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School Psychology Review
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School-Based Interventions for Middle School

Students With Disruptive Behaviors: A Systematic
Review of Components and Methodology
Alexander Alperin, Linda A. Reddy, Todd A. Glover, Briana Bronstein, Nicole

B. Wiggs & Christopher M. Dudek
To cite this article: Alexander Alperin, Linda A. Reddy, Todd A. Glover, Briana Bronstein, Nicole
B. Wiggs & Christopher M. Dudek (2021): School-Based Interventions for Middle School Students
With Disruptive Behaviors: A Systematic Review of Components and Methodology, School
Psychology Review, DOI: 10.1080/2372966X.2021.1883996
To link to this article: https://doi.org/10.1080/2372966X.2021.1883996
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School Psychology Review
https://doi.org/10.1080/2372966X.2021.1883996
CHILDREN, RESEARCH, AND PUBLIC POLICY
School-Based Interventions for Middle School Students With Disruptive

Behaviors: A Systematic Review of Components and Methodology
Alexander Alperin , Linda A. Reddy , Todd A. Glover , Briana Bronstein , Nicole B. Wiggs , and
Christopher M. Dudek
Rutgers, The State University of New Jersey
ABSTRACT ARTICLE HISTORY

This is the first systematic review of the school outcome literature for behavior interventions used Received November 2, 2020
with middle school students exhibiting disruptive behaviors. A total of 51 investigations (published Accepted January 25, 2021
between 2000 and 2020) including 6,498 students and 264 implementers were coded on four KEYWORDS
dimensions (i.e., sample, interventions, methodology, and outcomes). This review examined disruptive behavior, middle
intervention effects on implementer and student outcomes, yielding small to large positive effects. school, behavior interventions,
Strengths of the reviewed studies included the specification of student characteristics, teachers
operationalization of implementers’ professional development, and assessment of intervention
ASSOCIATE EDITOR
fidelity. Most studies used single-case designs or randomized controlled trial experimental designs Prerna Arora
to evaluate the effectiveness of the interventions. Weaknesses included an absence of student
diagnostic information; lack of data on implementers, attrition, and follow-up; and inadequate use
of parent involvement. School practitioners should be mindful of developmental challenges and
consider targets and barriers to implementation. Additional large-scale, rigorous experimental
designs are warranted.
IMPACT STATEMENT
This is the first study to review the school outcome literature for behavior interventions and supports
used with middle school students with or at risk of disruptive behavior disorders (DBDs). Research-
based behavior interventions are essential to ameliorating the negative outcomes associated with
student disruptive behavior in middle school, which is a significant transitional period.
To ensure that school practitioners (e.g., school psychol- 2005), middle school students also experience substantial
ogists, interventionists, teachers) can adequately support emotional, physical, cognitive, and social changes (Farmer
middle school students (students in grades sixth through et al., 2015). For most students, the middle school years
eighth) with or at risk of disruptive behavior disorders include puberty and reductions in parent and teacher
(DBDs), it is crucial to evaluate the existing intervention supervision (Bierman et al., 2013; Eccles, 1999). During
research for this population. DBDs, such as oppositional middle school, students become more dependent and
defiant (ODD) or conduct disorders (CD), are pervasive, influenced by their peer group. Peer group relationships
chronic, and severe conditions that negatively impact can rapidly change, which may serve as a trigger for inap-
many children and adolescents (Wang et al., 2012). Middle propriate behavior (Farmer et al., 2015; Lochman, 2010).
school students are at the highest risk of developing DBDs, Typically, academic performance, enthusiasm for school,
with 25% of middle school students displaying disruptive and self-esteem decline throughout middle school, while
behaviors (i.e., defiance, disobedience, aggression, and loneliness, conflict with adults, and antisocial behaviors
hostility toward authority figures) in the classroom increase (Erath et al., 2009). Together, these factors con-
(Erickson & Gresham, 2019). tribute to a high-risk environment where students are
DBDs among middle school students are particularly more likely to act out their feelings of loneliness and fear
concerning given that middle school represents a signifi- (Eccles & Roeser, 2011).
cant developmental and vulnerable transition period. In Given these unique challenges, middle school students
addition to a new school environment with a greater num- with or at risk of DBDs require targeted interventions to
ber of teachers, larger class sizes, and more rigid academic address their specific needs. Without appropriate inter-
expectations (Erickson & Gresham, 2019; Evans et al., ventions, students may be negatively impacted in many
CONTACT Alexander Alperin alexander.alperin@gsapp.rutgers.edu Graduate School of Applied and Professional Psychology, Rutgers University, 152
Frelinghuysen Road, Piscataway, NJ 08854, USA.
Supplemental data for this article is available online at http://dx.doi.org/10.1080/2372966X.2021.1883996.
© 2021 National Association of School Psychologists
2 School Psychology ReviewDOI: 10.1080/2372966X.2021.1883996
facets of their life. Specifically, middle school students with accordingly, it is important to focus on the quality of sup-
or at risk of DBDs are at an increased risk for future unem- port afforded in school settings. Reddy et al. (2020) suggest
ployment, mental health difficulties, and diminished over- that providing school practitioners such as paraprofession-
all well-being (Erickson & Gresham, 2019; Schwartz et al., als with comprehensive professional development can lead
2018). Academically, students exhibiting disruptive behav- to improved practices. Guidance from legislation (e.g.,
iors are more likely than any other group of students to Every Student Succeeds Act [ESSA]; Civic Impulse, 2016)
experience poor achievement (Bradley et al., 2008; Wagner outlines the importance of school practitioners’ profes-
& Davis, 2006). Socially, this population has difficulty sional development for maximizing student outcomes.
building and maintaining relationships with peers, sib- To help ensure that practices with the greatest potential
lings, parents, and teachers (Baker, 2005; Malecki & Elliot, for addressing the needs of middle school students with or
2002; Walker et al., 2004). at risk of DBDs are utilized, it is imperative that schools
Students’ disruptive behavior also impacts teacher well- implement functionally indicated research-based behavior
being and burnout, as well as the learning environment interventions. Research-based behavior interventions can
for other students in the classroom. In a national survey be implemented by a wide range of school practitioners,
of teachers, 39% reported that students’ disruptive and including school psychologists, teachers, and paraprofes-
aggressive behavior was one of the primary reasons for sionals, and can have a far-reaching impact (Alperin et al.,
resigning from their teaching positions (Bettini et al., 2020). Such interventions are especially critical in middle
2020; United States Department of Education, Institute for school given that teachers at this level are responsible for
Education Sciences, 2010). The risk of teacher burnout is the needs of multiple classes of students (e.g., five to six
increased by emotional exhaustion and low self-esteem classes, more than 100 students; Evans et al., 2005; Peterson
and self-efficacy (Garwood et al., 2018), which are exac- et al., 2009 ) and as a result, have less opportunities to inter-
erbated by classroom disruptive behaviors. Recent esti- vene with individual students than in elementary grades.
mates suggest that two and a half hours of classroom Given the unique academic and social demands in mid-
instruction are lost each week due to disruptive behaviors, dle school, it is important for school practitioners to be
which adds up to three weeks of instructional time over mindful of selecting environmentally and functionally
the course of a school year (Education Advisory Board, appropriate research-based behavior interventions. In
2019). Moreover, greater levels of student disruptive selecting interventions, it is important for school practi-
behaviors are related to lower levels of teachers’ self-effi- tioners to consider the function of disruptive behaviors
cacy (Zee et al., 2017), and lower levels of teacher self-ef- (e.g., attention-seeking or escaping work demands; Alperin
ficacy are predictive of emotional exhaustion (Dicke et al., et al., 2020; Cook et al., 2014), whether disruptive behaviors
2014). Similarly, difficulties in managing classroom behav- are pervasive within a class or confined to an individual or
iors contribute to teachers’ diminished confidence, self- small group of students, and whether students require
esteem, and self-efficacy, which negatively impact training in new skills or maintenance of existing compe-
teacher–student interactions, student outcomes, teacher tencies (Ramsey et al., 2017; Reinke et al., 2014).
burnout, and retention (Aloe et al., 2014; Dicke et al., In addition to selecting interventions based on their
2014). To address these negative outcomes, researchers contextual appropriateness, it is also important to consider
have asserted that teachers need effective classroom behav- the quality of evidence supporting their efficacy and
ior management training and supports (Bettini et al., 2020; whether multiple methodologically sound, experimental
Reddy et al., 2020). investigations of their implementation have demonstrated
Despite these consequences, many middle school stu- positive outcomes (Cook et al., 2015). Recommendations
dents with disruptive behaviors often do not receive for the use of interventions with strong empirical support
behavioral health services (e.g., Conroy & Brown, 2004; are highlighted in guidelines from federal initiatives (e.g.,
Epstein et al., 2015; Furlong & McGilloway, 2015; Murray ESSA; Civic Impulse 2016; Individuals with Disabilities
et al., 2014). Factors interfering with the receipt of care Education Act [IDEA], 2004; No Child Left Behind
include lack of problem recognition, provider inaccessi- [NCLB], 2002). Overall, it is important for school practi-
bility, and negative parent and youth attitudes toward tioners to be aware of the extent to which certain interven-
mental health (e.g., stigma; Chandra & Minkovitz, 2006; tions are substantiated by investigations with rigorous
Erath et al., 2009). For students who do receive behavioral research methodologies (Maggin et al., 2015). Several
health services, Langer et al. (2015) report that 70–80% frameworks have been developed for determining the
receive services through the school system. Emerging empirical rigor of intervention research, including the
research suggests that schools can be successful in reme- Council for Exceptional Children’s (CEC, 2014) 28 quality
diating some of these challenges (Kern et al., 2017) and indicators (QIs).
School-Based Interventions for Middle School Students 3
To ensure that school practitioners meet the complex or meta-analyses evaluated the literature on drug preven-
and changing needs of students in middle school contexts, tion (i.e., Flynn et al., 2015; Lize et al., 2017), obesity pre-
a comprehensive quality and quantity appraisal of school- vention (i.e., Stevens, 2010), and strategies to enhance
based intervention research for this population is needed. parent involvement (i.e., Hill & Tyson, 2009). Furthermore,
Interventions that effectively ameliorate student disruptive the vast majority of these reviews did not utilize a system-
behavior in middle school settings likely have different atic framework for evaluating the empirical rigor of the
critical elements (e.g., greater emphasis on peer context) included studies (e.g., CEC, 2014). Overall, a synthesis of
than those designed for use with elementary or high school interventions and supports specifically for middle school
students. To date, no systematic reviews or meta-analyses students with disruptive behaviors is missing in the exist-
have critically analyzed school-based behavior interven- ing literature.
tions and supports for middle school students with dis- To address this gap, the present article systematically
ruptive behaviors. The existing reviews and meta-analysis reviews the school-based literature on behavior interventions
of school-based interventions have mainly examined: (a) and supports implemented with middle school students
interventions (i.e., peer assisted learning interventions) (grades 6 to 8) exhibiting disruptive behaviors. This article
for specific grade levels which do not include middle serves as the first review focused on behavior intervention
school (e.g., elementary school students; Ginsburg-Block research for middle school settings (grades 6 to 8). To this
et al., 2006; Rohrbeck et al., 2003); or (b) interventions end, we critically evaluate the extant literature based on: (a)
(e.g., behavior contracts, coaching for specific behavior sample characteristics, (b) intervention components, (c)
praise, group contingency, guided notes, opportunities to research methodologies, and (d) outcomes reported. This
respond, response cards, social skills) for a broad age range analysis approach (i.e., quality and quantity appraisal of rel-
(i.e., K–12) without disaggregating results for middle evant literature) informs school practitioners and scholars
school students (e.g., Bowman-Perrott et al., 2015; Ennis about the extent to which research supports the use of inter-
et al., 2020; Konrad et al., 2009; MacSuga-Gage & ventions designed for specific contexts (e.g., for various
Simonsen, 2015; Maggin et al., 2012; McKenna et al., 2016; behavioral functions, group sizes) with middle school stu-
Owiny et al., 2018; Randolph, 2007). dents, a population that has been commonly overlooked.
The aforementioned reviews were singularly focused Thus, this systematic synthesis and evaluation of the behavior
on specific types of interventions (e.g., behavior contracts). intervention literature for the middle school population offers
No reviews have focused on multiple intervention types targeted directions for research and practice.
used exclusively with middle school students. Notably,
although critical reviews by Evans et al. (2014, 2018),
Pelham et al. (1998), and Pelham and Fabiano (2008) of METHOD
psychosocial treatments for students with ADHD included Literature Search and Selection Criteria
studies with middle school students, they did not disag-
gregate findings for this population. Similarly, Lane et al.’s A comprehensive search was conducted in May of 2020 to
(2009) systematic review for function-based interventions ensure a thorough review of the research literature evalu-
for students with emotional and/or behavioral disorders ating outcomes of behavior interventions used in the mid-
synthesized research across both middle and high school dle school population. Articles were selected for inclusion
settings. Further, although Simonsen et al. (2008) reviewed if they adhered to the following criteria: (a) published
the intervention research on evidence-based classroom peer-reviewed articles and/or dissertations written in
management practices and Thompson (2011) conducted English1; (b) empirical analysis of original data (e.g.,
a systematic review on evidence-based interventions for reviews and meta-analyses were not included); (c) inves-
students with challenging behaviors, neither of these tigations that examined the efficacy or effectiveness of a
reviews disaggregated findings specifically for the middle behavior intervention to reduce classroom disruptive
school context. School practitioners need to consider the behavior (i.e., behavior that results in an office discipline
sample characteristics of the supporting research to choose referral or is considered off-task, inappropriate physical,
interventions that best meet their students’ needs. inappropriate verbal, and/or noncompliant; Alperin et al.,
Understanding which interventions are appropriate for 2020; Irvin et al., 2004; Simonsen et al., 2011); (d) inclusion
middle school students given their unique needs is crucial. of primarily middle school (50% or more; 6th through 8th
There are a handful of reviews and meta-analyses spe- grade) samples; and (e) published between 2000 and pres-
cific to middle school, but these studies did not examine ent. Exclusion criteria removed studies published before
the evidence for interventions that aim to reduce disrup- 2000 as well as commentaries, theoretical papers, reviews,
tive behavior in the classroom. Rather, these reviews and/ and meta-analyses. Legislation such as the response to
intervention (RTI) provision of the 2004 Individuals with criteria. If not enough information was provided in the
Disabilities Education Act (IDEA, 2004), has led to a shift abstract (i.e., it was unclear whether disruptive behavior
in the classroom environment and an uptick in the imple- was targeted by the intervention, whether the study was a
mentation of research-based interventions in schools primary source for the data analysis, or who was included
during the early 2000s (Thompson, 2011). Thus, our in the sample), the study was retained for further analysis.
review focused on studies from 2000 and beyond to com- Using the relevant studies, the first author conducted an
pile behavior interventions that are relatively consistent ancestral search using conceptual papers and reviews from
with the current middle school classroom setting. In addi- relevant databases and journals to identify additional cita-
tion, we excluded investigations evaluating interventions tions that may meet inclusion criteria. The review process
for students with bullying or victim concerns, intellectual resulted in a total of 71 studies.
disabilities, autism spectrum disorders, bipolar disorder, The complete manuscript for all 71 studies were
or severe medical conditions (e.g., cerebral palsy) given obtained and systematically screened to ensure inclusion
differences in the origin of the disorder and the need for criteria were met. Studies that required additional review
more unique and comprehensive interventions. were evaluated on the inclusion criteria by multiple coders
First, Quicksearch2 (which includes hundreds of data- for consensus. Each of the 71 studies were examined for
bases such as Education Resources Information Center citations that would further expand the included literature.
[ERIC], National Social Science Database [NSSD], Citations that matched the needs of the present review
ProQuest, PsycArticles, and Web of Science) and Google were located and evaluated based on the inclusion criteria.
Scholar databases were filtered to include results from the A total of 51 investigations met our inclusion criteria and
years 2000 to present and searched with the following key were subsequently coded.
terms: strategies, interventions, behavior interventions,
disruptive behaviors, externalizing behaviors, problem
Structured Review Coding Procedure
behaviors, middle school, and adolescent.3 Once this
search identified a possible intervention, it would then be A systematic coding procedure used in prior intervention
entered into the databases along with the term “middle research for children and adolescents (e.g., Reddy et al.,
school” and/or “adolescent” (e.g., “response cards middle 2018; please see Supplemental Figure 1) was adopted to
school”). To guard against publication bias, both published review the literature on four dimensions (50 variables): (a)
and unpublished studies were included in our search. sample characteristics, (b) intervention components, (c)
Second, the Clearinghouse for Military Family Readiness research methodologies, and (d) outcomes reported. The
Continuum of Evidence database was searched using the dimensions and specific variables coded in this review
filtering function (i.e., the topic “Behavioral Problems”, the were informed by previous meta-analytic reviews of
target population “Adolescents” and “Middle Childhood”, school-based interventions for students with emotional
and the sector “School-based”). Similarly, The What and behavior disorders (e.g., Reddy et al., 2009). Variables
Works Clearinghouse database was also searched/filtered were coded through either indicating (a) Yes or No (e.g.,
by specifying the topic as “Behavior Interventions” and “Was intervention implementation fidelity assessed?”), or
the grades as sixth through eighth. Third, a review (filtered (b) providing descriptive information (e.g., “What was the
to show results from 2000 to present) of pertinent journals4 name of intervention?”; please see Supplemental Figure 1
that publish research on behavioral interventions used for more detail).
with students was conducted to ensure a comprehensive For the first dimension, sample characteristics, 20 vari-
search (i.e., Journal of Positive Behavior Interventions, ables were coded. These included student characteristics,
Psychology in the Schools, School Psychology Quarterly, specifically overall sample size, middle school sample size,
School Psychology Review, Journal of Educational mean age, gender, ethnicity, inclusion and exclusion cri-
Psychology, Behavioral Disorders, and Journal of Emotional teria, special education classification, Diagnostic and
and Behavioral Disorders). Statistical Manual of Mental Disorders (5th ed.; DSM-5;
Fourth, after the search was completed, the resulting American Psychiatric Association, 2013) diagnosis, crite-
investigation titles were screened for relevancy. Titles not ria or procedures used to diagnose students, comorbidity,
pertinent to this review were discarded (e.g., having to do other relevant factors (e.g., medical), and school-based
with national security, finances, entrepreneurship, etc.). services. Characteristics of the intervention implementer
Figure 1 presents a summary of the search that yielded a were also coded (i.e., number of implementers, term used
total of 1,450 published and 8 unpublished (i.e., disserta- to describe implementer, gender, age, ethnicity, education
tions) unique studies. Fifth, relevancy was further evalu- level, years of experience, and experience with specific
ated through a review of 1,458 abstracts using inclusion disabilities).
Figure 1. Flowchart of the Literature Review Process
The intervention components dimension included 14 (i.e., in-person or video representation of intervention
variables. First, the intervention implementation process implementation was provided to implementers), (g) role
was coded, which consisted of detailing the name of the playing (i.e., implementers practiced intervention with
intervention, function of the intervention (i.e., class- other adults), (h) lecture (i.e., there was a didactic com-
room, acquisition, attention, and escape), dosage (ses- ponent in the training), (i) test performance (i.e., imple-
sions and duration), parent involvement, use of manual, menter had to achieve a certain score, such as 90%, on a
fidelity, progress monitoring, and social validity. Second, test in order to complete the training), (j) feedback (i.e.,
the components of professional development (PD) deliv- implementers were given feedback/directions on how to
ered to intervention implementers, were coded. This improve knowledge and/or skills following implemen-
included whether training was given to implementers, tation), (k) self-monitoring (i.e., implementers tracked
focus of the training (e.g., behavior interventions, knowl- aspects of their own performance or behavior in regards
edge), trainer information, duration of training, and to implementation of intervention), and (l) follow-up
information on training elements. Information on imple- (i.e., implementer intervention practices were monitored
menter training elements were coded such as: (a) ratio- after training).
nale (i.e., the importance for training and/or selected The third dimension, research methodology, included
intervention was provided to implementers), (b) descrip- 14 variables consisting of research design, use of a control
tion (i.e., training and/or intervention was explained to group, treatment alternative group, random assignment,
the implementers), (c) intervention script (i.e., explicit attrition, data collection (measures, method, stages, and
directions were provided to implementers for what they source), interrater reliability, descriptive statistics, statis-
should say to students when implementing an interven- tical tests and techniques, and clinical significance tests
tion), (d) fidelity checklist (i.e., printed list of interven- (use and type of test). Two variables, outcomes (i.e., adult,
tion steps were shared with implementers), (e) training students) and type of outcomes (i.e., skills, knowledge, or
materials (i.e., training resources, such as PowerPoint behavior), were coded on the fourth dimension, outcomes
slides, were shared with implementers), (f) modeling reported.
Coder Training and Reliability reported intervention mean from the baseline mean and
dividing the result by the pooled baseline standard devi-
A total of 11 coders reviewed the resulting 51 investiga-
ation (where provided; Thompson, 2011). When the
tions meeting study criteria. Ten of the coders were
means and standard deviations were not provided in an
advanced school psychology doctoral students, and one
article, the study author was contacted to provide the miss-
coder was full-time research staff member with over 20
ing information. This approach was consistent with
years’ experience as a behavioral consultant in schools.
Thompson’s review (2011). For randomized controlled
The lead author trained and supervised coders on the
trial experimental research designs, the effect size was cal-
coding system via several methods. First, coders were
culated using Hedges g, which is a bias corrected standard-
trained on the structured coding system and coding was
ized mean difference (i.e., comparing treatment and
modeled by the trainer (approximately 2 hours). Second,
control groups at posttest; Bonvanie et al., 2017). Cohen’s
coders independently practiced coding two studies and
(1988) d-ratios and Hedges g (i.e., effect sizes of .20 to .49
were provided feedback on their codes compared to a
were small; .50 to .79 medium; and .80 and greater were
master coding sheet. Third, coding practice continued
large) were used for interpretation.
until coders reached the criteria of 90% accuracy. Once
accuracy was obtained, coders independently reviewed
studies. Two coders reviewed each study. A coding to RESULTS
mastery approach was used to evaluate coder accuracy
Sample Characteristics
and reliability. The lead author separately reviewed and
coded all studies, the results of which were used as the Student Information
criterion. The accuracy of a second coder for each article A total of 6,498 students were included in 50 reviewed
reviewed was then compared against the master-coder articles (Hunter & Haydon, 2019 did not report the num-
criterion. The lead author discussed differences in coding, ber of students; see Tables 1 and 2). Middle school students
and established agreement on coding of the studies. comprised the entire sample in 47 of the 51 studies (92%).
Overall, percent of coder agreement was 99% (SD = Gender was reported in 82% (42/51 studies) of the inves-
1.06%; range of agreement per study was 96% to 100%; tigations with 2,756 male students and 1,969 female stu-
please see Supplemental Tables 1 and 2).5 dents. Of the 34 studies (67%) that reported race and/or
ethnicity, 16 studies contained primarily White samples,
eight studies had mostly Black participants, and seven
Quality Appraisal
studies were comprised predominantly of Hispanic par-
A total of 43 studies met criteria for and were reviewed ticipants. Inclusion and exclusion criteria for the student
using the CEC (2014) QIs. The remaining eight articles sample was reported in 35 out of 51 (69%) studies. Special
could not be coded for quality because they consisted of education classification for participants was included in
baseline intervention research designs without a compar- 14 articles (27%), with seven studies and three studies
ison group, which is not considered sufficient for making reporting that a majority of their sample had a classifica-
causal inferences about efficacy, according to CEC (2014) tion of Emotionally Disturbed (ED) and Other Health
guidelines. Of the 43 investigations, a total of 28 QIs (i.e., Impaired (OHI) for ADHD, respectively. Each of the 11
22 apply to single-subject designs and 24 apply for group studies (22%) that reported DSM information on partici-
comparison designs) addressed the following areas: (a) pants also reported that a majority of their participants
Context and Setting; (b) Participants; (c) Intervention had a diagnosis of ADHD. Comorbid diagnoses were
Agents; (d) Description of Practice; (e) Implementation reported in six studies (12%). Approximately 55% of the
Fidelity; (f) Internal Validity; (g) Outcome Measures/ studies (28/51 studies) reported information on educa-
Dependent Variables; and (h) Data Analysis. The CEC tional placement with general education classrooms used
(2014) defined methodologically sound studies as meeting in the majority of the studies (14/28 studies, 50%).
all QIs across 8 areas. Each of the 43 studies were coded
for all 28 QIs (i.e., Yes, No, or N/A) by authors.
Approximately 30% of the studies were double coded to Intervention Implementer Data
ensure consistency. Consensus coding was used to address A total of 41 of the 51 studies (80%) provided information
discrepancies. on the implementers of the intervention. Of these studies,
To quantify the intervention’s impact on student dis- 23 reported that the classroom teacher served as the pri-
ruptive classroom behavior, effect sizes were used. If effect mary implementer of interventions. In total, there were
sizes were not provided in a single-subject investigation, 264 implementers. Implementers were primarily female
they were calculated (if possible) by subtracting the (77 females, 60 males) and gender was reported in 45%
Table 1. Empirical Studies of Classroom-Wide Behavior Intervention Studies

Author(s) Intervention Participant Sample Classroom Research Design Student Outcomes Adult Outcomes
Name Number and Type Setting
Class-Wide Intervention Strategies
Kartub et al. Positive Behavior 525 students Not reported Pre and post study Hallway noise decreased Not reported
(2000) Support: Hallway design; no postintervention and at
Noise comparison group follow-up.
Mitchem et al. Class-wide 97 students; 10 students General Single-subject Improved on-task bx Not reported
(2001)*** Peer-Assisted at risk for DBDs; 1 education research compliance, and social skills for
Self- teacher language arts design: multiple all students in 3 classes and 10
Management classroom baseline target at-risk students. Social
competence ratings increased,
while antisocial behavior ratings
decreased.
Oswald et al. PBS: Hallway 950 students; 60 middle Not reported Pre and post; no Increased hallway transition bx Not reported
(2005) Noise school staff comparison group (i.e., decreases in run, jump,
curse, kick, push, and/or
scream).
Kamps et al. Class-wide Peer 975 students; 25 Not reported Quasi-experimental Increased active student Not reported
(2008)* Tutoring teachers interrupted time behaviors (i.e., reading, writing,
series design; in answering questions); decreases
conjunction with the were noted in disruptive
single-subject behavior. Addition of
reversal design motivational component (i.e.,
lottery system) was more
effective than when
intervention implemented
independently.
Conklin (2010) CW-FIT 80 students (38 were in Not reported Single-subject ABAB Increased student adaptive Increase in
Dissertation** middle school); 3 reversal and multiple behaviors (i.e., compliance, hand teacher adaptive
teachers (1 middle baseline raising, and on-task behavior). behavior (i.e.,
school) specific praise).
Beeks and Mystery 26 students; 1 general General Single-subject; AB Decreased talking, out-of-seat, Not reported
Graves Motivator education teacher education changing criterion and hitting peer behaviors.
(2016) science
classroom
Dart et al. Classroom 41 students; 3 general General Single-subject; Increased on-task behaviors and Not reported
(2016)*** Password education teachers education concurrent multiple decrease of disruptive
baseline behaviors.
Harvey (2018) Good Behavior 4 students with Alternative Single-subject; Decreased inappropriate Not reported
Thesis** Game (GBG) emotional disturbance; school for ABCAC reversal behaviors; increase in
1 teacher, 1 students with appropriate behaviors.
paraprofessional, and 4 disruptive
behavior behaviors
interventionists
Chaffee et al. Tootling 41 students with General Single-subject: Decreased class-wide Not reported
(2020)*** disruptive behaviors; 2 education A-B-A-B-C reversal disruptive behavior and
general education design w/ increase in class-wide
teachers maintenance phase academic engagement.
Wills et al. CW-FIT 6 students; 3 general General Single-subject; ABAB On-task behavior varied across Two of the three
(2019)*** education teachers education withdrawal classrooms; the average teachers increased
improvement was greater than praise statements
20%. and decreased
reprimands.
Monson et al. CW-FIT 56 students; 2 students General Single-subject; ABAB Increased classroom on-task Increased teacher
(2020)** at risk in at least one of education art reversal behavior; 1 target student praise.
the School Social classrooms increased his on-task behavior.
Behavior Scales, Second
Edition (SSBS-2); 2 art
teachers
Speight et al. CW-FIT 35 students with low 1 general Single-subject; Immediacy and strength of Increased levels of
(2020)*** rates of on task education, 2 multiple baseline change in student on-task praise; decrease of
behavior; 3 general inclusion across conditions behavior was evident in all reprimands in two of
education teachers; 2 classrooms classrooms. the three
special education classrooms.
teachers
Note. N = 12 classroom wide behavior intervention studies targeting middle school students with or at risk of DBDs. Articles denoted with
***
received 100%; **80–99%; *>80%; based on the CEC QI. Italicized articles did not require CEC QI scores due to study designs.
Table 2. Empirical Studies of Small Group or Individual Behavior Intervention Studies

Author(s) Intervention Name Participant Sample Classroom Research Design Student Outcomes Staff and Parent
Number and Type Setting Outcomes/Validity
Acquisition Intervention Strategies
Gonzales et al. Bridges to High 22 students; 30 family Not reported Pre/post study Increased use of coping Improved parenting
(2004) School Program members; 1 marriage/ design, no strategies; decreased depressive practices; parents
family therapist, 2 controls symptoms and disruptive bx; reported improved
bachelors level case students reported using learned discipline and
workers, and 3 clinical skills at follow up interview (12 relationship with their
psychology doctoral months post). child at follow up
students interview (12 months
post).
Gureasko-Moore Self-Management 6 students with ADHD; 1 General Single-subject: Increased class prep skills (i.e., in Not reported
(2004) researcher education two multiple- seat, on-task, materials ready)
Dissertation** baseline and homework bx.
designs
Hansen and 1. Social skills 9 students w/emotional Self-contained Single-subject Increased number of positive Not reported
Lignugaris-Kraft instruction disturbance (5 middle special research design: statements students emitted
(2005)* 2. Dependent group school); 1 special education withdrawal to peers; decreased rate of
contingency education teacher; 1 classroom negative statements emitted
special education to the same peers (only
paraprofessional when group contingency
intervention was
implemented with
students).
Gureasko-Moore Self-Management 3 students with ADHD; 1 Not reported Single-subject Improved class preparation bx Not reported
et al. (2006)** researcher multiple baseline (i.e., in seat, on-task, materials
across ready, homework complete/ on
participants time).
Evans et al. Challenging Horizon 79 students with ADHD; Not reported RCT Increased social functioning Not reported
(2007)** Program – after attrition, 29 and decreased inattention.
consultation model treatment; 24 control
Langberg et al. Challenging 48 students who scored Not reported RCT Improved academic progress, Not reported
(2007)** Horizons Program- “below basic” on a self-esteem, and overall
after school version standardized test; severity of problem bx.
(21 tx, 27 control);
undergraduate
student implementers
(total n not reported).
Molina et al. Challenging 23 students with ADHD Not reported RCT Improved functioning Not reported
(2008)** Horizons Program- (12 tx; 11 control); 8 (internalizing symptoms and
after school version undergraduate student self-esteem); treatment
implementers prevented the deterioration in
functioning seen in the
comparison group.
Peterson et al. Coping Power 119 high-risk students Not reported RCT Improved adaptive skills across Not reported
(2009)* Program (107 middle school; 63 groups
treatment; 56 control); 9 Tx group: decrease in
program facilitators, 2 depressive symptoms, learning
clinical psychologists; 7 difficulties and school
masters-level graduate problems; increased positive
assistants social skills and functional
communication; more positive
bx (children participating in
groups of more experienced
leaders).
Lochman et al. Fast Track 891 students exhibiting Not reported RCT Grade 7 students decreased Not reported
(2010)** disruptive behaviors hyperactive problems
(445 tx; 446 control); behaviors and lower rates of
implementers not self-reported delinquency; little
reported overall impact on student
functioning in disruptive bx
problems, peer deviance,
and social skills.
Thompson and STAR intervention 10 students with Alternative Single-subject: AB Improved student/ teacher Not reported
Webber (2010) emotional disturbance; setting design relations; increased student
4 special education time dedicated to academic
teachers, 1 social work; fewer student bx
worker problems; reduction in
teacher-generated office
referrals.
(Continued)
Table 2. Continued
Briere and Self-Monitoring 2 students with high Not reported Single-subject: Decreased off-task bx for Not reported
Simonsen Intervention levels of off-task reversal functionally relevant bx vs.
(2011)** behavior; 1 researcher nonrelevant bx.
Gonzales et al. Bridges to High 516 students (338 Tx; Not reported RCT Positive effects at 1-year Improvements in
(2012)** School Program 178 control); posttest; improved coping parenting practices
implementers/staff not efficacy, academic
reported engagement, family cohesion,
and GPA; reduced externalizing
and internalizing symptoms,
substance use, and disciplinary
actions; majority of effects were
moderated by language
(Spanish versus English
speaking).
Evans et al. Challenging 326 students with Not reported RCT CHP-AS group showed Not reported
(2016)** Horizons Program- ADHD (112 CHP-AS improved organization,
after school version group; 110 CHP-M time-management skills,
group, 104 control); homework, and ADHD
number of symptoms of inattention
implementers (maintained into next school
(undergraduate year), and small GPA
students) not improvements.
reported.
Floyd (2016) Self-Monitoring 3 students with learning Inclusion Single-subject: Improved on-task and Not reported
Dissertation** Intervention disabilities; 1 researcher classroom ABAB withdrawal compliance bx; students
learned to accurately
self-monitor when cued.
Smith et al. I Control 152 (83 Tx; 69 control) Self-contained RCT Tx group students were better Not reported
(2017)** students w/ emotional able to initiate tasks and
and/or behavioral reported better emotional
challenges; 17 special control.
education teachers.
Strait et al. Student Check Up 88 students; 41 General RCT Tx group self-reported higher Not reported
(2017)** treatment; 46 control; 11 education self-efficacy and effort
undergraduate self-efficacy; higher ratings of
psychology student importance of in-class
implementers participation.
Martin (2018) Self-Regulation 27 students; 14 Not reported RCT (mixed Increased mastery goal Not reported
Dissertation** instruction treatment; 13 control; 1 method) orientation and greater
researcher reduction in disciplinary
referrals related to avoidance
behaviors.
Muratori et al. Coping Power 839 students (497 Tx; Not reported RCT Reduced internalizing Not reported
(2020)** Universal for middle 542 control); 20 teachers problems; improved prosocial
school students in Tx; control not bx (home and school). Parents of
reported Tx group reported small
improvement in externalizing
problems.
Attention Seeking/Reinforcement Intervention Strategies
Jones et al. Positive Peer 3 students; 1 teacher Residential Single-subject: Increased use of prosocial bx Not reported
(2000)* Reporting (PPR) program for nonconcurrent with peers; increased
delinquency multiple baseline sociometric ratings.
March and Horner 1. Behavior 1. 24 students with 1. Not reported 1. Pre/ post study 1. 80% (4 of 5) students w/ Not reported
(2002)* Education Program disruptive behaviors; 3 2. General and design, no (adult) attention maintained bx
(BEP) special education special controls and 62.5% (5 of 8) w/ (peer)
2. Functional Based teachers, 1 school education 2. Single-subject: attention maintained bx
Support psychologist, 1 school classrooms multiple baseline improved; 27% (3 of 11)
counselor, 1 educational across students w/ escape maintained
assistant participants bx improved.
2. 3 students; 5 teachers 2. Students with escape-
motivated bx reduced problem
bx and increased academic
engagement.
Hawken and Behavior Education 4 students with Not reported Single-subject: Reduced problem bx; increased Not reported
Horner (2003)** Program (BEP) disruptive behaviors; multiple baseline academic engagement.
staff not reported across subjects
Davis and O’Neill Response Cards 4 students with Resource Single-subject: Increased weekly quiz scores, Not reported
(2004)* disruptive behaviors; classroom; ABAB reversal rate and accuracy of academic
staff not reported writing class responding; varied effects on
off-task bx.
(Continued)
Table 2. Continued
Hawken (2006) Behavior Education 10 students with Not reported Pre/post study Decreased problem bx Not reported
Program (BEP) disruptive behaviors; design, no (reductions in office discipline
number of controls referrals).
implementers was not
reported
George (2010)** Response Cards 29 students with Emotional Single-subject: Increased on-task bx in Tx Not reported
emotional behavior support within subject (M = 93%) vs. control
disorders; 5 special classrooms crossover (M = 84%). Tx post-tests scores
education teachers (M = 75.82) greater than control
(M = 66.27). Tx students higher
average levels of academic
responding and more correct
academic.
Haydon and Opportunities to 2 students (1 with General Single-subject: Increased students’ time Decrease in teacher
Hunter (2011)** respond off-task behaviors); 1 education ABCBC on-task correct academic redirections;
general education classrooms responses, and test scores. increased praise
teacher statements,
increase in student
opportunities to
respond.
Simonsen et al. Behavior Education 42 students with Not reported RCT Decreased off-task bx. Not reported
(2011)** Program (BEP) disruptive behavior
(27 Tx; 15 control); 3
school counselors, 1
social worker, 1 school
psychologist, 2 vice
principals,3 graduate
student interns
Lane et al. (2012)* Behavior Education 4 students with General Single-subject: Increased students’ Not reported
Program (BEP) disruptive behaviors; 1 education single-subject performance to match
paraprofessional changing or exceed the established
criterion goals per intervention
phase (maintenance was
limited).
Maynard et al. Check and Connect 260 students (134 Tx; Not reported RCT (Randomized Improved student academic Not reported
(2014)** 126 control) block design) performance; significantly
fewer office disciplinary
referrals.
Turtura et al. Academic behavior 3 students with General Single-subject: Decreased off-task and Not reported
(2014)** check-in/check-out disruptive behaviors; 1 education ABAB reversal disruptive bx; increased
Paraprofessional classwork and homework
completion and correct
responses.
Simmons and Response Cards 5 students; 2 teachers Inclusion Single-subject: AB Increased student on task bx, Not reported
Smith (2015) classroom class participation and weekly
quiz and test scores.
Powers et al. Check and Connect 54 students (27 Tx; 27 Not reported RCT Positive impact on school Not reported
(2017)*** control); 27 mentors attendance; no improvement
(graduate students) in grades/ disciplinary
referrals.
Escape Intervention Strategies
Ervin et al. (2000)* Antecedent 3 students w/ADHD, General Single-subject: Decreased disruptive bx. Not reported
Modifications (ODD/emotional education alternating
disturbance); 3 teachers treatments
De Pry and Sugai 1. Active Supervision 26 students with General Single-subject: Decreased classroom bx Increased teacher
(2002)** 2. Precorrections disruptive behaviors; 1 education ABAB problems. use of active
3. Daily data review teacher supervision and/or
precorrection.
Kern et al. 1. Choice Making 6 students with severe University- Single-subject: Positive effects on student Not reported
(2002)** 2. Incorporation of emotional disturbances; affiliated ABAB engagement and
high-interest 2 teachers approved private disruptive bx.
activities school serving
students with
severe behavioral
challenges
Ramsey et al. Choice Making 5 students with Residential Single-subject: Increased on-task bx, task Not reported
(2010)*** diagnosis of emotional Setting ABAB withdrawal completion, and task accuracy;
and behavior disorders two of the three middle school
with a concomitant students exhibited higher
psychiatric disorder (2 percentages of time on task,
high school; 3 middle task completion, and task
school); 3 special accuracy.
education teachers
(Continued)
Table 2. Continued
Faul et al. (2012)** Precorrection 2 students with General Single-subject: Decreased off-task and Not reported
disruptive behaviors; 2 education alternating increased on-task bx.
general education treatments
teachers
Andreasen (2015) Noncontingent 4 students with 4 general Single-subject: Decreased disruptive bx (i.e., Not reported
Thesis Reinforcement disruptive behaviors; 4 education AB talking and out-of-seat).
general education classrooms
teachers
Ramsey et al. Choice Making 9 students with 2 classrooms; Single-subject: Increased task completion Not reported
(2017)* emotional and residential reversal and accuracy; reduced
behavior disorders; facility disruption.
1 teacher
Hunter and Classroom Number of students 3 classrooms Single-subject: AB Decreased student disruptive All 3 teachers
Haydon (2019) management not reported; 3 teachers with each bx. decreased teacher
package (i.e., that were identified by classroom redirections.
precorrection, active administrators due to including more
supervision, and an excessive number of than 30
explicit timing) student disruptions. students
Note. Articles denoted with ***received 100%; **80–99%; *> 80%; based on the CEC QI. Italicized articles did not require CEC QI scores due to study designs.
(23/51 studies) of the investigations. Nineteen studies training elements were coded for the professional devel-
specified the implementers’ education; 18 studies reported opment of implementers (see Tables 3 and 4 for details).
the implementers’ years of experience; 13 studies described
the implementers’ ethnicity; six studies stated the age of
the implementers; and three studies provided information Research Methodology
pertaining to the implementers’ classroom experience with Studies were coded for research design. Approximately
individuals with specific disabilities. 63% of the studies (32/51), employed a single-subject
research design, whereas fourteen studies (27%) utilized a
randomized controlled trial experimental research design.
Intervention Components Five studies (10%) had a one-group pretest–posttest
Approximately 78% (40/51) of the studies specified the research design, and one study (i.e., Kamps et al., 2008)
behavior function of the intervention that was used with used a quasi-experimental research design. Control groups
students. Sixteen studies detailed interventions that were were utilized in only 15 studies (29%). Attrition was
designed to address skill deficits; 10 studies used interven- reported in 16 studies overall (31%).
tions geared toward class-wide behavioral problems; eight
studies employed interventions to address attention seek- Data Collection
ing from peers and/or teachers; and six studies had inter- Baseline (pretest) and postintervention (posttest) data
ventions for escape motivated behaviors. Sixteen of the 51 were reported in all 51 studies, with nine studies (18%)
(32%) studies reported that behavior interventions collecting follow-up data. Outcome data were reported
included parent involvement (e.g., completing of behavior
education plans, daily report cards, homework behavior
checklist, parent meetings with school staff, parent train- Table 3. Intervention Characteristics
ings). Of these 16 studies, nine involved enhancing com- Intervention Characteristics Number of Studies
munication with parents regarding student academic and/ (N = 51)
Interventions
or behavioral progress, and seven studies included parent Specified function of behavior 40
behavior management training (see Table 3 for details). Included a home-based component 16
Thirty-one of the 51 studies (61%) reported providing Mainly communication with parent(s) 9
Parent trainings 7
professional development to the implementers of the inter- Used manual 22
vention. All but two of the 31 studies focused professional Assessed intervention implementation 42
Monitored student progress 40
development solely on the delivery of the intervention (i.e., Assessed social validity 30
the other two studies also aimed to enhance implementers Implementer Trainings
general knowledge). The professional development of Reported training implementers 31
Focus of training was solely implementation 29
implementers was facilitated by “intervention developers” of intervention
(Powers et al., 2017), researchers, and school psychologists. 6–9 training components 7
3–5 training components 16
The duration of professional development ranged from 1–2 training components 9
30 minutes to 45 hours. Across the 31 studies, 12 specific Assessed social validity 30
Table 4. Description of Professional Development (PD) Components

PD Component Description Number of Studies (n = 51)
Rationale The importance for training and/or selected intervention is provided. This often connects 9
objectives/goals with training/intervention.
Description Training and/or intervention is explained. 20
Intervention script Explicit directions are provided to implementers for what they should say to student(s) when 8
implementing an intervention.
Fidelity checklist Printed list of intervention steps is shared. 12
Training materials Training resources (e.g., PowerPoint slides) are shared. 21
Modeling In-person or video representation of intervention implementation is provided. 8
Role playing Implementers practiced intervention or strategies with other adults. 9
Feedback After implementation, implementers are given feedback/directions on how to improve 14
knowledge and/or skills.
Self-monitoring Implementer track aspects of their own performance or behavior. 2
Lecture There is a didactic component in the training. 11
Follow-up Implementer intervention practices are monitored after training. 15
Performance criterion Implementer had to achieve a score (e.g., 90%) on a test to start implementing intervention. 3
using observational assessments (36 studies, 71%), rating research designs, 29% (7/24) were single-subject research
scales (27 studies, 53%), students’ grades (11 studies, 22%), designs, 8% (2/24) used one-group pretest–posttest
and office discipline referral data (i.e., number of times a research designs, and 4% (1/24; i.e., Kamps et al., 2008)
student was referred to the school administrator for dis- employed a quasi-experimental research design.
ruptive behavior; 7 studies, 14%). For observational assess- Parametric tests were used to analyze outcome data in 20
ments, two studies (i.e., Chaffee et al., 2020; Dart et al., studies (39%; e.g., t-tests, multivariate analysis of variance,
2016) used the Behavioral Observation of Students in and general or hierarchical linear models). In regard to
Schools (BOSS; Shapiro, 2004), and one study (i.e., Kamps the research design of the 20 studies that analyzed outcome
et al.,2008) employed the Code for Instructional Structure data with parametric tests, 70% (14/20) were randomized
and Student Academic Response (CISSAR) ecobehavioral controlled trial experimental research designs; 15% (3/20)
computerized observation system (Greenwood et al., were single-subject research designs; 10% (2/20) employed
1994). The most frequently used rating scales were: Child one-group pretest–posttest research designs; and 5% (1/20;
Behavior Checklist (3 studies; CBCL; Achenbach, 1991), i.e., Kamps et al., 2008) used a quasi-experimental research
Behavior Assessment System for Children (3 studies; design. Six studies used nonparametric tests (12%, e.g.,
BASC; Reynolds & Kamphaus, 2004), Impairment Rating chi-square tests), with four studies (4/6, 67%) employing
Scale (3 studies; IRS; Fabiano et al., 2006), Social Skills single-subject research designs and two studies (2/6; 33%)
Rating System (3 studies; SSRS; Gresham & Elliot, 1990), utilizing randomized controlled trial experimental
and Social Skills Improvement System (2 studies; SSIS; research designs. The clinical significance of intervention
Gresham & Elliott, 2006). Four studies conducted func- changes was examined in 26 of the 51 studies (49%) via
tional behavioral analysis interviews using the Functional percent improvement or effect sizes (see Table 5). Of these
Assessment Checklist for Teachers and Staff (FACTS; 26 studies, 50% (13/26) were randomized controlled trial
March et al., 2000). experimental research designs, 42% (11/26) had sin-
Interrater reliability was collected in 33 studies gle-subject research designs; and 8% (2/26) utilized either
(65%). All 51 studies specified the source of outcome a one-group pretest–posttest research design (i.e., Oswald
data, with teacher (37 studies, 73%), student (25 studies, et al., 2005) or a quasi-experimental research design (i.e.,
49%), and parent raters (10 studies, 20%) serving as the Kamps et al., 2008).
most frequently used sources. Most of the investigations
(38/51, 75%) used multiple data sources (e.g., students
and parents, students and teachers) to inform out- Outcomes Reported
come data. Across the 51 investigations, outcomes were reported for
(a) students or (b) students and adults (e.g., parents and
Data Analysis teachers). Specifically, 42 studies (82%) reported outcomes
For data analysis, all studies used descriptive statistics to for students only and nine studies (18%) reported out-
describe findings in at least one outcome behavior mea- comes for both students and adults.
sure and approximately 47% (24/51) of the studies used Using at least one or more outcome measures, positive
statistical methods to analyze outcomes. Of the 24 studies findings were noted in all studies. Seven studies (14%)
that used statistical methods to analyze outcomes, 58% demonstrated improvements in teacher practices and skills
(14/24) were randomized controlled trial experimental in areas such as behavior management techniques and
Table 5. Effect Sizes Reported in Empirical Studies for Disruptive Behavior

Male CEC QIs
Author(s) Intervention na (%) Dependent Variable (Met/Total) ES Description
Class-Wide Intervention Strategies
Dart et al. (2016) Classroom Password 41 n/a On-task behavior; inappropriate 22/22 NAP = 0.64 to 0.99
physical and verbal behavior Weak to strong effect sizes
Conklin (2010) CW-FIT 38 100% Compliance; on-task behavior; 21/22 SMD ES = –3.86 to 4.66***
Dissertation inappropriate physical and
verbal behavior
Monson et al. (2020) CW-FIT 56 48% On-task behavior 20/22 *Cohen’s d = 1.24 to 2.41
Large effect sizes
Speight et al. (2020) CW-FIT 35 n/a On-task behavior 22/22 PND = 83% to 100%
Moderate to strong effect
Oswald et al. (2005) Hallway Noise 60 n/a Disruptive behavior n/a Partial eta-squared is 0.49
Large effect size
Beeks and Graves (2016) Mystery Motivator 26 38% Inappropriate physical and verbal 17/22 Cohen’s d = 1.47 to 3.33
behavior Large effect sizes
Mitchem et al. (2001) Peer-Assisted Self-Management 10 70% Antisocial behavior 22/22 SMD ES = –0.65 to −0.59***
Chaffee et al. (2020) Tootling 41 56% On-task behavior inappropriate 22/22 NAP = 0.63 to 0.96
physical and verbal behavior Tau-U = –1.04 to 0.92***
Weak to large effect sizes
Acquisition Intervention Strategies (Small Group/Individual)
Gonzales et al. (2012) Bridges to High School Program 338 49% School engagement; externalizing 21/24 ES = 0.32 to 3.49
symptoms; school disciplinary
actions
Evans et al. (2007) CHP – consultation model 53 77% Disruptive behavior 23/24 Cohen’s d = 0.27 to 0.65
Small to medium effect sizes
Evans et al. (2016) CHP – after school version 112 71% Disruptive behavior 23/24 *Hedges’ g = 0.05 to 0.48. No effects to
small effect sizes
Langberg et al. (2007) CHP – after school version 21 67% Impairment 21/24 Cohen’s d = 0.23 to 0.77
Small to medium effect sizes
Molina et al. (2008) CHP – after school version 11 74% Externalizing problems; conduct 21/24 Cohen’s d = 0.18. Small effect sizes
problems
Muratori et al. (2020) Coping Power Universal 839 49% Disruptive behavior 22/24 ES = 0.06 to 0.14
Peterson et al. (2009) Coping Power Program 63 61% Attention problems; hyperactivity; 19/24 Cohen’s d = 0.22 to 0.61. Small to
externalizing problems; school medium effect sizes
problems; behavior symptoms
Lochman et al. (2010) Fast Track 445 69% Disruptive behavior 22/24 Cohen’s d = 0.14 to 0.16. Small effect sizes
Martin (2018) Self-regulation instruction 13 63% Disruptive behavior 21/24 Hedges’ g = 0.44*. Small effect size
Briere and Simonsen Self-Monitoring Intervention 2 50% On-task behavior 19/22 Cohen’s d = 0.34 to 1.06**
(2011) Small to large effect sizes
Floyd (2016) Self-Monitoring Intervention 3 n/a On-task behavior 19/22 Cohen’s d = 1.79 to 3.59*
Dissertation Large effect sizes
Thompson and Webber STAR intervention 10 80% Office Disciplinary Referrals n/a Cohen’s d = 0.52 to 3.25
(2010) Medium to large effect sizes
Strait et al. (2017) Student Check Up 88 31%
Self-efficacy; Participation; 22/24 Cohen’s d = –0.23 to 0.45***. Small effect
Academic risk sizes
Smith et al. (2017) I Control 83 n/a Behavior regulation; Disruptive 21/24 ES = –0.41 to 0.55***
behavior; Social Skills
Attention Seeking/Reinforcement Intervention Strategies (Small Group/Individual)
March and Horner (2002) Behavior Education Program 24 83% Office disciplinary referrals 16/22 Cohen’s d = –0.95*, −0.28***, and 1.26b
(BEP) for functions of adult attention, peer
attention, and escape. Small and
large effective sizes.
George (2010) Response Cards 29 79% On-task behavior 20/22 Cohen’s d = 1.11*
Large effect size
Haydon and Hunter Opportunities to respond 1 100% On-task behavior 21/22 Cohen’s d = 15.65*
(2011) Large effect size
Simonsen et al. (2011) Behavior Education Program 42 76% On-task behavior; problem 22/24 ES = –0.90 to 0.65***
(BEP) behavior; social skills Small to large effect sizes
Lane et al. (2012) Behavior Education Program 4 100% Compliance 17/22 Cohen’s d = –0.18* to 1.47***. No effects
(BEP) to large effect sizes
Maynard et al. (2014) Check and Connect 189 44% Office Disciplinary Referrals 20/24 Cohen’s d = –0.27***
Small effect size
Powers et al. (2017) Check and Connect 45 67% Office Disciplinary Referrals 24/24 Hedges’ g = 0.10 to.52*c
Escape Intervention Strategies (Small Group/Individual)
Faul et al. (2012) Precorrection 2 100% Disruptive behavior 19/22 Cohen’s d = –2.35** to−1.86***.
Large effect sizes
Hunter and Haydon Precorrection, Active supervision, n/ad n/a Disruptive behavior n/a Cohen’s d = –16.27* to
(2019) Explicit timing −3.37***. Large effect sizes
Note. Authors indicates randomized controlled trial (n = 14).
*
Indicates that means and standard deviation was extracted from study to calculate effect sizes. **Indicates that authors were contacted and provided means and standard
deviation in communication to calculate effect sizes. ***Negative effects indicate desired direction (e.g., reduction of negative behaviors).
a
The n listed is what the articles used to calculate effect size. bFor students with escape motivated disruptive behavior, their rates of ODR increased following BEP intervention.
c
Please note that Powers et al. (2017) effect sizes is for the control group having fewer ODRs than the treatment group. d3 classrooms.
instructional support skills. Two studies (4%) indicated research design. Only Speight et al. (2020) and Wills et al.
improvements in positive parenting practices (e.g., paren- (2019) corresponded to the same intervention (i.e.,
tal monitoring, consistent discipline; i.e., Gonzales et al., CW-FIT). Each of the other five studies corresponded to
2004; Gonzales et al. 2012). different interventions. Thus, other than CW-FIT, no
Seventeen studies (33%) broadly described improve- intervention was supported by more than one method-
ments in student disruptive behavior without clarifying a ologically sound study. On average, the 14 randomized
specific focus (i.e., problem behavior, disruptive behavior, controlled trial experimental research design studies met
appropriate behavior, conduct problems, functioning, and 90% of the 24 QIs and the 29 single-subject design studies
externalizing). Twenty-nine studies (57%) demonstrated met 86% of the 22 QIs.
improvements in student on-task behavior; 13 studies Results varied across the QIs. All 43 studies (100%)
(25%) found improvements in student academic perfor- provided adequate information regarding the critical fea-
mance; six studies (12%) indicated that students’ social tures of the context or setting (“Context and Setting”) and
skills had improved; five studies (10%) yielded positive described the critical features of the practice or interven-
results in students’ self-regulation; four studies (8%) tion (“Description of Practice”). Approximately 91% of the
showed improvements in students’ cooperation or com- studies (39 total studies, including 25 out of 29 single-sub-
pliance; and two studies (4%) described improvements in ject design studies and 14 out of 14 randomized controlled
student coping skills. Five studies (10%) showed decreases trial experimental research designs) analyzed data appro-
in student office disciplinary referrals; four studies (8%) priately and reported information on effect sizes (“Data
demonstrated decreases in student inappropriate verbal Analysis”). Thirty-four of the 43 studies (79%) assessed
behavior; four studies (8%) indicated students had fewer and reported fidelity of implementation (“Implementation
internalizing problems; and two studies (4%) found Fidelity”). Twenty-seven of the 43 studies (63%) described
decreases in students’ inappropriate physical behavior. the critical features of the intervention agent (“Intervention
One study (i.e., Powers et al., 2017) found that students in Agent”). Approximately 63% of the studies (27 studies; 19
the treatment group had significantly better eighth-grade out of 29 single-subject design studies and 8 out of 14
attendance than controls, while another study (i.e., randomized controlled trial experimental research
Gonzales et al., 2012) described improvements in family designs) used psychometrically sound outcome measures
cohesion. Overall, the range in the magnitude of the effects to gauge intervention effect (“Outcome Measures/
(after removing the negative sign for desired reductions Dependent Variables”). Approximately 60% (26/43) of the
in negative behaviors) were −0.23 to 16.276 (see Table 5). studies provided sufficient information regarding the pop-
For studies utilizing an RCT design, effect sizes ranged ulation of participants (i.e., participant demographics,
from −0.23 to 3.49. For the three primary dependent vari- disability, risk status, and method for determining status;
ables, effect sizes ranged from 0.05 to 16.277 for disruptive “Participants”) and demonstrated adequate internal valid-
behavior, 0.34 to 15.658 for on-task behavior, and 0.07 to ity (“Internal Validity”).
4.76 for academic performance. For the studies that pro-
vided professional development to the implementers of
the intervention, effect sizes ranged from −0.23 to 15.65.9 DISCUSSION
Effect sizes for investigations that provided at least six
training components (see Table 4) ranged from −0.23 to Results of the present study highlight the strengths and
2.41. In regard to studies that had teachers serve as imple- weaknesses of the existing school-based outcome literature
menters, effect sizes ranged from 0.06 to 16.27.10 for behavior interventions used with middle school stu-
dents (grades 6 to 8) with or at risk of DBDs. To date, no
systematic reviews or meta-analyses of behavior interven-
tion outcome data for this school population exist. Given
Quality Appraisal
the developmental and environmental changes for stu-
Of the 43 studies (29 single-subject and 14 randomized dents in middle school (e.g., Muratori et al., 2020; Powers
controlled trial experimental research designs) that were et al., 2017), efficacious interventions may differ from
reviewed using the CEC QIs, seven studies (16%) met all those used at the elementary or high school level. Serving
28 QIs and are considered methodologically sound. Of as the first systematic review of middle school behavior
these seven studies, six were considered single-subject intervention research, this article provides readers a range
research designs (i.e., Chaffee et al., 2020; Dart et al., 2016; of research-based behavior interventions and supports
Mitchem et al., 2001; Ramsey et al., 2010; Speight et al., implemented with middle school students with disruptive
2020; Wills et al., 2019) and one study (i.e., Powers et al., behaviors. Further, the synthesis from this review spot-
2017) utilized a randomized controlled trial experimental lights areas of strength and gaps in the current literature
for future development and validation for the middle roles (e.g., teacher, researcher, interventionist, etc.). Nearly
school population. half of the studies indicated teachers were the primary
intervention implementer, suggesting that on an approx-
imate equal basis other types of school personnel utilize
Strengths of the Empirical Literature and implement behavioral interventions for middle school
students. Specification of the intervention provider is
A key strength of the reviewed studies was the use of important for making inferences about the utility and fea-
experimental design methodology for the majority of stud- sibility of intervention implementation and intervention
ies. Experimental designs provide greater control over the outcomes (Han & Weiss, 2005). This is important to deter-
measured outcomes to reduce external factors contribut- mining, for example, whether a teacher may achieve better
ing to the results. Thus, findings from such studies can be outcomes than a paraprofessional, school psychologist, or
generalized with greater confidence. Although only 27% researcher who is implementing the same classroom-based
of studies utilized randomized experimental designs, intervention. Furthermore, specification of the imple-
which provide the greatest control over confounding fac- menter may afford insights into what knowledge base,
tors and safeguards to maximize internal validity and pro- education requirements, or experiences influence inter-
mote generalizability (Shadish et al., 2002), single-case vention uptake and success, as well help identify the appro-
designs with some level of control for confounds were used priate intervention to match the type of implementer.
in 63% of the studies. Nearly half of the studies (23/51, 45%) utilized profes-
Considering that the unique challenges of middle sional development approaches that had three or more
school can exacerbate maladaptive student behavior, it is training components (e.g., rationale, description, etc.).
important to note that a majority of the studies (47/51, Training implementers with a comprehensive professional
92%) in this review targeted middle school students only. development framework may enhance the learning of
Gender was reported in most studies (42/51, 82%), and a behavior management principles as well as promote trans-
sizable female student sample was included in this review. fer of skills (Reddy et al., 2020). This is essential, as man-
This is important, given that girls are at a high risk of being aging students with disruptive behaviors is often
underidentified and treated for their educational and challenging due to their complex academic and socioemo-
behavioral needs (Coutinho & Oswald, 2005) and the tional needs and requires a great deal of flexibility from
importance of accounting for gender when examining adults (Bauermeister et al., 2006; Liu, 2004; Reddy et al.,
student behavioral outcomes (Ferguson et al., 2010). It is 2020). Overall, effect size estimates were generally in the
also a strength of the reviewed literature that 100% (43/43) large range (Cohen, 1988) supporting the need for profes-
of the studies described the context and setting (QI 1.1; sional development when implementing behavior inter-
CEC, 2014) of the intervention, which further aids in rep- vention for this population. Further comprehensive and
lication efforts. If subsequent replication efforts confirm effective professional development models may have led
intervention efficacy, then the identification of context and to more successful implementation, which in turn, might
setting will aide practitioners in selecting appropriate have led to improved student outcomes.
interventions to match the context of their students, class-
rooms, and schools.
Weaknesses of the Empirical Literature
The majority of reviewed studies (42/51, 82%) moni-
tored implementation fidelity and student progress. This review highlights several gaps in the reviewed empir-
Measuring fidelity is crucial to establishing the internal ical literature that offer opportunities for future research
validity of an investigation (van Dijk, 2019). It is also to practice initiatives. With respect to research design,
important for operationalizing the critical components of although there were studies that utilized randomized,
the intervention that may contribute to its efficacy and experimental designs, most did not. Randomized, exper-
determining which aspects of implementation are most imental designs help rule out potential confounds in
feasible and where adaptations may need to be made to observed findings. The majority of studies (32/51, 63%)
maximize outcomes (Dane & Schneider, 1998; de Leeuw utilized single-case methods, which are vulnerable to
et al., in press; O’Donnell, 2008; Swanson et al., 2013). threats to internal validity and overinflation of the mag-
Forty of the 51 studies (78%) also monitored student prog- nitude of effects (Shadish et al., 2002). Furthermore, only
ress. This is a strength of the literature as research suggests 60% (26/43) of studies met the CEC’s QIs for internal
that collecting data on student progress contributes to goal validity, which makes it difficult for school practitioners
attainment (Bruhn et al., 2016). and scholars to rule out confounds in the findings from
Among the reviewed studies, most (41/51, 80%) much of this literature. With regard to data analysis, less
reported the number of implementers and their respective than half of the studies included statistical (24/51, 47%)
and clinical significance (26/51, 49%) techniques (e.g., Furthermore, teachers’ beliefs, attitudes, and behaviors
effect sizes) to assess outcomes, making it difficult to draw toward an intervention may contribute substantially to
conclusions about intervention efficacy. Measuring the their fidelity of intervention implementation (Forman
magnitude of effects of interventions and supports is et al., 2013). It is important to examine these factors to
imperative for helping practitioners and researchers select help discern their potential influence.
interventions that meet the needs of students. While professional development was provided in over
It is noteworthy that less than half of the studies (22/51, half of the studies (31/51, 61%) reviewed, few studies
43%) in this review used manualized interventions. This reported using experiential learning methods such as role
makes it difficult to discern the consistency with which playing and self-monitoring. Experiential learning expe-
the interventions were implemented. Missing data, includ- riences increase engagement from implementers and leads
ing attrition and follow-up data, is another weakness of to more effective communication and implementation
the reviewed studies. Less than half of the articles (16/51, skills (Chen et al., 2003; Kolb & Kolb, 2009).
31%) reported attrition, calling into question the accuracy As only 60% (26/43) of studies met the CEC’s QIs for
of effect sizes obtained. It is possible that effects were providing sufficient information about the population of
inflated due to attrition of students who performed poorly. participants, student data collection was another weakness
This may be especially problematic given the use of sin- of the reviewed studies. A variety of demographic data
gle-subject design studies for the majority of studies. were present in most of the articles; however, special edu-
Scholars have noted that “loss of respondents during a cation classifications, diagnostic data (DSM and comorbid
single-case time-series intervention study can produce diagnoses), and current school services were reported in
artificial effects if that loss is systematically related to the less than half of the reviewed studies. Therefore, in the
experimental conditions” (Kratochwill et al., 2010, p. 10). absence of such information it may be difficult for practi-
In regard to outcome data, long-term follow up data (9/51, tioners to interpret how findings from these studies apply
18%) were often not reported. As middle school students to their own unique contexts. Similarly, the omission of
with disruptive behaviors often have negative long-term data on special education status makes it difficult to make
outcomes, it is critical to examine the effects of behavior determinations about the effectiveness of interventions for
interventions on proximal and distal student outcomes. students in special populations.
Research suggests that school-based interventions that Finally, there were seven studies that met all the CEC’s
enhance the skills of middle school students, improve QIs for methodologically sound studies. However, due to
family–school relations, and encourage parent involve- the lack of research on behavioral interventions imple-
ment can effectively reduce disruptive behavior in schools mented in middle school, only the CW-FIT intervention
(Eyberg et al., 2008; Gonzales et al., 2004; Hill & Tyson, had more than one methodologically sound single-subject
2009). Despite these promising results, only 16 studies study (i.e., Speight et al., 2020; Wills et al., 2019). Only the
(31%) in this review included strategies to enhance parent Check and Connect intervention had a supporting meth-
involvement or support. It is possible that the limited use odology sound group comparison study (i.e., Powers et al.,
of parent involvement in intervention delivery for this 2017). This limits the confidence with which claims can
population may have contributed to some of the modest be made about the effectiveness of individual interventions
findings reported in the reviewed studies. that school practitioners consider for middle school stu-
Although the number of implementers and their posi- dents displaying disruptive behaviors.
tion (e.g., teacher, researcher) were often reported in
reviewed studies, information about their gender, ethnic-
ity, age, education level, years of experience, and experi- Implications for School Practice
ence with specific disabilities was often not provided. It is
important to evaluate the potential influence of such Findings from this review offer suggestions for school-
demographic and contextual characteristics on the efficacy based practice. Middle school students with or at risk of
of an intervention. Examining the influence of these fac- DBDs need behavior interventions and supports. As mid-
tors may help to determine, for example, whether school dle school is a significant transition period for students, it
practitioners with more experience implementing behav- is imperative that school practitioners are mindful of the
ior interventions and supports in authentic classroom developmental challenges in this context when selecting,
settings may yield greater student engagement, interven- tailoring, and implementing behavior interventions. The
tion fidelity (i.e., more skillful implementation), and sub- influence and frequent turnover of the peer group, as well
sequently better student outcomes than those with less or as the increased academic expectations, interactions with
limited experience in schools (e.g., Peterson et al., 2009). multiple teachers and classrooms, and newfound
autonomy, should be considered when delivering behavior component and mandates three parent meetings over the
interventions and supports to meet students’ needs. Below course of the academic year. The after-school version also
are highlights of example interventions with empirical has evidence that its benefits are sustained at follow up
support in the literature. (Evans et al., 2016). Despite the numerous strengths of this
Due to the social and environmental changes (e.g., intervention, it is targeted to middle school students with
larger class sizes) inherent in middle school, class-wide ADHD and thus, might not be suitable for use with stu-
interventions are a critical first step to addressing disrup- dents who do not have this disorder. Furthermore, the
tive behaviors. Classroom interventions can positively intervention seems to increase attentiveness, but its impact
affect 80% to 90% of students (Monson et al., 2020). Our on other classroom disruptive behaviors is mixed.
review calls attention to some promising class-wide inter- Although efficacy of the Bridges to High School
ventions for middle school students displaying disruptive Program has support from only one randomized con-
behaviors. For example, CW-FIT is a multitiered group trolled trial research study (i.e., Gonzales et al., 2012; pos-
contingency intervention that utilizes evidence-based itive program effects were evident at 1 year follow up, effect
practices such as teaching classroom expectations and sizes for reducing externalizing symptoms ranged from
providing praise to students (Wills et al., 2019). CW-FIT 0.32 to 3.49) and is designed for Mexican American stu-
also contains a social skills training component. Research dents, it is a multicomponent intervention that targets
demonstrates that this intervention is effective for increas- parenting practices, student coping strategies, school
ing teacher praise and student on-task behavior (i.e., engagement, and family relations. In addition, the Bridges
Conklin, 2010; Monson et al., 2020; Speight et al., 2020; to High School Program focuses on decreasing both stu-
Wills et al., 2019). Furthermore, according to the CEC dent externalizing and internalizing problems. Taken
2014 QIs, two of the investigations in this review (i.e., together, this intervention appears to be a promising
Speight et al., 2020; Wills et al., 2019) that support CW-FIT approach for use with middle school students with disrup-
can be considered methodologically sound. CW-FIT has tive behaviors. Despite this intervention’s positive benefits
also been found to have demonstrated implementation on key mediators (i.e., effective parenting, adolescent cop-
fidelity and social validity from teachers and students ing, adolescent school engagement, and family cohesion)
alike. In addition to CW-FIT, class-wide peer tutoring and student behaviors, implementation might be consid-
involves students collaboratively supporting each other’s ered challenging as the program required 45 hours of pre-
learning in dyads (Kamps et al., 2008). An advantage to service training, 3 hours of weekly training, and 2 hours of
class-wide peer tutoring is that students enhance their weekly supervision. Furthermore, the Bridges to High
social and behavioral skills. Kamps et al. (2008) found that School Program was validated with Mexican American
teachers could implement this intervention with fidelity, students only and thus might not be generalizable to the
and it led to increased active student behaviors (e.g., class wider middle school population.
participation) and decreases in disruptive behavior. Students often exhibit disruptive behaviors to gain
Middle school students’ disruptive behaviors can often attention from others (Cook et al., 2014). Table 2 presents
be attributed to a skill deficit, which underscores the two interventions, the Behavior Education Program (i.e.,
importance of choosing an intervention from the acqui- Simonsen et al., 2011) and Check and Connect (i.e.,
sition intervention category in Table 2 (Alperin et al., Maynard et al., 2014; Powers et al., 201711), which are sup-
2020). The following interventions have support from ported by randomized controlled trial design research
randomized controlled trials, which provide safeguards (Powers et al., 2017 met all CEC QIs and is considered
for reducing potential confounds and increasing interval methodologically sound) to address students with prob-
validity and generalizability: Challenging Horizons lem behaviors maintained by peer or adult attention. Both
Program (i.e., Evans et al., 2007, 2016; Langberg et al., the Behavior Education Program, also known as Check-In/
2007; Molina et al., 2008), Coping Power Program (i.e., Check-Out (CICO), and Check and Connect interventions
Peterson et al., 2009), Fast Track (i.e., Lochman et al., are promising for use with middle school students display-
2010), Bridges to High School Program (i.e., Gonzales ing disruptive behaviors due to its emphasis on feasibility,
et al., 2012), I Control (i.e., Smith et al., 2017), Student parent involvement, progress monitoring, and academic
Check Up (i.e., Strait et al., 2017), Self-Regulation instruc- engagement. The Behavior Education Program is espe-
tion (i.e., Martin, 2018), and Coping Power Universal (i.e., cially suited for use with middle school students with dis-
Muratori et al., 2020). Of these interventions, the ruptive behaviors as it often aims to enhance appropriate
Challenging Horizons Program has an extensive research social behaviors.
base. In addition, the after-school version of the Students with disruptive behaviors that are maintained
Challenging Horizons Program has a social skills by escaping demands present unique challenges in schools
(Cook et al., 2014). These students often require great Additional large-scale investigations are needed that uti-
effort on behalf of educators to keep them engaged in aca- lize rigorous experimental designs to assess the effects of
demic work. Furthermore, common strategies, such as specific interventions on teacher and student outcomes.
time out or office disciplinary referrals, often inadvertently Studies that employ a randomized controlled trial research
reinforce the student’s disruptive behaviors. Additional design are crucial for ruling out confounds (i.e., aligning
research is needed to investigate efficient research-based with CEC’s QIs for internal validity) and generalizing find-
interventions that reduce disruptive behavior for ings about which interventions are most effective. Such
escape-motivated middle school students (who do not studies are important for guiding school practitioners in
have developmental disabilities). In Table 2, all escape selecting the most efficacious behavior interventions to
intervention studies utilized single-subject research use in their respective settings. Relatedly, to accurately
designs. Of the interventions presented in this category, assess the impact of an intervention, research should use
the most promising may be Choice Making, which has significance tests in tandem with an appropriate research
three research studies (i.e., Kern et al., 2002; Ramsey et al., design to measure outcomes and effect sizes that estimate
2010, 2017) that support its efficacy. Specifically, Ramsey meaningful changes in the functioning of students (Reddy
et al. (2010) met each of the CEC’s QIs and can be consid- et al., 2018; Shadish et al., 2002). Effect sizes are essential
ered a methodologically sound research study. Given mid- in assisting scholars with the planning of replication
dle school students demand for autonomy (Patall & research (Kenny & Judd, 2019).
Zambrano, 2019), Choice Making might be an ideal inter- In addition to conducting more rigorous and larg-
vention as it facilitates students’ sense of control over the er-scale investigations, future research should also evaluate
classroom environment (Ramsey et al., 2010). the efficacy of behavioral interventions that can be used
to address students who exhibit disruptive behavior to
escape demands. Currently, the vast majority of research
Summary of Implications for School Practice
for escape-motivated disruptive behavior has focused on
Due to the importance of the peer group, increased aca- students with developmental disabilities and not typically
demic demands, influence of multiple teachers and class- developing students (Cook et al., 2014). In particular, Lane
rooms, and need for autonomy, it is essential that middle et al. (2012) propose that the Behavior Education Program,
school practitioners select and adapt research-based inter- which is shown to be effective for reducing attention seek-
ventions appropriately depending on the function on the ing student disruptive behavior (March & Horner, 2002),
student’s disruptive behavior. Specifically, disruptive along with the use of a bonus clause (e.g., allows student
behavior can be widespread throughout a classroom or to escape a nonpreferred activity if they meet behavior
limited to a specific student or small group of students. goal) might address middle school students whose disrup-
Students might behave disruptively due to a skill deficit, a tive behavior has the primary function of escape; however,
need to get attention from others, or to escape a situation additional research is needed in this area.
or demand. When considering a behavior intervention, Another key finding in this review is the importance of
school practitioners, in addition to the function of the parent involvement in behavior interventions for middle
disruptive behavior, should be cognizant of several factors: school students. Future research should investigate strat-
the quality of the supporting research (e.g., RCT, CEC 2014 egies that effectively enroll parent involvement and input
QIs), evidence of social validity and implementation fidel- in the intervention planning and implementation process
ity, and whether the intervention targets social skills and in schools. Moreover, future studies should evaluate the
encourages parental involvement. Highlights of example level of parent involvement needed (e.g., simply enhance
interventions with empirical support in Tables 1 and 2 communication with parents, provide them with training,
include CW-FIT and class-wide peer tutoring (class-wide or conduct family psychotherapy) to obtain desired stu-
intervention strategies), Challenging Horizons Program dent outcomes.
and Bridges to High School Program (acquisition inter- It is important that future research focus on clear oper-
vention strategies), Behavior Education Program and ationalization of intervention implementation. Use of
Check and Connect (attention seeking/reinforcement manualized interventions can be helpful in this regard, as
intervention strategies), and Choice Making (escape inter- they have been found to contribute to a more effective,
vention strategies). focused, data-based, and faithful service delivery as well
as assist with replication (Dumas et al., 2001). As it is well
documented that implementation fidelity maximizes an
Implications for School-Based Research
intervention’s impact on student outcomes (Bianco, 2010),
Despite these limitations, findings from this review offer it is important that school practitioners have access to
avenues for future research for youth in middle school. implementation data to make informed decisions about
which approaches can be implemented faithfully and have this review approach allowed for a greater level of inclu-
optimal impact on students. More research is needed to sion, it is possible that the overall quality and rigor of
examine the effects of behavior interventions on imple- research design varied across the published articles and
mentation fidelity and student outcomes. dissertations. We elected to include investigations with
Future investigations are warranted to identify specific more diverse qualities to most accurately and comprehen-
factors that moderate or mediate the effects of an inter- sively represent the larger intervention literature and to
vention on student outcomes. Randomized controlled guard against publication bias (e.g., Cooper, 2017). Fifth,
trials can be valuable for establishing the influence of many of the studies in this review did not fully meet the
specific student characteristics, to clarify when and with evaluation criteria (quality indicators) set forth by the
whom an intervention results in positive outcomes. Council for Exceptional Children (2014). Additional rig-
Furthermore, since most of the implementers in the orous studies are needed to advance this research for this
reviewed studies were teachers, it is important for addi- population. Finally, although this systematic review pro-
tional investigations to rigorously examine the influence vides the first step for understanding the literature evalu-
of roles (e.g., teacher, paraprofessional, interventionist), ating research-based behavior interventions and middle
characteristics, and prior experiences of adult imple- school student behavior outcomes, quantitative compari-
menters on the quality of intervention delivery and stu- sons of the outcomes is not possible at this time.
dent goal attainment in the middle school population.
Finally, research is needed that examine the differentiated
effects of published and nonpublished studies for this CONCLUSION
population and context. While we included peer-re- This review offers a synthesis of the school-based behavior
viewed studies and dissertations that represented a range interventions and supports used with middle school stu-
of research designs and methodologies, we did not exam- dents with or at risk of DBDs. We hope the findings from
ine the possibility of outcome differences in this body of this review offer researchers and school practitioners valu-
literature. able insights about the elements of behavior interventions
for middle school students with challenging behaviors and
possible effects of interventions on intended outcomes.
Likewise, it is the goal of this review to offer an empirical
LIMITATIONS
foundation for developing and evaluating new behavior
This review is not without limitations. The first limitation interventions and supports approaches that meet the
revolves around middle school literature on the whole. unique developmental, social, and academic needs for this
Limited peer-reviewed studies address middle school stu- population.
dents who display disruptive behaviors in the classroom
and thus the literature base limits the number of studies
per intervention. Future research is needed that validates
NOTES
the efficacy of specific interventions with middle school
students with or at risk for disruptive behavior disorders. 1. International studies were included provided they met
Further, the existing literature does not allow for differen- inclusion criteria.
2. This database was also filtered to only include results
tiation between intervention effects on specific disruptive
written in English.
behaviors or disability categories. Second, in our search 3. Boolean string: strat* OR interv* AND disrupt* OR ex-
procedures, we did not use a first author search or forward ternal* OR problem OR behavior AND Middle School
search of included articles. Third, the vast majority of the OR Adolescent*
studies measured changes in dependent variables using 4. Journals were searched with same key terms as databases.
observational assessments with a range of observer train- 5. Across all variables, coder agreement was 99% with
agreement per variable ranging from 93.27% to 100%.
ing methods. Observational assessments could lead to 6. Conklin (2010), Haydon and Hunter (2011), and Hunter
inconsistent data and observer drift during study imple- and Haydon (2019) investigations yielded very large ef-
mentation. Future research should use rigorous observer fect sizes. When omitting these studies, effect sizes
training and reliability criterion testing to assess changes ranged from –0.23 to 3.59.
in intervention practices and student outcomes. Fourth, 7. Without Hunter and Haydon (2019) investigation, effect
sizes would range from 0.05 to 3.49.
we did not use methodological characteristics as part of
8. Without Haydon and Hunter (2011) and Conklin (2010)
the inclusion criteria given that we wanted to include all investigations, effect sizes would range from 0.34 to 2.41.
school-based intervention studies conducted for youth 9. Without Conklin (2010) and Hunter and Haydon (2019),
with disruptive behaviors in middle school contexts. While effect sizes ranged from –0.23 to 3.49.
10. Without Conklin (2010), Haydon and Hunter (2011), Bauermeister, J. J., So, C. Y., Jensen, P. S., Krispin, O., & El Din,
and Hunter and Haydon (2019) investigations, effect siz- A. S. (2006). Development of adaptable and flexible treat-
es ranged from 0.06 to 3.33. ment manuals for externalizing and internalizing disorders
11. While this study did not demonstrate a decrease in office in children and adolescents. Revista Brasileira de Psiquiatria
disciplinary referrals, it did impact school attendance (Sao Paulo, Brazil: 1999), 28(1), 67–71. https://doi.org/10.1590/
positively. The authors speculate that school-level vari- s1516-44462006000100013
ables might have negatively impacted the students’ office *Beeks, A., & Graves, S., Jr. (2016). The effects of the mystery
disciplinary referrals. motivator intervention in an urban classroom. School
Psychology Forum: Research in Practice, 10(2), 142–156.
Bettini, E., Gilmour, A. F., Williams, T. O., & Billingsley, B.
(2020). Predicting special and general educators’ intent to
DISCLOSURE continue teaching using conservation of resources theory.
The authors have no conflicts of interest to report. Exceptional Children, 86(3), 310–329. https://doi.org/10.1177/
0014402919870464
Bianco, S. D. (2010). Improving student outcomes: Data-driven
instruction and fidelity of implementation in a Response to
FUNDING Intervention (RTI) model. Teaching Exceptional Children
Plus, 6(5), 2–13.
This work was supported by the U.S. Department of Education Bierman, K. L., Coie, J., Dodge, K., Greenberg, M., Lochman, J.,
– Institute of Education Sciences NCSER efficacy project McMohan, R., & Pinderhughes, E. (2013). School outcomes
(awarded to Rutgers, The State University of New Jersey) under of aggressive-disruptive children: Prediction from kinder-
Grant # R324A170069. The positions and opinions expressed in garten risk factors and impact of the fast track prevention
this article are solely those of the authors. program. Aggressive Behavior, 39(2), 114–130. https://doi.
org/10.1002/ab.21467
Bonvanie, I. J., Kallesøe, K. H., Janssens, K. A., Schröder, A.,
ORCID Rosmalen, J. G., & Rask, C. U. (2017). Psychological interven-
tions for children with functional somatic symptoms: A sys-
Alexander Alperin http://orcid.org/0000-0002-5872-1076 tematic review and meta-analysis. The Journal of Pediatrics,
Linda A. Reddy http://orcid.org/0000-0001-8314-2810 187, 272–281. https://doi.org/10.1016/j.jpeds.2017.03.017
Todd A. Glover http://orcid.org/0000-0001-7100-8139 *Bowman-Perrott, L., Burke, M. D., de Marin, S., Zhang, N., &
Briana Bronstein http://orcid.org/0000-0003-0040-3574 Davis, H. (2015). A meta-analysis of single-case research on
Nicole B. Wiggs http://orcid.org/0000-0002-5417-5864 behavior contracts: Effects on behavioral and academic out-
Christopher M. Dudek http://orcid.org/0000-0002-8338-4489 comes among children and youth. Behavior Modification,
39(2), 247–269. https://doi.org/10.1177/0145445514551383
Bradley, R., Doolittle, J., & Bartolotta, R. (2008). Building on
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professional-delivered Motivational Interviewing on aca- Alexander Alperin, PsyD, is an Assistant Research Professor in
demic outcomes. Advances in School Mental Health the Graduate School of Applied and Professional Psychology at
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0X.2017.1333915 behavior disorders, evidence-based interventions, and trau-
Swanson, E., Wanzek, J., Haring, C., Ciullo, S., & McCulley, L. ma-informed practices. He is a licensed psychologist in New
(2013). Intervention fidelity in special and general education Jersey and New York.
research journals. The Journal of Special Education, 47(1),
3–13. https://doi.org/10.1177/0022466911419516 Linda A. Reddy, PhD, is a Professor and Assistant to the Dean
Thompson, A. M. (2011). A systematic review of evidence-based for Research and Innovations in the Graduate School of
interventions for students with challenging behaviors in Applied and Professional Psychology at Rutgers University.
school settings. Journal of Evidence-Based Social Work, 8(3), She has over 140 publications on classroom assessment, coach-
304–322. https://doi.org/10.1080/15433714.2010.531220 ing, disruptive behavior disorders, and measurement develop-
*Thompson, A. M., & Webber, K. C. (2010). Realigning student ment and validation. She has served as PI or Co-PI on
and teacher perceptions of school rules: A behavior manage- numerous federal and private foundation grants. She is a
ment strategy for students with challenging behaviors. Children Fellow of APA and AERA, SSSP member and a licensed psy-
& Schools, 32(2), 71–79. https://doi.org/10.1093/cs/32.2.71 chologist in New Jersey.
*Turtura, J. E., Anderson, C. M., & Boyd, R. J. (2014). Addressing
task avoidance in middle school students: Academic behavior Todd A. Glover, PhD, is an Associate Research Professor in the
check-in/check-out. Journal of Positive Behavior Interventions, Graduate School of Applied and Professional Psychology at
16(3), 159–167. https://doi.org/10.1177/1098300713484063 Rutgers University. His research focuses on integrating evi-
United States Department of Education, Institute for Education dence-based interventions and high quality professional devel-
Sciences. (2010, March 10). Teacher’s perceptions about opment into systems of support for students. He has served as a
teaching and school conditions, by control and level of school: PI or Co-PI on numerous federal grants.
Briana Bronstein, PhD, is Postdoctoral Research Associate in behavior disorders, evidence-based practices, implementation
the Graduate School of Applied and Professional Psychology at science, and social media use by school-based personnel.
Rutgers University. Her research interests include implementa-
tion of evidence-based practices, preservice and teacher educa- Christopher M. Dudek, MEd, is a Research Analyst and Project
tion, behavior management and services for children with Manager of large-scale multisite research projects at the
disruptive and challenging behaviors. Graduate School of Applied and Professional Psychology at
Rutgers University. His research interests include developing
Nicole B. Wiggs, PhD, is an Assistant Research Professor in the educator and classroom observational assessments, instruc-
Graduate School of Applied and Professional Psychology at tional coaching, technology tools and evidence-based profes-
Rutgers University. Her research interests include disruptive sional development interventions for educators.

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School Psychology Review

ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/uspr20

School-Based Interventions for Middle School

Alexander Alperin, Linda A. Reddy, Todd A. Glover, Briana Bronstein, Nicole

To link to this article: https://doi.org/10.1080/2372966X.2021.1883996

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CHILDREN, RESEARCH, AND PUBLIC POLICY

School-Based Interventions for Middle School Students With Disruptive

ABSTRACT ARTICLE HISTORY

Figure 1. Flowchart of the Literature Review Process

Table 1. Empirical Studies of Classroom-Wide Behavior Intervention Studies

Table 2. Empirical Studies of Small Group or Individual Behavior Intervention Studies

Table 4. Description of Professional Development (PD) Components

Table 5. Effect Sizes Reported in Empirical Studies for Disruptive Behavior

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