School-based programs can curb aggressive behaviors in students

School-based programs can curb aggressive behaviors in students, according to a new systematic review.

Moreover, troubled youth can be helped throughout their student years. "The improvements can be achieved in both primary and secondary school age groups," says the report.

According to the authors, the most effective programs are those that help students learn key social skills such as listening, thinking about the feelings of others, working cooperatively and being assertive in constructive ways.

"The majority of aggressive children are choosing to use that behavior because they don't have the skills to achieve what they wish to achieve any other way," said lead author Julie Mytton, M.D., a public health physician at the University of the West of England.

With violence increasing among young students and numerous highly publicized school shootings in the United States, interest in a science-based approach to violence prevention has been on the rise for more than a decade. Yet, the 2001 U.S. Surgeon General's report on youth violence says, "While hundreds of prevention programs are being used in schools and communities throughout the country, little is known about the effects of most of them."

The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Mytton and colleagues identified 56 randomized controlled trials evaluating programs designed to reduce aggressive behavior in at-risk students. Most took place in the United States and compared a school program to either no program at all or an alternative activity.

Of these, 34 studies involving nearly 3,000 students measured changes in aggressive behavior after the school program. Nine studies involving about 1,700 participants looked at whether there was any change in school actions such as detention, suspension or court contacts.

The intensity of the interventions varied widely, from a single two-hour discussion group to more than 53 hours of intervention spread over two years. Some programs included extracurricular components such as parent training or community interventions.

"These programs are capable of producing moderate beneficial effects," concludes the study. The authors estimate that for every 100 nonparticipating students who continued their aggressive behavior, only 52 to 59 youths who participated in the programs did so.

The benefits were similar in both elementary and secondary school programs and when programs were delivered to mixed-sex or boys-only groups. In seven studies that followed up after one year, the improvements remained apparent.