Structured Teaching On Behavioral Problems

School age is the period between 6-12 years. Schoolers are emerging as creative persons who are preparing for their future role in society. The school years are a time of new achievement and new experiences. Children’s individual needs and preferences should be respected. Children who are productive and engaged in the school experience, whether academic or vocational, is not likely to become at – risk student.

All young children can be naughty, defiant and impulsive from time to time, which is perfectly normal. However, some children have extremely difficult and challenging behaviors that are outside the norm for their age. The behavior of some children and adolescent are hard to change. Children do not always display their reactions to events immediately although they may emerge later. Children who suffer from behavior disorders are at a higher risk for school failure, suicide, and mental health problems.

A behavioral problem is a departure from normal (acceptable) behavior beyond a point, to the extent behavioral problems can manifest themselves in many ways. There are interchangeable terms for behavior disorders- disruptive behavior disorder, conduct disorders, emotional disorders, and emotional disturbances.

Warning signs of behavior disorders include:

Harming or threatening themselves, other people

Damaging or destroying property

Lying or stealing

Not doing well in school, skipping school

Early smoking, drinking or drug use

Early sexual activity

Frequent tantrums and arguments

Consistent hostility towards authority figures.

Children misbehave for a variety of different reasons. Children problems are often multi-factorial and the way in which they are expressed may be influenced by a range of factors including developmental stage, temperament, coping and adaptive abilities of the family, the nature and duration of illness.

The school is an institution in society specifically designed as the formal instrument for educating children. School is a place where children spend the largest portion of their time outside the home. Schools should offer a safe and respectful learning environment for everyone.

In addition to scholastic achievement, school experiences should contribute to healthy development in terms of harmonious interpersonal relations and positive self image. Teachers appear to be important social partners, as the quality of a teacher and child relationship has been related to several aspects of short and long-term school adaptation. Studies have shown that teachers may reject these children, respond to them with less support and punishment than other child receives.

A parent is really the child’s first teacher and critical to student success is the involvement of parent. A teacher is a person who provides students’ direct classroom teaching, or classroom-type teaching in a non-classroom setting, or educational services directly related to classroom teaching. Teachers play an influencing role in development of personality. Listening to child’s problems is an important skill of a teacher.

Disruptive behavior is a major factor contributing to teacher stress and discontent and significantly affects teachers’ capacity to maintain a productive and orderly learning environment. Most teachers and school personnel concur that they are able to identify behavioral and academic problems within first few weeks of a school year. Teacher’s expectations and actions greatly affect the child’s behavior. Dealing with difficult or inappropriate behavior in schools can be a challenging task for any educator, regardless of experience.

Teachers need to use positive interactive approaches than responding to inappropriate behaviors. Teachers need to communicate care and concern rather than a desire to punish when reacting to inappropriate behaviors. Children with behavioral problems have received more criticism and have suffered deterioration in their interactions with teachers over time.

The early detection and treatment of children with behavioral problems at an early age may reduce treatment costs and improve quality of life of those children. Effective way of reducing behavioral problems can be through behavioral plan developed by parents, teachers, children, administrators and school staff. Use positive interactive approaches that remove the need for inappropriate behavior. The components include, inform pupil what is expected, avoid threats, build self confidence, use positive modeling and provide positive learning environment.

REVIEW OF LITERATURE

Review of literature is a key step in research process. The typical purpose for analyzing a review existing literature is to generate research question to identify what is known and what is not known about the topic. The major goals of review of literature are to develop a strong knowledge base to carry out research and non research scholarly activity.

Review of literature from the present study is been divided into:

Studies related to behavioral problems of school children

Studies related to knowledge of teachers on behavioral problems of school children

Studies related to structured teaching programme.

Studies related to behavioral problems of school children

Margrot Prior, Shanya Virasinghe and Diana Smart (2005) conducted a study on behavioral problems in Sri Lankan school children associations with socio economic status, age, gender, academic progress and religion. Using the strengths and difficulties questionnaire modified version of the rutter parent questionnaire including items on children’s strength: with parent, teacher and child informants, was administered to assess the mental health problems in this population. In this study 10 – 13 years children were included. The study concluded that rates and types of problems consistent with other international studies on children mental health. Problem rates were higher in boys and were associated with lower socio economic status, religion and poorer academic performance. The study confirms the need for development of child and adolescent health services in Sri Lanka.

Sujit Sar Khel, Vinod Kumar Sinha, Mani Arora, Push De Sarkar (2006) done a study on prevalence of conduct disorder in schoolchildren of Kanke. The study included 240 students studying in class V to X. Stratified random sampling were used to estimate the prevalence of conduct disorder in children. Present and Lifetime Version screening interview was used to assess the children. The result showed that conduct disorder was found in 4.58%; the ratio of boys to girls being 4.5:1. Childhood onset was found in 73% and adolescent onset in 27%. Mild conduct disorder was found in 36%, moderate in 64% and severe conduct disorder in none.

Manuel Barrera et al. (2002) gave an intervention on early elementary school to reduce conduct problems: A randomized trial with Hispanic and Non-Hispanic children. The study included European American (n = 116) and Hispanic (n = 168) children from 3 communities were randomly selected to an intervention or no-intervention control condition. Intervention families received parent training, and their children received social behavior interventions and supplementary reading instruction over a 2-year period. The study concluded that at the end of a 1-year follow-up, treated children showed less teacher-rated internalizing and less parent-rated coercive and antisocial behavior than controls.

Maj Prakash, Brig .S. Sudarsanan, P.K. Pardal, S. Chaudhury (2006) conducted a study on behaviour problems in a paediatric outpatient department. A sample of 50 children between the ages of 6-14 years was selected randomly for the study. The data was collected by administering child behaviour check list to children. The study concluded that behaviour problems in the subjects were externalizing ones and the mean score was 40.7 than internalizing problems and the mean score was 10.3.

Mc Farlane.J.M, Groff JY, O’Brien .J.A, Watson. K. (2006) done a comparative study on behaviors of children who are exposed and not exposed to intimate partner violence: an analysis of 330 black, white, and Hispanic children. Samples included 258 abused mothers and 72 non abused mothers and their children were between age of 18 months to 18 years of age and these children were compared with normative children. Data was collected using child behavior checklist from mothers. Data was analyzed using multiple analysis of variance performed for ages 6 through 18 years revealed a significant group difference (Frequency[3,183] = 3.13). Univariate tests revealed significant group differences for internalizing behavior (Frequency [1,185] = 6.81), externalizing behavior (Frequency [1,185] = 7.84), and total behavior problems (Frequency [1,185] = 9.45). Overall, children of abused mothers had significantly higher internalizing (58.5 +/- 12.1), externalizing (55.5 +/- 12.4), and total behavior problems (57.6 +/- 12.3) scores than the internalizing (52.9 +/- 13.7), externalizing (49.7 +/- 10.6), and total behavior problems (51.0 +/- 13.0) scores exhibited for children of non abused mothers.

b) Studies related to knowledge of teachers on behavioral problems of school children

Bibou-Nakou, G.Kiossseoglou and A. Stogiannidou (2008) done a study on elementary teachers perceptions regarding school behavior problem: implications for school psychological services. The study involved 200 elementary school teachers. The questionnaire was administered to assess casual attributions and goal directed behavior on part of teachers when dealing with classroom misbehavior problems. The study concluded that misbehavior related attributions were significantly associated with teachers preferred practices and suggested that application of psychological principles to education practice should be included.

Sarah B. Dwyer, Jan M.Nicholson (2005) assessed teacher’s knowledge of children exposure to family risk factors: accuracy and usefulness. The study involved 756children indicated that teachers had accurate knowledge of children exposure to factors such as adverse life events and family socio economic status, which predicted children mental health problem at 1 year follow up. The study concluded that asking teachers to report children exposure to particular family risk factors is feasible method for identifying children for selective interventions.

Stuart W. Twemlo, M.D (2005) estimated the prevalence of teachers who bully students in school with differing levels of behavioral problems. In this study 214 teachers answered anonymous questionnaire about their perceptions of teachers who bully students and their own practices. Teachers were grouped into whether they taught at low, medium or high suspension rate schools. The study concluded that teachers from high suspension rate schools reported they bullied more students, had experienced more bullying when they were students, had worked with more bullying teachers over the past three years and had seen more bullying teachers over the past year.

Dougherty J, Pucci P, Hemmila MR, Wahl WL, Wang SC, Arbabi S (2007) did a comparative study on worldwide child and adolescent mental health begins with awareness: a preliminary assessment in nine countries. In this study awareness campaign was conducted among community leaders, health professionals and teachers. The school-based studies were conducted in communities in nine countries. The study concluded that there is an increase in willingness to discuss emotional problems freely and suggested that utility of collaborating with schools so as to foster better child mental health in such under resourced communities.

Kaiser, Ann P; Cai, Xinsheng; Hancock, Terry B; Foster, E Michael. (2007) conducted a survey on of primary school educators regarding burn-risk behaviors and fire-safety education. A written survey, consisting of 24 questions, was distributed to 8 primary schools. The study results shows that twenty percent of elementary school educators surveyed had experience teaching burned children (mean age: 7+/-3; range: 2-17); 8% had experience with children that were injured due to fire-play. Fire experimentation begins at 6.1+/-2 years of age (range: 2-13). Educators believe students can benefit from a fire prevention curriculum beginning at 7.3+/-1.8 years (range: 5-12).

c) Studies related to effectiveness of structured teaching programme

Pamela Orpinas and Arthur M. Home (2008) conducted a workshop on teacher-focused approach to prevent and reduce student’s aggressive behavior: the guiding responsibility and expectations for adolescents for today and tomorrow teacher program. The goals of the program were (1) to increase teacher awareness of different types of aggression, risk factors, role of the classroom teacher, and influence of the school climate on the child’s behavior; (2) to develop strategies that will prevent aggression; (3) to improve teacher management skills to reduce power struggles and aggression; and (4) to enhance skills to assist students who are the targets of aggression. The study included guiding responsibility and expectations for adolescents for today and tomorrow manuals were administered to teacher. The study concluded that teachers had to increase teacher awareness of different types of aggression, risk factors, role of the classroom teacher, and influence of the school climate on the child’s behavior; to develop strategies that will prevent aggression; to improve teacher management skills to reduce power struggles and aggression; and to enhance skills to assist students who are the targets of aggression.

Lorrie L. Hoffman (2009) conducted a workshop on improving school climate: reducing reliance on rewards and punishment. The study included 200 teachers. Data was collected by survey on school climate and classroom management methods among teachers who are exposed to and not exposed to the conscious discipline workshops. The study demonstrated that the untrained group was unaware of the social relationship and cultural principles of conscious discipline that include releasing external control, embracing conflict resolution and implementing a more emotionally targeted reward structure in the classroom. Many teachers also showed improvement in student/teacher relationships (r=.325) and in mutual support among teachers (r=.306).

Kathleen Lynne Lane, Andrea Phillips and M. Annette Little (2009) did experimental study on preventing conduct problems and improving school readiness: evaluation of the incredible year’s teacher and child training programs in high-risk schools. The study included teachers and students. Data was collected from them before and after the intervention. The intervention included teaching social and emotional school curriculum for students and trains teachers in effective classroom management skills and in promotion of parent-school involvement. They sent home weekly homework to encourage parents’ involvement. The study concluded that an intervention used by the teachers was effective and the students showed more social competence and emotional self-regulation and fewer conduct problems than control teachers and students.

Carolyn M. Evertson (2005) did an experimental study on training teachers on classroom management in secondary classrooms. The studies in primary grades and more recently in the secondary grades show that the more academically effective teachers in those generally had better organized classrooms and fewer behavioral problems. Additionally, research indicates that the key to managing classrooms effectively begins from the first day of school with the systematic approach, advance preparation and planning. The study concluded that workshops and manuals were enough to provide changes in teacher’s behavior in the desired direction: However more specific information about nature of the training was needed to support the development of an exportable statewide model with recommendations and guidelines for use. The role that classroom observation could play in encouraging teachers to practice and perform the desired behaviors needed to be explored further.

Lee Canter and Terry Paulso (2006) did a pilot study on college credit model of in- school consultation: a functional behavioral training programme. The study included 50 teachers and data was collected before and after classes for teachers in mental health principles and techniques. The teacher was trained in the implementation of functional- behavioral intervention skills. The study concluded that teachers post test score was significantly higher than pre test score. The study suggested that teachers gained knowledge on functional behavioral skills.

NEED FOR THE STUDY

Disruptive behavior students are in every classroom across the nation. Teachers are constantly searching for assistance, guidance, ideas, suggestions and relief from this challenge. Yet teachers must remember that they are the source of hope for many of these children and the person who plays a most important role in their lives. A teacher’s words and actions can affect child forever. Success in school involves being able to complete work, stay organized, get along with kids and adults, be positive about your abilities and school, follow rules, and do your best work. Before we understand children behavior, we must understand their needs. In addition to their physical needs, kids need fun, clothing, freedom, power, and a sense of belonging.

Teachers who exhibit high level of efficacy use more positive reinforcement, prefer to work with whole group and present with students who are experiencing difficulty rather than ignoring or giving up on them. The teacher’s ability to be empathetic can also be associated with student’s success. School based intervention has been popular for a number of years and has produced varying degree of success in prevention of behavioral problems in children.

Children should be allowed to express their true fears and anxieties about impending events. Older children may exhibit relationship disturbances with family and friends, poor school performance and behavior regression. It can be difficult to assess whether behavior of such children is normal or sufficiently problematic to require intervention.

Conduct disorder are seen in appropriate 5-8% of general child population. Kadzins review of prevalence indicated that the estimated rate of conduct disorder in children aged 4-18 has ranged from 2-6%. Conduct disorder for youth underage of 18 range from 6-16% for males, 2-9% for females. Prevalence of conduct disorder was 4.58% more common in boys, the majority had childhood onset, and one-third had co morbid attention deficit hyperkinetic disorder. Conduct disorder prevalence in United States is 1-6% (1999) in children. Conduct disorder prevalence in New York is 12% had moderate level of conduct disorder and 4% had severe conduct disorder.

The study was undertaken in the schools under rural and urban field practice areas of Department of community medicine. The total population of children between (10-19 yrs) of all schools was included. The prevalence of conduct disorders were maximum (12.9%) in the 6-14 yrs age group.

Oppositional defiant disorder prevalence rate is 2-16% for youth (American psychiatry association 2000).

School refusal occurs at all ages, appropriately 1-5% of all school-aged children have school refusal. In US aged 14-16 years children showed that 4.3% of teenagers, suffers from school phobia and 5% are identified as school refusal. The average age of onset is 7.5 years and 10.5 years.

A study was conducted on prevalance of behavioral problems of school going children in Ludhiana. The study included 957 school children they assessed the behavioral problems by using Rutter B scale, which was to be completed by the class teachers. Based on the screening instrument results and parental interview, 45.6% of the children were estimated to have behavioral problems, of which 36.5% had significant problems.

A comparative study was done on preschool teacher’s knowledge, attitude and practices on childhood developmental and behavioral disorders. The study involved 503 preschool teachers. It compared early childhood educators well versed in normal development and childhood developmental and behavioral disorders were evaluated in detecting children with potential difficulties, refer for early diagnosis and intervention. The study concluded that educational deficits in childhood developmental and behavioral disorders were found among preschool teachers. The study suggested that there is need to improve their skills to aid integration and improve special education needs, calling for training and resource support.

A workshop was done on children with behavior problems: improving elementary school teachers’ skill to keep these children in class. This study aimed at improving their skills for coping with behavioral problems in children. The ability to hold these children helps to prevent them from dropping out of school and avoids referral to special education programs. The workshop integrated 2 interventions (1) Behavior modification skills. (2) Experimental work on the feelings that the misbehaved child evokes in teachers. In this workshop 57 elementary school teachers participated pre-test and post-test was administrated. The study concluded that evaluation of teacher’s skills and their ability to cope with child who misbehaves score was higher in the post-test than the pre-test. Evaluation of emotional variables after workshop had no significant change in scores.

In the light of the above mentioned studies the investigator observed that the prevalence rate of psychiatric disorder in India is more in middle class children and the knowledge of teachers regarding behavioral disorder is inadequate. If the early identification of conduct disorder is not done in the child age then they may go for antisocial personality disorder. So the investigator took up this study for diploma in education students so that helps in of early identification of behavioral problems among school children.

SCOPE OF THE STUDY

The study to assess the effectiveness of structured teaching programme on behavioral problems of school children has tremendous scope in practice, education and further research. The scope related to nursing practice has manifold. The research contributes to detect the effective alternative intervention to manage the behavioral problems of school children, its prevention and rehabilitative measures. It attributes further research in clinical practice for super specialty in psychiatric nursing.

The research to develop structured teaching programme helps to mould the nursing education curriculum in depth about its discharge process, preventive and curative procedures. The nursing educators can rebuild the concepts further in education.

The findings of this study, further helps the researchers to act as catalyst to generalize the findings. The new research findings help for extensive in depth research in different aspects of assessing the effectiveness of structured teaching programme in managing the behavioral problems of school children.

When behavioral problems of school children are reduced, the body’s immune system gets a boost that also effectively enhances cognitive abilities, it is considered as an effective intervention in managing stress, behavior disorders, and many other illnesses.

The findings of this study help the school teachers in changing mental attitude towards problems and develop effective way to behavioral problems of school children. The research finding of the study contributes to know the epidemiology of behavioral problems of school children and in turn helps in medical and national health statistics. This data further helps to view the future planning and contributes in national health programme.

STATEMENT OF THE PROBLEM

“A study to assess the effectiveness of structured teaching programme on behavioral problems of school children among diploma in education students in selected college at Mandi Gobindgarh.”

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MAIN OBJECTIVE

To assess the effectiveness of structured teaching to reduce the behavioral problems of school children.

Sub Objectives

To modify and translate standardized tools of assessing stress and coping strategies among hospitalized clients

To check validity and reliability of developed/modified tools.

To assess the existing knowledge of diploma in education students regarding behavioral problems of school children.

To evaluate the effectiveness of structured teaching programme on behavioral problems of school children among diploma in education students.

To find out association between knowledge score of diploma in education students on behavioral problems of school children with selected demographic variables.

OPERATIONAL DEFINITIONS

Effectiveness:

It refers to the significant difference between pre and post test knowledge scores of diploma in education students on behavioral problems of school children after receiving structured teaching programme.

Structured teaching programme:

It refers to systematically developed instructional aids designed for diploma in education students on behavioral problems of school children.

Behavioral problems:

Behavioral problem refers to a behavior that goes to an extreme level- behavior that is not slightly different from the usual.

It includes the conditions like conduct disorder, aggression, stealing, lying, truancy, bullying, fire setting, impulsivity, oppositional defiant disorder and school fear.

Diploma in education students:

It refers to diploma in education students who are studying in diploma in education college at Mandi Gobindgarh.

Assumptions

Assumptions are the basic principles that are accepted as being true on the basis of logic or reason, without proof or verification.

The study assumes that

Diploma in education students may have inadequate knowledge regarding behavioral problems of school children.

Structured teaching programme may improve the knowledge of diploma in education students.

Diploma in education students’ knowledge may vary with selected demographic variables.

Hypothesis

Hypothesis is a statement of predicted relationship between variables.

H1-There will be significant difference between pre and post test knowledge scores of diploma in education students on behavioral problems of school children after administering structured teaching programme.

H01: There will be no significant difference between pre and post test knowledge scores of diploma in education students on behavioral problems of school children after administering structured teaching programme.

H2-There will be significant association between the knowledge scores of diploma in education students on behavioral problems of school children with selected demographic variables.

H02:-There will be no significant association between the knowledge scores of diploma in education students on behavioral problems of school children with selected demographic variables.

DELIMITATION

Study is delimited to diploma in education students.

Effectiveness of a structured teaching programme in terms of knowledge aspects only.

MATERIALS AND METHODS

Research approach

Quantitative approach

Research design

Pre experimental one group pre-test post-test design

Pretest X (Structured Teaching Programme) Posttest

Variables

The Independent variable of the study is “Structured Teaching Programme on behavioral problems of school children.”

The dependent variable in the study will include “Knowledge of diploma in education students on behavioral problems of school children.”

Research Setting

The study will be conducted in a selected diploma in education college.

The reason for selecting the setting is:

1) Easy access to subjects

2) Administration approval and expected cooperation

Target Population

Population includes clients who are diploma in education students

Sampling procedure

For selecting subjects

The Purposive sampling technique through non-probability sampling approach will be used for selecting the study subjects fulfilling the inclusion criteria.

Inclusion Criteria

Clients who are willing and able to participate

Males & females of age range 20 – 25 years.

Clients who are able to read and write English.

Written informed consent

Exclusion Criteria

Who have been previously sensitized with same or similar intervention.

Sample size

Out of the total clients who will be admitted in a selected college of education, complete enumeration will be done and those who fulfill the inclusion criteria will be taken for the study. A total 200 samples, after meeting the inclusion criteria will be included.

Tools and protocol for data collection

The tool consists of

The structured interview schedule comprised of two sections.

SECTION-I

Socio Demographic Data: It contains the questions related to identification data, socio demographic data, and clinical profile of the clients. The data includes 8 items which age, gender, religion, education, marital status, residence, type of family and family income.

SECTION-II

Self administered structured Knowledge questionnaire consists of 40 items. The tools will be checked for validity and reliability. Content Validity will be done by having the expert opinions from different fields and reliability will be done by split half method.

Method of Data Collection

Data will be collected by using developed and modified tools.

The data will be collected in the following manner:

Upon review of clients, consenting subjects who will meet the inclusion criteria will be selected.

Self introduction & establishing rapport with the subjects.

Setting up of conductive atmosphere for data collection.

Subject will be assured of the confidently of their data.

On the first day purpose of the study will be explained to the sample and informed consent was taken before starting the study.

A pretest will be conducted by self administration of structured knowledge questionnaire to each sample. Duration of 25 minutes will be given for each sample to complete the tool .

On the same day the Structured Teaching Programme will be administered on behavioral problems of school children for 45 minutes using flash cards, ohp sheet and slides.

Post test will be conducted by using the same structured knowledge questionnaire after 7 days of the structured teaching programme.

Plan of pilot study

Pilot study will be conducted on the diploma in education students and will be admitted in a selected college of education in Mandi Gobindgarh with 10% samples to check the feasibility of the study and validity of the tools and methodology.

Methods of data analysis

The data obtained will be analyzed in terms of objectives of the study using descriptive and inferential statistics. The plan of data analysis will be as follows:-

Organize data in master sheet or computer.

Demographic data will be analyzed in terms of frequencies and percentage.

The knowledge of diploma in education students before and after administration of STP will be analyzed in terms of frequencies, percentage, mean, mean%, standard deviation and would be presented in the form of bar, cone diagram.

The significant difference between pre test and post test score will be determined by paired “t” test.

‘χ2’ test is used to determine the association between pre-test and post-test knowledge scores with selected demographic.

Does the study require any investigation or intervention to be conducted on patients or other humans or animals? If so describe briefly.

Yes, the study requires intervention to be conducted on diploma in education students.

Has ethical clearance been obtained from your institution?

Formal permission will be obtained from Principal diploma in education college Mandi Gobindgarh.

Informed consent will be obtained from all the participants of diploma in education students.

The participants will be assured that the information collected will be kept confidential.

The participants will be informed that their participation was voluntary and have the freedom to withdraw on their own at any time from the study.

TENTATIVE CHAPTER SCHEME

SR.No

CONTENT

1

Introduction

2

Review of literature

3

Methodology

Conceptual framework

Preparation of tool

Validation of tool

Reliability of tool

Pretesting of the tool

Pilot study

Data Collection

Analysis and Interpretation

4

Results

5

Discussion

6

Conclusion

7

Summary

8

References

9

Annexure

10

Submission of dissertation