Elementary school intervention improved adult mental, sexual and economic well-being

Fifteen years after they completed an intervention program designed to help their social development in elementary school, young adults reported better mental health, sexual health and higher educational and economic achievement than a control group of young adults who didn't receive the intervention, according to a new study.

The data, collected when the participants were 24 and 27 years old, comes from the ongoing Seattle Social Development Project that is following a group of people from childhood into adulthood. The results are being published Tuesday in the Archives of Pediatrics & Adolescent Medicine.

"We are seeing that the intervention appears to affect developmentally important outcomes that change as people age," said J. David Hawkins, lead author of the study and founding director of the University of Washington's Social Development Research Group.

"The effects of working with children in elementary school show up in their teen years as their rates of violence, heavy alcohol use and dropping out of school are reduced. By age 21 more of them have completed high school and have better jobs. And by ages 24 and 27 they are above the median in socio-economic status and education and they are having less mental health and sexual health problems."

Hawkins said the researchers look at both the age 24 and age 27 data to better understand early adulthood.

"By looking at both ages we get a clearer picture of patterns that are starting to emerge. This is particularly true of mental health, where at both ages those who received the full intervention during the elementary grades have fewer symptoms and lower rates of anxiety, social phobia, post traumatic stress disorder or a major depressive episode."

The study involved 598 students from 15 Seattle public schools serving high-crime neighborhoods. The participants were divided into three groups. One group of 146 students received the intervention in grades one through six. A second group of 251 students received a partial intervention only in the fifth and sixth grades and the third group of 201 children was not exposed to the program.

The intervention involved teachers, student and their parents. Teachers were given training in classroom management and strategies for instruction. Children were taught impulse control, how to get what they want without aggressive behavior, how to recognize the feelings of other people and how to stay out of trouble and still have a good time. Parents were taught family management skills, how to involve children in setting family rules, how to use positive reinforcement and how to better monitor their children.

The young adults surveyed in this study were evenly split between males and females. Forty-six percent were white, 26 percent black, 22 percent Asian-American and 6 percent Native American.

Hawkins said a "dose" effect noted from the intervention when participants were younger was still evident. Those people who received the full intervention in grades one through six showed the strongest effects and the most positive functioning in young adulthood. Those who received the partial intervention showed lesser effects, though they fared somewhat better than people who did not receive either intervention.

The study also showed those who received the full intervention had significantly fewer lifetime sexually transmitted diseases. This finding relates to earlier results from the Seattle Social Development Project that showed children who received the full intervention started having sex later, had fewer sex partners and used condoms more consistently when they were teenagers.

On the economic front, the full-intervention group reported higher income, increased responsibilities at work and more community involvement. However, the full intervention had no effect on reducing substance use or cutting criminal behavior in young adulthood.

"We have documented long-term effects on economic, sexual and mental health from ensuring that urban teachers have the tools to teach the diversity of students they encounter and parents have the skills to raise kids in the complex world in which we live," said Hawkins.

"The real value in following people over time is that we get to see how what we do in childhood affects their lives and has enduring effects as they change. We can't know how one phase of development affects the next step unless we follow people over time."

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Hawkins JD, Kosterman R, Catalano RF, Hill KG, Abbott RD. Effects of Social Development Intervention in Childhood 15 Years Later. Arch Pediatr Adolesc Med. 2008 Dec;162(12):1133-1141   [Abstract]