This paper examined the facilitators and barriers to implementation of mindfulness training (MT) across seven secondary/high schools using a qualitative case study design. Schools varied in level of implementation. Within schools, head teachers, members of school senior leadership teams, and staff members involved in the implementation of MT were interviewed individually. In addition, focus groups were conducted with other members of school staff to capture a broad range of views and perspectives. Across the case studies, several key themes emerged, which suggested four cornerstones to successful implementation of MT in schools. These were: people, specifically the need for committed individuals to champion the approach within their schools, with the support of members of the senior leadership teams; resources, both time and financial resources required for training and delivery of MT; journey, reflecting the fact that implementation takes time, and may be a non-linear process with stops and starts; and finally perceptions, highlighting the importance of members of the school community sharing an understanding what MT is and why it is being introduced in each school context. Similarities and differences between the current findings and those of research on implementation of other forms of school mental health promotion programs, and implementation of MT in healthcare settings, are discussed.
The purpose of this study is to examine the effects of motives for volunteering on respondents' mortality risk 4 years later.Logistic regression analysis was used to examine whether motives for volunteering predicted later mortality risk, above and beyond volunteering itself, in older adults from the Wisconsin Longitudinal Study. Covariates included age, gender, socioeconomic variables, physical, mental, and cognitive health, health risk behaviors, personality traits, received social support, and actual volunteering behavior.
Replicating prior work, respondents who volunteered were at lower risk for mortality 4 years later, especially those who volunteered more regularly and frequently. However, volunteering behavior was not always beneficially related to mortality risk: Those who volunteered for self-oriented reasons had a mortality risk similar to nonvolunteers. Those who volunteered for other-oriented reasons had a decreased mortality risk, even in adjusted models.
This study adds to the existing literature on the powerful effects of social interactions on health and is the first study to our knowledge to examine the effect of motives on volunteers' subsequent mortality. Volunteers live longer than nonvolunteers, but this is only true if they volunteer for other-oriented reasons.
BACKGROUND: Social and emotional learning (SEL) positively impacts children's school achievement and adult productivity. Successful implementation of SEL relies on teachers' pedagogical beliefs and practices.AIMS: We examined whether the Teachers' SEL Belief Scale designed in the United States is adoptable in low-income countries such as Malawi in response to a growing interest in teacher practices in SEL but a lack of research instruments in these countries.
SAMPLES: The data used in this study were from 432 teachers working in 34 randomly selected primary schools in Zomba, a rural district in Malawi.
METHODS: We used multiple-group confirmatory factory analysis to investigate the factor structure and the invariance of the adapted scale across teachers with different characteristics such as gender and training experience in SEL. When invariant, we compared group mean differences among teachers in our sample by gender and training experience.
RESULTS: We found that the Teachers' SEL Belief Scale measured a similar construct of pedagogical perceptions of SEL among the sampled teachers, and it functioned equivalently across teachers with different genders and training experiences. Female teachers had lower perceived institutional support for SEL instruction compared to male teachers. Untrained teachers had lower levels of pedagogical comfort as well as perceived support for SEL compared to trained teachers.
CONCLUSIONS: Our findings validate the adaptability of the Teachers' SEL Belief Scale in low-income contexts such as Malawi. We did not find evidence of systematic bias relative to group membership. In addition, significantly lower pedagogical comfort and institutional support among female and untrained teachers suggest areas for policy intervention to improve teacher performance in SEL in Malawi.
Objective(1) Evaluate feasibility and acceptability of a mindfulness-based group in adolescent girls at-risk for type 2 diabetes (T2D) with depressive symptoms, and (2) compare efficacy of a mindfulness-based versus cognitive-behavioral group for decreasing depressive symptoms and improving insulin resistance.
Design and setting
Parallel-group, randomized controlled pilot trial conducted at a university.
Participants
Thirty-three girls 12–17y with overweight/obesity, family history of diabetes, and elevated depressive symptoms were randomized to a six-week mindfulness-based (n = 17) or cognitive-behavioral program (n = 16).
Interventions
Both interventions included six, one-hour weekly group sessions. The mindfulness-based program included guided mindfulness awareness practices. The cognitive-behavioral program involved cognitive restructuring and behavioral activation.
Main outcome measures
Adolescents were evaluated at baseline, post-intervention, and six-months. Feasibility/acceptability were measured by attendance and program ratings. Depressive symptoms were assessed by validated survey. Insulin resistance was determined from fasting insulin and glucose, and dual energy x-ray absorptiometry was used to assess body composition.
Results
Most adolescents attended ≥80% sessions (mindfulness: 92% versus cognitive-behavioral: 87%, p = 1.00). Acceptability ratings were strong. At post-treatment and six-months, adolescents in the mindfulness condition had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral condition (ps < .05). Compared to the cognitive-behavioral condition, adolescents in the mindfulness-based intervention also had greater decreases in insulin resistance and fasting insulin at post-treatment, adjusting for fat mass and other covariates (ps < .05).
Conclusions
A mindfulness-based intervention shows feasibility and acceptability in girls at-risk for T2D with depressive symptoms. Compared to a cognitive-behavioral program, after the intervention, adolescents who received mindfulness showed greater reductions in depressive symptoms and better insulin resistance.
Mindfulness has become a fixture of both clinical treatment and popular culture. Much research and theoretical scholarship have operationalized “mindfulness” as clinicians use the term, yet no research has examined popular (i.e., lay) conceptions of mindfulness. Mindfulness trainings and interventions are now widely offered on college campuses. Thus, as a starting point for assessing lay conceptions of the construct, we examined how undergraduate college students at an urban university (N = 361) conceptualize mindfulness. In open-ended responses, participants linked mindfulness to awareness of external objects, internal sensations, or being in the present moment. When rating sentences on how well they represented mindfulness, participants strongly associated mindfulness with controlling emotions. In both the open-ended and sentence stem responses, mindfulness was rarely associated with psychological acceptance, which is notable because of the importance of acceptance in mindfulness-based clinical treatments. Implications and future directions are discussed.
There's a strong case for making social and emotional learning (SEL) skills and competencies a central feature of elementary school. Children who master SEL skills get along better with others, do better in school, and have more successful careers and better mental and physical health as adults. Evidence from the most rigorous studies of elementary-school SEL programs however is ambiguous. Some studies find few or no effects, while others find important and meaningful effects. Or studies find effects for some groups of students but not for others. What causes such variation isn't clear, making it hard to interpret and act on the evidence. What are the sources of variation in the impacts of SEL programs designed for the elementary years? To find out, Stephanie Jones, Sophie Barnes, Rebecca Bailey, and Emily Doolittle examine how the theories of change behind 11 widely used school-based SEL interventions align with the way those interventions measure outcomes. Their central conclusion is that what appears to be variation in impacts may instead stem from imprecise program targets misaligned with too-general measures of outcomes. That is to say, program evaluations often fail to measure whether students have mastered the precise skills the programs seek to impart. The authors make three recommendations for policy makers, practitioners, and researchers. The first is that we should focus more on outcomes at the teacher and classroom level, because teachers' own social-emotional competency and the quality of the classroom environment can have a huge effect on students' SEL. Second, because the elementary years span a great many developmental and environmental transitions, SEL programs should take care to focus on the skills appropriate to each grade and age, rather than taking a one-size-fits-all approach. Third, they write, measurement of SEL skills among children in this age range should grow narrower in focus but broader in context and depth.
This study examines the relative contributions of giving versus receiving support to longevity in a sample of older married adults. Baseline indicators of giving and receiving support were used to predict mortality status over a 5-year period in the Changing Lives of Older Couples sample. Results from logistic regression analyses indicated that mortality was significantly reduced for individuals who reported providing instrumental support to friends, relatives, and neighbors, and individuals who reported providing emotional support to their spouse. Receiving support had no effect on mortality once giving support was taken into consideration. This pattern of findings was obtained after controlling for demographic, personality, health, mental health, and marital-relationship variables. These results have implications for understanding how social contact influences health and longevity.
An abstract is unavailable.
PURPOSE: Fatigue is one of the most common and bothersome refractory symptoms experienced by cancer survivors. Mindful exercise interventions such as yoga improve cancer-related fatigue; however, studies of yoga have included heterogeneous survivorship populations, and the effect of yoga on fatigued survivors remains unclear.METHODS: We randomly assigned 34 early-stage breast cancer survivors with cancer-related fatigue (≥4 on a Likert scale from 1-10) within 1 year from diagnosis to a 12-week intervention of home-based yoga versus strengthening exercises, both presented on a DVD. The primary endpoints were feasibility and changes in fatigue, as measured by the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). Secondary endpoint was quality of life, assessed by the Functional Assessment of Cancer Therapies-Breast (FACT-B).
RESULTS: We invited 401 women to participate in the study; 78 responded, and we enrolled 34. Both groups had significant within-group improvement in multiple domains of the fatigue and quality of life scores from baseline to post-intervention, and these benefits were maintained at 3 months post-intervention. However, there was no significant difference between groups in fatigue or quality of life at any assessment time. Similarly, there was no difference between groups in adherence to the exercise intervention.
CONCLUSIONS: Both DVD-based yoga and strengthening exercises designed for cancer survivors may be good options to address fatigue in breast cancer survivors. Both have reasonable uptake, are convenient and reproducible, and may be helpful in decreasing fatigue and improving quality of life in the first year post-diagnosis in breast cancer patients with cancer-related fatigue.
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is associated with significant alterations in neuronal integrity resulting from either hypoxemia and/or sleep loss. A large body of imaging research supports reductions in gray matter volume, alterations in white matter integrity and resting state activity, and functional abnormalities in response to cognitive challenge in various brain regions in patients with OSA. In this study, we used high-density electroencephalography (hdEEG), a functional imaging tool that could potentially be used during routine clinical care, to examine the regional distribution of neural activity in a non-clinical sample of untreated men and women with moderate/severe OSA.DESIGN: Sleep was recorded with 256-channel EEG in relatively healthy subjects with apnea-hypopnea index (AHI) > 10, as well as age-, sex-, and body mass index-matched controls selected from a research population initially recruited for a study on sleep and meditation.
SETTING: Sleep laboratory.
PATIENTS OR PARTICIPANTS: Nine subjects with AHI > 10 and nine matched controls.
INTERVENTIONS: N/A.
MEASUREMENTS AND RESULTS: Topographic analysis of hdEEG data revealed a broadband reduction in EEG power in a circumscribed region overlying the parietal cortex in OSA subjects. This parietal reduction in neural activity was present, to some extent, across all frequency bands in all stages and episodes of nonrapid eye movement sleep.
CONCLUSION: This investigation suggests that regional deficits in electroencephalography (EEG) power generation may be a useful clinical marker for neural disruption in obstructive sleep apnea, and that high-density EEG may have the sensitivity to detect pathological cortical changes early in the disease process.
Important features of the self-concept can be located outside of the individual and inside close or related others. The authors use this insight to reinterpret data previously said to support the empathy-altruism model of helping, which asserts that empathic concern for another results in selflessness and true altruism. That is, they argue that the conditions that lead to empathic concern also lead to a greater sense of self-other overlap, raising the possibility that helping under these conditions is not selfless but is also directed toward the self. In 3 studies, the impact of empathic concern on willingness to help was eliminated when oneness--a measure of perceived self-other overlap--was considered. Path analyses revealed further that empathic concern increased helping only through its relation to perceived oneness, thereby throwing the empathy-altruism model into question. The authors suggest that empathic concern affects helping primarily as an emotional signal of oneness.
The purpose of this study was to investigate whether dispositional mindfulness (the tendency to be mindful in general daily life) accounts for variance in psychological symptoms and wellbeing after accounting for the influence of dispositional self-control (the tendency to be self-disciplined, reliable, hardworking, etc.). A large sample of undergraduate students (N=280) completed self-report measures of mindfulness, self control, psychological wellbeing, and general psychological distress (depression and anxiety, and stress). As expected, both mindfulness and self-control were positively correlated with wellbeing and negatively correlated with general distress. Mindfulness was found to account for significant variance in psychological wellbeing and general distress after accounting for self-control. In addition, mindfulness was a significant moderator of the relationship between self-control and psychological symptoms. Results show that although self-control predicts significant variance in psychological health, mindfulness predicts incremental variance, suggesting that a mindful approach to ongoing experience can contribute to mental health in persons who are highly self-disciplined and hardworking.
BackgroundA large proportion of mindfulness-based therapy trials report statistically significant results, even in the context of very low statistical power. The objective of the present study was to characterize the reporting of “positive” results in randomized controlled trials of mindfulness-based therapy. We also assessed mindfulness-based therapy trial registrations for indications of possible reporting bias and reviewed recent systematic reviews and meta-analyses to determine whether reporting biases were identified.
Methods
CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS databases were searched for randomized controlled trials of mindfulness-based therapy. The number of positive trials was described and compared to the number that might be expected if mindfulness-based therapy were similarly effective compared to individual therapy for depression. Trial registries were searched for mindfulness-based therapy registrations. CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS were also searched for mindfulness-based therapy systematic reviews and meta-analyses.
Results
108 (87%) of 124 published trials reported ≥1 positive outcome in the abstract, and 109 (88%) concluded that mindfulness-based therapy was effective, 1.6 times greater than the expected number of positive trials based on effect size d = 0.55 (expected number positive trials = 65.7). Of 21 trial registrations, 13 (62%) remained unpublished 30 months post-trial completion. No trial registrations adequately specified a single primary outcome measure with time of assessment. None of 36 systematic reviews and meta-analyses concluded that effect estimates were overestimated due to reporting biases.
Conclusions
The proportion of mindfulness-based therapy trials with statistically significant results may overstate what would occur in practice.
BackgroundA large proportion of mindfulness-based therapy trials report statistically significant results, even in the context of very low statistical power. The objective of the present study was to characterize the reporting of “positive” results in randomized controlled trials of mindfulness-based therapy. We also assessed mindfulness-based therapy trial registrations for indications of possible reporting bias and reviewed recent systematic reviews and meta-analyses to determine whether reporting biases were identified.
Methods
CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS databases were searched for randomized controlled trials of mindfulness-based therapy. The number of positive trials was described and compared to the number that might be expected if mindfulness-based therapy were similarly effective compared to individual therapy for depression. Trial registries were searched for mindfulness-based therapy registrations. CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS were also searched for mindfulness-based therapy systematic reviews and meta-analyses.
Results
108 (87%) of 124 published trials reported ≥1 positive outcome in the abstract, and 109 (88%) concluded that mindfulness-based therapy was effective, 1.6 times greater than the expected number of positive trials based on effect size d = 0.55 (expected number positive trials = 65.7). Of 21 trial registrations, 13 (62%) remained unpublished 30 months post-trial completion. No trial registrations adequately specified a single primary outcome measure with time of assessment. None of 36 systematic reviews and meta-analyses concluded that effect estimates were overestimated due to reporting biases.
Conclusions
The proportion of mindfulness-based therapy trials with statistically significant results may overstate what would occur in practice.
PURPOSE: Reviews of yoga research that distinguish results of trials conducted during (versus after) cancer treatment are needed to guide future research and clinical practice. We therefore conducted a review of non-randomized studies and randomized controlled trials of yoga interventions for children and adults undergoing treatment for any cancer type.METHODS: Studies were identified via research databases and reference lists. Inclusion criteria were the following: (1) children or adults undergoing cancer treatment, (2) intervention stated as yoga or component of yoga, and (3) publication in English in peer-reviewed journals through October 2015. Exclusion criteria were the following: (1) samples receiving hormone therapy only, (2) interventions involving meditation only, and (3) yoga delivered within broader cancer recovery or mindfulness-based stress reduction programs.
RESULTS: Results of non-randomized (adult n = 8, pediatric n = 4) and randomized controlled trials (adult n = 13, pediatric n = 0) conducted during cancer treatment are summarized separately by age group. Findings most consistently support improvement in psychological outcomes (e.g., depression, distress, anxiety). Several studies also found that yoga enhanced quality of life, though further investigation is needed to clarify domain-specific efficacy (e.g., physical, social, cancer-specific). Regarding physical and biomedical outcomes, evidence increasingly suggests that yoga ameliorates sleep and fatigue; additional research is needed to advance preliminary findings for other treatment sequelae and stress/immunity biomarkers.
CONCLUSIONS: Among adults undergoing cancer treatment, evidence supports recommending yoga for improving psychological outcomes, with potential for also improving physical symptoms. Evidence is insufficient to evaluate the efficacy of yoga in pediatric oncology. We describe suggestions for strengthening yoga research methodology to inform clinical practice guidelines.
Scaling in educational settings has tended to focus on replication of external programs with less focus on the nature of adaptation. In this article, we explore the scaling of Personalization for Academic and Social-emotional Learning (PASL), a systemic high school reform effort that was intentionally identified, developed, and implemented with adaption in mind for both the innovation and the scaling process itself. Drawing on focus group and individual interviews with administrators, guidance counselors, and teachers in eight urban high schools in Florida, we explore five elements of scale: depth, sustainability, spread, shift in reform ownership, and evolution of PASL. We find that implementers demonstrated a depth of belief, sustainability, and spread related to the idea of personalization. They did not show the same levels of sustainability and spread regarding the organizational routines related to PASL, although this differed widely by school. The reform approach using continuous improvement helped with shift in reform ownership and gave implementers control over the evolution of the reform. Despite this active involvement, administrators and teachers responded to PASL much like they would have an external reform, identifying the lack of time and school norms as impeding the implementation of routines and practices.
Objective: To report experimental impacts of a universal, integrated school-based intervention in social-emotional learning and literacy development on change over 1 school year in 3rd-grade children's social-emotional, behavioral, and academic outcomes. Method: This study employed a school-randomized, experimental design and included 942 3rd-grade children (49% boys; 45.6% Hispanic/Latino, 41.1% Black/African American, 4.7% non-Hispanic White, and 8.6% other racial/ethnic groups, including Asian, Pacific Islander, Native American) in 18 New York City public elementary schools. Data on children's social-cognitive processes (e.g., hostile attribution biases), behavioral symptomatology (e.g., conduct problems), and literacy skills and academic achievement (e.g., reading achievement) were collected in the fall and spring of 1 school year. Results: There were main effects of the 4Rs Program after 1 year on only 2 of the 13 outcomes examined. These include children's self-reports of hostile attributional biases (Cohen's d = 0.20) and depression (d = 0.24). As expected based on program and developmental theory, there were impacts of the intervention for those children identified by teachers at baseline with the highest levels of aggression (d = 0.32-0.59) on 4 other outcomes: children's self-reports of aggressive fantasies, teacher reports of academic skills, reading achievement scaled scores, and children's attendance. Conclusions: This report of effects of the 4Rs intervention on individual children across domains of functioning after 1 school year represents an important first step in establishing a better understanding of what is achievable by a schoolwide intervention such as the 4Rs in its earliest stages of unfolding. The first-year impacts, combined with our knowledge of sustained and expanded effects after a second year, provide evidence that this intervention may be initiating positive developmental cascades both in the general population of students and among those at highest behavioral risk. (Contains 4 tables and 3 figures.)
Social and Emotional Learning (SEL) refers to the process through which individuals learn and apply social, emotional, behavioral, and character skills required to succeed in schooling, the workplace, relationships, and citizenship. In public discussion of SEL, not everyone can quite agree on what it is. To some, it involves a set of tools for learning, while others see it as a way of promoting resilience in the face of both normative and traumatic stresses. Others see it as a system of values, virtues, habits, and personality or character traits. Still others focus on the importance of neurocognitive skills such as working memory or cognitive flexibility. This lack of consistency does not mean, that SEL is "soft," immeasurable, irrelevant, or faddish. According to the Aspen Institute's National Commission on Social, Emotional, and Academic Development, "It means that social and emotional development is multifaceted and is integral to academics--to how school happens, and to how learning takes place." Generally, SEL skills can be grouped into three interconnected domains: (1) Cognitive regulation skills; (2) Emotional competencies; (3) Social and interpersonal skills. Interest in SEL is high among education leaders, practitioners, and policymakers. There is clear evidence that promoting SEL via high-quality programs, systems, and strategies in both school and out-of-school settings can be effective. There are multiple ways that schools and districts approach SEL. Most common are school-based prevention and intervention programs, typically comprehensive, scripted curricula with sequenced lessons and explicit instruction in SEL skills--some emphasizing conflict resolution, others focused on empathy, and others targeting a range of skills and competencies. In many settings, it can be difficult to implement comprehensive SEL programs, which often offer teachers and schools inadequate flexibility or adaptability. This article details some guides state policymakers could use to shape and decide which statewide efforts to employ. The guidelines provided are organized around four actions: (1) conducting a needs assessment; (2) alignment of approaches; (3) focus on adults; and (4) development and communication of a plan.
Self-compassion involves being touched by and open to one’s own suffering, not avoiding or disconnecting from it, generating the desire to alleviate one’s suffering and to heal oneself with kindness. Self-compassion also involves offering nonjudgmental understanding to one’s pain, inadequacies, and failures, so that one’s experience is seen as part of the larger human experience. This chapter will provide an overview of theory and research on self-compassion and its link to psychological well-being, which is the goal of clinical practice. It will discuss what self-compassion is and what it is not (e.g., a form of weakness, selfishness, etc.), and provide empirical evidence to support these distinctions. Finally, it will discuss methods that have been developed to teach individuals how to be more self-compassionate in their daily lives, some clinical implications of self-compassion training, and future directions for research.
The article discusses various topics published within the issue including the role of schools and related settings in supporting social and emotional learning (SEL) skill development, the ways by which schools can nurture SEL in students and the cultivation of SEL skills in schools.
Schools are an important context for children's social and emotional development. In classrooms and other school settings, children and adolescents need to have skills such as managing negative emotions, being calm and focused, following directions, and navigating relationships with peers and adults. To build and support these skills, schools have widely adopted social and emotional learning (SEL) programs. When well-designed and well-implemented, SEL programs are associated with positive outcomes; however, effect sizes are generally modest even for the most promising interventions. This issue of "Social Policy Report" proposes that schools should take a new approach: integrating the teaching and reinforcement of SEL skills into their daily interactions and practices with students. It explains that research warrants a new perspective and highlights a range of new approaches and support strategies that are designed to be time-efficient, low-cost, and integrated with (rather than distracting from) academic curricula. These strategies are grounded in an organizing framework for SEL and a review of current programmatic approaches to SEL. They are introduced with a set of principles for creating better integration of SEL into educational practice and accompanied by recommendations about the role of policy. (Contains 1 figure and 4 footnotes.) [Commentaries from David Osher, Kathleen Lynne Lane, Janice Jackson, and Meria Joel Carstarphen are included. Commentaries are individually referenced.].
Schools are an important context for children's social and emotional development. In classrooms and other school settings, children and adolescents need to have skills such as managing negative emotions, being calm and focused, following directions, and navigating relationships with peers and adults. To build and support these skills, schools have widely adopted social and emotional learning (SEL) programs. When well-designed and well-implemented, SEL programs are associated with positive outcomes; however, effect sizes are generally modest even for the most promising interventions. This issue of "Social Policy Report" proposes that schools should take a new approach: integrating the teaching and reinforcement of SEL skills into their daily interactions and practices with students. It explains that research warrants a new perspective and highlights a range of new approaches and support strategies that are designed to be time-efficient, low-cost, and integrated with (rather than distracting from) academic curricula. These strategies are grounded in an organizing framework for SEL and a review of current programmatic approaches to SEL. They are introduced with a set of principles for creating better integration of SEL into educational practice and accompanied by recommendations about the role of policy. (Contains 1 figure and 4 footnotes.) [Commentaries from David Osher, Kathleen Lynne Lane, Janice Jackson, and Meria Joel Carstarphen are included. Commentaries are individually referenced.].
A variety of universal school-based social and emotional learning (SEL) programs have been designed in the past decades to help children improve social-emotional and academic skills. Evidence on the effectiveness of SEL programs has been mixed in the literature. Using data from a longitudinal follow-up study of children (n = 414) originally enrolled in a clustered randomized controlled trial (RCT) when they were in Head Start, we examined whether universal SEL services in third grade were associated with the development of children from disadvantaged families. We took advantage of pairwise matching in the RCT design to compare children who had similar family background and preschool experiences but received different doses of SEL services in third grade. The results showed that the frequent (i.e., weekly to daily) exposure to SEL opportunities was associated with favorable social-emotional and academic development in third grade, including increased social skills, student-teacher relationship, and academic skills, as well as reduced impulsiveness.
Pages |