Edited by: Vera Coelho, University of Maia, Portugal
Reviewed by: Caroline Christopher, Vanderbilt University, United States; Sofia Guichard, University of Porto, Portugal
This article was submitted to Special Educational Needs, a section of the journal Frontiers in Education
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Early interventions that foster the participation, engagement, and development of children attending preschools, including those in economically disadvantaged (low-income) neighborhoods, are of high priority. One such intervention is a universal socioemotional learning (SEL) program called Promoting Alternative Thinking Strategies (PATHS®) which aims to promote social emotional competence and positive adjustment in children, in general, and may have unique benefits for children attending preschool in low incomes areas. In the SEL field, areas in need of exploration include the possible role that neighborhood income level (i.e., all residents’ income in a postal code that a preschool is located in) could have for children’s social emotional competence and positive adjustment and how neighborhood income level may relate to benefits of an intervention such as PATHS. The study aims were to investigate 1) the baseline group differences in social emotional competence and adjustment depending on the neighborhood income level and 2) to determine if neighborhood income level moderated the effects of PATHS on children’s social emotional competence and adjustment from pre to posttest. Participants were 275 children aged four to five years old, from the preschools randomized into an immediate intervention (
Universal school-based interventions that promote social emotional learning (SEL) are increasingly implemented to promote healthy development among young children (
Inclusive education in ECEC provides opportunities to improve achievement and positive development for each child (
From the perspective of ECEC and inclusive education as suggested by the
According to the Affective-Behavioral-Cognitive-Dynamic Model of Development (ABCD-model;
The early social emotional skills encompassed within the intrapersonal and interpersonal competence domains are regarded as fundamental for healthy development, including mental health (
Moreover, recent meta-analysis based on 82 intervention studies showed significant positive impacts of SEL interventions on children’s social emotional competence, attitudes, and academic performance compared with children in control conditions (
Child engagement includes at least three components, i.e., behavioral, emotional, and cognitive engagement components (
Promoting Alternative Thinking Strategies (PATHS®) is a universal SEL intervention that is designed to promote children’s social emotional competence (
More specifically, other U.S. based studies have shown intervention-related benefits in child emotional knowledge skills, social interactions, and reductions in social withdrawal (
Neighborhood income level plays an important, but less explored role in children’s development (
For the sake of brevity, in the remainder of this article, all residents’ income at the postal code/neighborhood/preschool level is referred to as neighborhood income level. Neighborhood income level is notably connected to where a cohort of children attend preschool, although their homes may or may not be located in this neighborhood. Indeed, the neighborhood income level in which schools are located could be critical in terms of the quality of ECEC as reflected in preschools (
According to ecological systems theory (
The links between neighborhood context and aspects of child development could be explained through the impact of different structural or social mechanisms. Lack of safety, poor social cohesion, and the quality and structure of the family environment play an important role for development of cognitive, emotional, and behavioral skills (
For example, a Swedish cross-sectional study with children four to six years old (a subset of children in the present study) showed that those children attending preschools in economically advantaged areas had elevated letter recognition and more rapid naming of objects (i.e., indicators of linguistic and reading development), in comparison to children attending preschool in disadvantaged areas (
Given the need to examine neighborhood income level and children’s social emotional competence and behavior/adjustment, the following hypotheses were posed and guided this study:
H1. At baseline (or pretest), the level of social emotional competence and behavior/adjustment will significantly differ between children attending preschools in economically advantaged relative to economically disadvantaged neighborhoods. Guided by theory (e.g.,
H2. Neighborhood income level will moderate the effects of PATHS on children’s social emotional competence and indicators of behavior/adjustment from pre to posttest (please see
Conceptual model with neighborhood income as a moderator of the effects of PATHS. This figure is an adaptation of
Participants were 275 children aged four to five years old at baseline (
Allocation of preschools and children divided by economically disadvantaged and advantaged neighborhood groups.
EDN |
EAN |
|||||
Paths% ( |
Control% ( |
Total% ( |
Paths% ( |
Control% ( |
Total% ( |
|
Preschools | 8 | 3 | 11 | 6 | 9 | 15 |
Children | 94 | 24 | 118 | 157 | 51 | 157 |
EDN, economically disadvantaged neighborhood; EAN, economically advantaged neighborhood.
Prior to the intervention study described here, two years of formative studies were carried out in order to culturally adapt PATHS to a Swedish preschool context. This was done according to a cultural adaptation process called the Planned Intervention Adaptation (PIA) protocol (
Children individually participated in the child tasks administered by trained research assistants during preschool visits. Teacher ratings of participating children were collected, and teachers and participating classroom received incentives for study participation such as movie vouchers/gift card of a nominal amount. Parents provided written consent for child participation and children provided verbal assent regarding their study participation. Implementation data were collected, and observer ratings of fidelity were carried out during the school year for intervention schools. This study was approved by a regional ethics review panel (dnr. 2012/1714-31/5). The protocol was registered at
The measures are described in the order of the hypothesized outcomes (primary, secondary, and distal) for this intervention trial that were based on the results of prior studies of preschool PATHS in the U.S. (i.e.,
Primary outcome measures were all child tasks and included: The Assessment of Children’s Emotional Skills (ACES;
For the ACES (
For the Challenging Situations Task (CST;
The three other child tasks in the primary outcomes are indicators of different aspects of executive functioning. All tasks followed a standardized protocol. For the Knock and Tap task (
The final indicator of executive functioning was a standardized Word Span task which was designed to provide an indicator of working memory (WM;
The remainder of the outcome measures were either observer (researcher) or teacher reports of children’s social competence (secondary outcomes) or behavior/adjustment (distal outcomes). For the secondary outcomes, teacher reported scales included the Social Competence Scale (SCS;
The other teacher reported hypothesized secondary outcomes were three scale scores from the Preschool and Kindergarten Behavior Scales (PKBS;
For observer reported scales among the hypothesized secondary outcomes, a scale of the SCS (
For the SCS items used in the play observation, in this case, only the scale score on prosocial/communication skills was used (and not all three scales within the SCS) and seven items (and not six items as in the teacher report for this scale) were used. Further, the response options also differed from the teacher reported SCS and for the play observation ratings, the SCS (prosocial/communication skills item) response options were added to in number of responses possible and were from 1 = Not at All to 5 = Very Well, with an added response option called did not observe, which was scored as missing). This modified SCS prosocial/communication scale was used by two observers who rated children’s behavior in two standardized play situations with a large toy to be shared and played with by three children participating in the study (i.e., the Mobile Country Farm and the Marble Run Play Set). Observers made a separate rating for each of the three children during the play situation. The observers’ inter-rater reliability was excellent and ranged from 0.92 to 0.93 (across toys; intraclass correlation coefficients). For the Task Orientation scale (
For the distal outcomes, all scales were teacher rating of children’s behavior and adjustment. In this case, additional scales from the PKBS (
The other teacher rated scales measuring distal outcomes were from the ADHD Rating Scale–IV (
First, we categorized preschools in economically disadvantaged and advantaged neighborhoods by comparing all resident incomes (e.g., monthly average income before taxes) for the postal code in which participating preschools were situated in during the intervention trial. This information came from registry data collected by Statistics Sweden. This amount was then compared against the average income for the entire region in which these postal codes were located during the time period of the intervention trial, which was 533, 475 Swedish crowns in year 2014, and 580, 675 Swedish crowns in year 2016. This comparison resulted in a categorization of either advantaged (above the regional average income) or disadvantaged (below the regional average income) resident income that was dummy coded into one of two possible categories and this represents the neighborhood income level that was then used in the hypothesis related analyses.
The H1 analyses involved an examination of possible average group differences in baseline level of social emotional competence and behavior/adjustment between children attending schools in economically disadvantaged neighborhoods in comparison to children attending schools in economically advantaged neighborhoods with a series of independent sample t-tests. We controlled family wise (primary, secondary, distal outcomes) error with a correction for the interpretation of a significant group difference by using a modified Holm-Bonferroni method which address the increased risk of Type I error due to multiple t-tests conducted.
The H2 related analyses consisted of a series of just-identified two-wave structural equation models (SEM) to test the possibility of the moderation of intervention effects on child level outcomes, by neighborhood income level. We used one model for each outcome variable. Each model included the posttest (called T2) outcome as the response variable and the same set of predictor variables. The predictors of the T2 outcome were PATHS (1 = intervention, 0 = comparison), age, cohort (1 = cohort 1, 2 = cohort 2), income (1 = above average, 0 = below average), and an interaction term (PATHS*income;
Mplus 8.6 (
Means and standard deviations at baseline.
Pre-test |
EDN |
EAN |
|||
Min-max | M | SD | M | SD | |
ACES-emotional knowledge | 1–10 | 6.83 | 1.95 | 7.05 | 1.64 |
CST-emotional awareness | 0–11 | 4.31 | 1.51 | 4.21 | 1.81 |
CST-SPS: competent | 0–8 | 2.32 | 2.31 | 2.61 | 2.21 |
CST-SPS: aggressive | 0–9 | 0.94 | 1.56 | 0.62 | 1.27 |
CST-SPS: inept | 0–7 | 0.57 | 1.03 | 0.55 | 1.14 |
IC1: knock and tap task | 6–30 | 22.37 | 6.95 | 26.01 | 4.60 |
IC2: day-night task | 0–47 | 24.90 | 14.56 | 30.56 | 12.70 |
WM: word span task | 0–23 | 10.02 | 4.51 | 11.56 | 4.38 |
Prosoc/communication | 0.67–4 | 2.85 | 0.81 | 3.00 | 0.94 |
Prosocial skills (observer) | 1–5 | 3.55 | 0.73 | 3.65 | 0.72 |
Task orientation | 0.44–4 | 2.76 | 0.90 | 3.03 | 0.82 |
Social cooperation | 1.18–3 | 2.60 | 0.43 | 2.65 | 0.44 |
Social interaction | 0.10–3 | 2.32 | 0.58 | 2.44 | 0.53 |
Social independence | 0.50–3 | 2.63 | 0.44 | 2.68 | 0.38 |
Social withdrawal | 0–2.29 | 0.61 | 0.60 | 0.61 | 0.61 |
Anxiety/somatic symptoms | 0–2.71 | 0.45 | 0.59 | 0.48 | 0.54 |
Aggression | 0–2.88 | 0.43 | 0.62 | 0.47 | 0.71 |
Inattention | 0–3 | 0.92 | 0.80 | 0.60 | 0.72 |
Hyperactivity/impulsivity | 0–3 | 0.81 | 0.80 | 0.60 | 0.65 |
EDA, economically disadvantaged neighborhood; EAA, economically advantaged neighborhood.
To examine H2 (i.e., did children attending preschools in economically disadvantaged neighborhoods differentially benefit from the intervention in terms of improvements in their social emotional competence and behavior/adjustment), we conducted a series of covariate adjusted SEM models with the interaction term (PATHS*income) predicting post-test outcomes. This creates a comparison between four subgroups of children, those in the intervention condition attending preschools in advantaged or disadvantaged neighborhoods, as well as those in the control condition attending preschools in advantaged and disadvantaged neighborhoods.
Standardized interaction parameter estimates,
Outcomes | Predictors | St. estimate | 95% CI | St. errors | |
ACES-emotional knowledge | Paths |
–0.164 | 0.542 | [–0.607,0.279] | 0.269 |
Paths low income | 0.489 | 0.012 | [0.170,0.807] | 0.193 | |
Paths high income | 0.324 | 0.098 | [0.002,0.647] | 0.196 | |
CST-emotional awareness | Paths |
0.440 | 0.103 | [–0.004,0.884] | 0.270 |
Paths low income | –0.293 | 0.091 | [–0.579, –0.008] | 0.174 | |
Paths high income | 0.147 | 0.573 | [–0.282,0.575] | 0.260 | |
CST-SPS: competent | Paths |
0.196 | 0.622 | [–0.458,0.849] | 0.397 |
Paths low income | 0.060 | 0.866 | [–0.524,0.643] | 0.355 | |
Paths high income | 0.256 | 0.178 | [–0.057,0.568] | 0.190 | |
CST-SPS: aggressive | Paths |
0.438 | 0.166 | [–0.082,0.958] | 0.316 |
Paths low income | –0.309 | 0.283 | [–0.783,0.164] | 0.288 | |
Paths high income | 0.128 | 0.500 | [–0.184,0.441] | 0.190 | |
CST-SPS: inept | Paths |
–0.146 | 0.728 | [–0.837,0.545] | 0.420 |
Paths low income | 0.402 | 0.218 | [–0.135,0.939] | 0.326 | |
Paths high income | 0.256 | 0.290 | [–0.142,0.654] | 0.242 | |
IC1: knock and tap task | Paths |
–0.455 | 0.147 | [–0.972,0.061] | 0.314 |
Paths low income | 0.418 | 0.149 | [–0.059,0.894] | 0.290 | |
Paths high income | –0.038 | 0.840 | [–0.345,0.269] | 0.187 | |
IC2: day-night task | Paths |
0.271 | 0.238 | [–0.107,0.650] | 0.230 |
Paths low income | –0.251 | 0.186 | [–0.564,0.061] | 0.190 | |
Paths high income | 0.020 | 0.896 | [–0.229,0.269] | 0.151 | |
WM: word span task | Paths |
0.085 | 0.771 | [–0.394,0.564] | 0.291 |
Paths low income | 0.322 | 0.134 | [–0.031,0.675] | 0.215 | |
Paths high income | 0.406 | 0.070 | [0.037,0.776] | 0.225 | |
Prosocial/communication skills | Paths |
–0.113 | 0.684 | [–0.571,0.344] | 0.278 |
Paths low income | –0.219 | 0.389 | [–0.638,0.199] | 0.255 | |
Paths high income | –0.332 | 0.052 | [–0.773, –0.051] | 0.171 | |
Prosocial skills (observer | Paths |
0.615 | 0.097 | [0.006, 1.225] | 0.371 |
Paths low income | 0.136 | 0.675 | [–0.398,0.670] | 0.324 | |
Paths high income | 0.751 | 0.002 | [0.244,0.772] | 0.241 | |
Task orientation | Paths |
0.268 | 0.374 | [–0.229,0.766] | 0.302 |
Paths low income | –0.015 | 0.950 | [–0.399,0.370] | 0.234 | |
Paths high income | 0.254 | 0.221 | [–0.087,0.594] | 0.207 | |
Social cooperation | Paths |
–0.355 | 0.128 | [–0.738,0.029] | 0.233 |
Paths low income | 0.190 | 0.364 | [–0.154,0.534] | 0.209 | |
Paths high income | –0.165 | 0.244 | [–0.399,0.068] | 0.142 | |
Social interaction | Paths |
–0.452 | 0.122 | [–0.471,0.018] | 0.292 |
Paths low income | 0.214 | 0.440 | [–0.123,0.337] | 0.277 | |
Paths high income | –0.238 | 0.123 | [–0.249,0.009] | 0.155 | |
Social independence | Paths |
–0.491 | 0.068 | [–0.934, –0.049] | 0.269 |
Paths low income | 0.193 | 0.387 | [–0.174,0.561] | 0.224 | |
Paths high income | –0.298 | 0.110 | [–0.245,0.008] | 0.187 | |
Social withdrawal anxiety/somatic symptoms | Paths |
0.549 | 0.047 | [0.094, 1.00] | 0.276 |
Paths low income | –0.389 | 0.079 | [–0.750, –0.028] | 0.219 | |
Paths high income | 0.160 | 0.484 | [0.216,0.536] | 0.229 | |
Paths |
0.618 | 0.089 | [0.020, 1.216] | 0.363 | |
Paths low income | –0.566 | 0.082 | [–1.101, –0.031] | 0.325 | |
Paths high income | 0.052 | 0.813 | [–0.309,0.413] | 0.219 | |
Aggression | Paths |
–0.336 | 0.153 | [–0.722,0.051] | 0.235 |
Paths low income | –0.136 | 0.503 | [–0.470,0.198] | 0.203 | |
Paths high income | 0.200 | 0.213 | [–0.064,0.463] | 0.160 | |
Inattention | Paths |
0.619 | 0.068 | [0.062, 1.176] | 0.339 |
Paths low income | –0.367 | 0.242 | [–0.882,0.149] | 0.313 | |
Paths high income | 0.252 | 0.159 | [–0.043,0.547] | 0.179 | |
Hyperactivity/impulsivity | Paths |
–0.103 | 0.722 | [–0.579,0.373] | 0.289 |
Paths low income | 0.234 | 0.373 | [–0.198,0.666] | 0.262 | |
Paths high income | 0.131 | 0.405 | [–0.128,0.390] | 0.157 |
*Connotes interaction term.
Subgroup means and standard deviations.
EDN |
EAN |
|||||||||||||||
Paths |
Control |
Paths |
Control |
|||||||||||||
Pre-test |
Post-test |
Pre-test |
Post-test |
Pre-test |
Post-test |
Pre-test |
Post-test |
|||||||||
M | SD | M | SD | M | SD | M | SD | M | SD | M | SD | M | SD | M | SD | |
ACES-emotional knowledge | 7.06 | 1.89 | 7.81 | 1.29 | 5.95 | 1.96 | 7.13 | 1.24 | 6.80 | 1.85 | 7.66 | 1.42 | 7.16 | 1.52 | 7.48 | 1.42 |
CST-emotional awareness | 4.24 | 1.45 | 4.42 | 1.37 | 4.54 | 1.74 | 5.00 | 1.66 | 3.74 | 1.40 | 4.29 | 1.19 | 4.41 | 1.93 | 4.29 | 1.34 |
CST-SPS: competent | 2.52 | 2.35 | 2.93 | 2.35 | 1.54 | 2.04 | 2.23 | 2.40 | 2.40 | 2.31 | 3.12 | 2.35 | 2.70 | 2.17 | 2.89 | 2.18 |
CST-SPS: aggressive | 0.94 | 1.51 | 0.48 | 0.92 | 0.95 | 1.76 | 1.09 | 2.24 | 0.86 | 1.77 | 0.54 | 1.36 | 0.52 | 0.98 | 0.65 | 1.46 |
CST-SPS: inept | 0.54 | 0.99 | 0.54 | 1.15 | 0.68 | 1.17 | 0.81 | 1.46 | 0.67 | 1.39 | 0.58 | 1.07 | 0.50 | 1.01 | 0.41 | 0.87 |
IC1: knock and tap task | 23.64 | 6.33 | 26.02 | 5.74 | 16.91 | 7.03 | 22.21 | 7.85 | 26.85 | 3.97 | 25.80 | 4.82 | 25.76 | 4.84 | 26.18 | 4.76 |
IC2: day-night task | 27.24 | 12.23 | 31.86 | 13.30 | 15.79 | 16.25 | 29.71 | 15.03 | 30.55 | 12.47 | 36.72 | 11.78 | 30.57 | 12.87 | 35.85 | 10.74 |
WM: word span task | 10.49 | 4.37 | 13.17 | 4.41 | 8.09 | 4.63 | 10.27 | 4.04 | 11.43 | 4.76 | 14.45 | 4.30 | 11.61 | 4.21 | 11.91 | 4.71 |
Prosoc/communication | 2.90 | 0.80 | 3.08 | 0.81 | 2.45 | 0.79 | 2.88 | 0.99 | 3.01 | 1.04 | 3.12 | 0.73 | 2.98 | 0.89 | 3.17 | 0.79 |
Prosocial skills (observer) | 3.68 | 0.70 | 3.69 | 0.68 | 3.10 | 0.67 | 3.34 | 0.60 | 3.43 | 0.72 | 4.20 | 0.55 | 3.74 | 0.70 | 3.60 | 0.59 |
Task orientation | 2.90 | 0.83 | 2.90 | 0.79 | 2.22 | 0.95 | 2.54 | 1.06 | 2.97 | 0.82 | 3.37 | 0.83 | 3.06 | 0.82 | 3.08 | 0.76 |
Social cooperation | 2.64 | 0.41 | 2.61 | 0.56 | 2.30 | 0.45 | 2.28 | 0.69 | 2.64 | 0.49 | 2.63 | 0.41 | 2.66 | 0.40 | 2.73 | 0.35 |
Social interaction | 2.32 | 0.60 | 2.48 | 0.55 | 2.33 | 0.44 | 2.27 | 0.63 | 2.31 | 0.56 | 2.45 | 0.44 | 2.54 | 0.49 | 2.67 | 0.38 |
Social independence | 2.64 | 0.44 | 2.70 | 0.46 | 2.54 | 0.42 | 2.49 | 0.37 | 2.65 | 0.38 | 2.66 | 0.42 | 2.71 | 0.28 | 2.80 | 0.28 |
Social withdrawal | 0.55 | 0.60 | 0.49 | 0.59 | 1.01 | 0.38 | 1.05 | 0.64 | 0.49 | 0.50 | 0.50 | 0.50 | 0.68 | 0.65 | 0.54 | 0.56 |
Anxiety/somatic symptoms | 0.40 | 0.53 | 0.32 | 0.44 | 0.80 | 0.86 | 0.92 | 0.97 | 0.39 | 0.44 | 0.40 | 0.38 | 0.53 | 0.58 | 0.51 | 0.54 |
Aggression | 0.41 | 0.63 | 0.54 | 0.74 | 0.54 | 0.55 | 0.77 | 1.03 | 0.51 | 0.86 | 0.45 | 0.65 | 0.46 | 0.62 | 0.41 | 0.63 |
Inattention | 0.89 | 0.79 | 0.73 | 0.78 | 1.19 | 0.83 | 1.35 | 1.00 | 0.60 | 0.66 | 0.60 | 0.63 | 0.59 | 0.76 | 0.47 | 0.59 |
Hyperactivity/impulsivity | 0.71 | 0.74 | 0.87 | 0.93 | 1.59 | 0.86 | 1.37 | 1.09 | 0.71 | 0.64 | 0.62 | 0.69 | 0.54 | 0.65 | 0.54 | 0.64 |
EDN, economically disadvantaged neighborhood; EAN, economically advantaged neighborhood.
However, there were two significant interaction effects for the secondary outcomes, and three significant interaction effects for the distal outcomes.
First, there was a PATHS*income interaction effect on observer rated prosocial skills (a hypothesized secondary outcome),
Next, we found a PATHS*income interaction on teacher rated social independence (secondary outcome),
Furthermore, there was a PATHS*income interaction effect on three of the examined distal outcomes, namely teacher rated social withdrawal, anxiety symptoms and inattention. The interaction effect for social withdrawal was
Also, within the examined distal outcomes, we found a PATHS*income interaction on anxiety symptoms,
Finally, we found a PATHS*income interaction on inattention (distal outcome),
Promoting the use of evidence-based SEL interventions in ECEC settings may enable engagement and participation and boost the psychosocial development of a diversity of children. However, not all children live in optimal or even sufficient conditions in order to achieve the best possible development and growth. The economic level of the neighborhood context has important implications in terms of the quality of ECEC (
The overall goal with the PATHS conceptual model is to support children’s ability to self-regulate emotions and behaviors as well as to prevent or reduce behavioral and emotional problems. From an earlier study with the same dataset (
However, the present study indicated that there are some important baseline differences in participating children’s social emotional competence and adjustment. Indeed, our results showed that at baseline, children attending preschools in economically disadvantaged neighborhoods, relative to children attending preschool in advantaged neighborhoods, showed lower levels on a number of measured outcomes such as inhibitory control, working memory, task orientation as well as higher levels of inattention. This is in line with the theoretical assumptions of the importance of neighborhood contexts for child development (e.g.,
To address such possible disparities in the opportunities for children’s social emotional competencies to develop, ECEC with emphasis on social emotional development is key. The implementation of SEL-interventions in ECEC in economically disadvantaged neighborhoods in particular, has been suggested as key preventive effort in terms of child developmental disparities (
Similarly, in economically disadvantaged neighborhoods, children participating in PATHS showed reductions in social withdrawal and anxiety compared to control group children. Although children attending preschool in economically disadvantaged neighborhoods did not differ in these outcomes at entry into PATHS (H1 results), the group from economically disadvantaged neighborhoods appeared to benefit more in these outcomes from PATHS when compared to control group children. This is an important finding as these outcomes have been found to be concurrently and predictively associated with an increased risk of a range of negative adjustment outcomes, including social-emotional difficulties (
The beneficial effects of PATHS on the development of social emotional skills and adjustment in children in economically disadvantaged neighborhoods could however be tempered with the findings that PATHS children from advantaged neighborhoods also appeared to improve in their teacher rated prosocial behavior, but not their social independence, when compared to control group children also attending preschool in advantaged neighborhoods. Possibly, such a finding may be indicative of a maintenance of disparity between the advantaged and disadvantaged groups, in that children from both advantaged and disadvantaged groups entered the project with similar levels of these outcomes.
In this study, we could not investigate the potential linking mechanisms to the associations between PATHS and child outcomes which could provide some explanations to the results in this study. Based on the research from earlier studies, one potential mechanism to these links could be the family-level variables, such as parenting practices (
In Sweden, ECEC is publicly subsidized and thus affordable for many parents. Consequently, more than 95% of children four to five years old attend ECEC on a daily basis (
There are several study limitations that are important to note. We measured only one facet of the neighborhood context, namely mean level of all residents’ income in a postal code (an administrative registry-based neighborhood demarcation), to address the neighborhood economic advantage/disadvantage. Other facets, such as physical characteristics and possibilities for social and economic development, including business reforms in the neighborhood could be important to more holistically capture economic advantage/disadvantage in neighborhoods, as well as resident perceptions of neighborhood boundaries and economic advantage/disadvantage.
Moreover, teachers who rated participating children and observers of children’s play (in the play task) were not blind to study condition. As we lack measurements of the quality of preschools in the projects, we assume that the quality of ECEC is, at least in part, based on the economic level of the neighborhood context (
Even though parents are important socializing agents in their children’s development (
Other limitations include the overall relatively small sample in the study, particularly in economically disadvantaged group, which could potentially be a risk for a type II error (
Despite these limitations, there are several strengths to be noted. This study is to our knowledge, the first study to investigate the possibility of moderated intervention-related effects of PATHS with the preschool neighborhood context as one of the key moderators examined, with the use of registry data on income for all inhabitants’ living within the immediate neighborhoods in which children’s preschools are located. Moreover, the beneficial effects of the intervention delivered in the proximal context of ECEC, as evidenced in this study, provide an important basis for development of high-quality ECEC particularly in economically disadvantaged neighborhoods in Sweden, as a means to reduce possible disparities in societal opportunities for children to develop their social emotional competence in equitable and optimal ways.
The overall implications of the study findings for the future implementation of PATHS in settings in which children experience less economic resources are provisional and require additional examination in further similar Swedish trials to come away with firm conclusions for a Swedish context in particular. Past studies in lower income areas with preschool PATHS have primarily been conducted in the U.S. where income distribution and social welfare system is different than in Sweden. Thus, we are cautious in interpreting the future implications of the study findings for Swedish settings until further Swedish studies with preschool PATHS are conducted. In future Swedish trials, it would be important to test the relative importance and benefits of PATHS implemented for one versus two years (with the same cohort of children). Such an approach could help to determine if PATHS would be associated with even more profound benefits if it is conducted over a longer period of time in order to achieve a very broad array of intended outcomes across a range of social emotional competence domains, in children in general and for children attending preschool in lower resourced neighborhoods as well.
Our study showed that there are some disparities in social and emotional competence and adjustment among children attending preschools in economically disadvantaged and advantaged neighborhoods (see results for H1), some of which could be reduced with the inclusive educational program focusing on socioemotional learning (SEL interventions and practices). Children in preschools in economically advantaged neighborhoods involved in PATHS showed improvements in their prosocial skills, but not social independence in comparison to children in control group also attending preschool in advantaged neighborhoods. In addition, children attending schools in economically disadvantaged neighborhoods, who took part in PATHS showed reduced levels of inattention, social withdrawal, and anxiety relative to children in control group who also attend preschool in disadvantaged neighborhoods. Given that inattention (e.g.,
The datasets presented in this article are not readily available because this study’s ethical review does not allow for study data to be in a public repository. Requests to access the datasets should be directed to SK.
The studies involving human participants were reviewed and approved by The Stockholm Regional Ethics Review Board (dnr. 2012/1714-31/5). Written informed consent to participate in this study was provided by the participants’ legal guardian/next of kin.
SK, HG, and LF-W: manuscript conceptualization and writing. SK and KE: data analysis. LF-W, HG, KE, TO, and LE: funding acquisition. All authors: writing. All authors approved the final draft of the manuscript and are accountable for attesting to the accuracy of the work represented in this manuscript.
This study was co-funded by the 1st call on Children’s Mental Health funded by the Swedish Council for Working Life and Social Research, the Swedish Research Council, Formas, and VINNOVA (dnr: 259-2012-71), the Clas Groschinsky Memorial Fund, and Stockholm University’s Centrum för Kompetensutveckling inom Vård och Omsorg (CKVO).
We sincerely thank and recognize the essential contributions of the children and educational professionals who took part in this study. We also thank the Applied Developmental Science Research group members who are instrumental supporters of the wider PATHS research study in Sweden.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.