Brief Behavioral Teacher Training for Behavioral Difficulties

NCT06127030 | Active Not Recruiting

• 2 other identifiers: METc 2023/183PPO-RF-34
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this two-armed randomized controlled trial is to investigate the effectiveness of a new, individually tailored, brief behavioral training for teachers of children with behavioral difficulties at school. The main questions the study aims to answer are:

• Does the brief teacher training reduce the severity of four daily rated target behaviors in specific classroom situations compared to practice as usual (PAU) on the short term?
• Does the brief teacher training program reduce the severity of the same four daily rated target behaviors in other classroom situations, behavioral difficulties of the child at school and at home, and the impairment of the child in the school situation and reduce the number of behavioral difficulties of the child at school judged as troublesome by the teacher, and improve the teacher-student relationship quality, teachers' sense of efficacy, and teachers' behavior management strategies compared to practice as usual (PAU) on the short term?
• Are short-term improvements maintained at 3 months follow-up? Teachers will be randomly assigned (simple randomization) to (a) three sessions of brief teacher training with PAU, or (b) PAU only. The brief teacher training provides teachers with individually tailored stimulus control and contingency management techniques to treat children's behavioral difficulties in two (bi)weekly training sessions of two hours and a third session of one hour in which the training will be evaluated and maintenance training will be provided. PAU may include any support or treatment as regularly provided by mental health care centers, schools, school collaborations and/or other organizations, except from pharmacological treatment for children's behavioral difficulties and/or behavioral teacher training/support. PAU can also imply that there is no support or treatment.

Conditions

Behavioral Difficulties; Behavioral Problem of Child

Keywords

Behavioral teacher training; Brief teacher training; Individually-tailored; School-based support

Outcome Measures

Primary Outcomes (1)

• Severity of four daily rated target behaviors in specific classroom situations

  The primary outcome measure will be the severity of teacher-rated daily measured target behaviors in specific classroom situations. Teachers select four daily occurring behavioral difficulties of the child in the classroom (i.e., target behaviors of the intervention) and the specific situations. Target behaviors will be selected from an adapted version of a list (Hornstra et al., 2021; Van den Hoofdakker et al., 2007), with teachers indicating daily occurrence (yes/no) and rating severity on a 5-point Likert scale (1=not severe to 5=extremely severe). Specific classroom situations will be selected from the School Situation questionnaire (SSQ-R; DuPaul \& Barkley, 1992). Severity of the target behaviors in these specific situations will be measured with brief daily phone calls to teachers on four consecutive school days, by the researchers. Teachers report whether the four selected target behaviors occurred (yes/no) and rate their severity on a 5-point scale.

  Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only)

Secondary Outcomes (8)

• Severity of daily the same four daily rated target behaviors in other classroom situations than the specified situation which is used as primary outcome (see primary outcome measure for details on administration)

  Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only)

• Teacher-reported severity of behavioral difficulties of the child in the classroom

  Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only)

• Teacher-reported number of child behavioral difficulties in the classroom that the teacher considers troublesome

  Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only)

• Teacher-reported child impairment at school associated with behavioral difficulties

  Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only)

• Teacher-reported quality of the teacher-student relationship

  Before randomization (T0), one week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1), three months after T1 (T2, experimental arm only)].

Other Outcomes (8)

• Teacher/school-reported history of mental healthcare/support.

  Before randomization (T0)

• Teacher/school-reported use of mental health care or support for behavioral difficulties of the child in the classroom

  One week after the brief training (experimental arm)/eight weeks after T0 (control arm) (T1)

• Caregiver-reported history of mental healthcare/support

  Before randomization (T0)

Study Arms (2)

Brief behavioral teacher training and optional practice as usual

EXPERIMENTAL

A brief, individualized, three-session teacher training that exists of two (bi)weekly individually tailored training sessions of 120 minutes, and a third session of 60 minutes. Teachers and children may receive practice as usual as well. The practice as usual may include any support or treatment as regularly provided by mental health care centers, schools, school collaborations and/or other organizations, except from pharmacological treatment for children's behavioral difficulties and/or behavioral teacher training/support. Practice as usual can also imply that there is no support or treatment.

Behavioral: Brief behavioral teacher training

Practice as usual only (PAU)

ACTIVE COMPARATOR

PAU may include any support or treatment as regularly provided by mental health care centers, schools, school collaborations and/or other organizations, except from pharmacological treatment for children's behavioral difficulties and/or behavioral teacher training/support. PAU can also imply that there is no support or treatment. There are no criteria for professionals providing PAU.

Behavioral: Practice as usual only (PAU)

Interventions

Brief behavioral teacher training BEHAVIORAL

A brief behavioral teacher training program that combines individually-tailored stimulus control and contingency management techniques to treat children's behavioral difficulties in two (bi)weekly training sessions of two hours and a third session of one hour in which the training will be evaluated and maintenance training will be provided.

Also known as: The PAINT-T program, Brief teacher training

Brief behavioral teacher training and optional practice as usual

Practice as usual only (PAU) BEHAVIORAL

PAU may include any support or treatment as regularly provided by mental health care centers, schools, school collaborations and/or other organizations, except from pharmacological treatment for children's behavioral difficulties and/or behavioral teacher training/support. PAU can also imply that there is no support or treatment.

Also known as: PAU

Practice as usual only (PAU)

Eligibility Criteria

• Age: 4 Years - 13 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• The teacher works in regular elementary education, special elementary education or special education (in Dutch: cluster 4);
• The teacher indicates that the child displays at least four behavioral difficulties in the classroom on a daily basis that the teacher wants to target in the training (using a list of target disruptive behaviors (Hornstra et al., 2021; Van den Hoofdakker et al., 2007)).
• The teacher has received behavioral training or behavioral support aimed at remediating behavioral difficulties of the concerned child within the past year;
• The teacher already participates in the study with another child.

You may not qualify if:

• The child has a diagnosis of autism spectrum disorder (as reported by parents, we will not perform any measures to assess autism spectrum disorder);
• The child currently receives pharmacological treatment for behavioral difficulties (e.g., methylphenidate).

Sponsors & Collaborators

• Accare: lead

Study Sites (1)

Accare Child Study Center

Groningen, Provincie Groningen, 9723 HE, Netherlands

Location

Related Publications (29)

• Abikoff HB, Thompson M, Laver-Bradbury C, Long N, Forehand RL, Miller Brotman L, Klein RG, Reiss P, Huo L, Sonuga-Barke E. Parent training for preschool ADHD: a randomized controlled trial of specialized and generic programs. J Child Psychol Psychiatry. 2015 Jun;56(6):618-31. doi: 10.1111/jcpp.12346. Epub 2014 Oct 16.

  PMID: 25318650 BACKGROUND

• Abikoff H, Gallagher R, Wells KC, Murray DW, Huang L, Lu F, Petkova E. Remediating organizational functioning in children with ADHD: immediate and long-term effects from a randomized controlled trial. J Consult Clin Psychol. 2013 Feb;81(1):113-28. doi: 10.1037/a0029648. Epub 2012 Aug 13.

  PMID: 22889336 BACKGROUND

• Bearss K, Lecavalier L, Minshawi N, Johnson C, Smith T, Handen B, Sukhodolsky D, Aman M, Swiezy N, Butter E, Scahill L. Toward an exportable parent training program for disruptive behaviors in autism spectrum disorders. Neuropsychiatry (London). 2013 Apr;3(2):169-180. doi: 10.2217/npy.13.14.

  PMID: 23772233 BACKGROUND

• Breider S, de Bildt A, Nauta MH, Hoekstra PJ, van den Hoofdakker BJ. Self-directed or therapist-led parent training for children with attention deficit hyperactivity disorder? A randomized controlled non-inferiority pilot trial. Internet Interv. 2019 Aug 8;18:100262. doi: 10.1016/j.invent.2019.100262. eCollection 2019 Dec.

  PMID: 31890615 BACKGROUND

• Devilly GJ, Borkovec TD. Psychometric properties of the credibility/expectancy questionnaire. J Behav Ther Exp Psychiatry. 2000 Jun;31(2):73-86. doi: 10.1016/s0005-7916(00)00012-4.

  PMID: 11132119 BACKGROUND

• Drummond et al., (2015). Methods for the economic evaluation of health care programs (Fourth edition). Oxford University Press.

  BACKGROUND

• DuPaul, G. J., & Barkley, R. A. (1992). Situational Variability of Attention Problems: Psychometric Properties of the Revised Home and School Situations Questionnaires. Journal of Clinical Child Psychology, 21(2), 178-188. https://doi.org/10.1207/S15374424JCCP2102_10

  BACKGROUND

• Eyberg SM, Johnson SM. Multiple assessment of behavior modification with families: effects of contingency contracting and order of treated problems. J Consult Clin Psychol. 1974 Aug;42(4):594-606. doi: 10.1037/h0036723. No abstract available.

  PMID: 4847264 BACKGROUND

• Eyberg, S. M., & Pincus, D. (1999). Eyberg Child Behavior Inventory and Sutter-Eyberg Student Behavior Inventory: Professional manual. Psychological Assessment Resources.

  BACKGROUND

• Fabiano GA, Pelham WE Jr, Waschbusch DA, Gnagy EM, Lahey BB, Chronis AM, Onyango AN, Kipp H, Lopez-Williams A, Burrows-Maclean L. A practical measure of impairment: psychometric properties of the impairment rating scale in samples of children with attention deficit hyperactivity disorder and two school-based samples. J Clin Child Adolesc Psychol. 2006 Sep;35(3):369-85. doi: 10.1207/s15374424jccp3503_3.

  PMID: 16836475 BACKGROUND

• Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007 May;39(2):175-91. doi: 10.3758/bf03193146.

  PMID: 17695343 BACKGROUND

• Franke N, Keown LJ, Sanders MR. An RCT of an Online Parenting Program for Parents of Preschool-Aged Children With ADHD Symptoms. J Atten Disord. 2020 Oct;24(12):1716-1726. doi: 10.1177/1087054716667598. Epub 2016 Sep 8.

  PMID: 27609783 BACKGROUND

• Hornstra R, van der Oord S, Staff AI, Hoekstra PJ, Oosterlaan J, van der Veen-Mulders L, Luman M, van den Hoofdakker BJ. Which Techniques Work in Behavioral Parent Training for Children with ADHD? A Randomized Controlled Microtrial. J Clin Child Adolesc Psychol. 2021 Nov-Dec;50(6):888-903. doi: 10.1080/15374416.2021.1955368. Epub 2021 Aug 23.

  PMID: 34424102 BACKGROUND

• Kaminski JW, Valle LA, Filene JH, Boyle CL. A meta-analytic review of components associated with parent training program effectiveness. J Abnorm Child Psychol. 2008 May;36(4):567-89. doi: 10.1007/s10802-007-9201-9. Epub 2008 Jan 19.

  PMID: 18205039 BACKGROUND

• Koomen HM, Verschueren K, van Schooten E, Jak S, Pianta RC. Validating the Student-Teacher Relationship Scale: testing factor structure and measurement invariance across child gender and age in a Dutch sample. J Sch Psychol. 2012 Apr;50(2):215-34. doi: 10.1016/j.jsp.2011.09.001. Epub 2011 Oct 5.

  PMID: 22386121 BACKGROUND

• Leijten P, Gardner F, Melendez-Torres GJ, van Aar J, Hutchings J, Schulz S, Knerr W, Overbeek G. Meta-Analyses: Key Parenting Program Components for Disruptive Child Behavior. J Am Acad Child Adolesc Psychiatry. 2019 Feb;58(2):180-190. doi: 10.1016/j.jaac.2018.07.900. Epub 2018 Nov 26.

  PMID: 30738545 BACKGROUND

• Leijten P, Melendez-Torres GJ, Gardner F. Research Review: The most effective parenting program content for disruptive child behavior - a network meta-analysis. J Child Psychol Psychiatry. 2022 Feb;63(2):132-142. doi: 10.1111/jcpp.13483. Epub 2021 Jul 9.

  PMID: 34240409 BACKGROUND

• Luman M, van Meel CS, Oosterlaan J, Geurts HM. Reward and punishment sensitivity in children with ADHD: validating the Sensitivity to Punishment and Sensitivity to Reward Questionnaire for children (SPSRQ-C). J Abnorm Child Psychol. 2012 Jan;40(1):145-57. doi: 10.1007/s10802-011-9547-x.

  PMID: 21789519 BACKGROUND

• Pianta, R. C. (1992). Student-teacher relationship scale - Short form. Psychological Assessment Resources.

  BACKGROUND

• Pluess M, Assary E, Lionetti F, Lester KJ, Krapohl E, Aron EN, Aron A. Environmental sensitivity in children: Development of the Highly Sensitive Child Scale and identification of sensitivity groups. Dev Psychol. 2018 Jan;54(1):51-70. doi: 10.1037/dev0000406. Epub 2017 Sep 21.

  PMID: 28933890 BACKGROUND

• Reef J, Diamantopoulou S, van Meurs I, Verhulst FC, van der Ende J. Developmental trajectories of child to adolescent externalizing behavior and adult DSM-IV disorder: results of a 24-year longitudinal study. Soc Psychiatry Psychiatr Epidemiol. 2011 Dec;46(12):1233-41. doi: 10.1007/s00127-010-0297-9. Epub 2010 Oct 10.

  PMID: 20936464 BACKGROUND

• Slagt M, Dubas JS, van Aken MAG, Ellis BJ, Dekovic M. Sensory processing sensitivity as a marker of differential susceptibility to parenting. Dev Psychol. 2018 Mar;54(3):543-558. doi: 10.1037/dev0000431. Epub 2017 Nov 20.

  PMID: 29154642 BACKGROUND

• Sperati A, Spinelli M, Fasolo M, Pastore M, Pluess M, Lionetti F. Investigating sensitivity through the lens of parents: validation of the parent-report version of the Highly Sensitive Child scale. Dev Psychopathol. 2024 Feb;36(1):415-428. doi: 10.1017/S0954579422001298. Epub 2022 Dec 12.

  PMID: 36503569 BACKGROUND

• Staff AI, van den Hoofdakker BJ, van der Oord S, Hornstra R, Hoekstra PJ, Twisk JWR, Oosterlaan J, Luman M. Effectiveness of Specific Techniques in Behavioral Teacher Training for Childhood ADHD: A Randomized Controlled Microtrial. J Clin Child Adolesc Psychol. 2021 Nov-Dec;50(6):763-779. doi: 10.1080/15374416.2020.1846542. Epub 2021 Jan 20.

  PMID: 33471581 BACKGROUND

• Tschannen-Moran, M., & Hoy, A. W. (2001). Teacher efficacy: capturing an elusive construct. Teaching and Teacher Education, 17(7), 783-805. https://doi.org/10.1016/S0742-051X(01)00036-1

  BACKGROUND

• Twisk J, de Boer M, de Vente W, Heymans M. Multiple imputation of missing values was not necessary before performing a longitudinal mixed-model analysis. J Clin Epidemiol. 2013 Sep;66(9):1022-8. doi: 10.1016/j.jclinepi.2013.03.017. Epub 2013 Jun 21.

  PMID: 23790725 BACKGROUND

• van den Hoofdakker BJ, van der Veen-Mulders L, Sytema S, Emmelkamp PMG, Minderaa RB, Nauta MH. Effectiveness of behavioral parent training for children with ADHD in routine clinical practice: a randomized controlled study. J Am Acad Child Adolesc Psychiatry. 2007 Oct;46(10):1263-1271. doi: 10.1097/chi.0b013e3181354bc2.

  PMID: 17885567 BACKGROUND

• Ward RJ, Bristow SJ, Kovshoff H, Cortese S, Kreppner J. The Effects of ADHD Teacher Training Programs on Teachers and Pupils: A Systematic Review and Meta-Analysis. J Atten Disord. 2022 Jan;26(2):225-244. doi: 10.1177/1087054720972801. Epub 2020 Dec 17.

  PMID: 33331193 BACKGROUND

• Webster-Stratton C, Reid MJ, Hammond M. Preventing conduct problems, promoting social competence: a parent and teacher training partnership in head start. J Clin Child Psychol. 2001 Sep;30(3):283-302. doi: 10.1207/S15374424JCCP3003_2.

  PMID: 11501247 BACKGROUND

Study Officials

• Barbara van den Hoofdakker, Prof. dr.

  Accare child study centre; University Medical Center Groningen

  PRINCIPAL INVESTIGATOR

• Marjolein Luman, Dr.

  Free university of Amsterdam

  PRINCIPAL INVESTIGATOR

• Saskia van der Oord, Prof. dr.

  KU Leuven

  PRINCIPAL INVESTIGATOR

• Tycho Dekkers, Dr

  Accare child study centre; University Medical Center Groningen

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: N/A The investigator will not perform any outcome assessments.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: To examine the research objectives, a randomized controlled trial with two arms will be used. Teachers will be randomly assigned (equal randomization) to (a) brief teacher training with practice as usual (PAU) or (b) PAU only

Study Record Dates

• First Submitted: November 7, 2023
• First Posted: November 13, 2023
• Study Start: December 13, 2023
• Primary Completion: July 4, 2025
• Study Completion (Estimated): December 1, 2026
• Last Updated: October 6, 2025

Record last verified: 2025-10

Data Sharing

• IPD Sharing: Will not share

Locations

NL (1)