Neurocognitive Moderation of Paths Effects on Behavioral Outcomes in Young, Low Income Urban Children

The substantial variability in effects of interventions designed to reduce or prevent behavioral problems demands that we identify the source(s) of differential responsivity to extend their reach. Studies of moderation that take into account changes at the level of neurodevelopment will enable the more efficient design or modification of interventions that target impactful moderating mechanisms. Also critical is to conduct this research with young children who are less cognitively and behaviorally developed and, thus, more malleable. To maximize program effectiveness for a greater number of children prior to entrenchment of problems, we sought to determine which individual features (e.g., level of neurocognitive and emotional functioning) portend program outcomes.

The present study administered the universal program, PATHS, because, similar to all other evidence-based interventions, it exerts only small-moderate effect sizes (d-.2 to .3). Thus, there is a need to understand which children are most amenable to this approach. Our model maps program components to theoretically relevant neurodevelopmental “prerequisites”. PATHS’s components target self/impulse control, emotion regulation, social problem solving, communication skills, and sensitivity to consequences in interpersonal contexts. Processing of program materials, thus, requires children to (a) be cognizant of and responsive to potential negative consequences of their behavior, (b) inhibit inappropriate behavioral responses, (c) become more facile in recognizing emotions and using language to convey their feelings to others, and (d) understand and act on the benefits of deliberate and cautious decision making. Children, particularly those at highest risk (by virtue of low income and/or conduct problems), may show subtle inhibitory control (IC) and emotion regulatory (ER) delays that interfere with assimilation and execution of these abilities.

Children (n=327) about to enter kindergarten were recruited from 4 schools in high poverty neighborhoods. All kindergarten classes in 2 schools received PATHS for 2 years, while an attentional control was administered in the other 2 schools. From kindergarten through the middle of 2^nd grade, an extensive test battery of IC, ER, IQ, language, and sociometric scripts characterized participating children in the schools and teachers rated their behavior. Results indicate strong moderation by particular dimensions of IC and ER, with lower functioning children responding less well to PATHS than those higher functioning. Interestingly, program effects and neurocognitive moderation diminished in the follow up year (mid second grade); inattention moderated this decay. Our findings reinforce the importance of (a) tracking outcomes over time; (b) identifying active ingredients of any given program and (c) offering impactful program components across development to sustain change in neurodevelopmental trajectories.