Integrating positive behavior support and emotional learning programs in children with special educational needs at risk for externalizing and internalizing problems: evaluating TIME-IN

ISRCTN ISRCTN54456609
DOI https://doi.org/10.1186/ISRCTN54456609
Secondary identifying numbers ISBN 978-94-6292-288-4
Submission date
17/03/2017
Registration date
28/03/2017
Last edited
17/05/2021
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Special education students with learning disabilities are known to be at risk for developing emotional and behavioural problems. This can threaten students' school readiness and complicate teaching, requiring punishment which may lead to dropping out of school. In contrast, emotional problems are often underestimated and are likely to remain unaddressed. Unfortunately, solely using punishment strategies to deal with problem behaviour seems to be ineffective and only makes the problems worse. Previous research shows that programmes such as the School-Wide Positive Behaviour Support (SWPBS) can be effective at preventing and addressing external problems (i.e. behavioural issues). However, SWPBS lacks clear evidence-based interventions for dealing with negative emotions and internalizing problems (i.e. emotional problems). Therefore, the TIME-IN programme was developed as a school-wide healthcare policy, which extends SWPBS by also adding emotional support systems such as Emotion Regulation Training (ERT). TIME-IN aims to improve the inclusion of special education students with learning disabilities in the classroom by teaching adaptive emotion regulation strategies and by reducing externalised and internalised problems, which is also a key priority for Flemish government as part of recent educational reformation. The aim of this study is to test the effectiveness of the TIME-IN programme on children’s emotion regulation, behaviour and emotional well-being in special education children.

Who can participate?
Children aged 8-12 with learning disabilities, their parents and their special education teachers.

What does the study involve?
Participating schools are allocated to either receiving the TIME-IN programme or to continue as normal. Schools receive the programme if they display that they are willing and ready to implement it. TIME-IN is supervised by a school psychologist and follows a three level approach using proactive (creating or controlling a situation), preventive (preventing a situation) and curative (curing a situation) programmes. TIME-IN works to create a school wide plan to create a safe school environment and to determine student’s special educational needs. The programme also includes training on classroom management, promoting emotional awareness, coaching emotional regulating strategies (i.e. problem-solving) and repairing conflicts between teachers and children. Schools who do not receive the TIME-IN programme continue with their normal care. Emotional regulation strategies and school readiness of students are measured before and after the programme using questionnaires for teachers, students and their parents.

What are the possible benefits and risks of participating?
A possible benefit with participating is that the programme may improve children's school readiness and prevent school drop-out. There are no notable risks with participating.

Where is the study run from?
MPI 't Craeneveld Oudenaarde (Belgium)

When is the study starting and how long is it expected to run for?
September 2015 to June 2015

Who is funding the study?
1. Educational Government (Belgium)
2. Special Research Fund Ghent University (BOF) University of Ghent (Belgium)

Who is the main contact?
Mr Henk Weymeis
Henk.Weymeis@Ugent.be

Study website

Contact information

Mr Henk Weymeis
Scientific

University of Ghent
Henri Dunantlaan 2
Gent
9000
Belgium

ORCiD logoORCID ID 0000-0001-8887-8376
Phone +32 485 652 678
Email henk.weymeis@ugent.be

Study information

Study designProspective controlled two armed non randomised study
Primary study designInterventional
Secondary study designNon randomised study
Study setting(s)School
Study typePrevention
Participant information sheet Not available in web format, please use contact details to request a participant information sheet
Scientific titleExtending School-Wide Positive Behaviour Support (SWPBS) with emotional support systems: a non-randomized study testing the effectiveness of a school-wide health care policy TIME-IN in Flemish special education
Study acronymTIME-IN
Study objectives1. TIME-IN improves special education children's adaptive emotion regulation strategies compared to a control group with no intervention
2. TIME-IN reduces both children's externalizing and internalizing problems compared to a control group with no intervention
3. TIME-IN reduces both children's externalizing and internalizing problems through adaptive emotion regulation
Ethics approval(s)Ethical Commission of Ghent University Faculty of Psychology and Pedagogical Sciences, 22/9/2014, ref: 2014/45
Health condition(s) or problem(s) studiedChildren with learning disabilities, at risk for developing behavioural, emotional and academic problems (clinical sample).
InterventionParticipating schools are allocated to either receiving the intervention or to the control group. Schools are allocated based on their readiness to implement the intervention programme and based on the implementation criteria such as sufficient awareness of need and motivation to get started with the implementation of a demanding school-wide programme. This is done through discussions with school boards. Control schools are chosen randomly selected from an ongoing study on school readiness in 18 nearby schools.

Intervention group (TIME-IN):
Participating schools implement the TIME-IN programme over nine months. This consists of 48 meetings, lasting a total of 122 hours. Five workshops of three hours and one two-hour plenary information sessions is devoted to the development and presentation of a school-wide charter and additionally three three-hour discussion sessions are held over the year to evaluate the schools action plan. Next, one plenary information session (three hours) is organised to discussion children's screening results and six workshops of three hours on the implementation of a school-wide quality assurance system is implemented: Action-Oriented Working in the Classroom (AOW). 30 teachers are trained about the programme through five three-hour workshops. The school clinical psychologist staff receive four workshops (three hours) to training outside classroom interventions. Finally two school-parent contacts (three hours) are organised to involve parents in the learning process.

Teachers are expected to enhance a safe classroom climate by formulating and visualizing positive behavioural expectations, practicing relational skills and providing clear instructions regarding the course content. Teachers promote emotional competencies using classroom emotional thermometers tools which enhance emotion identification by visualising different emotions and fostering emotional understanding. Students' special needs and adaptive emotion regulation strategies are improved by using a student reminder card. When aggressive behaviour or an emotional crisis arise, staff use the Life Space Crisis Intervention procedure in order to repair the conflictual relationship between teachers and child. Teachers support the children to cool down and receive assistance from the school psychologist.

Control group (Care as usual):
The control group does not receive any interventions and continue with their normal care.

School readiness is measured at baseline and at month nine (after the intervention) using questionnaires for teachers, students and their parents in a multi-informant assessment procedure.
Intervention typeBehavioural
Primary outcome measureCurrent primary outcome measures as of 16/10/2020:
1. Adaptive emotion regulation strategies are measured using the FEEL-KJ at baseline and 9 months
2. Maladaptive emotion regulation strategies are measured using the FEEL-KJ at baseline and 9 months
3. Depressive symptoms are measured using the Child Depression Inventory (CDI) at baseline and 9 months

Previous primary outcome measures:
1. Externalizing problems are measured using the Teacher Report Form (TRF) at baseline and 9 months
2. Internalizing problems are measured using the Teacher Report Form (TRF) at baseline and 9 months
3. Depressive symptoms are measured using the Child Depression Inventory (CDI) at baseline and 9 months
Secondary outcome measuresCurrent secondary outcome measures as of 16/10/2020:
1. Externalising problems are measured using the Teacher Report Form (TRF; intervention group) and Child Behaviour Checklist (CBCL; control group) at baseline and 9 months
2. Internalising problems are measured using the Teacher Report Form (TRF; intervention group) and Child Behaviour Checklist (CBCL; control group) at baseline and 9 months

Previous secondary outcome measures:
Emotional regulation strategies are measured using FEEL-KJ is measured using at baseline and 9 months
Overall study start date20/05/2014
Completion date30/06/2015

Eligibility

Participant type(s)Other
Age groupChild
Lower age limit8 Years
Upper age limit12 Years
SexBoth
Target number of participantsT0: 100 participants T1: 100 participants
Total final enrolment162
Key inclusion criteria1. Special Education Children with learning disabilities between 8 - 12 years old

Updated 20/03/2018:
1. Children between 8-12 years old with special educational needs (SEN; i.e. children with a learning and/or a mild intellectual disability)

2. Their biological parents (father and/or mother)
3. Their Special Education Teacher
Key exclusion criteria1. Children, parents or teachers who do not consent to participate in the study
2. Children younger than 8 and older than 12 years
3. Children who are not primarily diagnosed with a learning disability (in Flemish education this is categorised as 'Type BA - special education')
Date of first enrolment01/09/2014
Date of final enrolment15/09/2014

Locations

Countries of recruitment

  • Belgium

Study participating centre

MPI 't Craeneveld
Serpentsstraat 63
Oudenaarde
9700
Belgium

Sponsor information

Flemish Government Education
Government

Hendrik Consciencegebouw
Koning Albert II laan 15
Brussels
1210
Belgium

Website http://onderwijs.vlaanderen.be/
ROR logo "ROR" https://ror.org/04qxsrb28

Funders

Funder type

University/education

Ghent University

No information available

Results and Publications

Intention to publish date31/12/2020
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planCurrent publication and dissemination plan as of 16/10/2020:
Results publication submitted to Frontiers - Psychology or Clinical Setting (03/07/2020). Publication of the results in an internal research report, to be available for all stakeholders (school district, school managing board, teachers, parents and students) is planned.

Previous publication and dissemination plan:
The protocol is currently under review; the results will be submitted later this spring at a peer-reviewed scientific journal. Also, publication of the results in an internal research report, to be available for all stakeholders (school district, school managing board, teachers, parents and students) is planned.
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available upon request from Henk Weymeis (henk.weymeis@ugent.be).

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 01/07/2019 16/10/2020 Yes No
Results article 27/04/2021 28/04/2021 Yes No

Editorial Notes

17/05/2021: PubMed address added.
28/04/2021: Publication reference added.
16/10/2020: The following changes were made to the trial record:
1. The primary and secondary outcome measures were updated.
2. The public title was changed from 'Promoting positive behaviour and emotional readiness in special education children: Effectiveness of a school-wide health care policy TIME-IN' to 'Integrating positive behavior support and emotional learning programs in children with special educational needs at risk for externalizing and internalizing problems: evaluating TIME-IN'.
3. The publication and dissemination plan was updated.
4. Publication reference added.
5. The intention to publish date was changed from 31/12/2019 to 31/12/2020.
21/03/2019: The following changes were made to the trial record:
1. The intention to publish date was changed from 01/09/2018 to 31/12/2019
2. The total final enrolment was added
20/03/2018: The following changes were made to the trial record:
1. The inclusion criteria were updated.
2. The scientific title was changed from 'Extending school-wide positive behaviour support (swpbs) with emotional support systems in promoting school readiness: Effect of time-in on special education children's externalizing and internalizing problems' to 'Extending School-Wide Positive Behaviour Support (SWPBS) with emotional support systems: a non-randomized study testing the effectiveness of a school-wide health care policy TIME-IN in Flemish special education'.
3. The intention to publish date was changed from 01/09/2017 to 01/09/2018.