Systematic Efficacy Replication Study of Conjoint Behavioral Consultation in Elementary Schools

Study Overview
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Brief Summary
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The purpose of this project is to conduct an impact evaluation of the Conjoint Behavioral Consulting (CBC) intervention under real-world conditions as an IES Efficacy Replication trial. CBC is a family-school partnership intervention proven efficacious for children with serious emotional and behavior problems. The investigation will conduct a systematic efficacy replication of CBC to identify important process and context variables in need of attention prior to a CBC effectiveness study. School-based specialists (SBSs) will implement CBC and will be responsible for working directly with parents and teachers who have a student with or at risk for severe emotional disturbance, with more implementation support (i.e., non-routine conditions) than would be expected under routine conditions to ensure adequate fidelity of implementation. The research questions examine the impact of CBC, when implemented by SBSs, on student, parent, and teacher outcomes, as well its effect on mediational pathways. In addition, the research team will gather stakeholder feedback in focus groups to provide information about factors that stakeholders perceive as impeding or promoting CBC adoption, implementation, and sustainability.

Detailed Description
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Sixty schools will be recruited for this impact evaluation (20 from Madison Metropolitan School District, and 40 from Milwaukee Public Schools). The population for this evaluation will consist of the 12 children from grades k-4 in each participating school who demonstrate the highest levels of behavioral and/or emotional difficulties in school, based on teacher ratings on the BASC3-BESS screening (and whose families consent to participate in the evaluation). The total population for this evaluation will include 720 students. Baseline will take place at the beginning of the intervention school year, outcome 1 at the end of the intervention school year, and outcome 2 at the end of the subsequent school year. At all three timepoints, the research team will gather parent questionnaires (covering competence in problem solving, parenting strategies, parent-teacher relationships, and their child's social and behavioral functioning), teacher questionnaires in relation to each study child (covering the parent-teacher relationship, teacher competence in problem solving, and the student's social and behavioral functioning), direct observations of teacher and student behavior in the classroom, and student records related to discipline.

Official Title
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Systematic Efficacy Replication Study of Conjoint Behavioral Consultation in Elementary Schools

Conditions
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Emotional Disturbances

Intervention / Treatment
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* Behavioral: Conjoint Behavioral Consultation (CBC)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Enrolled in kindergarten, Grade 1, Grade 2, Grade 3, or Grade 4 at recruitment Among the 12 students with the highest risk score on the Behavioral and Emotional Screening System 3 Behavioral and Emotional Screening System (BASC3-BESS) in the above grade span in their school (among those with parental consent for screening). Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 10 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Conjoint Behavioral Consultation (CBC) is an indirect consultation process focused on ameliorating problematic behaviors associated with severe emotional disturbance through structured, data-based problem solving and collaborative, consistent implementation of evidence-based interventions across home and school settings, while simultaneously enhancing family-school partnerships.. In CBC, problems are identified, defined, analyzed, and treated through strengths-based, mutual, collaborative interactions between parents and teachers with the support of a consultant. Through CBC, parents and teachers are taught evidence-based procedures to address behavior problems in their respective settings. Parents and teachers assume complementary roles and shared responsibility for identifying student goals and addressing challenging behaviors.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: CBC Treatment Group<br>For this group, school staff who work with families and teachers to address student emotional and behavioral concerns will use the CBC model to do so. | Behavioral: Conjoint Behavioral Consultation (CBC)<br>* Within the treatment group, CBC will be integrated into how a school-based specialist works with families and teachers of children with or at risk of severe emotional disturbance.<br>* Other names: Teachers and Parents as Partners (TAPP);|
| No Intervention: Control Group<br>For this group, school staff who work with families and teachers to address student emotional and behavioral concerns will engage in business as usual. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Child Externalizing Problems, Parent Report, Outcome 1 | Change in children's norm-referenced t-scores on the Externalizing Problems subscale of the Behavior Assessment System for Children, Third Edition, parent report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child Externalizing Problems, Teacher Report, Outcome 1 | Change in children's norm-referenced t-scores on the Externalizing Problems subscale of the Behavior Assessment System for Children, Third Edition, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child Externalizing Problems, Parent Report, Outcome 2 | Change in children's norm-referenced t-scores on the Externalizing Problems subscale of the Behavior Assessment System for Children, Third Edition, parent report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Child Externalizing Problems, Techer Report, Outcome 2 | Change in children's norm-referenced t-scores on the Externalizing Problems subscale of the Behavior Assessment System for Children, Third Edition, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Child Internalizing Problems, Parent Report, Outcome 1 | Change in children's norm-referenced t-scores on the Internalizing Problems subscale of the Behavior Assessment System for Children, Third Edition, parent report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child Internalizing Problems, Teacher Report, Outcome 1 | Change in children's norm-referenced t-scores on the Internalizing Problems subscale of the Behavior Assessment System for Children, Third Edition, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child Internalizing Problems, Parent Report, Outcome 2 | Change in children's norm-referenced t-scores on the Internalizing Problems subscale of the Behavior Assessment System for Children, Third Edition, parent report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Child Internalizing Problems, Teacher Report, Outcome 2 | Change in children's norm-referenced t-scores on the Internalizing Problems subscale of the Behavior Assessment System for Children, Third Edition, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Child Behavioral Symptoms, Parent Report, Outcome 1 | Change in children's norm-referenced t-scores on the Behavioral Symptoms subscale of the Behavior Assessment System for Children, Third Edition, parent report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child Behavioral Symptoms, Teacher Report, Outcome 1 | Change in children's norm-referenced t-scores on the Behavioral Symptoms subscale of the Behavior Assessment System for Children, Third Edition, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child Behavioral Symptoms, Parent Report, Outcome 2 | Change in children's norm-referenced t-scores on the Behavioral Symptoms subscale of the Behavior Assessment System for Children, Third Edition, parent report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Child Behavioral Symptoms, Teacher Report, Outcome 2 | Change in children's norm-referenced t-scores on the Behavioral Symptoms subscale of the Behavior Assessment System for Children, Third Edition, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Child Adaptive Skills, Parent Report, Outcome 1 | Change in children's norm-referenced t-scores on the Adaptive Skills subscale of the Behavior Assessment System for Children, Third Edition, parent report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child Adaptive Skills, Teacher Report, Outcome 1 | Change in children's norm-referenced t-scores on the Adaptive Skills subscale of the Behavior Assessment System for Children, Third Edition, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child Adaptive Skills, Parent Report, Outcome 2 | Change in children's norm-referenced t-scores on the Adaptive Skills subscale of the Behavior Assessment System for Children, Third Edition, parent report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Child Adaptive Skills, Teacher Report, Outcome 2 | Change in children's norm-referenced t-scores on the Adaptive Skills subscale of the Behavior Assessment System for Children, Third Edition, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Child School Problems, Teacher Report, Outcome 1 | Change in children's norm-referenced t-scores on the School Problems subscale of the Behavior Assessment System for Children, Third Edition, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child School Problems, Teacher Report, Outcome 2 | Change in children's norm-referenced t-scores on the School Problems subscale of the Behavior Assessment System for Children, Third Edition, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Child Social Skills, Parent Report, Outcome 1 | Change in children's norm-referenced t-scores on the Social Skills subscale of the Social Skills Improvement System Rating Scales, parent report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child Social Skills, Teacher Report, Outcome 1 | Change in children's norm-referenced t-scores on the Social Skills subscale of the Social Skills Improvement System Rating Scales, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child Social Skills, Parent Report, Outcome 2 | Change in children's norm-referenced t-scores on the Social Skills subscale of the Social Skills Improvement System Rating Scales, parent report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Child Social Skills, Teacher Report, Outcome 2 | Change in children's norm-referenced t-scores on the Social Skills subscale of the Social Skills Improvement System Rating Scales, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Child Problem Behaviors, Parent Report, Outcome 1 | Change in children's norm-referenced t-scores on the Problem Behaviors subscale of the Social Skills Improvement System Rating Scales, parent report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child Problem Behaviors, Teacher Report, Outcome 1 | Change in children's norm-referenced t-scores on the Problem Behaviors subscale of the Social Skills Improvement System Rating Scales, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child Problem Behaviors, Parent Report, Outcome 2 | Change in children's norm-referenced t-scores on the Problem Behaviors subscale of the Social Skills Improvement System Rating Scales, parent report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Child Problem Behaviors, Teacher Report, Outcome 2 | Change in children's norm-referenced t-scores on the Problem Behaviors subscale of the Social Skills Improvement System Rating Scales, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Child Autism Behaviors, Parent Report, Outcome 1 | Change in children's norm-referenced t-scores on the Autism Behaviors subscale of the Social Skills Improvement System Rating Scales, parent report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child Autism Behaviors, Teacher Report, Outcome 1 | Change in children's norm-referenced t-scores on the Autism Behaviors subscale of the Social Skills Improvement System Rating Scales, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Child Autism Behaviors, Parent Report, Outcome 2 | Change in children's norm-referenced t-scores on the Autism Behaviors subscale of the Social Skills Improvement System Rating Scales, parent report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Child Autism Behaviors, Teacher Report, Outcome 2 | Change in children's norm-referenced t-scores on the Autism Behaviors subscale of the Social Skills Improvement System Rating Scales, teacher report version. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Parenting Strategies: Consistent Discipline, Outcome 1 | Change in score for the Consistent Discipline subscale of the Parenting Strategies instrument. Scores are calculated based on the mean rating across 11 items, with possible mean scores ranging from 1-5. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Parenting Strategies: Consistent Discipline, Outcome 2 | Change in score for the Consistent Discipline subscale of the Parenting Strategies instrument. Scores are calculated based on the mean rating across 11 items, with possible mean scores ranging from 1-5. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Parenting Strategies: Parental Acceptance, Outcome 1 | Change in score for the Parental Acceptance subscale of the Parenting Strategies instrument. Scores are calculated based on the mean rating across 8 items, with possible mean scores ranging from 1-5. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Parenting Strategies: Parental Acceptance, Outcome 2 | Change in score for the Parental Acceptance subscale of the Parenting Strategies instrument. Scores are calculated based on the mean rating across 8 items, with possible mean scores ranging from 1-5. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Parenting Strategies: Positive Reinforcement, Outcome 1 | Change in score for the Positive Reinforcement subscale of the Parenting Strategies instrument. Scores are calculated based on the mean rating across 12 items, with possible mean scores ranging from 1-5. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Parenting Strategies: Positive Reinforcement, Outcome 2 | Change in score for the Positive Reinforcement subscale of the Parenting Strategies instrument. Scores are calculated based on the mean rating across 12 items, with possible mean scores ranging from 1-5. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Teacher Strategies: Positive Strategies, Outcome 1 | Change in score for the Positive Strategies subscale of the Teacher Strategies instrument. Scores are calculated based on the mean rating across 22 items, with possible mean scores ranging from 1-5. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Teacher Strategies: Inappropriate Strategies, Outcome 1 | Change in score for the Inappropriate Strategies subscale of the Teacher Strategies instrument. Scores are calculated based on the mean rating across 9 items, with possible mean scores ranging from 1-5. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Parent-Teacher Relationship: Parent Perspective on Joining, Outcome 1 | Change in score for the Joining subscale of the Parent-Teacher Relationship Scale II, parent version. Scores are calculated based on the mean rating across 19 items, with possible mean scores ranging from 1-5. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Parent-Teacher Relationship: Teacher Perspective on Joining, Outcome 1 | Change in score for the Joining subscale of the Parent-Teacher Relationship Scale II, teacher version. Scores are calculated based on the mean rating across 19 items, with possible mean scores ranging from 1-5. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Parent-Teacher Relationship: Parent Perspective on Communication, Outcome 1 | Change in score for the Communication subscale of the Parent-Teacher Relationship Scale, parent version. Scores are calculated based on the mean rating across 5 items, with possible mean scores ranging from 1-5. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Parent-Teacher Relationship: Teacher Perspective on Communication, Outcome 1 | Change in score for the Communication subscale of the Parent-Teacher Relationship Scale, teacher version. Scores are calculated based on the mean rating across 5 items, with possible mean scores ranging from 1-5. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Parent Competence in Problem Solving, Outcome 1 | Change in score for the Parent Competence in Problem Solving Scale. Scores are calculated based on the mean rating across 8 items, with possible mean scores ranging from 1-6. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Teacher Competence in Problem Solving, Outcome 1 | Change in score for the Teacher Competence in Problem Solving Scale. Scores are calculated based on the mean rating across 8 items, with possible mean scores ranging from 1-6. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Parent Competence in Problem Solving, Outcome 2 | Change in score for the Parent Competence in Problem Solving Scale. Scores are calculated based on the mean rating across 8 items, with possible mean scores ranging from 1-6. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Behavior Watch Student: Inappropriate Motor Activity, Outcome 1 | Change in score for Inappropriate Motor Activity on the Behavior Watch observation tool, student version. Scores are calculated based on the rate observed for intervals recorded, with a possible score of 0.0-1.0. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Behavior Watch Student: Inappropriate Motor Activity, Outcome 2 | Change in score for Inappropriate Motor Activity on the Behavior Watch observation tool, student version. Scores are calculated based on the rate observed for intervals recorded, with a possible score of 0.0-1.0. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Behavior Watch Student: Off Task, Outcome 1 | Change in score for Off Task on the Behavior Watch observation tool, student version. Scores are calculated based on the rate observed for intervals recorded, with a possible score of 0.0-1.0. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Behavior Watch Student: Off Task, Outcome 2 | Change in score for Off Task on the Behavior Watch observation tool, student version. Scores are calculated based on the rate observed for intervals recorded, with a possible score of 0.0-1.0. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Behavior Watch Student: On Task, Outcome 1 | Change in score for On Task on the Behavior Watch observation tool, student version. Scores are calculated based on the rate observed for intervals recorded, with a possible score of 0.0-1.0. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Behavior Watch Student: On Task, Outcome 2 | Change in score for On Task on the Behavior Watch observation tool, student version. Scores are calculated based on the rate observed for intervals recorded, with a possible score of 0.0-1.0. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Behavior Watch Student: Appropriate Interactions, Outcome 1 | Change in score for Appropriate Interactions on the Behavior Watch observation tool, student version. Scores are calculated based on the rate observed for intervals recorded, with a possible score of 0.0-1.0. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Behavior Watch Student: Appropriate Interactions, Outcome 2 | Change in score for Appropriate Interactions on the Behavior Watch observation tool, student version. Scores are calculated based on the rate observed for intervals recorded, with a possible score of 0.0-1.0. | Baseline/pre-intervention (beginning of school year 1) to end of school year 2 (approximately 19 months) | 
| Behavior Watch Teacher: Positive Tangible Consequences, Outcome 1 | Change in score for Positive Tangible Consequences on the Behavior Watch observation tool, teacher version. Scores are calculated based on the rate observed for intervals recorded, with a possible score of 0.0-1.0. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Behavior Watch Teacher: Effective Command, Outcome 1 | Change in score for Effective Command on the Behavior Watch observation tool, teacher version. Scores are calculated based on the rate observed for intervals recorded, with a possible score of 0.0-1.0. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Behavior Watch Teacher: Positive Attention, Outcome 1 | Change in score for Positive Attention on the Behavior Watch observation tool, teacher version. Scores are calculated based on the rate observed for intervals recorded, with a possible score of 0.0-1.0. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Behavior Watch Teacher: Use of Reductive Techniques, Outcome 1 | Change in score for Use of Reductive Techniques on the Behavior Watch observation tool, teacher version. Scores are calculated based on the rate observed for intervals recorded, with a possible score of 0.0-1.0. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) | 
| Behavior Watch Teacher: Negative Attention, Outcome 1 | Change in score for Use of Negative Attention on the Behavior Watch observation tool, teacher version. Scores are calculated based on the rate observed for intervals recorded, with a possible score of 0.0-1.0. | Baseline/pre-intervention (beginning of school year 1) to end of school year 1 (approximately 7 months) |