Adaption and Implementation of the Engage Programme: Teaching Self Regulation Through Play, Within the Early Childhood Curriculum.

doi:10.21203/rs.3.rs-1359890/v1

PDF

Research Article

Adaption and Implementation of the Engage Programme: Teaching Self Regulation Through Play, Within the Early Childhood Curriculum.

https://doi.org/10.21203/rs.3.rs-1359890/v1

This work is licensed under a CC BY 4.0 License

You are reading this latest preprint version

Self-regulation is essential for successful human functioning across the lifespan. Difficulties in self-regulation early in life have been associated with a wide array of adverse outcomes including difficulties with school transition, educational attainment, and social functioning in childhood, as well as employment, mental health, physical health, relationships, and criminal activity in adulthood. ENGAGE (Enhancing Neurobehavioural Gains with the Aid of Games and Exercise) is a play-based intervention fostering the development of self-regulation in pre-schoolers and has led to improvements when used within the home setting. Given that most children attend some form of early childhood education setting, this is an ideal environment in which to teach self-regulation. The aim for this study was to ascertain whether ENGAGE can be implemented within an ECE group setting and whether this also leads to improved self-regulation. This trial has been registered with the Australian New Zealand Clinical Trials Registry (ANZCTR); trial number ACTRN12622000364774; trial web address: https://www.anzctr.org.au/ACTRN12622000364774.aspx. 668 children aged 3-5 years and their teachers, across 28 Early Childhood Education Centres (ECE) participated. Children’s self-regulation skills were assessed via scores on the Hyperactivity, Aggression, and Attention Problems subscales of BASC-2. Results indicted no significant changes in self-regulation skills across a 10-week waitlist period. Following 10 weeks of the ENGAGE programme, significant improvements in self-regulation were reported, and these were maintained at 2- and 6-month follow-up. These findings indicate that ENGAGE translates well into the ECE setting and has the potential to have population-based impacts on self-regulation abilities which could lead to more positive societal outcomes.

The early childhood education (ECE) setting plays a significant role in successfully preparing children for the transition to formal schooling. It is now well known that successful school transitions require strong self-regulation;^1,2 which generally refers to the capability of controlling one’s cognitive focus (thoughts), emotions (feelings), and behaviour (actions). Without good self-regulation children struggle to focus and engage with learning material at school. This is evidenced by numerous study findings indicating that self‐regulation predicts academic achievement^3–8. Poor self-regulation in early childhood has also been linked to later unemployment, criminality, poverty, and mental and physical health difficulties⁹.

Early childhood settings are an opportune environment for teaching self-regulation as many young children are enrolled in at least some form of early childhood care, providing the opportunity for population-based approaches. ECE settings are generally heavily play-based and focused on child-directed learning. Children learn self-regulation through play. For example, many games involve turn-taking, remembering rules, focusing on what others are doing to keep up with the game, plan their next move, and manage frustration when things are not going well in the game. Hence, play is an ideal forum in which to teach self-regulation.

Several studies have examined game-based approaches to skill development within the preschool setting. For example, Tominey and McCleland¹⁰ have developed a programme focused on improving preschoolers’ executive functioning, a core component of self-regulation. Their programme is called Red Light, Purple Light (RLPL) and involves 6 different circle time games played twice a week over eight weeks, in groups of five to eight children. The games increase in complexity over time and focus on improving attention, working memory and inhibitory control. Several studies have trialled this intervention and found that it leads to more improvements in the targeted skills (ie., attention, working memory, and inhibitory control) and academic achievement when compared control conditions involving the early education curriculum as usual^10,11,12. Keown, Franke & Triggs¹³ conduced a randomized controlled trial of RLPL with similar results to those of the studies mentioned prior; but this study also measured changes in more general self-regulatory abilities within the classroom to indicate generalisability of skills. Results indicated no statistical differences between the RLPL and control groups in generalisable self-regulatory skills, as measured by teacher ratings on the Child Behaviour Rating Scale. It is possible that the interventions narrow focus on six games and three core skills limits generalisability. This is in line with the findings from computer-game based interventions for training working memory (e.g., Cogmed¹⁴) which have led to improvement in the targeted skills but these improvements have not transferred outside of the practiced tasks¹⁵

To broaden the intervention focuses through a more wholistic approach to self-regulation, and improve generalisability of treatment effects, Healey and colleagues^16,17 developed a play-based intervention aimed at fostering the development of self-regulation in pre-schoolers; namely ENGAGE (Enhancing Neurobehavioural gains with the Aid of Games and Exercise). The programme focuses on skill building by identifying areas of development, selecting games that utilise the target skills, and then systematically playing the games at increasingly challenging levels. Games are focused on the three areas of self-regulation (emotional regulation, cognitive regulation, and behavioural regulation; see Table 1 for examples of games within each domain). For instance, puzzles require planning and focused attention. For children who struggle to complete puzzles, the first stage may be complete a simple puzzle over a few days, teaching the children how to approach puzzles. They might find the 4 corner pieces in the first session, then the remaining edge pieces in the second session, then fill in the middle over subsequent sessions so that after 4 or 5 days the puzzle is complete. The next week the aim would be to complete a puzzle over fewer sessions, then in one session, then to complete more complex puzzles. The focus of the intervention is on structure, consistency, repetition, scaffolding and building complexity. Any games can be used within this programme – the focus is on teaching skills through play, not on being required to play any specific games. ENGAGE does include an array of examples of games that target specific skill areas, along with ways in which to make each game simpler and more complex in order to meet the children’s skill areas. The intention is to pitch the game at a level that is slightly challenging for the child but not too difficult, in order to maintain enthusiasm and engagement and to incrementally build skills over time.

ENGAGE has been successful in improving self-regulatory abilities of hyperactive pre-schoolers when administered in a home-based setting. Here, parents played games with their children for half an hour a day over an 8-week period. An initial open trial of the intervention showed that regular, targeted, incremental game-play lead to significant reductions in hyperactivity (behavioural regulation), aggression (emotional regulation) and attention problems (cognitive regulation) following the 8-week intervention¹⁶ A randomised controlled trial comparing ENGAGE to the well-known parenting behavioural management training programme, Triple P (Positive Parenting Programme) also indicated that it led to significant reductions in hyperactivity, aggression and attention problems as rated by parents and teachers. There were no significant differences in treatment effects for ENGAGE and Triple P indicating that while they address self-regulation skill development very differently, both result in similar improvements in self-regulation. The study also found that there were no significant improvements in self-regulation during an 8-week waitlist period, suggesting improvements were the result of the interventions¹⁷.

Given its effectiveness within the home setting, and the fact that the ECE environment is likely to capture the largest sample of the population, the aim of this study was to explore whether ENGAGE could be successfully implemented in a group setting with all children within an ECE, and whether it would lead to improvements in self-regulatory abilities in these children.

Participants

ENGAGE was administered within 28 Early Childhood Education (ECE) centres in Auckland, New Zealand. Across the centres there were a total of 940 children aged 3–4years. Parental consent was given to collect data on 668 of these children. The only eligibility criteria for child participation were that they were enrolled at a participating ECE centre and that they were aged between 3–4 years.

ECEs were recruited within the Auckland region of New Zealand. This is the largest and most diverse region in the country and therefore enabled an ethnically and economically diverse group of centres to be recruited. Centres were contacted via already established connections with the Auckland Kindergarten Association (AKA). Centres who had had prior exposure to the ENGAGE programme, or who were actively involved in other learning support interventions were precluded from participating. All of the centres who were invited to participate agreed to take part in the research.

Experimental Design

This was an open trial and thus all participating ECE centres received the ENGAGE intervention. Data was collected in five phases: T1. An initial baseline assessment which was followed by a 10-week waitlist period of “education as usual” at each centre; T2. Post-waitlist assessment; T3. Post-ENGAGE assessment, which occurred after 10 weeks of active ENGAGE implementation within the ECE centre; T4. Re-assessment 2 months post-ENGAGE implementation; and T5. Re-assessment six months post-ENGAGE implementation.

Procedure

The AKA made face-to-face contact with all participating centres’ teachers to provide them with the broad research aims and programme information. The centres where then grouped into regional areas (Central, West, and South Auckland) and trained in the programme administration by experienced ENGAGE trainers within the AKA team. Once they began implementing the ENGAGE programme within their centres, the AKA team provided 5 hours a week of teacher support for the full duration of the 10-week programme.

Enhancing Neurobehavioural Gains with the Aid of Games and Exercise (ENGAGE). This intervention involved teachers spending a minimum of 30 minutes a day exposing children to ENGAGE activities within a group format. Games were typically played at set times (often during morning or afternoon mat times). Some games were played within larger groups (e.g., 15 children) and some in smaller groups (e.g., 3–5 children), depending on the types of games being played. The games were typically run by 1 or 2 teachers at a time. All of the games targeted neurocognitive areas known to be associated with self-regulation (see Table 1for examples of the games along with a brief description).

Shortly before beginning the 10-week intervention period of the study, teachers attended training workshops run by accredited ENGAGE trainers who were also trained ECE teachers and support workers. Teachers were also provided with a programme manual outlining the programme philosophy, as well as step by step implementation information and lists of games to try. Teachers were encouraged to introduce any other games that they knew and that involved the targeted skills (i.e., emotional, behavioural, and/or cognitive regulation).

Once the intervention began the ECEs received regular check-in visits by the ENGAGE trainers/facilitators throughout the 10-week period, enabling frequent trouble shooting and discussion of any concerns.

Ethical Approval

This study received ethical approval from the University of Otago Human Ethics Committee prior to commencement. Informed consent was obtained from both parents and teachers and data was only collected for those children whose parents had provided signed consent. While conducting this study, all ethical standards of the American Psychological Association were adhered to.

Trial Registration

This study was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR); trial number ACTRN12622000364774 (01/03/2022); trial web address: https://www.anzctr.org.au/ACTRN12622000364774.aspx.

Measures

Behavioral Measures

Behavior Assessment System for Children (BASC-2)¹⁸ is a well-validated and normed scale designed to assess wide ranging areas of child functioning, as rated by parents and teachers. Of particular interest to this study were the Hyperactivity, Aggression, and Attention Problems subscales of this measure as they are indicative of self-regulatory ability. Teachers were asked to complete these 3 subscales of the BASC-2 at each of the five data collection points within this study. Scores across time points were standardized (M = 50 and SD = 10).

Data Analysis

We assessed changes in scores for hyperactivity, aggression and attention problems across time using linear mixed model with random intercepts. For each outcome, models were estimated using data from (i) T1 to T3 for n = 565 children with data across all three measurements; (ii) T1 to T4 for n = 409 children with data across all four measurements; and (iii) T1 to T5 for n = 114 children with data across all five measurements. T1 was the reference category in all models. Because models were restricted to children with data across all time points assessed, controls for time-invariant factors such as gender, age at first assessment, ethnicity, and early childhood centre were not necessary.

Qualitative Data

Anecdotal/Observational Findings

The ENGAGE trainers/facilitators elicited feedback from teachers and made their own observations at each visit to/check-in with the centre during the intervention period.

As anticipated, the implementation of games in the initial 2–3 weeks required a level of persistence from many teachers and often game periods would conclude in less than 30 minutes. However, by the midpoint of the programme, most of the teachers were able to comfortably sustain game playing for 30 minutes and were reporting observable gains in most children’s ability to participate.

During the latter part of the intervention period, subtle variations in the implementation of games were observable; with ECE teachers beginning to organically adapt the games to meet the needs of their different learning environments and learners.

ECEs with stronger pre-existing practice were more likely to have progressed the complexity and level of challenge in their games and/or developed more accessible versions of games for children who were less able to participate in the larger group games. These modifications were based on teachers’ own understanding of self-regulation as delivered in the initial ENGAGE training workshop (e.g. while encouraged within the ENGAGE philosophy, they occurred organically and were not prescribed by ENGAGE facilitators). These ECEs were also more likely to appropriately use intentional language to explain the games to children, support their participation and success, and assist with generalising their emerging skills and strategies to support other classroom activities.

ECEs with below-average pre-existing educational practices and/or higher staff churn during the trial period were more likely to implement static versions of the games, with little variation of the games throughout the 10-week period. These ECEs were also less likely to initiate or scaffold smaller group or individual games, and less likely to use appropriate language to support the delivery of games and the generalising of skills.

Quantitative Data

Behavioural Ratings

The statistical analyses are presented in three phases. First, we examined whether there were any differences in self-regulation scores in the waitlist compared to the active ENGAGE phase of the study (see Table 2). The final sample available for these analyses included 565 children for whom we had both parent consent to collect data and completed BASC-2 teacher ratings at all three time points. The reason for the missing data was due to children having left the centre (many of whom turned 5 and went to school as in New Zealand children start school on their 5th birthday) during the data collection phase. Teachers completed ratings on all children with parental consent that were enrolled at the centre at the time of each wave of data collection.

Results indicated that there were no significant changes in self-regulation scores within the waitlist period where the centres continued with their early childhood curriculum as usual. Following the introduction of the ENGAGE programme, results indicate that there was a significant improvement in self-regulation skills - as indicated by statistically significant reductions in Hyperactivity, Aggression and Attention Problems as T3.

Secondly, we examined whether the treatment gains post-ENGAGE were maintained two months (T4) following the end of the active implementation of the programme (see Table 3). The final sample available for these analyses included 409 children for whom we had both parent consent to collect data and completed BASC-2 teacher ratings at all four time points.

Results indicated that for those with four measurement points there were no significant differences in the self-regulation scores across the waitlist period where the ECEs continued with their curriculum as usual. There were significant improvements in self-regulation scores at the end of the 10-week active ENGAGE programme implementation, as evidenced by significant reductions in Hyperactivity, Aggression and Attention Problems scores. These improvements were maintained two months after the active programme implementation had ended.

The final set of analyses examined whether the treatment gains post-ENGAGE continued to be maintained six months (T5) following the end of the active implementation of the programme (see Table 4). The final sample available for these analyses included 114 children for whom we had both parent consent to collect data and completed BASC-2 teacher ratings at all five time points.

Results indicated that again there were no significant differences in the self-regulation scores across the waitlist period where the ECEs continued with their curriculum as usual. There were significant improvements in self-regulation scores at the end of the 10-week active ENGAGE programme implementation, as evidenced by significant reductions in Hyperactivity, Aggression and Attention Problems scores. These improvements were maintained both two and six months after the active programme implementation had ended.

The aim of this study was to investigate whether the ENGAGE programme, focused on improving self-regulatory skills in pre-schoolers, and originally designed as a programme for parents and their children, would be able to be implemented within a group ECE setting.

Results indicated that ENGAGE translated well to the ECE setting. Qualitative data collected indicated that teachers were very enthusiastic about the play based-approach and while it took a few weeks to get things running smoothly, once the teachers and children became familiar with the approach and it was embedded into their curriculum, the programme was easily administered, and observable gains were made within a short-period of time. An important finding, however, was that ECEs with stronger pre-existing practice were able to more fully implement ENGAGE by enabling the implementation to develop organically to meet the needs of the children and centres. Those with poorer pre-existing practices remained very rigid in their implementation indicating that future work will need to be focused on scaffolding these ECEs and enabling them to make organic adaptions to best suit their environment and their learners through more intentional guidance on adaption to the setting to enable the programme to have optimal effects.

With regard to changes in self-regulation scores on the BASC-2 ratings by teachers, the Early Childhood Curriculum as usual did not lead to significant changes in self-regulatory abilities over a 10-week period. Once the ENGAGE programme was implemented for 10 weeks significant improvements in self-regulation were rated by teachers. These improvements were maintained at both 4- and 6-month follow-up.

These findings are in line with those of past findings for ENGAGE when implemented with parents and children in the home setting (Healey & Halperin, 2014, Healey & Healey, 2019); and thus indicate that the programme is similarly effective when implemented by teachers within group format with the ECE sector.

Findings are also in line with similar intervention studies such as the Red Light, Purple Light programme which uses a play-based approach to improving executive functioning in pre-schoolers (Tominey & McClelland, 2011; Schmitt, McClelland, Tominey & Acock, 2015; Duncan, Schmitt, Burke, & McClelland, 2018).

While these findings suggest that a play-based approach to teaching self-regulation skills is effective and well suited to the early childhood environment, the current study is not without limitations. The use of a waitlist period prior to administering the programme provided a control for behavioural change, however his study relied solely on teacher report to assess changes in self-regulatory ability. The issues here are two-fold: Firstly, the teachers were involved in administering the intervention and as such may be biased toward reporting improvements; and secondly repeatedly filling in the same rating scale may lead to response biases. Future studies would be well served to include more objective measures. It would also be helpful to incorporate both parent-report of behaviour change, as well as complementary focused play activities within the home setting to support the play being done at the ECE centres.

Despite the limitations discussed above, our results indicate that ECE teachers playing games targeting self-regulation skills in a structured, regular, and incremental manner leads to significant improvements in pre-schoolers self-regulation skills; which were not seen when they participated in the ECE curriculum as usual. As such this approach has the potential to have wide population-based effects as we know that poor self-regulation in the preschool years is predictive of a wide array of adverse outcomes across the lifespan.

Acknowledgements:

We thank The Tinadall Foundation, New Zealand for funding this work.

This research was conducted in partnership with Methodist Mission Southern and the Auckland Kindergarten Association, without whom the data would not have been able to be collected. We also thank the families who provided consent for their children to participate, the teachers who administered the ENGAGE programme and provided the data and ENGAGE trainers/facilitators who enabled the programme to be disseminated among 28 Early Childhood Centres with regular monitoring and follow-up.

Author contributions:

Dione Healey wrote the main manuscript text and lead the study, Matthew Healey provided methodological input, and Barry Milne conducted the analyses and prepared the tables. All authors were involved in preparing the manuscript.

Competing Interests:

None to declare.

Data Availability

The datasets analysed during the current study are available from the corresponding author on reasonable request.

Blair, C. School readiness: Integrating cognition and emotion in a neurobiological conceptualization of children’s functioning at school entry. American Psychologist, 57, 111–27 (2002).
Blair, C., & Diamond, A. Biological processes in prevention and intervention: The promotion of self-regulation as. A means of preventing school failure. Developmental Psychopathology, 20, 899–91 (2008).
Blair, C., & Razza, R.P. Relating effortful control, executive function and false belief understanding to emerging math and literacy ability in kindergarten. Child Development, 78, 647–63 (2007).
Liew, J., McTigue, E., Barrois, L., & Hughes, J. Adaptive and effortful control and academic self-efficacy beliefs on achievement: A longitudinal study of 1st through 3rd graders. Early Childhood Research Quarterly, 23, 515–526. (2008).
McClelland, M. M., Cameron, C. E., Connor, C. M., Farris, C. L., Jewkes, A. M., & Morrison, F. J. Links between behavioral regulation and preschoolers’ literacy, vocabulary and math skills. Developmental Psychology, 43, 947–959. (2007)
McClelland, M. M., Acock, A. C., & Morrison, F. J. The impact of kindergarten learning-related skills on academic trajectories at the end of elementary school. Early Childhood Research Quarterly, 21, 471–490. (2006).
McClelland, M. M., Morrison, F. J., & Holmes, D. L. Children at-risk for early academic problems: The role of learning-related social skills. Early Childhood Research Quarterly, 15, 307–329. (2000).
Valiente, C., Lemery-Chalfant, K., Swanson, J., & Reiser, M. Prediction of children’s academic competence from their effortful control, relationships, and classroom participation. Journal of Educational Psychology, 100, 67–77. (2008).
Moffit, T.E., et. al. A gradient of childhood self-control predicts health, wealth, and public safety. Proceedings of the National Academy of Sciences, <bvertical-align:super;>108</bvertical-align:super;>, 2693-98 (2011).
Tominey, S., & McClelland, M. M. Red light, purple light: Findings from a randomized trial using circle time games to improve behavioral self-regulation in preschool. Early Education & Development, 22, 489–519. (2011).
Schmitt, A.A., McClelland, M. M., Tominey, S.L., Acock, A.C. Strengthening school readiness for Head Start children: Evaluation of a self-regulation intervention. Early Childhood Research Quarterly 30, 20–31 (2015)
Duncan, R.J., Schmitt, A.A., Burke, M., & McClelland, M.M. Combining a kindergarten readiness summer programme with a self-regulation intervention improves school readiness. Early Childhood Research Quarterly 42, 291–300. (2018)
Keown, L.J., Franke, N., & Triggs, C.M. An evaluation of a classroom-based intervention to improve executive functions in 4-year old children in New Zealand. Early Childhood Education Journal 48, 621–31 (2020).
Klingberg, T., et al.Computerized training of working memory in children with ADHD: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 177–86. (2005).
Chacko, A., et al. A randomized clinical trial of Cogmed working memeory training in school-age children with ADHD: A replication in a diverse sample using a control condition. Journal of Child Psychology and Psychiatry, 55 247–55 (2014)
Healey. D., & Halperin, J. Enhancing Neurobehavioral Gains with the Aid of Games and Exercise (ENGAGE): Initial open trial of a novel early intervention fostering the development of preschoolers’ self-regulation. Child Neuropsychology 21, 465–80 (2015)
Healey, D., & Healey, M. Randomized controlled trial comparing the effectiveness of structured play (ENGAGE) and behaviour management (Triple P) in reducing problem behaviours in preschoolers. Scientific Reports, 9 3497
Reynolds, C.R., & Kamphaus, R.W. BASC-2: Behaviour Assessment for Children, Second Edition. Bloomington, MN: Pearson Assessments (2004).

Table1 List of the games included in the ENGAGE programme.

Behavioural Self-Regulation Musical Statues	Move around while music is playing. Freeze when the music stops
Animal Speeds	Regulate the speed of your activity between small, moderate, and fast speeds
Skipping	Regulate the speed at which skipping occurs
Ball and Spoon Race	Hold a spoon with a ball on it and move from one place to another at varying speeds
Simon Says	Repeat an action if Simon says to do “this” but do not repeat an action when Simon says do “that”
Snap	Card game where if identical cards are placed down in a sequence, you place your hand on the cards and say “Snap”
Hop Scotch	Aim a token for the correct number in the sequence and hop to that number
Drawing	Improve fine motor control through drawing
Leap Frog	Remain still while other jump over you and wait until it is your turn to jump over others
Cognitive Self-Regulation Copy Me	Watch a sequence. Then repeat the sequence from memory
Object Copy	Observe and structure being built. Re-create the structure from memory
Ball Games	Various games that involve having to focus on the ball and catch it
Puzzles	Complete puzzles
Cups Memory	Remember which cups have been picked up and the token underneath removed
Card Memory	Remember where the matching card is and turn over 2 matching cards to collect a pair
Beading	Thread beads either from memory of a sequence or according to various changing rules
Tracking Memory	Watch cups being moved around on a table and afterward identify which one has the token under it
List Memory	Remember a list that is continually being added to
Sorting	Sort various materials according to different rules
Emotional Self-Regulation Relaxation	Various exercises involving tension and relaxation of muscles
Deep Breathing	Learn to breathe in by filling your stomach with air (like a balloon) and then breath out slowly
Yoga	Basic yoga exercises to encourage controlled relaxation

Table 2

Differences in BASC scores between the waitlist and active ENGAGE periods.
BASC scores	T1 M(SD) n = 565	T2 M(SD) n = 565	T3 M (SD) n = 565	Pairwise comparisons (z-test)
Hyperactivity	51.72 (10.36)	51.49 (10.27)	48.92 (9.44)	T2 v T1: z= -0.79, p = 0.429 T3 v T1: z= -9.54, p < 0.001
Aggression	51.16 (10.49)	51.06 (10.58)	49.05 (9.36)	T2 v T1: z= -0.31, p = 0.754 T3 v T1: z= -6.71, p < 0.001
Attention Problems	51.66 (10.03)	51.81 (9.92)	49.05 (9.36)	T2 v T1: z = 0.51, p = 0.611 T3 v T1: z= -10.37, p < 0.001

Table 3

Differences in BASC scores between the waitlist, active ENGAGE period, and two months following the active ENGAGE period.
BASC scores	T1 M(SD) n = 409	T2 M(SD) n = 409	T3 M (SD) n = 409	T4 M (SD) n = 409	Pairwise comparisons (z-test)
Hyperactivity	50.93 (10.05)	50.88 (10.17)	48.23 (8.66)	47.85 (8.69)	T2vT1: z= -0.16, p = 0.875 T3vT1: z= -7.87, p < 0.001 T4vT1: z= -8.96, p < 0.001
Aggression	50.20 (9.82)	50.22 (10.33)	48.52 (8.73)	48.65 (8.85)	T2vT1: z = 0.05, p = 0.958 T3vT1: z= -4.69, p < 0.001 T4vT1: z= -4.32, p < 0.001
Attention Problems	51.35 (9.99)	51.52 (9.72)	48.68 (9.43)	47.74 (9.55)	T2vT1: z = 0.47, p = 0.640 T3vT1: z= -7.59, p < 0.001 T4vT1: z= -10.25, p < 0.001

Table 4

Differences in BASC scores between the waitlist, active ENGAGE period, and both two and six months following the active ENGAGE period.
BASC scores	T1 M(SD) n = 114	T2 M(SD) n = 114	T3 M (SD) n = 114	T4 M (SD) n = 114	T5 M(SD) n = 114	Pairwise comparisons (z-test)
Hyperactivity	49.33 (8.64)	48.94 (9.54)	46.20 (7.44)	46.37 (7.88)	43.14 (6.37)	T2vT1: z= -0.59, p = 0.556 T3vT1: z= -4.74, p < 0.001 T4vT1: z= -4.49, p < 0.001 T5vT1: z= -4.83, p < 0.001
Aggression	49.35 (9.63)	49.46 (10.91)	47.56 (7.84)	47.59 (7.87)	47.68 (6.68)	T2vT1: z = 0.17, p = 0.866 T3vT1: z= -2.56, p = 0.010 T4vT1: z= -2.52, p = 0.012 T5vT1: z= -2.40, p = 0.017
Attention Problems	49.80 (9.22)	49.58 (9.49)	46.99 (8.90)	46.67 (8.84)	46.93 (7.80)	T2vT1: z= -0.34, p = 0.730 T3vT1: z= -4.40, p < 0.001 T4vT1: z= -4.91, p < 0.001 T5vT1: z= -4.51, p < 0.001

No competing interests reported.

PDF

Reviewers agreed at journal
25 Apr, 2022
Reviewers agreed at journal
22 Apr, 2022
Reviewers invited by journal
22 Apr, 2022
Editor assigned by journal
22 Apr, 2022
Editor invited by journal
14 Mar, 2022
Submission checks completed at journal
14 Mar, 2022
First submitted to journal
14 Feb, 2022

You are reading this latest preprint version

Adaption and Implementation of the Engage Programme: Teaching Self Regulation Through Play, Within the Early Childhood Curriculum.

Status:

Version 1

Abstract

Introduction

Method

Results

Discussion

Conclusion

Declarations

References

Tables

Competing Interests

Status:

Version 1