1. School-Based Time-Out: The Hows of Previous Implementation Gregory E. Everett, Ph.D. Southern Illinois University Edwardsville INTRODUCTION Time-out (TO) is a procedure to decrease behavioral frequency (Shriver & Allen, 1996) through, a period of time in a less reinforcing environment made contingent on a behavior (Brantner & Doherty, 1983, p. 87). Regardless of whether it produces punishing (Brantner & Doherty) or reinforcing (Plummer, Baer, & LeBlanc, 1977 ) consequences TO is not a one-size-fits-all intervention, but rather an interconnected series of differing procedural variables (Turner & Watson, 1999). As most studies evaluate the sum effectiveness of TO, it is often implemented in different ways leaving no comprehensive formulation of procedural variables to guide implementation or make effective empirical comparison. Although difficulty exists in identifying which variables should be included in a TO, both Harris (1985) and Wilson and Lyman (1982) discuss implementation of several parameters including (a) verbalized reason for TO implementation, (b) warning prior to TO, (c) instructional and/or physical implementation, (d) TO location, (e) TO duration, and (f) TO release contingencies. In addition, Turner and Watson provide a guide outlining the use of TO in the schools in which they consider questions based on many of these parameters. Although important, such reviews are complicated by several factors. First, they are primarily theoretical and discuss the hows of TO implementation (i.e., How would one go about using a given procedural variable?), rather than the whats of TO usage (i.e., What TO parameters have been employed in the past?). Second, the most recent was conducted 10 years ago (i.e., Turner & Watson) and although this signifies the longevity of TO research, it also indicates that new developments have yet to be incorporated into the research base. Finally, none have empirically reviewed TO usage in the schools. Therefore, the current review was conducted to summarize both (a) participant- related variables providing information regarding with whom, for whom, and for what behaviors TO is employed in the schools, and (b) the frequency of use of those TO procedural variables outlined in previous reviews in order to update and extend them. RESULTS Participant-Related and Behavioral Variables. Across the 47 TO interventions, 240 participants were included in treatment (45.0% males, 11.7% females, 43.3% not reported). (1) Participant age: M = 8.7 years (SD = 2.5) for the 32.6% (n = 78) of participants upon which data could be calculated. (2) Participant ethnicity: Not reported (79.2%), African American (10.4%), Caucasian (9.2%), Hispanic (1.3%). (3) Participant psychological diagnoses: Not reported (59.2%), identified diagnosis (38.3%), typically developing (2.5%). For diagnosis, emotionally disturbed or emotionally/behaviorally disordered (31.5%) ADHD (26.1%). (4) School-based change agent: 80.9% (n = 38) were implemented by special education teacher (with classroom aide in 34.2% [n = 13] of instances), 12.8% (n = 6) by regular education teacher, and 6.4% (n = 3) by other. (5) Intervention setting: 76.6% (n = 36) in special education classroom, 12.8% (n = 6) in regular education classroom, 4.3% (n = 2) in activity setting (i.e., school gym), and 6.4% (n = 3) other. (6) Whether or not TO was used alone: Table 1. (7) Externalizing behaviors targeted for change: Table 2. TO Procedural Variables. (1) Verbalized reason: Included in 38.3% (n = 18) of TOs with none specifically outlining its absence. Most (61.7%; n = 29) made no mention of this parameter. (2) Verbalized warning: Included in 14.9% (n = 7) and specifically omitted from 6.4% (n = 3) of TOs. Most (78.7%; n = 37) made no mention of this parameter. (3) Instructional/physical implementation: Physical guidance alone in 44.7% (n = 21) of TOs, instructional means alone in 10.6% (n = 5), both in 21.3% (n = 10), and not reported in 23.4% (n = 11) of TOs. (4) Location: Table 3. (5) Duration: Table 4. (6) Escape contingencies: Not reported in 76.6% (n = 36) of TOs. When outlined, TO barrier (10.6%; n = 5), repeated returns (8.5%; n = 4), and a holding procedure (4.3%; n = 2). (7) Release procedures: Table 5. DISCUSSION The current review was conducted to provide a data-based foundation regarding previous TO usage in the schools spanning nearly three decades. Current results denote several important findings: Participant-Related and Behavioral Results TO is most often employed with children of early elementary-school age (M = 8.7 years). It is frequently difficult to ascertain both participant ethnicity & potential psychological diagnoses (i.e., both categories had not reported as their most frequent result). TO is more a special education than regular education intervention (i.e., Approximately 80% of reviewed TOs were conducted by a special education teacher in special education classroom). Nearly three-quarters of reviewed TOs were used in combination with other behavior management procedures (i.e., most commonly positive reinforcement of appropriate behavior) with the most common child behavioral target physical aggression. TO Procedural Variables Results By examining those categories (other than not reported) most frequently coded for each parameter an average school-based TO composed of (a) verbalized reason, (b) verbalized warning, (c) physical placement, (d) located in a chair in the same room as the behavioral infraction, (e) duration of 3 mins, (f) barrier to prevent escape, and (g) 3 min contingent delay release is constructed. Not reported was the most common result for verbalized reason, verbalized warning, & escape contingencies (i.e., 62%, 79%, and 77% respectively) and the second most common for instructional/physical implementation (i.e., 23%) & duration (i.e., 19%). METHOD Article Selection To investigate school-based usage of TO since 1980 a comprehensive search of the PsycINFO and ERIC databases was conducted using two differing spellings of TO as the primary search term (i.e., timeout, time-out) alone and in combination with school, teacher, and classroom. All searches were limited by: (a) publication year (1980 – 2009), (b) English language, and (c) peer-reviewed journal article. Articles were then included in the final database if they met additional criteria. First, articles in which TO was either the only intervention or an intervention component were included. Next, studies had to include TO used with children between ages 4 and 18 years. All included studies had to employ TO in the school setting with school personnel as the primary change agents. Finally, articles had to be experimental in nature including the manipulation of an independent treatment variable and the measurement of an externalizing-behavior dependent variable. In order to determine appropriateness for inclusion, abstracts for all identified studies were reviewed. If a decision regarding inclusion could not be reached from the abstract alone, the full text was read and evaluated. Such criteria created a final sample of 32 studies. Poster presented at the 2010 Convention of the National Association of School Psychologists, Chicago, IL For further information, please contact Gregory E. Everett, Ph.D., Southern Illinois University Edwardsville, Department of Psychology, Alumni Hall, Box 1121, Edwardsville, IL 62026-1121; Email: geveret@siue.edu REFERENCES Brantner, J. P., & Doherty, M. A., (1983). A review of timeout: A conceptual and methodological analysis. In S. Axelrod & J. Apsche (Eds.), The effects of punishment on human behavior (pp. 87-132). New York: Academic Press. Harris, K. R. (1985). Definitional, parametric, and procedural considerations in timeout interventions research. Exceptional Children, 51, 279-288. Plummer, S., Baer, D. M., & LeBlanc, J. M. (1977). Functional considerations in the use of procedural timeout and an effective alternative. Journal of Applied Behavior Analysis, 10, 689-705. Shriver, M. D., & Allen, K. D. (1996). The time-out grid: A guide to effective discipline. School Psychology Quarterly, 11, 67-74. Turner, H. S., & Watson, T. S. (1999). Consultants guide for the use of time-out in the preschool and elementary school classroom. Psychology in the Schools, 36, 135-148. Wilson, D. R., & Lyman, R. D. (1982). Time-out in the treatment of childhood behavior problems: Implementation and research issues. Child & Family Behavior Therapy, 4 (1), 5-20. ABSTRACT The current data-based review encompasses nearly three decades of research involving school-based use of time-out (TO). Although extensively researched, the use of TO in the schools continues to vary widely across a number of participant-related and procedural variables. As such, the current review provides descriptive data for 32 articles published between 1980 and 2009 along several sub-categories of both variables. Although results indicate wide school-based usage of TO as a behavior management strategy, several conclusions regarding with whom and how the intervention is used are drawn. More specifically, the application of many TO procedural variables remains diverse and is often unable to be ascertained. Article Evaluation As several articles included more than one TO intervention coding of all variables was conducted per individual TO rather than per article (i.e., across the 32 articles there were a total of 47 individually-coded TO interventions). Participant-related and behavioral variables. All TO interventions were coded for: (a) the number and gender of participants, (b) participant age, (c) participant ethnicity, (d) participant diagnosis, (e) school-based change agent – person (s) responsible for TO implementation, (f) intervention setting – location of experimental manipulation, (g) TO alone – was TO singularly employed separate from other behavioral interventions, and (h) behavior targeted – externalizing behavior targeted for change. For each category, a not reported coding was allowed. TO procedural variables. All TO interventions were coded for: (1) Verbalized reason – stated explanation prior to TO as to why it was initiated. (2) Verbalized warning – statement specifying TO for continued misbehavior. (3) Instructional/physical implementation – means of TO placement. Instructional indicated the child was verbally told to go to TO and physical indicated the child was physically guided to TO. (4) Location – setting where TO occurred. Categories included areas in (a) the same room as the misbehavior (i.e., chair, corner, desk, edge of activity, spot on floor) or (b) a separate room. (5) Duration – length of time in mins and seconds child remained in TO prior to release. (6) Escape contingencies – following TO escape, methods to prevent child from again leaving TO prior to release. Categories included (a) repeated returns – repetitive placement back to the TO location, (b) spanking – hitting the child on buttocks with an open hand, (c) holding – physically restraining the child in the TO location, and (d) barrier – use of a physical impediment to block TO escape. (7) Release procedures – means of TO dismissal. Categories included (a) time-based – children remained in TO for a predetermined length of time, (b) behavior-based – children remained in TO until specific behaviors were displayed, absent any time requirement, (c) contingent delay – children remained in TO until both time and behavioral requirements were met with duration extended for inappropriate behavior, and (d) child release – child determined when TO was over. Interrater reliability. Interrater reliability was assessed for 36% of the included TO interventions (i.e., 17 of 47) and averaged 99.2% across all variables (range = 95.3% – 100%) with 100% agreement across all participant- related/behavioral variables and 98.4% agreement across all TO procedural variables, including: (a) verbalized reason = 100%, (b) verbalized warning = 98.5%, (c) instructional/physical implementation = 98.8%, (d) location = 95.3%, (e) duration = 98%, (f) escape contingencies = 98.3%, and (g) release procedures = 100%. Table 1: Experimental Interventions nPercent a Time-out Alone1327.7 Time-out Not Alone3472.3 Other Interventions Used b Instructional Modifications25.9 Medication Management12.9 Planned Ignoring25.9 Positive Rein (praise)2367.6 Token System720.6 Other617.6 ______________________________________ a Sum of Time-out Alone and Time-out Not Alone percentages equals 100. b Sum of Other Interventions Employed is greater than 100 percent because a single time-out procedure was often used in combination with more than one other intervention. Table 2: Child Target Behavior nPercent a Aggression1838.3 Class Rule Violations24.7 Destructive Behavior49.3 Disruptive Behavior49.3 Inappropriate Touching24.7 Inappropriate Verbal Behavior1125.6 Noncompliance1327.7 Off-Task37.0 Out-of-Area24.7 Self-Injurious-Behavior614.0 Tanturms48.5 Other920.9 ______________________________________ a Sum of percentages is greater than 100 percent because a single time- out procedure was often used to treat multiple behaviors. Table 3: Time-Out Location nPercent a Areas Within Same Room b 3880.1 Chair1231.6 Corner615.8 Desk1026.3 Edge of Activity821.1 Spot on Floor25.3 Isolation in Another Room612.8 Not Reported817.0 Other48.5 ______________________________________ a Sum of major category percentages is greater than 100 percent because a single time-out procedure sometimes employed differing locations. b Subdivisions of Areas Within Same Room reflect calculations based on the 38 procedures that employed such methodology. Table 4: Time-Out Duration nPercent a Specific Duration Outlined b 3880.1 Less than 1 min615.8 1 min513.2 2 min615.8 3 min1334.2 4 min12.6 5 min25.3 7 min25.3 10 min12.6 15 min25.3 Not Reported919.1 Other49.5 ______________________________________ a Sum of major category percentages is greater than 100 percent because a single time-out procedure sometimes employed differing durations. b Subdivisions of Specific Duration Outlined reflect calculations based on the 38 procedures that employed such methodology. Table 5: Time-Out Release Procedures nPercent a Time-Based714.9 Contingent Delay b 2757.4 Less than 1 min + Contingent622.2 1 min + Contingent414.8 2 min + Contingent414.8 3 min + Contingent726.0 5 or more min + Contingent622.2 Child Release510.6 Not Reported1225.5 ________________________________________________________ a Sum of major category percentages is greater than 100 percent because a single time-out procedure sometimes employed differing release procedures. b Subdivisions of Contingent Delay Release reflect calculations based on the 27 procedures that employed such methodology.