The PATHS® Curriculum Improves Behavior by Improving Cognitive Executive Functions

Because the PATHS® program is based on a theory of vertical and horizontal control that focuses on the recruitment of language for regulating emotions and the development of reasoning and frontal control of executive functions (EF) to support social and emotional maturity in early and middle childhood, we hypothesized that the curriculum promotes more effective inhibitory control and emotion regulation. That is, we believed that the PATHS® Curriculum would nurture children (1) to become less impulsive and more planful in their social interactions, and (2) to recruit language to regulate behavior and communicate effectively with others (Greenberg and Kusche, 1993).

We recently tested this mediation model in a randomized controlled study of 318 second-and third-grade children (Riggs, Greenberg, Kusche and Pentz, 2006) that received one year of PATHS® intervention. Outcome findings examined teachers’ ratings of both internalizing and externalizing behavioral problems using the Teacher Report form (TRF) of the Child Behavioral Checklist (CBCL). EF were assessed by two well-known measures validated to activate anterior cingulate and dorso-lateral prefrontal cortex (Ravnkilde, Videbech, Rosenberg, Gjeede & Gade, 2002). Inhibitory control was assessed with the Stroop Test and verbal fluency was assessed using the Verbal Fluency Subtest of the McCarthy Scales of Children Abilities. To test a mediational model, it was first necessary to that the intervention affected both behavior and EF. Results indicated there were significant differences at post-test indicating greater improvements in both inhibitory control and verbal fluency in the intervention children. At the one-year follow-up, intervention children also were rated by teachers as lower in externalizing and internalizing problems on the TRF. Further, post-test changes in both inhibitory control and verbal fluency were significantly related to teacher ratings of behavior problems at follow-up.

The specific mediational hypothesis we tested was that EF skills would mediate the relationship between prevention/control group assignment and teacher-reported externalizing and internalizing behavior problems. The findings indicated that improvements in inhibitory control at posttest significantly mediated the relation between experimental condition and both teacher-reported externalizing and internalizing behavior at one-year follow-up. In addition, improvements in verbal fluency significantly mediated the relation between experimental condition and teacher reported internalizing behavior. However, improvements in verbal fluency showed only a trend towards explaining change in teacher-reported externalizing behavior.

These findings provide empirical support for the conceptual theory of action that underlies the PATHS® Curriculum model. That is, child neurocognitive functioning plays a key role in children’s social and emotional adaptation and changes in EF directly relate to reductions in behavioral problems. However, a broader view and incorporation of the biological substrate into our understanding of the processes would begin to assess less peripheral systems of mediation than only neuropsychological tests.