News: The facts about PAX


News: The facts about PAX

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News: The facts about PAX

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"Wow, that was amazing," Young tells his students. "Excellent work."

It's easy to see why Young is so pleased. For the last 20 minutes or so, these students have been on their best behaviour, carrying out their reading and writing assignments without creating any of the distractions or disruptions that are often associated with elementary classrooms.

Andrew Young, Teacher says the PAX program is making a big difference

Andrew Young, Teacher says the PAX program is making a big difference in his class

As a result, the class gets two fun activity breaks: For the next minute or two, they will get to play Graveyard - a contest in which some children get to try and make others giggle. That will be followed by a mini-dance party, which involves students mimicking the moves of two animated figures on a projector as music plays in the background.

The kids love it. They split into two teams - boys and girls - and spend the next few minutes trying to outdo each other on the floor.

To the casual observer, the idea of using classroom time for a quick physical activity break may seem like nothing more than a nice way for a teacher to inject some fun into the classroom routine. But there is much more going on here than meets the eye.

As it turns out, Young and his students are engaged in something called the PAX Good Behaviour Game. Developed by the Arizona-based PAXIS Institute, the game is one element of a comprehensive mental health strategy that includes a number of other evidence-based practices, also known as "kernels."

Taken together, the various elements of the strategy are designed to help students learn how to regulate their behaviour and collaborate with others for "peace, productivity, health and happiness."

In doing so, childhood health advocates and educators say the program also does something else: It provides kids with the tools they need to prevent harmful mental health outcomes, including bullying, substance abuse and even suicide.

"What you see in the classroom is that the kids have better control of their emotions and behaviours."

Needless to say, a classroom activity that can address these kinds of issues is going to attract the attention of policymakers. It's also going to generate some questions.

And it's up to Winnipeg researcher Depeng Jiang to come up with the answers.

Dr. Depeng Jiang is an Associate Professor in the Department of Community Health Sciences at the University of Manitoba and a lead of the Biostatistics group for the CHI Data Science platform.

Jiang is a biostatistician at the George & Fay Yee Centre for Healthcare Innovation and an associate professor of biostatistics in the Department of Community Health Sciences at the University of Manitoba's Faculty of Health Sciences. He and his research team, are in the third year of a major study into PAX. Their job is to analyze its effectiveness and determine what can be done, if anything, to improve its application.

Given the program's promise, Jiang and his team's work is of the utmost importance. Initial funding for the study came in the form of $200,000 over two years from Research Manitoba's Applied Health Services Grant, which is designed to support collaborations between policymakers, service providers, and researchers interested in working together to address health-system challenges. Research Manitoba partners with Manitoba Health, the regional health authorities, and the George & Fay Yee Centre for Healthcare Innovation to support applied health services research. In addition, Jiang and his team recently received a $100,000 grant from the Canadian Institute for Health Research, which will allow him to expand the study and develop the statistical methods needed for analyzing the data.

The PAX program first gained attention in this province in 2011 when it was introduced to students in the Seine River School Division by way of a pilot project sponsored by Healthy Child Manitoba, the cross-department government strategy for supporting children and families. Since then, the program has been implemented at more than 250 elementary schools across Manitoba.

The cornerstone of the PAX program involves a process for creating a vision for the classroom. The vision - created by the students - is essentially a wordmap of behaviours the kids would like to see more or less of in the classroom.

The vision informs the use of all the "kernels" used in the program, including the good behaviour game that Young plays in his classroom. The game involves the use of a unique vocabulary of made-up words, visual and audio cues, and a series of motivating activity breaks to inspire kids to achieve their vision. So, instead of spending all day asking, or telling, children to stop doing disruptive things, the game encourages them to do productive and co-operative things. And instead of calling certain behaviours "bad" or "good," they are referred to as "spleems" or "PAX."

Before the game is played, the teacher reviews the vision wordmap with the students to recall what actions would be spleems (shouting, talking while the teacher is talking, poking the kid in the next desk) and what kinds of actions would be PAX (concentrating on your work, being respectful, sharing).

The game is played while the children are doing some other classroom activity, such as silent reading, art, or group discussion. After a set amount of time, if a group has only done three "spleems," they get to enjoy a "brain activity break" - which can be something as simple as a short group laugh or dance.

It may sound silly, but it works.

"What makes the Manitoba PAX study different from other PAX studies is that we have a huge amount of population data."

The PAXIS Institute says the game teaches self-regulation, thereby improving a child's attention and reducing impulsiveness. Evidence suggests that the development of social and emotional self-regulation skills are important for a child's life-long physical and mental health, as well as their educational and economic success, according to information provided by the institute. It goes on to state that developing these skills can help kids reduce the risk of mental health problems and psychiatric disorders, including suicidal thoughts and attempts, while also helping prevent "addictions, bullying, violence and crime through age 21 and beyond . . . "

Young says he has been using the program in his classroom for several years and agrees that it has been useful in teaching kids self-regulation. "The PAX program has been of great value to me and the students," he says. "I think the students really learn how to control their emotions and feelings better by calming down after getting excited. It also gives them a chance to get out of their seats and do something active and fun."

Prairie Rose student Eknoor Gill also gives the program a thumbs up, saying he and the other kids enjoy getting an activity break at the end of a PAX game. "The game helps us to quiet down because we won't get the (activity break)," he says.

Gill also likes how PAX uses "tootles" (the opposite of tattles), which are essentially notes that students can write to each other when they think someone has done a PAX or a good thing. Notes like these can be used to foster positive friendships between kids. "The tootles are good because they make you (want to achieve) a high level of something," says Gill.

Leanne Boyd, Director of Policy Development, Research and Evaluation for Healthy Child Manitoba, says one of the more effective aspects of the program is that the children drive it.

"What you see in the classroom is that the kids have better control of their emotions and behaviours," says Boyd. "They are smiling. They are the agents of their own change."

Academic studies of the program have also been positive. A study in Washington State indicated that every dollar spent on PAX in schools generated about $65 worth of savings for the health, education and social services systems. The program has also been recognized by the Institute of Medicine for its ability to reduce suicidal thinking and attempts over the course of a person's lifetime.

In fact, the PAX Good Behaviour Game was singled out in the 2009 Institute of Medicine Report on the Prevention of Mental, Emotional, and Behavioural Disorders as the most proven prevention strategy available to individual teachers.

The results of these studies were echoed by initial small-scale reviews carried out following the initial implementation of the PAX program in Manitoba.

For example, one study showed that the average number of spleems in PAX classrooms drops from 11 to six. A randomized controlled trial by Healthy Child Manitoba also found that children who are in PAX classrooms have significantly fewer conduct problems (like bullying) and emotional issues (like feeling anxious or depressed). They also exhibit more pro-social behaviour, such as sharing or helping others.

After three weeks, says Boyd, "off-task behaviour" was reduced by 40 per cent, the equivalent of winning back an hour per day of teaching time.

While the initial findings were positive, Jiang was asked to take a deeper look.

As a result, Jiang and his team have spent the last two years statistically following a cohort of about 5,000 children who have participated in PAX since entering Grade 1 in the 2011-12 school year.

The team's early findings have turned up some interesting results. Among other things, the team's preliminary analysis suggests that PAX helps children develop communication and problem-solving skills. And it appears that the program has benefits for "moderate-risk" children - not just those at higher risk. Benefits may not be distributed evenly, though. Among the children at higher risk, it seems to help higher risk boys more than girls.

In expanding their research efforts this year, Jiang and his team surveyed all children in the province who completed Grade 5, and compared various health indicators of those who have been through the program with those who haven't. A report on the team's findings is pending.

Jiang says the Manitoba-wide study will provide a bigger base of data and more power to slice through the information to see the program's effects.

"What makes the Manitoba PAX study different from other PAX studies is that we have a huge amount of population data," says Jiang.

Of course, data alone doesn't mean much. As a biostatistician, it's Jiang's job to develop the analytical tools to understand the numbers. As a result, part of what Jiang and his team are doing is working on ways to break down data on a large group of children into clusters in order to see how it works on individuals - not just how it works on average.

That's particularly valuable in studying a program like PAX that has been offered to schools across the entire province, in inner city and suburban schools, in schools on First Nations and Hutterite colonies and to 21,000 students from all cultural, social and economic backgrounds.

Typically, statistical research like this would focus on the different variables that seem to lead to different results in the aggregate, across the entire population. For this study, Jiang and his team are using a "person-oriented approach," which looks at patterns of responses among different groups, allowing researchers to see variations in the effectiveness of the program for various groups of children. "Person-oriented approaches help researchers identify the strata of populations for whom interventions may be differentially effective," he says.

PAX isn't the only behavioural program Jiang is analyzing. He is currently in the middle of a five-year project, for Public Safety Canada, to assess a mental health program for very high-risk children in Kenora.

It uses a program developed in 1985 by the Child Development Institute in Toronto called Stop Now and Plan (SNAP). SNAP was developed for boys under 12 years of age who had been in trouble with the law. It has since evolved to offer gender-specific programs for children aged six to 11 and 12 to 17. It teaches emotional regulation to help children and youths make better decisions, and has the goal of keeping them in school and out of trouble.

He's also working with Project 11, a mental health program for children in Grades 5 to 8, created in honour of former Winnipeg Jets and Manitoba Moose hockey player Rick Rypien, who wore that number on his jersey. The program, developed and co-ordinated by the True North Foundation, is intended to help children build a sense of their classroom as a team and improve their ability to connect and feel empathy for each other. It also encourages physical wellness and academic performance.

Courtesy of WAVE Magazine writer - Bob Armstrong