Efficacy of behavioral classroom programs in primary school. A meta-analysis focusing on randomized controlled trials

PLoS One. 2018 Oct 10;13(10):e0201779. doi: 10.1371/journal.pone.0201779. eCollection 2018.


Objective: This meta-analysis evaluated the efficacy of behavioral classroom programs on symptoms of Attention-deficit Hyperactivity Disorder or Oppositional Defiant and/or Conduct Disorder in primary school children.

Method: Online database searches (in PubMed, Embase, Psycinfo, and Eric) yielded nineteen randomized controlled trials (N = 18,094), comparing behavioral classroom programs (including multimodal programs involving a classroom program) to no treatment/treatment as usual. Random-effects meta-analyses were conducted for teacher-rated and classroom-observed disruptive classroom behavior and for classroom-observed on-task behavior. Post-hoc analyses investigated whether effects depended on type and severity of problem behavior. Meta-regressions studied the moderating effects of age, gender, and intervention duration.

Results: Small positive effects were found on teacher-rated disruptive behavior (d = -0.20) and classroom-observed on-task behavior (d = 0.39). Program effects on teacher-rated disruptive behavior were unrelated to age, gender, type and severity, but negatively associated with intervention duration (R2 = 0.43).

Conclusion: Behavioral classroom programs have small beneficial effects on disruptive behavior and on-task behavior. Results advocate universal programs for entire classrooms to prevent and reduce disruptive classroom behavior.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / psychology*
  • Attention Deficit and Disruptive Behavior Disorders / psychology*
  • Child
  • Conduct Disorder / psychology*
  • Female
  • Humans
  • Male
  • Problem Behavior / psychology*
  • Randomized Controlled Trials as Topic
  • Schools
  • Social Behavior

Grants and funding

Funding for this study was provided by a number of charity organizations including Children’s Welfare Fund (Grant 5930790; https://www.kinderpostzegels.nl/), Nederlandse Stichting Gehandicapte Kind (Grant 20110028; https://www.nsgk.nl/), and Stichting Zonnige Jeugd (http://www.zonnigejeugd.nl/). These organizations had no role in the study design, literature search, analyses or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.