School-based intervention to address self-regulation and executive functioning in children attending primary schools in remote Australian Aboriginal communities

Bree Wagner¹, Jane Latimer², Emma Adams¹, Heather Carmichael Olson^{3

4}, Martyn Symons^{5

6}, Trevor G Mazzucchelli^{7

8}, Tracy Jirikowic⁹, Rochelle Watkins⁵, Donna Cross^{6

10

11}, Jonathan Carapetis^{6

12}, John Boulton¹³, Edie Wright¹⁴, Tracy McRae¹, Maureen Carter¹⁵, James P Fitzpatrick¹

Affiliations

¹ Alcohol and Pregnancy and Fetal Alcohol Spectrum Disorder Research Team, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
² Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
³ Seattle Children's Research Institute, Seattle, Washington, United States of America.
⁴ University of Washington School of Medicine, Seattle, Washington, United States of America.
⁵ National Health and Medical Research Council FASD Research Australia Centre of Research Excellence, Perth, Western Australia, Australia.
⁶ Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
⁷ Child and Family Research Group, School of Psychology, Curtin University, Perth, Western Australia, Australia.
⁸ Brain, Behaviour and Mental Health Research Group, School of Psychology, Curtin University, Perth, Western Australia, Australia.
⁹ Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, United States of America.
¹⁰ Health Promotion and Education Research Team, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
¹¹ CoLab-Collaborate for Kids, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
¹² Perth Children's Hospital, Perth, Western Australia, Australia.
¹³ The University of Newcastle, Newcastle, New South Wales, Australia.
¹⁴ Western Australian Department of Education Kimberley Education Region, Broome, Western Australia, Australia.
¹⁵ Nindilingarri Cultural Health Services, Fitzroy Crossing, Western Australia, Australia.

PMID: 32579567
PMCID: PMC7314028
DOI: 10.1371/journal.pone.0234895

School-based intervention to address self-regulation and executive functioning in children attending primary schools in remote Australian Aboriginal communities

Bree Wagner et al. PLoS One. 2020.

. 2020 Jun 24;15(6):e0234895.

doi: 10.1371/journal.pone.0234895. eCollection 2020.

Authors

Affiliations

¹ Alcohol and Pregnancy and Fetal Alcohol Spectrum Disorder Research Team, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
² Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
³ Seattle Children's Research Institute, Seattle, Washington, United States of America.
⁴ University of Washington School of Medicine, Seattle, Washington, United States of America.
⁵ National Health and Medical Research Council FASD Research Australia Centre of Research Excellence, Perth, Western Australia, Australia.
⁶ Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
⁷ Child and Family Research Group, School of Psychology, Curtin University, Perth, Western Australia, Australia.
⁸ Brain, Behaviour and Mental Health Research Group, School of Psychology, Curtin University, Perth, Western Australia, Australia.
⁹ Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, United States of America.
¹⁰ Health Promotion and Education Research Team, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
¹¹ CoLab-Collaborate for Kids, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
¹² Perth Children's Hospital, Perth, Western Australia, Australia.
¹³ The University of Newcastle, Newcastle, New South Wales, Australia.
¹⁴ Western Australian Department of Education Kimberley Education Region, Broome, Western Australia, Australia.
¹⁵ Nindilingarri Cultural Health Services, Fitzroy Crossing, Western Australia, Australia.

PMID: 32579567
PMCID: PMC7314028
DOI: 10.1371/journal.pone.0234895

Erratum in

Correction: School-based intervention to address self-regulation and executive functioning in children attending primary schools in remote Australian Aboriginal communities.
PLOS ONE Staff. PLOS ONE Staff. PLoS One. 2020 Jul 22;15(7):e0236485. doi: 10.1371/journal.pone.0236485. eCollection 2020. PLoS One. 2020. PMID: 32697786 Free PMC article.

Abstract

Executive functioning and self-regulation influence a range of outcomes across the life course including physical and mental health, educational success, and employment. Children prenatally exposed to alcohol or early life trauma (ELT) are at higher risk of impairment of these skills and may require intervention to address self-regulation deficits. Researchers partnered with the local Aboriginal health organization and schools to develop and pilot a manualized version of the Alert Program® in the Fitzroy Valley, north Western Australia, a region with documented high rates of fetal alcohol spectrum disorder and ELT. This self-controlled cluster randomized trial evaluated the effect of an 8-week Alert Program® intervention on children's executive functioning and self-regulation skills. Following parent or caregiver consent (referred to hereafter as parent), 271 students were enrolled in the study. This reflects a 75% participation rate and indicates the strong community support that exists for the study. Teachers from 26 primary school classrooms across eight Fitzroy Valley schools received training to deliver eight, one-hour Alert Program® lessons over eight-weeks to students. Student outcomes were measured by parent and teacher ratings of children's behavioral, emotional, and cognitive regulation. The mean number of lessons attended by children was 4.2. Although no significant improvements to children's executive functioning skills or behavior were detected via the teacher-rated measures as hypothesized, statistically significant improvements were noted on parent-rated measures of executive functioning and behavior. The effectiveness of future self-regulation programs may be enhanced through multimodal delivery through home, school and community based settings to maximize children's exposure to the intervention. Despite mixed findings of effect, this study was an important first step in adapting and evaluating the Alert Program® for use in remote Australian Aboriginal community schools, where access to self-regulation interventions is limited.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

**Fig 2. Percentage of students by total number of Alert Program® lessons attended.**

See this image and copyright information in PMC

References

1. Diamond A. Why improving and assessing executive functions in early life is critical 2016. [cited 2018 March 5]. In: Executive function in pre-school aged children: integrating measurement, neurodevelopment, and translational research [Internet]. Washington DC: American Psychological Association, [cited 2018 March 5]; [11–43]. Available from: https://ovidsp-tx-ovid-com.ezproxy.library.uwa.edu.au/sp-3.32.2a/ovidweb....
1. Miyake A. Individual differences in executive functions: Unity/diversity framework and recent research findings. International Journal Of Psychology. 2016;51(s1):1032–.
1. Zhou Q, Chen SH, Main A. Commonalities and differences in the research on children’s effortful control and executive function: a call for an integrated model of self-regulation. Child Development Perspectives. 2012;6(2):112–21.
1. Bridgett DJ, Oddi KB, Laake LM, Murdock KW, Bachmann MN. Integrating and differentiating aspects of self-regulation: effortful control, executive functioning, and links to negative affectivity. Emotion (Washington, DC). 2013;13(1):47–63. - PubMed
1. Hofmann W, Schmeichel BJ, Baddeley AD. Executive functions and self-regulation. Trends Cogn Sci. 2012;16(3):174–80. 10.1016/j.tics.2012.01.006 - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

School-based intervention to address self-regulation and executive functioning in children attending primary schools in remote Australian Aboriginal communities

Affiliations

School-based intervention to address self-regulation and executive functioning in children attending primary schools in remote Australian Aboriginal communities

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical