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Program Profile: SNAP® Under 12 Outreach Project

Evidence Rating: Effective - More than one study Effective - More than one study

Date: This profile was posted on April 09, 2012

Program Summary

A multisystemic intervention for boys under age 12 displaying aggressive and antisocial behavior problems. This program is rated Effective. It was associated with a significant decrease in children’s delinquency and aggression scores as well as a significant reduction in children’s levels of behaviors such as rule-breaking, aggression, and conduct problems. However, there was no significant effect of the program on the total numbers of convictions.

Program Description

Program Goals/Target Population
The SNAP® (Stop Now And Plan) Under 12 Outreach Project (SNAP® ORP) is a specialized, family-focused intervention for boys under age 12 who display aggressive and antisocial behavior problems. The primary goal of the program is to keep at-risk boys in school and out of trouble.

The SNAP® model provides a framework for teaching children and adults self-control and problem-solving and is grounded on the following principles: Scientist–Practitioner Model, Client-Centered Assessment, Gender Sensitive, Skill Acquisition and Generalization, Strength Focused, Continued Care, Collaborations and Partnerships, Community Based, Fidelity, and Accountability. The SNAP® model framework has been incorporated into various SNAP® programs based on needs and risks of different populations of children, youth, families, and communities such as SNAP® ORP, SNAP® Girls Connection, and SNAP® for Youth in Custody.

The program was originally developed in Ontario, Canada, in response to juvenile justice reforms made in 1984, when the minimum age of criminal responsibility was raised from 7 to 12 under the Young Offenders Act (now the Youth Criminal Justice Act). In Canada, children under 12 who commit offenses are handled by the provincial child welfare agencies, rather than by the juvenile justice system. SNAP® ORP serves boys ages 6–11 who have had police contact or are referred from other sources (e.g., schools, child welfare, parents) and who also are clinically assessed as engaging in above-average levels of aggressive, destructive, or other antisocial behavior. Typical referral behaviors include stealing, lying, truancy, assault, bullying, and aggression.


Program Theory
The conceptual framework of the program draws on several different theoretical models, including social interactional learning (parent management training), cognitive–behavioral, emotional regulation, self-control, social skills training, cognitive problem-solving, developmental, ecological, and attachment theories.

Program Components
SNAP® ORP employs a multisystemic approach, combining interventions that target the child, the family, the school, and the community. The program uses a variety of established interventions that are organized around SNAP®: skills training, training in cognitive problem-solving, self-control strategies, cognitive self-instruction, family management skills training, and parent training. The program’s screening and assessment procedures involve two interviews at intake—one with the child and one with the parent/guardian. In addition, boys are evaluated with the Early Assessment Risk List for Boys (known as EARL–20B), a risk-assessment tool for use with aggressive and delinquent boys under 12. The assessment determines the unique treatment needs of boys and their families.

A menu of 10 possible components is available to children and families based on their level of risk and need. Some of the primary components of the SNAP® ORP are:


  • SNAP® Boys Group, which is a structured group that teaches children the cognitive–behavioral self-control and problem-solving technique called SNAP®. The sessions are group discussion, modeling, behavioral rehearsal/role-playing, home practice exercise, in-vivo learning opportunities, and relaxation training. Using group manuals, the structured groups are facilitated by trained, designated staff. The boys groups consist of seven children placed according to developmental needs and ages. Specific topics, such as dealing with anger and avoiding trouble, are addressed. All SNAP® boys attend once a week for 1½ hours for at least one 12-week consecutive group session.
  • SNAP® Parent Group, which runs concurrently with the boys group and teaches parents self-control, problem-solving skills, and effective child management strategies with a special emphasis on monitoring skills based on SNAP® principles.
  • Individual Befriending/Mentoring, which provides children with individualized support from a SNAP® worker to enhance skills learned in the SNAP® Children’s Group and goal attainment. Children are also connected with volunteers to help the youths join structured recreational activities within their communities.
  • Stop Now And Plan Parenting (SNAPP—Individualized Family Counseling), based on strategies learned in the SNAP® Parent Group. It helps parents who are unable to attend the parent group and families who need additional parenting support. Continuing service after the parent group ends may take the form of ongoing individual family counseling or monthly Family Support Nights.
  • SNAP® School Advocacy/Teacher Support, which ensures that SNAP® children receive the best possible education. Where possible, teachers of all SNAP® children are contacted at the start of the program to introduce the program and SNAP® strategy and to offer behavior management support if needed.
  • SNAP® Long Term Connections/Continued Care: Families may continue to be involved in SNAP® as long as there is a need and interest. In addition to previously listed components, this may also include activities such as: SNAP® Parent Problem Solving Groups; Leader-In-Training Club; and participation as a Peer or Parent Mentor.
Available if needed are other program components, such as victim restitution, crisis intervention, Arson Prevention Program for Children (TAPP–C), and academic tutoring.

Evaluation Outcomes

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Study 1

Average Delinquency Scores

Augimeri and colleagues (2007) found that over time the experimental group improved significantly, according to the Child Behavior Checklist (CBCL) Delinquency scores. Between Time 1 and Time 2, when the experimental group received the SNAP® Under 12 Outreach Project (SNAP® ORP) intervention, children in the experimental group decreased by 4.0 points on average on the Delinquency scale, while children in the control group decreased by 0.5 points. At Time 2, the experimental group had an average Delinquency score of 4.9, while the control group had an average score of 8.4—a statistically significant difference. By Time 5, the experimental group had an average score of 3.1, compared with the control group, which had an average score of 6.5. The differences in average scores remained significant through all five time periods.

 

Average Aggression Scores

The average scores on the CBCL Aggression scale showed a similar pattern. Between Time 1 and Time 2, the scores of the experimental group decreased by 3.3 points, while the scores of the control group decreased by 0.4 points. At Time 2, the experimental group had an average Aggression score of 15.5, while the average score of the control group was 19.0—a statistically significant difference. By Time 5, the experimental group had an average score of 11.0, while the control group had an average score of 18.1—also statistically significant. The differences in average scores remained significant through all five time periods, except at Time 4 (12 months following Time 1).

 

Official Criminal Involvement

The percentage of children with at least one criminal conviction up to the 18th birthday was nearly twice as high for the control group compared with the experimental group (57 percent versus 31 percent); however, this difference was not statistically significant. There were also no significant differences between the groups in terms of the total number of convictions or the average number of convictions by offense type.

 

Study 2

Child Behavior Checklist

Lipman and colleagues (2008) found that boys in the SNAP® ORP treatment group and comparison group significantly improved on all measures on the CBCL from baseline to the 6-month follow-up. Multivariate analyses showed significant group differences favoring the SNAP™ ORP treatment group on targeted behaviors such as rule-breaking, aggression, conduct problems, and the total problems scale on the CBCL. However, there was no significant difference between the groups on the competence scale.

 

Teacher’s Report Form

Treatment group boys showed no significant improvements on the Teacher’s Reporting Form (TRF) measures, except for adaptive functioning. Comparison group boys showed no significant improvements on any of the TRF measures. Multivariate analyses showed no significant group differences on TRF scales, including rule-breaking, aggressive, conduct problems, total problems, and adaptive functioning.

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Evaluation Methodology

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Study 1

Augimeri and colleagues (2007) examined the immediate, short- and long-term effectiveness of the SNAP® Under 12 Outreach Project (SNAP® ORP), using a randomized controlled trial in Toronto, Ontario. The sample consisted of 32 children under age 12 (24 boys and 8 girls) who had been referred to the SNAP® ORP. To be eligible to participate in the SNAP® ORP and the study, children had to have police contact within 6 months of referral or a Tscore on the Delinquency scale of the Child Behavior Checklist (CBCL) of 70 or greater (indicating behavior problems more serious than 98 percent of peers of the same age and sex). The majority of the study sample was eligible under both requirements: 81 percent had a Tscore of 70 or more, and 78 percent had police contact. More than one third of the children were referred for more than one type of offending behavior. The primary reasons for referral included theft, fighting, severe defiance at home, vandalism, assault, arson, trespassing, and public mischief.

 

The original study design was to match 32 children, case-by-case in 16 pairs, on age, sex, and severity of delinquency (Tscore) on the CBCL. One member of each pair was randomly assigned to the experimental group, which received SNAP® ORP, and the other to the control group, which received a nonclinical activity/recreation program called the Cool Runners Club. However, a few modifications had to be made to the original design for several reasons. In the end, the two groups of children were analyzed as independent samples.

 

The experimental group (n=16) was 25 percent female, with an average age of 8.7 years. The control group (n=14) was 29 percent female, with an average age of 9.1 years. There were no significant differences between the groups, except on parental marital status. The experimental group was more likely to have married or cohabitating parents. The average CBCL Delinquency score was 8.9 for both groups, and the average CBCL Aggression score was also very similar (18.8 for the experimental group and 19.4 for the control group).

 

Measures of children’s delinquent and aggressive behaviors were collected by having parents rate behavioral items on the CBCL. Parents rated items as not applicable or not true, somewhat applicable or somewhat true, or very often applicable or often true. In addition, records of official criminal involvement were collected. A national criminal record search was performed that captured all offenses committed between each child’s 12th and 18th birthdays. Criminal records were coded to indicate the presence or absence of a finding of guilty for one or more charges, the total number of convictions, and offense type (i.e., property versus person).

 

Data was collected at five time periods over 18 months: Time 1 (pretreatment); Time 2 (posttreatment, at least 3 months after Time 1); Time 3 (3 months after Time 2); Time 4 (6 months after Time 3); and Time 5 (6 months after Time 4). The change in the experimental group score between Time 1 and each subsequent time period was compared with the change in the control group using a ttest.

 

The study did not include a no-treatment control group. At the end of Time 2, the experimental and control groups switched service modalities. Over the period between Time 2 and Time 3, the experimental group received the Cool Runners Club and the control group received the 3-month SNAP® ORP intervention. This was done to examine whether the children in the experimental group were able to maintain treatment gains made if they entered a short-term recreation program posttreatment, and to examine whether the control group would experience the same treatment benefits that the experimental group children received from the SNAP® ORP intervention after receiving a recreational type program. In practice, however, the SNAP® ORP treatment received by the control group was not as intensive as that received by the experimental group because of clinical staffing changes at the program. The purest test of the effect of the SNAP® ORP is obtained by the comparison of results at Time 1 and Time 2. The test of the effects of the SNAP® ORP after Time 2 is conservative, because it is essentially a comparison of more and less intensive SNAP® ORP treatment.

 

Study 2

Lipman and colleagues (2008) assessed the impact of SNAP® ORP implemented in Hamilton, Ontario. To be eligible for the program, boys had to be 6 to 11 years old, live in Hamilton, and have had police contact or be considered at risk of police contact. Boys accepted into the program had reported police contact or risk of police contact because of elevated scores (T–score>69) for offending behaviors on the CBCL or the Teacher’s Report Form (TRF). Sessions began in February 2002 and ran three times a year (winter, spring, and fall). Because of an extensive waiting list, boys and families waiting at least 6 months formed the comparison group (beginning in April 2005).

 

The SNAP® ORP treatment group included 223 boys, with an average age of 9.8 years. The comparison group included 116 boys with an average age of 9.4 years. At baseline, SNAP® ORP boys were significantly older than the boys in the comparison group, had more police contacts, had higher rates of any child welfare involvement, and higher scores on the CBCL rule-breaking scale. There were no other significant differences between the groups.

 

Offending behavior was measured by the rule-breaking, aggressive, and conduct scales on the CBCL and TRF. Social competence was measured by the total problems scale on the CBCL and TRF. Total competence, which represents engagement in community activities, social skills, and school, was measured with the CBCL. Adaptive functioning, which includes emotional problems and learning, was measured with the TRF.

 

Baseline data was collected during the first telephone and face-to-face interviews. Follow-up data collection occurred at 6, 12, 24, 36, and 48 months after the core component of the program began. Comparison data was collected at pretreatment and 6 months posttreatment while the comparison group was still on the waiting list. This study reported only on the baseline and 6-month follow-up results. Prepost data on the CBCL was available for 132 boys in the treatment group and 77 boys in the comparison group. Prepost data measured by the TRF was available for 102 treatment boys and 67 comparison boys.

 

Two sample ttests and chi-square analyses were used for descriptive statistics and precomparisons between the treatment and comparison groups. Changes in parent and teacher outcomes were analyzed using repeated measures analyses of variance (ANOVA). Age, measures of child welfare, and time between prepost assessments (days) were included as covariates.

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Cost

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The average cost of providing the SNAP® Under 12 Outreach Program services for a low-risk child is approximately $1,370 Canadian ($1,424 USD) for 4–6 months of service. For a moderate-risk child, program services cost approximately $3,300 ($3,430 USD) for 6–12 months of service. And for a high-risk child, services cost approximately $6,735 ($7,000 USD) for 12–18 months of service. Cost is based on structured clinical risk assessments dependent on level of risk and need conducted at intake/screening, post–SNAP® groups, treatment reviews, and discharge. Additional information on costs is available on the Child Development Institute Web site (please see Additional References for a link to the site).
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Implementation Information

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Organizations interested in implementing SNAP® are required first to complete the SNAP® Request for Qualifications Application. If approved, they then enter into an annual SNAP® licensing agreement negotiated with the Centre for Children Committing Offences (CCCO) at the Child Development Institute, which includes training and consultation. The CCCO provides core SNAP® Implementation Training for new affiliate sites. In addition, ongoing training is available for new staff at existing affiliate sites. The license was instituted to ensure treatment integrity/fidelity and to ensure that any SNAP® implementations adhere to key principles and approaches that are critical to program success.

Materials are available for purchase on the Child Development Institute Web site for SNAP® (please see Additional References for a link to the site). Information on training options is also available on the Web site.
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Evidence-Base (Studies Reviewed)

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These sources were used in the development of the program profile:

Study 1
Augimeri, Leena K., David P. Farrington, Christopher J. Koegl, and David Martin Day. 2007. “The SNAP™ Under 12 Outreach Project: Effects of a Community-Based Program for Children With Conduct Problems.” Journal of Child and Family Studies 16:799–807.

Study 2
Lipman, Ellen L., Meghan Kenny, Carrie Sniderman, Susanne O’Grady, Leena K. Augimeri, Sarah Khayutin, and Michael H. Boyle. 2008. “Evaluation of a Community-Based Program for Young Boys At-Risk of Antisocial Behavior: Results and Issues.” Journal of the Canadian Academy of Child and Adolescent Psychiatry 17(1):12–19.
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Additional References

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These sources were used in the development of the program profile:

Augimeri, Leena K., Depeng Jiang, Christopher J. Koegl, and John Carey. 2006. Differential Effects of the SNAP™ Under 12 Outreach Project (SNAP™ ORP) Associated With Client Risk and Treatment Intensity. Toronto, Ontario: Centre for Children Committing Offences, Child Development Institute. (This study was reviewed but did not meet Crime Solutions' criteria for inclusion in the overall program rating.)

Augimeri, Leena K., Pia Enebrink, Margaret M. Walsh, and Depeng Jiang. 2010. “Gender-Specific Childhood Risk Assessment Tools: Early Assessment Risk Lists for Boys (EARL–20B) and Girls (EARL–21G).” In Randy K. Otto and Kevin S. Douglas (eds.). Handbook of Violence Risk Assessment. Oxford, England: Routledge, Taylor, & Francis, 43–62.

Augimeri, Leena K., Depeng Jiang, Christopher J. Koegl, and John Carey. 2006. Differential Effects of the Under 12 Outreach Project Associated With Client Risk and Treatment Integrity. Toronto, Ontario: Center for Children Committing Offences, Child Development Institute.

Augimeri, Leena K., Christopher J. Koegl, and Kenneth Goldberg. 2001. “Children Under Age 12 Years Who Commit Offenses: Canadian Legal and Treatment Approaches.” In Rolf Loeber and David P. Farrington (eds.). Child Delinquents: Development, Interventions, and Service Needs. Thousand Oaks, Calif.: SAGE, 404–14.

Child Development Institute. 2008. “SNAP™ Under 12 Outreach Project (SNAP™ ORP): An Evidence-Based Award-Winning Model Program for boys Under 12 Years of Age in Conflict with the Law.” Toronto, Ontario, Canada: Center for Children Committing Offences, Child Development Institute.

———. 2010. “Stop Now And Plan (SNAP™).” Accessed March 27, 2012.
http://www.stopnowandplan.com/

Day, David Martin, and Leena Hrynkiw–Augimeri. 1993. Serving Children at Risk for Juvenile Delinquency: An Evaluation of the Earlscourt Under 12 Outreach Project (ORP). Toronto, Ontario: Earlscourt Child and Family Centre.

Hrynkiw–Augimeri, Leena, Debra J. Pepler, and Kenneth Goldberg. 1993. “An Outreach Program for Children Having Police Contact.” Canada’s Mental Health 41(2):7–12.

Koegl, Christopher J., David P. Farrington, Leena K. Augimeri, and David Martin Day. 2008. “Evaluation of a Targeted Cognitive–Behavioral Program for Children With Conduct Problems—The SNAP® Under 12 Outreach Project: Service Intensity, Age, and Gender Effects on Short- and Long-Term Outcomes.” Clinical Child Psychology and Psychiatry 13(3):419–34.

Pepler, Debra J., Margaret M. Walsh, Amy Yuile, Kathryn S. Levene, Depeng Jiang, Alice Rubin–Vaughan, and Jeanine Webber. 2010. “Bridging the Gender Gap: Interventions With Aggressive Girls and Their Parents.” Prevention Science 11(3):229–38.

Rubin–Vaughan, Alice, Debra J. Pepler, Margaret M. Walsh, Kathryn S. Levene, and Amy Yuile. 2011. “Risk for Girls’ Delinquency: Early Intervention to Promote Healthy Development.” InShari Miller, Leslie D. Leve, and Patricia K. Kerig (eds.), Delinquent Girls: Contexts, Relationships, and Adaptation. New York, N.Y.: Springer.

Walsh, Margaret M., Debra J. Pepler, and Kathryn S. Levene. 2002. “A Model Intervention for Girls With Disruptive Behavior Problems: The Earlscourt Girls Connection.” Canadian Journal of Counseling 36(4):297–311.

Webster, Christopher D., Leena K. Augimeri, and Christopher J. Koegl. 2002. “The Under 12 Outreach Project for Antisocial Boys: A Research-Based Clinical Program.” In Raymond R. Corrado, Ronald Roesch, Stephen D. Hart, and Jozef K. Gierowski (eds.). Multiproblem Violent Youth: A Foundation for Comparative Research on Needs, Interventions, and Outcomes. Amsterdam, Holland: IOS Press, 207–18.
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Related Practices

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Following are CrimeSolutions.gov-rated practices that are related to this program:

Targeted Truancy Interventions
These interventions are designed to increase attendance for elementary and secondary school students with chronic attendance problems. The practice is rated Effective for improving attendance.

Evidence Ratings for Outcomes:
Effective - More than one Meta-Analysis Education - Attendance/truancy



Mentoring
This practice provides at-risk youth with positive and consistent adult or older peer contact to promote healthy development and functioning by reducing risk factors. The practice is rated Effective in reducing delinquency outcomes; and Promising in reducing the use of alcohol and drugs; improving school attendance, grades, academic achievement test scores, social skills and peer relationships.

Evidence Ratings for Outcomes:
Effective - One Meta-Analysis Crime & Delinquency - Multiple crime/offense types
Promising - More than one Meta-Analysis Drugs & Substance Abuse - Multiple substances
Promising - One Meta-Analysis Education - Multiple education outcomes
Promising - One Meta-Analysis Mental Health & Behavioral Health - Psychological functioning
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Program Snapshot

Age: 6 - 11

Gender: Male

Geography: Suburban, Urban

Setting (Delivery): Other Community Setting

Program Type: Cognitive Behavioral Treatment, Family Therapy, Group Therapy, Mentoring, Parent Training, Wraparound/Case Management

Targeted Population: Young Offenders, Families

Current Program Status: Active

Listed by Other Directories: Model Programs Guide

Program Developer:
Leena K. Augimeri
Director, Scientific & Program Development & Centre for Children Committing Offences
Child Development Institute
46 St. Clair Gardens
Toronto, Ontario M6E 3V4
Phone: 416.603.1827 ext: 3112
Fax: 416.654.8996
Website
Email

Program Director:
Leena K. Augimeri
Director, Scientific & Program Development & Centre for Children Committing Offences
Child Development Institute
46 St. Clair Gardens
Toronto, Ontario M6E 3V4
Phone: 416.603.1827 ext: 3112
Fax: 416.654.8996
Website
Email

Researcher:
Margaret Walsh
Manager, Research and Evaluations
Child Development Institute
46 St. Clair Gardens
Toronto, Ontario M6E 3V4
Phone: 416.603.1827 ext: 3121
Fax: 416.654.8996
Website
Email

Training and TA Provider:
Nicola Slater
Manager, Centre for Children Committing Offences
Child Development Institute
46 St. Clair Gardens
Toronto, Ontario M6E 3V4
Phone: 416.603.1827 ext: 3148
Fax: 416.654.8996
Website
Email