Program Development Team Ping Ho, MA, MPH Giselle

Program Development Team Ping Ho, MA, MPH Giselle

Program Development Team Ping Ho, MA, MPH Giselle Friedman, LCSW Mike DeMenno The Impact of Group Drumming on Social-Emotional Behavior in Low-Income Children

UCLA Pediatric Pain Program Ping Ho, MA, MPH Jennie C.I. Tsao, PhD Lian Bloch, MA Lonnie K. Zeltzer, MD One-Day Training Program November 14, 2010

INTRODUCTION Children under age 18 25% of the total US population (74 million) DeNavas-Walt C, Proctor BD, Smith JC. Income, poverty, and health insurance coverage in the United States: 2007. Current Population Reports. Consumer Income. U.S. Census Bureau, Washington, DC. http://www.census.gov/prod/2008pubs/p60-235.pdf. INTRODUCTION

39% are low-income. Douglas-Hall A, Chau M. Basic facts about low-income children: Birth to age 18. National Center for Children in Poverty, Columbia University Mailman School of Public Health. INTRODUCTION Children from * groups are disproportionately

represented: *Latino (61%, 9.4 million) *African American (60%, 6.5 million) *Immigrant parents (58%, 7.4 million), *American Indian (57%, .3 million) Native-born parents (35%, 20.2 million) Asian (30%, .9 million) European American (26%, 10.9 million).

Douglas-Hall A, Chau M. Basic facts about low-income children: Birth to age 18. National Center for Children in Poverty, Columbia University Mailman School of Public Health. Mental Health Needs of LowIncome Youth Exposure to stressors predicts behavior problems and school failure.

Leventhal T, Brooks-Gunn J. Psychol Bull. Mar 2000;126(2):309-337. Youngstrom E, et al. Am J Community Psychol. Sep 2003;32(1-2):115-129. Sullivan MM, Rehm R. ANS Adv Nurs Sci. Jul-Sep 2005;28(3):240-251. Durlak JA. Am J Orthopsychiatry. Oct 1998;68(4):512-520. Mental Health Needs of LowIncome Youth Low-income youth exhibit internalizing (e.g., depressive, anxious, somatizing, posttraumatic stress)

& externalizing (e.g., antisocial, aggressive, delinquent, substance abusing) behavior. Leventhal T, Brooks-Gunn J. Psychol Bull. Mar 2000;126(2):309-337. McLeod JD, Shanahan MJ. J Health Soc Behav. Sep 1996;37(3):207-220. Turner RJ, Lloyd DA. Addiction. Mar 2003;98(3):305-315.

Grant KE, Katz BN, Thomas KJ, et al. Journal of Adolescent Research. Nov 2004;19(6):613-634. Xue Y, Leventhal T, Brooks-Gunn J, Earls FJ. Arch Gen Psychiatry. May 2005;62(5):554-563. Eamon MK, Mulder C. Am J Orthopsychiatry. Jan 2005;75(1):117-127. Mental Health Needs of LowIncome Youth Poor access to health and mental health care.

Ku L, Waidmann T. Kaiser Commission on Medicaid and the Uninsured. How race/ethnicity, immigration status, and language affect health insurance coverage, access to care and quality of care among the low income population. http://www.kff.org/uninsured/loader.cfm? url=/commonspot/security/getfile.cfm&PageID=22103. Accessed February 21, 2009. Flores G, Tomany-Korman SC. Racial and ethnic disparities in medical and dental health, access to care, and use of services in US children. Pediatrics. Feb 2008;121(2):e286-298. Mental Health Needs of LowIncome Youth

Reluctant to obtain services. Ojeda VD, Bergstresser SM. J Health Soc Behav. Sep 2008;49(3):317-334. Mental Health Needs of LowIncome Youth Reducing a single deficit vs. increasing core assets

Catalano RF, Berglund ML, Ryan JAM, Lonczak HS, Hawkins JD. Annals of the American Academy of Political and Social Science. Special Issue: Positive Development: Realizing the Potential of Youth. Jan 2004;591:98-124. Why Drumming? Why Drumming? Inclusive

Why Drumming? Inclusive, culturally relevant Triandis HC. J Pers. Dec 2001;69(6):907-924. Why Drumming? Inclusive, culturally relevant, reduces stress

Why Drumming? Inclusive, culturally relevant, reduces stress no stigma of therapy Bittman BB, Berk LS, Felten DL, et al. Altern Ther Health Med. 2001;7(1):38-47. Bittman B, Bruhn KT, Stevens C, Westengard J, Umbach PO. Adv Mind Body Med. Fall-Winter 2003;19(3-4):4-15. Bittman BB, Snyder C, Bruhn KT, et al. Int J Nurs Educ Scholarsh. 2004;1:Article12. Research Question

Could a school-based group drumming program integrated with activities from group counseling improve social and emotional behavior in low-income children? METHODS

Two experimental (drumming) classrooms vs Two control (standard education) classrooms in 97% socioeconomically disadvantaged school METHODS PARTICIPANT DEMOGRAPHICS

101 participants 54 experimental, 47 control

91 Latino, N = 10 Other ethnicity 54 female, 47 male Mean age = 10.5 years, range 10-12 METHODS ASSESSMENT 120-item portion of Teachers Report Form. Yields 24 scales of behavior.

Extensively tested for validity and reliability. Cited in over 1,000 publications AchenbachTM, Rescorla LA. Manual for the ASEBA school-age forms and profiles: An integrated system of multi-informant assessment. Burlington, VT: ASEBA; 2001. METHODS ASSESSMENT Short descriptions of internalizing and externalizing

behavior problems Response choices: 0 = Not True (as far as you know) 1 = Somewhat or Sometimes True 2 = Very True or Often True METHODS ASSESSMENT

4 teachers completed 120-item assessment for each student in class Rated students on behavior now or within last 2 months 2-week window for completion immediately pre- and post-intervention METHODS INTERVENTION

During school day Right after lunch

40-45 minutes weekly 12-weeks METHODS INTERVENTION Hybrid of activities from: Contemporary drum circles &

Group counseling METHODS SESSION THEMES 1. Focus and Listening constant theme METHODS

SESSION THEMES 1. Focus and Listening constant theme 2. Positive Behavior METHODS SESSION THEMES

1. Focus and Listening constant theme 2. Positive Behavior 3. Team Building METHODS SESSION THEMES 1.

2. 3. 4. Focus and Listening constant theme Positive Behavior Team Building Positive Risk Taking

METHODS SESSION THEMES 1. 2. 3. 4.

5. Focus and Listening constant theme Positive Behavior Team Building Positive Risk Taking Self-Esteem

METHODS SESSION THEMES 1. 2. 3. 4. 5.

6. Focus and Listening constant theme Positive Behavior Team Building Positive Risk Taking Self-Esteem Awareness of Others

METHODS SESSION THEMES 7. Leadership METHODS SESSION THEMES

7. Leadership 8. Sense of Self METHODS SESSION THEMES 7. Leadership

8. Sense of Self 9. Expressing Feelings METHODS SESSION THEMES 7. 8.

9. 10. Leadership Sense of Self Expressing Feelings Managing Anger

METHODS SESSION THEMES 7. 8. 9. 10. 11.

Leadership Sense of Self Expressing Feelings Managing Anger Managing Stress METHODS

SESSION THEMES 7. 8. 9. 10. 11. 12.

Leadership Sense of Self Expressing Feelings Managing Anger Managing Stress Empathy

METHODS SESSION THEMES 7. Leadership 8. 9. 10. 11.

12. 13. Sense of Self Expressing Feelings Managing Anger Managing Stress Empathy

Gratitude METHODS Solely facilitated by school counselornot expert drum circle facilitator. METHODS School counselornot expert drum circle

facilitator. Delivered to a whole classroom of students at a timenot groups of 10-15 or at risk. METHODS School counselornot expert drum circle facilitator. Delivered to a whole classroom of students at a

timenot groups of 10-15 or at risk. During school day after lunch. METHODS School counselornot expert drum circle facilitator. Delivered to a whole classroom of students at a timenot groups of 10-15 or at risk.

During school day after lunch. Spring semester of fifth grade. METHODS Classroom teacher as an active participant. METHODS

Classroom teacher as an active participant. Drums & rhythms reflect cultural diversity. METHODS Classroom teacher as an active participant. Drums & rhythms reflect cultural diversity.

Focus on process, not performance. Results 100% retention. Intervention classrooms improved significantly in 11 out of 24 possible behavior subscales.

Significantly Decreased Total Problems Significantly Decreased Total Problems Internalizing Problems Significantly Decreased

Total Problems Internalizing Problems Withdrawn/Depressed Behavior Problems Significantly Decreased Total Problems Internalizing Problems Withdrawn/Depressed Behavior Problems

Attention Problems and Inattention subscale Significantly Decreased Total Problems Internalizing Problems Withdrawn/Depressed Behavior Problems Attention Problems and Inattention subscale Anxiety Problems

Significantly Decreased Total Problems Internalizing Problems Withdrawn/Depressed Behavior Problems Attention Problems (and Inattention subscale) Anxiety Problems Attention Deficit/Hyperactivity Problems (and Inattention)

Significantly Decreased Total Problems Internalizing Problems Withdrawn/Depressed Behavior Problems Attention Problems (and Inattention subscale) Anxiety Problems Attention Deficit/Hyperactivity Problems (and Inattention)

Oppositional Defiant Problems Significantly Decreased Total Problems Internalizing Problems Withdrawn/Depressed Behavior Problems Attention Problems (and Inattention subscale) Anxiety Problems

Attention Deficit/Hyperactivity Problems (and Inattention) Oppositional Defiant Problems Posttraumatic Stress Problems Significantly Decreased Total Problems Internalizing Problems Withdrawn/Depressed Behavior Problems

Attention (and Inattention subscale) Anxiety Problems Attention Deficit/Hyperactivity Problems (and Inattention) Oppositional Defiant Problems Posttraumatic Stress Problems Sluggish Cognitive Tempo Conclusion

Can improve social-emotional behavior. Conclusion Can improve social-emotional problems.

May have broad public health value. McKinlay JB, Marceau LD. Am J Public Health. Mar 1999;89(3):295-298. Conclusion Can improve social-emotional problems. May have broad public health value.

Can increase student-counselor interaction. Burns BJ, et al. Health Affairs (Millwood). Fall 1995;14(3):147-159. Shaffer D, et al. J Am Acad Child Adolesc Psychiatry. Jul 1996;35(7):865-877. Conclusions May improve academic performance.

Durlak and Weissberg. Presentation at the Annual Meeting of the American Psychological Association. August 2005. Ashcroft M, Kirk E. Journal of Experimental Psychology. 2001;130:224-227. Conclusions May improve academic performance. Encourages continued participation. ONeill. Youth music engagement in diverse contexts. In: Mahoney et al, eds. Organized Activities as Contexts of Development. Mahwah, NJ:

Lawrence Erlbaum Associates, Publishers; 2005:255-273. Mahoney et al. Organized activities as developmental contexts for children and adolescents. In: Mahoney et al, eds. Organized Activities as Contexts of Development. Mahwah, NJ: Lawrence Erlbaum Associates, Publishers; 2005:3-22. Conclusions May improve academic performance. Encourages continued participation. Serves as hook for interest in

school. Verdugo. A Report on the Status of Hispanics in Education: Overcoming a History of Neglect. National Education Association. http://www.nea.org/assets/docs/mf_hispaniced.pdf. Accessed January 5, 2009. Conclusions May improve academic performance. Encourages continued participation. Serves as hook for interest in

school. Empowers students with skills for mental health. Who may benefit from this program? Who can deliver this program?

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