Fast Track Project Overview

Design of the Fast Track Project

Fast Track is a comprehensive 10-year intervention project designed to prevent serious antisocial behavior and related adolescent problems in three successive cohorts of children selected at being at high risk when entering first grade. The intervention is guided by a developmental theory positing the interaction of multiple influences on the development of antisocial behavior. Low-income, high crime communities place stressors and influences on children and families that increase their risk levels. In such contexts, families characterized by marital conflict and instability make consistent and effective parenting difficult to achieve, particularly with children who are impulsive and of difficult temperament. These children usually enter school poorly prepared for the social, emotional, and cognitive demands of this setting. Their parents often are unprepared to relate effectively with school staff and a poor home-school bond often exacerbates the child's adjustment problems. Often the child attends a school with a high density of other children who are similarly unprepared, and who are negatively influenced by disruptive classroom contexts and punitive teacher practices. Over time, aggressive and disruptive children are rejected by families and peers, and tend to receive less support from teachers--further exacerbating aggressive exchanges and academic difficulties. The process of escalating risk extends from elementary school years into adolescence, where peer influences, academic difficulties, and dysfunctional personal identity development can contribute to serious conduct problems and related risky behaviors. The Fast Track prevention program is thus based on the hypothesis that improving child competencies, parenting effectiveness, school context, and school-home communications will, over time, contribute to preventing antisocial behavior across the period from early childhood through adolescence.

The Study Sample

Fast Track identified a sample of high-risk children in kindergarten by their conduct problems at home and at school through multistaged screening of nearly 10,000 children. At each of four sites across the United States, sets of schools were matched on size, ethnic composition, and poverty, and randomly assigned to intervention and control conditions. Within the schools, teacher and parent ratings of aggressive, disruptive, and oppositional behavior were used to identify children at high risk for chronic conduct problems. In this manner, three successive cohorts were recruited in 1991, 1992, and 1993 to yield a sample of 891 children (445 in the intervention group, and 446 in the control group). Attrition throughout the study has been low, with participation rates for year eleven of the study at eighty percent for the control group, and eighty five percent for the intervention group.

Prevention Program

The developmental model guiding this project indicates that an effective prevention program would address classroom, school risk, and family risk factors, including communication between parents and schools. The program extends from first through the tenth grade, with particularly intensive interventions during the transitions at school entry and from elementary to middle school. The most intense phase of intervention took place in the first grade year for each of three successive cohorts. The six components of the elementary school phase of the intervention (grades 1-5) include:

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Project Overview
	Design of the Fast Track Project Fast Track is a comprehensive 10-year intervention project designed to prevent serious antisocial behavior and related adolescent problems in three successive cohorts of children selected at being at high risk when entering first grade. The intervention is guided by a developmental theory positing the interaction of multiple influences on the development of antisocial behavior. Low-income, high crime communities place stressors and influences on children and families that increase their risk levels. In such contexts, families characterized by marital conflict and instability make consistent and effective parenting difficult to achieve, particularly with children who are impulsive and of difficult temperament. These children usually enter school poorly prepared for the social, emotional, and cognitive demands of this setting. Their parents often are unprepared to relate effectively with school staff and a poor home-school bond often exacerbates the child's adjustment problems. Often the child attends a school with a high density of other children who are similarly unprepared, and who are negatively influenced by disruptive classroom contexts and punitive teacher practices. Over time, aggressive and disruptive children are rejected by families and peers, and tend to receive less support from teachers--further exacerbating aggressive exchanges and academic difficulties. The process of escalating risk extends from elementary school years into adolescence, where peer influences, academic difficulties, and dysfunctional personal identity development can contribute to serious conduct problems and related risky behaviors. The Fast Track prevention program is thus based on the hypothesis that improving child competencies, parenting effectiveness, school context, and school-home communications will, over time, contribute to preventing antisocial behavior across the period from early childhood through adolescence. The Study Sample Fast Track identified a sample of high-risk children in kindergarten by their conduct problems at home and at school through multistaged screening of nearly 10,000 children. At each of four sites across the United States, sets of schools were matched on size, ethnic composition, and poverty, and randomly assigned to intervention and control conditions. Within the schools, teacher and parent ratings of aggressive, disruptive, and oppositional behavior were used to identify children at high risk for chronic conduct problems. In this manner, three successive cohorts were recruited in 1991, 1992, and 1993 to yield a sample of 891 children (445 in the intervention group, and 446 in the control group). Attrition throughout the study has been low, with participation rates for year eleven of the study at eighty percent for the control group, and eighty five percent for the intervention group. Prevention Program The developmental model guiding this project indicates that an effective prevention program would address classroom, school risk, and family risk factors, including communication between parents and schools. The program extends from first through the tenth grade, with particularly intensive interventions during the transitions at school entry and from elementary to middle school. The most intense phase of intervention took place in the first grade year for each of three successive cohorts. The six components of the elementary school phase of the intervention (grades 1-5) include: Teacher-led classroom curricula (called PATHS) as a universal intervention directed toward the development of emotional concepts, social understanding, and self-control (including weekly teacher consultation about classroom management); and the following five programs administered to the high-risk intervention subjects: Parent training groups designed to promote the development of positive family-school relationships and to teach parents behavior management skills, particularly in the use of praise, time-out, and self-restraint; Home visits for the purpose of fostering parents' problem-solving skills, self-efficacy, and life management; Child social skill training groups (called Friendship Groups); Child tutoring in reading; and Child friendship enhancement in the classroom (called Peer Pairing).
		The adolescent phase of the intervention program (grades 6-10) included standard and individualized activities for high-risk youth and families. Group-based interventions were de-emphasized, in order to avoid promoting engagement with deviant peers. However, curriculum-based parent and youth group meetings were included in the intervention, to support children in their transition into middle school (grades 5-7). The focus of this phase of the intervention was primarily on individualized prevention planning, according to criterion-based assessment. Individualized services, designed to strengthen protective factors and reduce risk factors in areas of particular need for each youth, include: academic tutoring, mentoring, support for positive peer-group involvement, home visiting and family problem-solving, and liaisons with school and community agencies. Evaluation of the Fast Track Program The efficacy of the Fast Track prevention program is tested periodically, by comparing the group of children receiving intervention services to children in the control group, with regard to a wide range of problem-behavior outcomes and their development over time. The findings are modest to moderate in a positive direction, but statistically robust and indicative of the important impact of Fast Track as a set of preventive interventions. Significant progress was made toward the goal of improving competencies of the children receiving intervention services and their parents. Compared to the control group, the intervention children improved their social-cognitive and academic skills, and their parents reduced their use of harsh discipline. These group differences also were reflected in behavioral improvements during the elementary school years and beyond. Compared with children in the control group, children in the intervention group displayed significantly less aggressive behavior at home, in the classroom, and on the playground. By the end of third grade, 37 percent of the intervention group had become free of conduct problems, in contrast with 27 percent of the control group. By the end of elementary school, 33 percent of the intervention group had a developmental trajectory of decreasing conduct problems, as compared with 27 percent of the control group. Furthermore, placement in special education by the end of elementary school was about one-fourth lower in the intervention group than in the control group. Group differences continued through adolescence. Court records indicate that by eighth grade, 38 percent of the intervention group boys had been arrested, in contrast with 42 percent of the control group. Finally, psychiatric interviews after ninth grade indicate that The Fast Track program intervention has reduced serious conduct disorder by over a third, from 27 percent to 17 percent. These effects generalized across gender and ethnic groups, and across the wide range of child and family characteristics measured by Fast Track. The success of the Fast Track program has led to its implementation in several school systems across the country, as well as in several schools in Great Britain, Australia, and Canada. Fast Track is one of several chronic violence prevention programs, but it is one of the most rigorously evaluated.
	The Economic Evaluation of Fast Track The evaluation of Fast Track also includes an economic component. That study focuses on the impact that the program has had on participants' use of costly services, such as inpatient mental health services, juvenile detention, and special education. Funded by NIMH, the project has four aims: Identify the impact of Fast Track on social costs that will occur by the time participants are age 19; Calculate cost-effectiveness ratios for key outcomes, including measures of mental health status, delinquency, teenage pregnancy, drug and alcohol use, and sexually transmitted diseases, as well as a measure of quality of life and of the impact on care givers' well-being; Project future social costs for study participants (when the participants are age 20 or older); Identify subgroups of participants for whom the benefits of the intervention (or reductions in social costs) are especially large or small.
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