Evidence-Based Complementary and Alternative Medicine Table 1: Demographic characteristics of the four classrooms. Condition Sex Girls Boys Age, mean (SD) Race/ethnicity TE1 (n = 24) D 11 (45.8%) 13 (54.2%) 10.58 (0.58) 23 Latino 1 European American TE2 (n = 22) CN 13 (59.1%) 9 (40.9%) 10.46 (0.67) 21 Latino 1 Asian TE3 (n = 30) D 15 (50.0%) 15 (50.0%) 10.43 (0.57) 25 Latino 3 African American 2 Filipino 3 TE4 (n = 25) CN 15 (60.0%) 10 (40.0%) 10.48 (0.51) 22 Latino 2 African American 1 European American TE: teacher; D: drumming; CN: control. 2.4. Building Support from the School Community. Prior to the beginning of the study, all faculty and a few staﬀ from Napa Street Elementary School attended a free in-service drumming workshop at Remo Recreational Music Center in North Hollywood, California. The purpose of this was to increase support for the pilot study from the overall faculty and, in particular, to increase compliance from those that would be involved in the study. 2.5. Assessment. The quantitative assessment instrument utilized was the Teacher’s Report Form (TRF)—the teacher version of the Child Behavior Checklist—which yields a variety of scales of adaptive functioning derived from a mixed list of 120 factor-loaded items [69]. The TRF asks teachers to rate each of their students on problem behaviors over the past 2 months, with three possible response choices: 0 = not true (as far as you know), 1 = somewhat or sometimes true, 2 = very true or often true. TRF scale scores have been standardized based on normative data from children 6– 18 years of age, and the instrument has been subjected to extensive reliability and validity testing [69]. Use of the TRF has been reported in >1000 peer-reviewed publications [70] and its robustness has been demonstrated in multicultural settings as well [71]. The wide range of problem behavior scales oﬀered by the TRF was advantageous, given that the study was exploratory in nature and intended to inform the focus of assessments in future research. The TRF yields three broad-band scales: Total Problems (an aggregate of all items on the rating form), Internalizing Problems (a composite of scores from three narrow-band syndrome scales: Anxious/Depressed, Withdrawn/Depressed, Somatic Complaints) and External- izing Problems (a composite of scores from two narrow- band syndrome scales: Rule-Breaking Behavior, Aggressive Behavior). The TRF also derives three other narrow- band syndrome scales: Social Problems, Thought Problems, Attention Problems. In addition, it oﬀers two subscales for the syndrome scale of Attention Problems: Inattention and Hyperactivity-Impulsivity. This set of empirically based scales constitutes the core of the TRF. Items on the TRF can also be used to generate six scales that are consistent with categories from the Diag- nostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), for the American Psychiatric Associa- tion [72]: Aﬀective Problems, Anxiety Problems, Somatic Problems, Attention Deﬁcit/Hyperactivity Problems, Oppo- sitional Deﬁant Problems, and Conduct Problems. Further- more, the TRF oﬀers two subscales for the DSM-oriented scale of Attention Deﬁcit/Hyperactivity Problems: Inatten- tion and Hyperactivity-Impulsivity. Finally, four other scales can be scored using TRF items: Obsessive-Compulsive Prob- lems, Post-traumatic Stress Problems, Sluggish Cognitive Tempo, and Positive Qualities. Both experimental and control teachers completed a TRF for each student in her or his class within a 2-week window, immediately prior to the start of the study and immediately upon completion of the study. There was no missing data. 2.6. Protocol Development. The group drumming protocol was co-developed by a drum circle facilitator, a public health educator and the school counselor—a licensed clinical social worker familiar with the social, emotional and cultural needs of the research population. The intervention was solely administered by the school counselor and delivered to a whole classroom of students at a time, including the teacher—in order to foster indirect beneﬁts to students through stress reduction, observational learning, and/or car- ryover of session themes to the classroom. Prior to delivering the intervention, the counselor attended a weekend training session on drum circle facilitation and practiced facilitating drum circles under supervision with ﬁve classrooms of stu- dents at two socioeconomically similar elementary schools in the LAUSD. This served to conﬁrm the feasibility of working with a whole classroom of students at a time. To control for the integrity of the rhythmic component of the intervention, the drum circle facilitator, who was experienced in working with children, served as a silent participant observer during the sessions and oﬀered sugges- tions for improvement during debrieﬁng meetings. A lesson plan was outlined in advance of each session based upon the previous one, and it was delivered with consistency to both classrooms designated to receive the intervention. Upon completion of the study, a scripted manual was developed for future research use. 2.7. Intervention. The intervention took place during the school day, right after lunch, for 40–45 min weekly, over a 12-week period. It consisted of a hybrid of activities used in