed the most gains on Literacy Outcomes
Mediational Effects on Executive Functions
Task Orientation mediates effects on Literacy Outcomes and Teacher Ratings of Social Competence
DCCS marginally mediates Literacy Outcomes, but not social outcomes

- Dimension Change Card Sort (WM, Inhib Control, Set Shifting ) – Intervention Effect p.=06
- Peg-Tapping (Inhibitory Control) – no effect
- Backward Digits (Working Memory) – no effect
- Observed Sustained Task Orientation – p<.02
- Moderation of Outcomes by EF Skills
- Students with Lower Initial EF Skills showed the most gains in Intervention on Social-Emotional Outcomes
- Students with Higher Initial EF Skills showed the most gains on Literacy Outcomes
- Mediational Effects on Executive Functions
- Task Orientation mediates effects on Literacy Outcomes and Teacher Ratings of Social Competence
- DCCS marginally mediates Literacy Outcomes, but not social outcomes

## Closing Thoughts

- Universal prevention programs with:
- strong theoretical models
- well-trained teachers
- appropriate dosage (density of lessons and generalization)
- can substantially:
- Improve emotion regulation
- reduce the rate of mental health problems
- promote positive, healthy development
- improve cognitive performance
- Improving the “Underlying Shared Constraints” can significantly reduce the public health burden of poor outcomes for children

## Thanks

- Colleagues
- Karen Biermam
- Celene Domitrovich
- Carol Kusche
- Chi-Ming Kam
- Rebecca Cortes
- Christa Turskma
- Elizabeth Cook
- Julie Quamma
- Rob Nix
- Janet Welsh
- Scott Gest

- Numerous Funding Agencies
- 	NIMH
- 	NIDA
- 	NICHHD
- 	OCYF – Head Start
- 	W.T. Grant Foundation