An Experimental Study Examining the Use of Pretreatment Assessment to Personalize Interventions to Students with Externalizing Behaviors

Introduction: Many schools apply a “standard protocol” approach to intervention, which involves providing the same intervention to all students in a similar fashion (Sanetti & Simonsen, 2009). Unfortunately, previous research has found that the standard protocol approach often does not achieve desired outcomes, resulting in modest or negligible effects (e.g., Benner, Nelson, Sanders, & Ralston, 2012). The purpose of the current study was to examine the effects of the Student Intervention Matching System (SIMS), which is an assessment-to-action system that gathers pre-treatment data to inform more precise intervention selection for students with identified social, emotional, and behavioral problems. To accomplish this, an experimental study was performed to examine the relative efficacy of a personalized intervention approach on student outcomes when compared against an arbitrary intervention-as-usual comparison condition.

Methods: A matched randomized controlled trial was performed by assigning a sample of 59 students with identified externalizing behavior problems to either a personalized intervention using the SIMS or an arbitrary intervention-as-usual condition. Groups were equivalent at pre test. The SIMS diagnosed students’ externalizing behaviors as due to an acquisition (i.e., can’t do) or performance (won’t do) deficit and assigned students to either a skill or motivational intervention. Students in the arbitrary intervention-as-usual condition all received the same intervention: 10 weeks of social skills training. Outcome measures included the Social Skills Improvement System Rating Scales (SSIS) and direct behavior rating scales (DBR) assessing classroom behavior. Data were collected at pre and 10 weeks later at post.

Results: Altogether, post test results demonstrate significant main effects of treatment group on DBR [F(1,55)=15.28,p<.001] and SSIS scores [F(1,55)=12.53,p<.05]. Furthermore, compared to the generic condition, students who received personalized interventions showed moderate to large reductions in problem behavior on both the DBR (d= -1.3) and the SSIS (d = -.55).

Conclusions: The results of this study highlight the utility of using pretreatment assessment to inform the selection of personalized interventions for at-risk students based on the hypothesized acquisition or performance deficit underlying their externalizing behavior. These findings have significant implications for the applications of personalized intervention and prevention efforts in schools. By using pretreatment assessment to select from a menu of evidence-based intervention options, schools have the capacity to increase the precision of their intervention efforts and optimize outcomes for students with externalizing behaviors who need additional support.