University of Sussex
Lynch, Michael David.pdf (2.37 MB)

A mixed method analysis of an Early Intervention Program for students with behavioural and concentration difficulties in two schools in Malmö, Sweden

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posted on 2023-06-09, 00:25 authored by Michael David Lynch
The aim of this research, set in two schools in Malmö, Sweden, was to examine the outcomes of a combined approach of a behavioural modification program and a biofeedback intervention for students, aged 7 to 12, with behavioural and concentration difficulties. Biofeedback is the use of technology to measure physiological changes in the body (such as heart rate and breathing) and gives this information back to the user. The behavioural modification program was an intervention known as Family Class, whereby students (and their parents) attended for 12 weeks to work on classroom issues identified by the teacher. It is accepted that students with behavioural and concentration difficulties are at risk of going on to develop more severe problems such as ADHD, if early intervention programs are not implemented (Barkley, 1996). In addition, the Swedish education system is under increasing political pressure given poor international results (PISA, 2013) and poor high school graduation rates (Cederberg et al, 2011). Working as a social worker across two schools, I was ideally placed to assess the current intervention provision, adapt it and subsequently carry out the research to evaluate the outcomes. The research drew on a pragmatist epistemology (Hall, 2013) that supported the semi-experimental design used in the study. A mixed methods approach to gathering the data from parents, teachers and the students was used. Qualitative data collected before and after the intervention, were sought through interviews with students in which vignettes were used to identify their ideas on self-regulation of behaviour, whilst quantitative data on the impact of the combined intervention were gathered through pre/post measures using The Strengths and Difficulties Questionnaire, Biofeedback software and behavioural sheets. The thesis also traces the author’s changing identity from a practitioner to a researcher-practitioner. The experience of doing the research was interwoven into the fabric of the study, helping to ensure that the study is rooted in practice. In that respect, a key social work value, empowerment, was critically discussed by referring to the theories of Michel Foucault and John Dewey. A view that self-regulation can be seen as an act of empowerment was the resulting outcome of this theoretical discussion. This position supported the author’s personal practice and the intention behind the intervention was the focus of the research. The key findings from the qualitative data suggested that the majority of the sample of 13 students (most of whom had experienced difficulties for more than a year) had learnt self-regulation skills and understood self-regulation ideas; from their responses to the vignettes, it appeared students had moved from a position of reliance on teachers and other adults when managing behaviour and concentration difficulties to a position that encouraged a balance between the students’ self understanding on how to manage classroom challenges and the role the teacher can play in this. This was backed up by SDQ feedback from the parents and teachers on the changes in the students’ own behaviour in relation to the following categories: hyperactivity and attention, peer interaction and pro-social behaviour, conduct behaviour, emotional difficulties, impact on relationships and perceptions of the problem. The biofeedback data also showed that the group as a whole had learnt how to regulate their breathing and heart rate. The key implications for social work practice are that the combination of a behavioural modification approach such as Family Class with biofeedback has potential in helping students with behavioural and concentration difficulties in a school setting. The methods and methodology used in this research proved to be a suitable approach to identifying the impacts of an innovative intervention and could be considered by other social workers carrying out research in similar settings.


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  • doctoral

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  • eng


University of Sussex

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