Behaven Kids for Professionals

For more summaries of these research studies as they apply to parents, click here.


McTate, E., Badura Brack, A. S., Handel, P. J., & Burke, R. V. (In press). A program intervention for pediatric bipolar disorder: Preliminary results. Child and Family Behavior Therapy. Child & Family Behavior Therapy, 35, 179-292.

Abstract: Effectiveness of a behaviorally based day treatment program for young children diagnosed with Pediatric Bipolar Disorder (PBD) was evaluated using pre and post treatment mean scores from the Child Behavior Checklist (CBCL). Data were evaluated in aggregate and using the clinically significant change method for children diagnosed with PBD, Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), Adjustment Disorder, and no diagnosis/clinical and sub-clinical groups. We found significant treatment effects for all groups except the no diagnosis/sub-clinical group on the internalizing scale and for all groups on the externalizing scale. In addition to statistically significant improvements on both the internalizing and externalizing scales of the CBCL, clinically significant change was also supported for the PBD group as well as for the ADHD, ODD, and Adjustment Disorder groups. The limitations of the study and implications surrounding the behavioral treatment of pediatric bipolar disorder are discussed. Click HERE to view this article.


Burke, R. V., Kuhn, B. R., Peterson, J. L., Peterson, R. W., & Badura Brack, A. S. (2010). Don’t kick me out: Day treatment for two preschool children with severe behavior problems. Clinical Case Studies, 9, 28-40.

Abstract: Parents of young children with severe emotional and behavior problems have few services from which to choose once their child is expelled from preschool for aggressive and disruptive behavior.  Two case studies provide an overview of a multi-component, intensive day treatment program for children with moderate to severe behavior disorders. Proximal and distal program goals are to eliminate presenting problem behaviors and increase social competencies, and to reintegrate children back to their school, preschool, or daycare, respectively. The cases presented in this study provide preliminary evidence that day treatment is a viable option for young children with disruptive behavior disorders.


Burke, R. V., Kuhn, B. R., & Peterson, J. L. (2004). Brief report: A “storybook” ending to children’s bedtime problems: The use of a social story to reduce bedtime resistance and frequent night-waking. Journal of Pediatric Psychology, 29(5), 389-396.

Objective: To evaluate the efficacy and acceptability of a social story with tangible rewards to reduce children’s disruptive bedtime behavior and frequent night waking.

Method: Four children (ages 2 to 7), with clinically significant disruptive bedtime behavior, received the intervention, which consisted of a social story (The Sleep Fairy) that sets forth (a) parental expectations for appropriate bedtime behavior and (b) rewards for meeting those expectations.

Results: Parent sleep diaries indicated that children had a 78% average decrease in frequency of disruptive bedtime behaviors from baseline to intervention, with another 7% decrease at 3-month follow-up. Night wakings, a problem for 2 children during baseline, were not a problem during intervention and follow-up. Parents reported improved daytime behavior for 3 of the 4 children. Parents gave the intervention high acceptability ratings and maintained a high level of treatment fidelity.

Conclusions: Use of a social story helped parents implement a multi-component intervention using a familiar bedtime routine, thereby increasing the likelihood that implementation and effects occurred. The book format makes this intervention widely available to parents and professionals, with minimal costs and inconvenience.


Gilliam, W. S. (2005). Prekindergarteners left behind: Expulsion rates in state prekindergarten systems. New Haven, CT: Yale University Child Study Center.

Summary: The author conducted a study of expulsion practices from 3,898 pre-K classrooms from 52 state-funded programs representing 40 states.  Results indicated that:

  • 10% of pre-K teachers reported expelling a student in the past year.
  • Nationally, the pre-K expulsion rate was 6.67 students per 1,000 enrolled or 3.2 times the expulsion rate for K-12 students (2.09 per 1,000 enrolled students).
  • 4-year-olds were expelled at rates 50% higher than rates for 2- and 3-year-olds.  However, 5- and 6-year-olds were expelled at twice the rate of 4-year-olds.
  • African-American pre-K students were twice as likely to be expelled as European-American and Latino pre-school students and more than 5 times more likely to be expelled as Asian-American students in pre-K.
  • Boys were 4.5 times more likely to be expelled than girls among all but African-American pre-K students; among African-Americans, boys were more than 9 times more likely than girls to be expelled from pre-school.
  • Teachers in faith-affiliated, for-profit child care, and other community program were more likely than teachers in school-based and Head Start programs to expel pre-K students.
  • Teachers who had access – either on-site or on-call – to mental health consultation for developing interventions for dealing with behaviorally challenging students had significantly lower expulsion rates than those who had no access to such consultation.

The author provides a listing of pre-K expulsion rates by state pre-K system and ratios of pre-K to K-12 expulsion rates for participating states.

Implications. Key findings include the benefit of behavioral health support systems at an early age and the need for alternative settings for children who present behavioral challenges in currently available child care and pre-K programs.  Additionally, while it has been well-documented that African-American males are over-represented among students expelled or suspended from K-12 school settings, these results indicate that the problem may start even earlier for these students.  Early interventions may have the greatest benefit for students who are at greatest risk for continued behavior problems that disrupt the educational process.


Gilliam, W. S., & Shahar, G. (2006). Preschool and child care expulsion and suspension: Rates and predictors in one state. Infants & Young Children, 19, 228-245.

Summary: In a study of preschool and child care programs in state of Massachusetts, researchers found that:

  • 39.9% of surveyed preschool teachers reported that they expelled at least one child during the year prior to the study.
  • This resulted in an expulsion rate for Massachusetts preschoolers of 27.42 children per 1,000 children enrolled in preschool or child care programs; or more than 34 times the expulsion rate for K-12 students in Massachusetts (0.80 per 1,000 students).
  • The Massachusetts preschool expulsion rate was more than 13 times higher than the national K-12 expulsion rate.
  • Suspension rates for preschool children were substantially lower in Massachusetts than they were for K-12 classrooms.
  • There was a significant relationship between teachers who expelled students and teachers who suspended students, and vice-versa.
  • Teachers in public/private schools and Head Start programs were significantly less likely to expel students than their peers from for-profit child care programs or nonprofit agencies.  There were no significant differences among teachers of various levels of education or training and expulsion rates.
  • Teachers who reported high levels of job stress, with more students, and a larger proportion of 3-year-olds in their classrooms were significantly more likely to expel students from their program.

Implications: Interventions typically focus on “fixing” the child’s behavior or designing interventions that can be put in place to help the child.  However, helping teachers cope with job stress and feel better about their role in children’s lives may be as critical as effective behavior management strategies in reducing expulsions and suspensions.  Also, the authors recommend 3 strategies for helping reduce program expulsions: (a) maintain small class sizes, (b) pay special attention to the number of 3-year-olds in any one classroom, and (c) provide teachers with access to behavioral support specialists.


Burke, R. V., Howard, M. R., Peterson, J. L., Peterson, R. W., & Allen, K. D.  (In press).  Video performance feedback: Effects on targeted and non-targeted staff. Behavior Modification.

Abstract: This study used a multiple baseline with reversal design to assess whether visual performance feedback (VPF) influenced targeted and non-targeted staffs’ use of behavior specific praise (BSP) in a day treatment program.  This study expands on the typical VPF audience and assesses whether VPF can be effective with non-certified staff in a day treatment program for young children with behavior disorders, an environment in which it is difficult to maintain high rates of BSP.   In previous school-based studies, VPF has been collected by researchers and provided to targeted teaching staff.  In the current study, rather than relying on researchers, we used staff Instructors to collect VPF and assessed how that experience influenced the Instructors’ use of BSP.  Results suggest that VPF provided, on average, a doubling in rates of BSP use by directly targeted staff and more than a 50% increase in rates of BSP in non-targeted Instructors who collected BSP data.  Furthermore, three of the four participants had substantially higher praise-to-correction ratios during the VPF intervention when compared with baseline and reversal conditions.  Implications for improving treatment fidelity and reducing supervision time are discussed.