A prevention program that promotes emotional and social competencies and reduces aggression and behavior problems in elementary school-aged children. The program is rated Effective. Children in the intervention group had less peer-rated aggression and more social competence. Intervention classrooms had a more positive atmosphere, a higher level of interest and enthusiasm, and a greater ability to stay focused than comparison group classrooms.
This program’s rating is based on evidence that includes at least one high-quality randomized controlled trial.
The Promoting Alternative THinking Strategies (PATHS®) curriculum is a program that promotes emotional and social competencies and reduces aggression and behavior problems in elementary school–aged children, while simultaneously enhancing the educational process in the classroom.
The PATHS® curriculum is based on the ABCD (Affective–Behavioral–Cognitive–Dynamic) model of development, which places primary importance on the developmental integration of affect, behavior, and cognitive understanding as they relate to social and emotional competence. A basic premise is that a child’s coping, as reflected in his or her behavior and internal regulation, is a function of emotional awareness, affective–cognitive control, behavioral skills, social–cognitive understanding, and interaction with the environment.
The PATHS® curriculum is designed for use by educators and counselors in a multiyear, universal prevention model that concentrates primarily on school and classroom settings, but also includes information and activities for use with parents. Ideally, the program will be initiated at the start of schooling and continued through sixth grade. Teachers receive training in a 2- to 3-day workshop and in biweekly meetings with the curriculum consultant.
The PATHS® curriculum contains comprehensive lessons (36 to 52, depending on grade) that seek to provide children with knowledge and skills in three major conceptual domains: 1) Self-Control, 2) Feelings and Relationships, and 3) Social Problem-Solving.
For improving self-control, young children are taught the “Turtle Technique,” where they learn to stop and think before reacting to a situation. Older children use a Control Signals Poster. Emotional literacy includes teaching children to identify and label feelings, express feelings, assess the intensity of feelings, manage feelings, and understand the difference between feelings and behaviors. Younger children use Feeling Face cards throughout the day, while older children utilize such learning tools as a Feelings Dictionary or Feelings Thesaurus. Social problem solving includes age-appropriate lessons as well as Problem Solving Groups for solving real classroom problems. Generalization techniques and suggestions are included for use throughout the day. Handouts for parents are also provided.
The units also contain lessons that promote self-awareness, nonverbal and verbal communication skills, and a positive classroom atmosphere. A newly revised version was published in 2011 – 2012 that has a separate curriculum for each grade level from Preschool to Grade 6.
The evaluation by Pennsylvania State’s Conduct Problems Prevention Research Group (1999) found that children in the intervention group were rated by their peers as less aggressive as well as less hyperactive and disruptive. However, there were no significant effects on prosocial behavior and “most liked” ratings from peers.
Teacher-Rated Conduct Problems
No differences in teacher-rated conduct problems were found between the intervention and comparison groups.
Observer-Rated Classroom Atmosphere
Intervention classrooms were rated as having a significantly more positive atmosphere, a higher level of interest and enthusiasm, and a greater ability to stay focused than comparison group classrooms. Students in intervention classrooms were rated as better able to express feelings appropriately than those in comparison classrooms.
Kam, Greenberg, and Kusche (2004) found that no significant differences between the PATHS® intervention group and the comparison group in social problem solving. However, children in the intervention group displayed a significant increase in the percentage of solutions that were nonconfrontational, indicating self-control (15 percent versus 8 percent).
There was a significant difference between the intervention and control groups in the size of vocabulary of negative feelings in the expected direction. However, there was no significant difference in the size of the positive feelings vocabulary.
No differences in social competency were found between the intervention and comparison groups.
Child Mental Health
Teacher ratings of externalizing behavior decreased in the intervention group by a rate of 0.37 points and increased in the comparison group by a rate of 0.72 points per year. Teacher ratings of internalizing behavior increased in the intervention group and comparison groups. However, the increase in the intervention group (0.38 points per year) was significantly lower than the increase of the comparison group (1.83 points per year). Self-rated child depression decreased significantly in the intervention group (3.7 points per year), compared with the comparison group (0.85 points per year).
Domitrovich, Cortes, and Greenberg (2007) found that the intervention group scored significantly better than the comparison group on the Assessment of Children’s Emotions Scale—Accuracy, meaning children exposed to PATHS® had a larger receptive emotion vocabulary and were more accurate in identifying feelings. Intervention children also had significantly lower anger attribution bias scores. However, there were no significant group differences on measures of inhibitory control, attention, or problem solving.
The intervention group scored significantly better than the comparison group on measures of social competence. Teachers in the intervention classrooms rated their students as significantly more cooperative, emotionally aware, and interpersonally skilled than teachers in the comparison classrooms did. However, follow-up analyses suggest that the intervention effect of PATHS® was present for children with higher mean levels of verbal ability, but children in the intervention group with lower verbal ability were no different from comparison group children.
Teacher Report of Child
There were no significant differences on teachers’ ratings of externalizing behavior, but there were some significant effects observed on teachers’ ratings of internalizing behavior. Children exposed to PATHS® were significantly less likely to be described as withdrawn or lacking friends by their teachers at the end of the school year, compared with comparison children. At the more rural site, teachers rated intervention children as significantly less anxious than comparison children. However, there were no other significant differences on the teacher report of child outcomes.
Parent Report of Child
On the Head Start Competence Scale, parents of students in the intervention classrooms described their children as significantly more socially and emotionally competent than did parents of children in comparison classrooms. However, there were no significant differences on parents’ ratings of externalizing and internalizing behavior, or on any other parent report of child outcomes.
Pennsylvania State’s Conduct Problems Prevention Research Group (1999) evaluated Promoting Alternative THinking Strategies (PATHS®) using 48 elementary schools located across the country including Durham, S.C.; Nashville, Tennessee; Seattle, Washington; and central Pennsylvania. Schools were divided into matched sets based on size, achievement levels, poverty, and ethnic diversity. The sets were then randomly assigned to intervention or comparison conditions. The study was conducted in 3successive years, resulting in three cohorts of first graders. For each cohort, 12 elementary schools from each of the four geographic areas were included. A total of 6,715 children distributed across 378 classrooms (198 intervention and 180 matched comparisons) participated in the study. Groups were equivalent in percentage of children who received free or reduced lunch, percentage of ethnic minority children, and academic achievement scores.
While teachers in the comparison group pursued their usual lesson plans, teachers in the intervention classrooms delivered up to 57 lessons of the PATHS® curriculum emphasizing self-control, emotional awareness of peer relations, and solving problems.
The evaluators then assessed the impact of the PATHS® curriculum on students’ social competence using outcome measures, including:
The data was analyzed using hierarchical linear modeling (HLM) models, with classroom as the second level in a mixed model design. The unit of analysis was the classroom, rather than the student. Thus the analysis occurs at the level of implementation.
- Teacher reports of student social competence
- Individual sociometric interviews with all children who had parental consent
- The Authority Acceptance and Cognitive Concentration subscales of the Teacher Observation of Classroom Adaptation—Revised
- The Social Health Profile
- Sociometric interviews of children’s ratings of their peers on aggression, hyperactivity/disruptive behavior, and prosocial behavior
- Teachers’ ratings of children on how liked they were by their peers
- The Classroom Rating Form completed during 30-minute observations by impartial raters on items such as child’s level of disruption, ability to handle classroom transitions, ability to follow rules, and ability to express feelings.
This study—conducted by Kam, Greenberg, and Kusche (2004)—used a randomized control research design to examine the long-term effectiveness of the Promoting Alternative THinking Strategies (PATHS®) curriculum for special education students. The sample consisted of 133 students with disabilities––97 boys, 36 girls; 88 were white, 27 were African American, and 18 were of other ethnicities. The average age of the children at baseline was 8years and 8 months. Fifty-three children had learning disabilities, 23 had mild mental retardation, 31 had emotional and behavioral disorders, 21 had physical disabilities or health impairment, and 5 had multiple handicaps. The classrooms were mixed age (grades 1–3), and each contained children with a variety of disability classifications. The intervention group had higher mean internalizing behavior, which was controlled in the analyses. However, the study did not specify the number of students assigned to receive the intervention condition and the number of students assigned to receive the control condition.
Eighteen teachers from seven elementary schools in Seattle, Washington, volunteered to participate in the study and were randomly assigned to teach either the intervention or the comparison condition. Teachers in the intervention classrooms implemented a 1-year model of the PATHS® curriculum, while teachers in the comparison group pursued their traditional lesson plans. A battery of sociometric tests and teacher reports was then used to assess students’ long-term emotional development.
Study outcomes consisted of changes in students’ externalizing and internalizing behaviors, social competence, self-reported depression, affective vocabulary, and problem-solving skills. Data for all variables was collected at baseline (time 1) and for 3 successive years (times 2, 3, 4). Measures used were the Child Behavior Checklist, the Beck Depression Inventory for Children, the Social Competence subscale of the Teacher–Child rating scale, the Kusche Affective Interview, and the Social Problem-Solving Interview, which generates a total effectiveness score.
Missing data in the follow-up years ranged from 6 percent to 48 percent on different variables, but the statistical procedure used in this study, Hierarchical Linear Modeling, is able to deal with missing data.
This randomized clinical trial conducted by Domitrovich, Cortes, and Greenberg (2007) examined the impact of the PATHS® curriculum on social and emotional skills building among children in two regional Head Start programs in central Pennsylvania. The study used a mixed block design in which randomization took place at the building level. Within each of the two regional Head Start programs, blocks were created that contained at least two matched classrooms with similar neighborhood population density. Six classrooms (three pairs) were drawn from 15 eligible classrooms in one program and then randomly assigned to the intervention or the comparison group. Ten classrooms (five pairs) were drawn from among 13 eligible classrooms in the other program and randomly assigned to the intervention (n=120) or the comparison (n=126) conditions. The final sample was 246, of whom 120 boys were and 126 were girls. Forty-seven percent were African American, 38 percent white, and 10 percent Hispanic. Mean age for the children at baseline was 51 months.
Groups differed at baseline on age, ethnicity, and disability. These variables were controlled for using analysis of covariance. ANCOVAs were performed on each outcome, testing for main effects, site, group, and interaction of site by group. Attrition rate was 18 percent. Children who left the program tended to be higher functioning. The posttest evaluation occurred at the end of the school year.
Outcomes were affective development, social competence, and mental health. Measures used were a revised version of the Recognition of Emotion Concepts subtest from the Kusche Emotional Inventory, the Assessment of Children’s Emotions Scale, the Denham Puppet Interview assessing affective perspective-taking skills, two measures of inhibitory control, the Attention Sustained subtest from the Leiter Revised Assessment Battery on visual spatial memory and attention, the problem-solving portion of the Challenging Situations Task, the Preschool and Kindergarten Behavior Scale (both for teachers and for parents), and the Peabody Picture Vocabulary Test. Parents also filled out the Head Start Competence Scale, measuring children’s social and emotional skills that reflect interpersonal relationships and emotion regulation.
Information on material cost can be found by visiting the Promoting Alternative THinking Strategies 'Program Components and Pricing' page on the Channing Bete Web site (Channing Bete, 2011).
Teachers generally receive training in a 2- to 3-day workshop and in biweekly meetings with the curriculum consultant. More information on program implementation can be found by visiting the Promoting Alternative THinking Strategies training Web site (PATHS, 2010).
Evidence-Base (Studies Reviewed)
These sources were used in the development of the program profile:Study 1Conduct Problems Prevention Research Group. 1999. “Initial Impact of the Fast Track Prevention Trial for Conduct Problems: 2. Classroom Effects.” Journal of Consulting and Clinical Psychology 67:648–57.Study 2Kam, Chi Ming, Mark T. Greenberg, and Carol A. Kusche. 2004. “Sustained Effects of the PATHS Curriculum on the Social and Psychological Adjustment of Children in Special Education.” Journal of Emotional and Behavioral Disorders 12:66–78.Study 3Domitrovich, Celene E., Rebecca C. Cortes, and Mark T. Greenberg, 2007. "Improving Young Children’s Social and Emotional Competence: A Randomized Trial of the Preschool 'PATHS' Curriculum." Journal of Primary Prevention 28:67–91.
These sources were used in the development of the program profile:Channing Bete Company. 2011. “Program Components and Pricing.” Accessed June 1, 2011.http://www.channing-bete.com/prevention-programs/paths/paths.html Greenberg, Mark T., and Carol A. Kusche. 1998a. “Preventive Intervention for School-Aged Deaf Children: The PATHS Curriculum.” Journal of Deaf Studies and Deaf Education 3:49–63.———. 1998b. Promoting Alternative Thinking Strategies. Boulder, Colo.: Institute of Behavioral Sciences, University of Colorado.Greenberg, Mark T., Carol A. Kusche, Elizabeth T. Cook, and Julie P. Quamma. 1995. “Promoting Emotional Competence in School-Aged Children: The Effects of the PATHS Curriculum.” Development and Psychopathology 7:117–36.Greenberg, Mark T., Carol A. Kusche, and Sharon F. Mihalic. 1998. Blueprints for Violence Prevention, Book 10: Promoting Alternative Thinking Strategies. Boulder, Colo.: Center for the Study and Prevention of Violence.Kusche, Carol A., and Mark T. Greenberg. 1998. “Integrating Emotions and Thinking in the Classroom.” Think 9:32–34.(PATHS) Promoting Alternative THinking Strategies. 2010. “Home.” Accessed June 1, 2011.http://www.pathstraining.com/Social and Character Development Research Consortium. 2010. Efficacy of Schoolwide Programs to Promote Social and Character Development and Reduce Problem Behavior in Elementary School Children (NCER 2011–2001). Washington, D.C.: National Center for Education Research, Institute of Education Sciences, U.S. Department of Education.http://ies.ed.gov/ncer/pubs/20112001/pdf/20112001.pdf
Following are CrimeSolutions.gov-rated practices that are related to this program:School-Based Social and Emotional Learning (SEL) Programs
Designed to foster the development of five interrelated sets of cognitive, affective, and behavioral competencies, in order to provide a foundation for better adjustment and academic performance in students, which can result in more positive social behaviors, fewer conduct problems, and less emotional distress. The practice was rated Effective in reducing students’ conduct problems and emotional stress.Evidence Ratings for Outcomes:
Universal School-Based Social Information Processing Interventions for Aggression
| ||Juvenile Problem & At-Risk Behaviors - Multiple juvenile problem/at-risk behaviors|
| ||Mental Health & Behavioral Health - Internalizing behavior|
School-based violence prevention interventions that target social information-processing difficulties in students, aiming to reduce the aggressive and disruptive behavior of school-aged children. The practice is rated Promising for reducing aggressive behavior in school-aged children.Evidence Ratings for Outcomes:
Targeted School-Based Social Information-Processing Interventions for Aggression
| ||Juvenile Problem & At-Risk Behaviors - Aggression|
This practice examines targeted prevention efforts for particular students that attempt to improve one or more aspects of the students’ social information processing, aiming to prevent and/or reduce aggressive or violent behavior in school-aged children. The practice is rated Effective for reducing aggressive behavior in school-aged children.Evidence Ratings for Outcomes:
Early Self-Control Improvement Programs for Children
| ||Juvenile Problem & At-Risk Behaviors - Aggression|
This practice consists of programs designed to increase self-control and reduce child behavior problems (e.g., conduct problems, antisocial behavior, and delinquency) with children up to age 10. Program types include social skills development, cognitive coping strategies, training/role playing, and relaxation training. This practice is rated Effective for improving self-control and reducing delinquency.Evidence Ratings for Outcomes:
| ||Juvenile Problem & At-Risk Behaviors - Self-Control|
| ||Crime & Delinquency - Multiple crime/offense types|