A Pilot Study of Teacher-Child Interaction Training - Universal in Head Start (TCIT-U)

Children's Hospital of Philadelphia (CHOP)

Status: Terminated

Conditions: Child Development; Child Behavior; Child Behavior Problem

Treatments: Behavioral: Teacher-Child Interaction Training - Universal

Study type: Interventional

Funder types: Other

Identifiers

NCT04075071

IRB 19-016084 (Other Identifier)

19-016084

Details and patient eligibility

About

This pilot study aims to implement and evaluate Teacher-Child Interaction Training - Universal (TCIT-U), an empirically-supported classroom-based intervention aimed at improving child behavior and social-emotional skills through strengthening teacher-child relationships at a preschool that serves children from socially and economically disadvantaged backgrounds who are at risk for behavioral health difficulties. The main objectives are to (a) examine TCIT-U's effects on teacher behavior, teachers' sense of efficacy, and child behavior problems and social-emotional skills compared to usual care (UC) and (b) explore the feasibility and acceptability of implementing TCIT-U at a diverse urban preschool.

Full description

Disruptive behaviors and social-emotional skill deficits are common problems in early education settings and contribute to the high rates of preschool suspensions and expulsions. While teachers serve a critical role in children's behavioral health, they often lack evidence-based training in strategies that could improve child behavior and promote social-emotional skills. The goal of this project is to implement and evaluate Teacher-Child Interaction Training - Universal (TCIT-U), an empirically-supported classroom-based intervention aimed at improving child behavior and social-emotional skills through strengthening teacher-child relationships at a preschool that serves children from socially and economically disadvantaged backgrounds who are at risk for behavioral health difficulties.

The main objectives are to (a) examine TCIT-U's effects on teacher behavior, teachers' sense of efficacy, and child behavior problems and social-emotional skills compared to usual care (UC) and (b) explore the feasibility and acceptability of implementing TCIT-U at a diverse urban preschool.

This pilot study is a nonrandomized clinical trial comparing TCIT-U to a UC control group at urban preschool. Teachers in the intervention group will participate in TCIT-U. TCIT-U and UC teachers will complete measures at baseline, post-intervention, and end-of-the-school-year follow-up. All teachers will be observed for their TCIT-U skill use at baseline, mid-intervention, post-intervention, and follow-up. Qualitative interviews will be conducted with educational staff at follow-up to examine feasibility and acceptability data.

Participants will be eight teachers and approximately 80 children from four preschool classrooms in Philadelphia. Educational staff will also be invited to participate in qualitative interviews. Staff must speak English to participate. There is no exclusion criteria for children.

Four teachers from two Head Start classrooms will participate in TCIT-U. TCIT-U is an empirically-supported intervention aimed at strengthening teacher-child relationships and improving child behavior and social-emotional skills. TCIT-U includes group didactic and individualized coaching sessions. Four teachers from two other classrooms will serve as the UC control group.

Teacher behavior will be coded during live classroom observations. Teacher-reported questionnaires will measure teachers' sense of efficacy and child behavior and social-emotional skills. Qualitative interviews and satisfaction surveys will explore the feasibility and acceptability of implementing TCIT-U. Fidelity checklists will be completed by the TCIT-U Trainer and expert consultants to document intervention fidelity.

Enrollment: 70 patients

Sex: All

Ages: 3+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Teachers' Inclusion Criteria:

• Serve as a head, co-, and/or assistant teacher in a Head Start or PreK Counts classroom at the participating early childhood education center.
• Speak and read English proficiently.
• Provide written informed consent.

Teachers' Exclusion Criteria: Do not speak and read English proficiently.

Children's Inclusion Criteria:

• Enrolled in one of the participating Head Start or PreK Counts classrooms prior to baseline evaluations.
• Aged 3 through 5 years old.
• Provided an informational letter about the study to their parents.

Children's Exclusion Criteria: There are no exclusion criteria for children.

Educational Staff's Inclusion Criteria (qualitative interviews):

• Participated in or observed TCIT-U training and/or serve as a classroom-based (e.g., assistant, behavioral specialist) or administrative (e.g., center director) staff for the classrooms participating in TCIT-U.
• Speak and read English proficiently.
• Provide written informed consent.

Educational Staff's Exclusion Criteria (qualitative interviews): Do not speak and read English proficiently.

Trial design

Primary purpose: Prevention

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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70 participants in 2 patient groups

TCIT-U

Experimental group

Description:

Four teachers from two Head Start classrooms will be assigned to Teacher-Child Interaction Training - Universal (TCIT-U). TCIT-U occurs in two phases (6 weeks per phase): Child-Directed Interaction (CDI; focusing on relationship building) and Teacher-Directed Interaction (TDI; focusing on managing behavior problems). The TCIT-U Trainer (a licensed clinical child psychologist) will provide teachers with group didactic sessions (6 hours per phase) and individualized live coaching in their classrooms (20 minutes, once per week). Strategies include the use of PRIDE skills (Praise, Reflection, Imitation, Behavior Description, and Enthusiasm) or specific verbalizations that promote warm, responsive interactions, as well as classroom-appropriate behavior modification strategies which include using effective commands, prompts, natural consequences, differential social attention, and a modified time-out appropriate for use in a classroom.

Treatment:

Behavioral: Teacher-Child Interaction Training - Universal

Usual Care

No Intervention group

Description:

Four teachers from 2 PreK Counts classrooms will be assigned to the Usual Care (UC) group. They will continue their existing behavioral management strategies and techniques. Teachers will report on specific training in and use of other behavior management and social-emotional learning programs at baseline. At the conclusion of the study, UC teachers and staff will be offered didactic training in TCIT-U principles and strategies.