PAX = Peace Productivity Health Happiness

Prevention

By implementing well-proven science behind PAX, your children will experience:

Improved education/employment outcomes: Better reading and math scores, reduced need for special education services, fewer repeated grades, increased high school graduation, more college graduation, more full-time employment.Reduced need for public assistance: Less utilization of public housing, public assistance, unemployment compensation.Less legal involvement: Reduced experience of violent crime, reduced likelihood of arrest or detention.Better Mental health: Reduced externalizing problems (ADHD, Conduct Disorders, violence), less internalizing problems (Depression, Anxiety Disorders), less utilization of medication, reduced suicide, and suicidal thoughts.Less Substance Abuse: Less binge drinking or alcohol dependence, less use of nicotine or marijuana, reduced likelihood of opiate use or addiction.

PAXis

PAXIS Institute is the official purveyor of the Good Behavior Game® for replicating famous gold-standard randomized, comparative effectiveness trials at Johns Hopkins University, Center for Prevention and Early Intervention. The U.S. Institute of Medicine, the Surgeon General’s Office, the Substance Abuse and Mental Health Services, and other entities have cited the Good Behavior Game® studied at Johns Hopkins for remarkable long-term effects on reducing lifetime mental, emotional, and behavioral disorders and for increasing better lifetime education and other outcomes for young people. The commercial version, PAX Good Behavior Game®, includes the original publication used at Johns Hopkins, originally written by and implemented by Dr. Jaylan Turkkan (Turkkan, 1988). The commercially available version includes additional evidence-based kernels (Embry, 2004; Embry & Biglan, 2008) to improve ease of learning, training, and fidelity of implementation as well as improve reliability of proximal outcomes across diverse ages, grades, languages, socio-economic backgrounds, and cultures (Embry, 2002; Flannery et al., 2003). Materials, training, coaching/mentoring, and data monitoring for implementation and proximal results are standardized in iOS, Android, and Web applications.

What is PAX? The PAX Good Behavior Game® is an evidence-based practice that comes recommended by the Substance Abuse and Mental Health Service Administration (SAMHSA), the Washington State Institute for Public Policy, and the Institute of Medicine. By strengthening inhibition, extending self-regulation, and improving social emotional scaffolding, PAX GBG creates changes in everyday behavior with corresponding changes in neurochemical, neural connectivity, and epigenetic expression. As a consequence, students show strengthened inhibition, better regulation, social emotional improvements and resilience. PAX is the only classroom-based strategy shown to cause the expression of brain derived neurotropic factor (BDNF) genes that serve as adaptive protections for young people through adulthood and into future generations.

The tested and proven strategies in PAX GBG have been subjected to multiple randomized and control trials and numerous peer-reviewed studies. PAX has been shown to provide numerous short-term and lifetime benefits.

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PAXisSelf-RegulationThe PAX Good Behavior Game builds self-regulation in young people by creating shared relational language with adults and peers. By reinforcing desirable behaviors and inhibiting unwanted behaviors, children develop agency and command to delay gratification and reduce impulsivity. This increase in pro-social behavior and self-regulation paves the way for remarkably better academic, behavioral, and lifetime outcomes. PAX also develops and strengthens peer networks to improve relationships now and in the future.

Trauma-Informed CareThe PAX Good Behavior Game adheres to SAMHSA’s six key principles of trauma-informed approach and model for a trauma-informed classroom. PAX creates a nurturing setting in every school and classroom - allowing for young people to develop pro-social behaviors in a safe setting far from the predatory environments that encourage anti-social behavior. PAX provides teachers with research-based strategies shown to support development and prevent the re-traumatization of children who have been exposed to trauma. These strategies allow students to co-create consistent expectations and summon peer support in creating a nurturing classroom environment.

PBIS & Tiered-Intervention The PAX Good Behavior Game provides teachers and administrators with practical tiered-intervention strategies to implement PBIS in the classroom. These strategies work together to reinforce expected, pro-social behaviors while inhibiting problematic behaviors. PAX ensures evidence-based strategies and expectations for every student and uses data-driven decision-making to provide multiple levels of support for students with more severe needs. PAX creates for a unified, multi-tier approach that establishes consistent expectations throughout school.

Social and Emotional LearningThe PAX Good Behavior Game promotes social and emotional learning in all students. By engaging students in co-creating expectations and developing shared relational language and identity, children can begin to recognize their own thoughts and feelings as well as regulate their own emotions and behaviors. PAX also improves awareness for the needs of others and helps to improve peer support by developing and maintaining positive relationships with others. All this helps children to regulate their own behavior and choices in order to live peaceful, productive, healthy, and happy lives.

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Practical Tools For Enhancing PBIS PoliciesPAX GBG Aligns Seamlessly With The Core Principles Of PBIS:

PAXis

Effectively teach appropriate behavior to all children.PAX GBG employs empirically established behavioral kernels to explicitly improve all students’ self-regulation skills, pro-social behavior, and academic small units of proven background change.

Intervene early and use a multi-tier model of service delivery.PAX GBG is a universal intervention that uses proven behavioral strategies to provide scaffolding for teachers to create nurturing classroom environments and help all children learn the skills needed to self regulate and respond effectively to their environments. Each Kernel can also be tailored as Tier 2 and Tier 3 interventions for students and situations that require additional supports.

Use research-based, scientifically validated interventions to the extent available. Numerous studies, including randomized control trials, show that PAX GBG reduces conduct and behavior problems, improves academic success, decreases mental-health service utilization, and reduces initiation of substance abuse in the US, Canada, and Europe. The National Registry of Evidence-based Programs and Practices (NREPP), Institute of Medicine (IOM), Coalition for Evidence-based Policy, Washington State Institute for Public Policy, National Education Association (NEA), and the American Federation of Teachers (AFT) recognize the power of this strategy. More than 60 published studies exist on GBG alone; plus scores of others report on the active elements accessible at www.pubmed.gov.

Monitor student progress to inform interventions & use data to make decisions. With PAX GBG, teachers, schools, and communities have reliable and practical tools to monitor student prog-ress and outcomes including the PAX Up! App. This allows for real-time data collection and analysis to improve and adjust strategies in real time in order to improve implementation and student impact.

Establish Clear Behavioral Expectations. Using the PAX Vision, teachers and students co-create expectations for behaviors. The PAX Vision enables students to effectively predict and monitor behaviors for success for different environments and tasks. The PAX Vision process fosters students’ internalized locus of control, rather than depending on adult reminders. PAX Vision also increases students’ understanding of purpose-driven expectations, rather than relying on com-pliance.

Teaching and Labeling Appropriate Behavior.PAX GBG creates a common language for positive behavior, “PAX”– actions that promote peace, productivity, health and happiness; and problematic behavior, or “Spleems”– behaviors that get in the way of PAX. Using the novel words PAX and Spleems reduces limit-testing behaviors in children who struggle with appropriate behaviors and leads to faster generalization of behaviors to new settings and activities.

Observing and Praising Appropriate Behavioral Actions.PAX Quiet, PAX Voices, PAX Hands & Feet, OK/Not OK establish universal auditory and non-verbal cues to capture attention, notice and recognize positive behaviors and provide redirection as needed. Adults and students use Tootle Notes to recognize PAX behaviors, and Granny’s Wacky Prizes to celebrate successes.

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Meeting & Exceeding State ESSA Standards

What is ESSA?The Every Student Succeeds Act or ESSA took effect for the 2017-2018 school year. This federal education law replaced No Child Left Behind and granted states more authority over accountability, school performance, teacher quality, and other areas that received federal direction under previous law. With new standards under ESSA, schools implementing the PAX Good Behavior Game (PAX GBG) are well positioned to meet and exceed the increasing expectations placed on schools.

AccountabilityUnder ESSA, states select their own long-term and interim goals surrounding test proficiency, English language proficiency, and graduation rates. States must also select an additional indicator for improvement such as student engagement, school safety, or social emotional learning. Schools implementing PAX GBG have long demonstrated improved academic and statewide test outcomes (Weis, Osborne, and Dean, 2015). This improved grade-level progress also translates into higher graduation rates for schools implementing PAX GBG (Bradshaw, Zmuda, Kellam, & Ialongo, 2009). Schools implementing PAX GBG are primed to demonstrate progress in their additional state-selected indicator, as PAX schools routinely show increases in student engagement (Huber, et al., 2016), school safety (Krug, et al., 1997), and items related to social emo-tional learning (Wilson, Hayes, Biglan, & Embry, 2014, Jiang; Santos, Mayer, & Boyd, 2015; Furr-Holden, et al., 2004).

PerformanceLike previous legislation, ESSA creates special requirements for improving outcomes for under-performing schools and subgroups of students. PAX GBG plays an important role and has documented success in improving outcomes for students, schools, and communities that need help the most. For example, in Ohio, students of the lowest socio-economic status made the largest improvements in statewide testing scores after receiving PAX GBG (Weis, Osborne, and Dean, 2015). In another area, students at the greatest risk for mental, emotional, and behavioral disorders showed the greatest clinical improvement – many moving from high clinical risk to low clinical risk in under one semester of PAX GBG (Jiang, et al., 2018). PAX GBG has also been shown to improve the performance of students with disabilities (Bradshaw, et al., 2009). This is especially important under ESSA, as only 1% of students may take alternative testing (although about 13% of students have disabilities).

Teacher QualityESSA provides resources to improve teacher quality through professional development, while reducing many of the restrictions in place under No Child Left Behind. PAX GBG offers professional development in a number of challenging areas, including trauma and tiered intervention. PAX GBG has shown improvement in teacher outcomes including increased sense of efficacy as well as decreased stress and depression (Huber, et al., 2016; Ghadheri, Johansson, & Enebrink, 2017). This, in turn, ensures increased teacher retention and educa-tional stability throughout schools and communities. PAX GBG also offers an array of support models to fit each community as well as Strategic Planning and Development for ensuring long-term program success and sustainability.

PAXis

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PAXIS Institute is the official purveyor of the Good Behavior Game® for replicating famous gold-stan-dard randomized, comparative effectiveness trials at Johns Hopkins University, Center for Prevention and Early Intervention. The U.S. Institute of Medicine, the Surgeon General’s Office, the Substance Abuse and Mental Health Services, and other entities have cited the Good Behavior Game® studied at Johns Hopkins for remarkable long-term effects on reducing lifetime mental, emotional, behavioral disorders and for increasing better lifetime education and other outcomes for young people. The com-mercial version, PAX Good Behavior Game®, includes the original recipe used at Hopkins, originally written by and trained by Dr. Jaylan Turkkan [1]. The commercially available version includes additional evidence-based kernels [2, 3] to improve ease of learning, training and fidelity of implementation as well as improve reliability of proximal outcomes across diverse ages, grades, languages, social-economic backgrounds and cultures [4, 5]. Materials, training, coaching/mentoring, and data monitoring for imple-mentation and proximal results are standardized in iOS, Android & Web applications.

PAXis

PAX GBG Improves Academic Performance & Graduation Rates

With better self-regulation, students can have greater success in high-stakes testing. In Ohio, Licking County leaders introduced PAX GBG in 2006 with implementation growing to the county’s six districts. This created an opportunity to measure the effects of PAX GBG on state standardized test scores for student reading and math. While all students who received PAX GBG showed greater improvement than those who did not, this study demonstrated that children in schools with the highest poverty levels had the greatest improvement in reading and math scores, regardless of the curriculum (Weis, Osborne, & Dean, 2015).

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p <.001p <.001

Improvements on Standard Measuresof Academic Progress in Six Districts

in High Poverty Schools in Ohio

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NO PAX

Source: Weis, Osborne, & Dean, 2015

The statistical difference favoring PAX GBG is highly significant (greater than 1 chance in 1,000).

Naturally, parents, educators, and policymakers also want to know if PAX GBG is proven to impact academics and graduation. The original Johns Hopkins and new studies demonstrate increasing evidence of the real-world bene-fits of PAX GBG on standardized measures of academic success (Bradshaw et al., 2009; Ialongo et al., 1999). Why do the original Johns Hopkins studies that PAX GBG show increases in grade-level academics, high school graduation and university entry (Bradshaw et al., 2009)? Because…

Students gain voluntary control over attention, by reducing their own classroom disruptions; Peers and adults reinforce peaceful, productive, healthy, and happy behaviors every day; Teachers report less stress, enabling more effective instruction (O’Donnell, Morgan, Embry, O’Kelly, & Owens, 2016)

PAX = Peace Productivity Health Happiness

Evidence Of Proven Impact

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Evidence Of Proven ImpactPAX GBG Reduces Disturbing, Disruptive, & Inattentive Behaviors

From the first week of implementation, PAX GBG provides practical tools to nurture self-regulation in any school context to improve attention and reduce impulsivity throughout the school day. Teachers, students, administrators, and families can see, hear, and feel measurable change within weeks. Every teacher can download a PAX Up! App to measure the rapid change experienced by thousands of teachers and tens of thousands of students all over America, Canada, and Europe. The PAX Up! App improves implementation and benefits of PAX GBG (Elswick, Casey, Zanskas, Black, & Schnell, 2016). The immediate measure of success of PAX GBG is a rapid reduction in unwanted, inattentive, or problematic behaviors, called “Spleems” (an invented word to better engage students as agents of change). PAX GBG works quickly for most students; others may require more time or “higher dose”. These changes predict better lifetime outcomes in mental and behavioral health for students and society (Bradshaw, Zmuda, Kellam, & Ialongo, 2009; S. G. Kellam et al., 2011; S. G. Kellam et al., 2012; Sheppard G. Kellam et al., 2014; Wilcox et al., 2008; Yan et al., 2009).

PAX GBG affects the common symptoms of Adverse Childhood Experiences (ACEs) or trauma exposure. ACEs burden large percentages of children in schools (Ballard et al., 2015). Long-term follow-up studies consistently show that one or two years of exposure to PAX GBG remits, heals, or averts many of the long-term outcomes of Adverse Childhood Experiences (Felitti et al., 1998). The rapid reduction in symptoms of ACEs, as well as the well-documented public-health benefits of PAX GBG, has resulted in commitments by state, provincial, and even national governments to implement PAX GBG for the prevention and treatment of childhood mental, emotional, and behavioral disorders.

In 2010, the U.S. Center for Mental Health Services (CMHS) began funding diverse replications of PAX Good Behavior Game across the U.S. In 2013, CMHS specially commissioned a new project to test a 3-month, rapid implementation of PAX GBG(Wilson et al., 2014). All of the schools represented were Title I settings–across urban, suburban, and rural districts. Every site demonstrated significant changes in observable behaviors. These observations are the same types of measure often used in clinical studies to show the benefits of medication or therapy.

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3-Month Impact of PAX in Eight US School Districts on Disturbing,Disruptive, and Inattentive Behaviors Per 15 Minutes

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Published in: Wilson, D. S., Hayes, S. C., Biglan, A., & Embry, D. D. (2014). Evolving the Future: Toward a Science of Intentional Change. Brain and Behavioral Sciences, 37(4), 395-416

In 2015, New Mexico launched a similar public-health prevention demonstration of PAX GBG. Within 75 days, at the end of the school year, classes using PAX GBG saw at least 50% reduction in disturbing, disruptive, or inattentive behaviors across three districts. These early behavior-change indicators predict long-term benefits (Dolan, Kellam, Brown, Werthamer-Larsson, & et al., 1993; Kellam et al., 2011). Using PAX GBG during any activity throughout the day replicates the same benefits in schools everywhere: inner-cities, suburbia, towns, villages, rural or frontier areas, and tribal or indigenous sites. Indigenous leaders and elders often comment that PAX represents what their ancestors taught. Peace, Productivity, Health and Happiness are universal values for children among the worlds’ adults who love, care for, and teach children.

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PAX GBG Reduces Symptoms Of Mental, Emotional,& Behavioral Disorders

PAX GBG Increases Student Proscocial BehaviorsAfter-school programs aim to provide academic and enrichment opportunities during non-school hours for children, however the national evaluation of after-school programs showed that they unintentionally fostered antisocial, delinquent behavior—the opposite of what was intended. PAX After-School was developed with private and federal funding to respond to this situation. A 2017 study showed that PAX After-School created significant increases in prosocial behaviors (Smith, Osgood, Oh, & Caldwell, 2017), which is important because they predict large, positive lifetime outcomes (Jones, Greenberg, & Crowley, 2015). PAX After-school also reduced symptoms of ADHD (Smith, Osgood, Oh, & Caldwell, 2017). During this study, children attended PAX aftercare for just a few hours per day (Smith, Osgood, Oh, & Caldwell, 2017).

PAX GBG Reduces Stress For TeachersTeacher stress and burnout are epidemic in many Western countries. About half of new teachers in America leave teaching within five years. The prospect of ‘yet another program’ often creates more stress for teachers than the promises those programs offer. Vendors promise that their educational programs or practices are “brain compatible” or the "next big thing". Very few educational or prevention programs have measured impact on teachers’ wellbeing, but PAX GBG has. For example, a 2017 Swedish study revealed that teachers who implemented PAX GBG and received mentoring support experienced a more than 60% reduction of stress (Ghaderi et al., 2017). New efforts are currently underway to replicate these findings.

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One-Semester Benefits of Province-Wide Mental-Health Benefits of PAX GBG v. Control

(p<.001) (p<.001)

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Improved Mental-Health =• Fewer conduct problems• Fewer emotional problems• Less hyperactivity• Fewer peer problems• Better prosocial skills

Jiang, D., Santos, R., Josephson, W., Mayer, T., & Boyd, L. (2018). A Comparison of Variable- and Person-Orient-ed Approaches in Evaluating a Universal Preventive Intervention. Prev Sci. doi:10.1007/s11121-018-0881-x

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Conclusion: After 12 weeks of implementing PAX, Irishteachers report a signifcant improvement in studentswith hyperactivity or emotional disorders. Approximatelyone student moved from clinical range to normative range.

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The lasting skill that the students will take away is self-regulation – they can control their own be-haviour. There is no naming of any child; they have to be responsible for their own behaviour.

The skills that [my students] have developed relate to being more aware of other people, group work, team work, knowing that it is good to have a fun release and then to calm down and refocus. They are able to regulate themselves. Even if they have two or three SPLEEMS, they are able to pull themselves back. The pupils are definitely more self-aware; they are able to know what they need to do to get things done.

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What Irish Teachers Said After 12 Weeks

PAX GBG helps teachers and students create a nurturing environment (Biglan, Flay, Embry, & Sandler, 2012) in their class-rooms, using specific PAX language, evidence-based kernels/cues, and the PAX Game itself. Within a semester of exposure to well-implemented PAX GBG, there can be population-level treatment effects on psychiatric and behavioral disorders in children, as demonstrated by a public-health implementation of PAX GBG province-wide in Manitoba, Canada (Jiang et al., 2015). These benefits persist at least into the 3rd grade, and are now to be examined in 5th grade Musci et al., 2013; Musci, Masyn, Benke, et al., 2015; Musci, Masyn, Uhl, et al., 2015; Musci, Uhl, Maher, & Ialongo, 2015).

Evidence Of Proven Impact

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Scientists in Ireland and Sweden have replicated similar results (Ghaderi et al., 2017; O’Donnell et al., 2016). For example, the Irish implementation demonstrated similar student benefits on the same measures (the Strengths and Difficulties Questionnaire, after just 12 weeks of exposure to PAX GBG. On average, one student per classroom, moved from moderate or high-risk for emotional problems, conduct problems, hyperactivity/inattention or peer relationship problems to low risk, in 12 weeks. A 2017 study by the Swedish Karolinska Institute found even stronger impact on the Strengths and Difficulties Questionnaire across all domains for mental, emotional, and behavioral health, with 5 months of implementation. Why does PAX GBG create mental and behavioral well-being, even causing remission of mental, emotional, and behavioral disorders based on the long-term outcome studies with one or two years implementation? Acclaimed neuro-scientists, including Bruce Perry and developmental psychologists like Anthony Biglan argue that nurturing environments are key for reducing the impact of childhood trauma and putting children on a resiliency path for positive developmental outcomes. PAX GBG has been shown to cause positive brain-gene expression, as predicted by Bruce Perry’s work about children with trauma histories Musci et al., 2013; Musci, Masyn, Benke, et al., 2015; Musci, Masyn, Uhl, et al., 2015; Musci, Uhl, Maher, & Ialongo, 2015).

PAX GBG Improves Family RelationshipsPAX GBG materials and trainings employ previously proven Evidence-Based Kernels (Embry & Biglan, 2008) that are well document-ed to improve parent-child interactions as well as school success (Kelley, 1990). Students who receive PAX GBG are far less likely to get into trouble at school, be sent to the principal’s office, be suspended, or develop mental/behavioral disorders. Reducing these problems have been shown to have a beneficial effect on reducing family stress and conflict (Bradshaw et al., 2009). Specifically, children’s increased self-regulation skills promote positive interactions with parents (Ialongo et al., 2001; Ialongo et al., 1999).Since PAX GBG students are less likely to be suspended, use alcohol and drugs, engage in violent or delinquent behavior or in early sex, family conflict is dramatically reduced (Furr-Holden, Ialongo, Anthony, Petras, & Kellam, 2004; Ialongo et al., 2001). In turn, these prevention effects reduce the risk of inter-generational trauma, such as alcohol or drug abuse in the home, drug-affected babies, and violence or other child maltreatment. PAX GBG Improves Lifetime OutcomesConsider the multiple, lifetime benefits that PAX GBG creates for students, schools, families, and society—with a rate-of-return on investment of 63-to-1 or more. PAX GBG reduces the need for special education services and increases the likelihood of students to graduate from high school, enter college, and have gainful employment (Bradshaw et al., 2009; Furr-Holden et al., 2004; Ialongo et al., 2001; S. Kellam et al., 2008; Petras et al., 2008; Storr, Ialongo, Kellam, & Anthony, 2002; Wilcox et al., 2008; Yan et al., 2009). This means productive citizens paying taxes.

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High School Graduation Girls

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Suicidal Thoughts All Boys & Girls -51%

Any Psychiatric Services All Boys -40%

Violent Crime Among Hi-Aggressive Boys -32%

Anti-Social Personality Disorder, Hi-Aggressive Boys -60%

Any Drug Use All Boys -50%

Opiate Use by All Boys and Girls -64%

Alcohol Abuse All Boys & Girls -35%

Regular Smoking Among Aggressive Boys -65%

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Special Education Services All Boys -57%

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Snapshot of Good Behavior Game®Computation of Relative Difference = (GBG/Control)-1

Few prevention strategies have the replicated impact on lifetime Computation of Relative Difference = (GBG/Control)-1 developmental outcomes, as the good behavior game and its Evidence-Based Kernels (Shoemaker, Tully, Niendam, & Peterson, 2015). PAX GBG is scalable as a universal, public health strategy to prevent mental, emotional, psychiatric, and disorders and even suicide (Embry, 2011). Because of the multiple replications, the Washington State Institute for Public Policy developed a formula to estimate monetary benefits of PAX GBG. This formula, combined with the longitudinal data from the Hopkins trials allow communities to estimate the impact PAX GBG will have on students when reach their twenties. For example, if 10,000 students receive well-implemented PAX GBG for two years, major benefits happen including 65% reduction in lifetime risk of hard drug use (e.g. opiates).

Evidence Of Proven Impact

Notably, no psychotropic medication has proven benefits similar to those of PAX GBG– whole cohorts of elementary children demonstrating lasting benefits 5, 10, 15, or 20 years after stopping treatment. Thus, PAX GBG is a universal “behavioral vaccine” that has lifetime benefits if used for one or more years. That’s why PAX GBG was named as “The Next Big Thing” for the universal prevention of psychiatric disorders (Shoemaker et al., 2015).

Aos, S., Lee, S., Drake, E., Pennucci, A., Klima, T., Miller, M., . . . Burley, M. (2013). Good Behavior Game, Return on Investment: Evidence-Based Options to Improve Statewide Outcomes(July), 8. Retrieved from http://www.wsipp.wa.gov/BenefitCost/Program/82

Ballard, E. D., Van Eck, K., Musci, R. J., Hart, S. R., Storr, C. L., Breslau, N., & Wilcox, H. C. (2015). Latent classes of childhood trauma exposure predict the development of behavioral health outcomes in adolescence and young adulthood. Psychol Med, 45(15), 3305-3316. doi:10.1017/s0033291715001300

Biglan, A., Flay, B. R., Embry, D. D., & Sandler, I. N. (2012). The critical role of nurturing environments for promoting human well-being. American Psychologist, 67(4), 257-271. doi:10.1037/a0026796

Bradshaw, C. P., Zmuda, J. H., Kellam, S., & Ialongo, N. (2009). Longitudinal Impact of Two Universal Preventive Interventions in First Grade on Educational Outcomes in High School. Journal of Educational Psychology, 101(4), 926-937.

Dolan, L. J., Kellam, S. G., Brown, C. H., Werthamer-Larsson, L., & et al. (1993). The short-term impact of two classroom-based preventive interventions on aggressive and shy behaviors and poor achievement. Journal of Applied Developmental Psychology, 14, 317-345.

Domitrovich, C. E., Bradshaw, C. P., Berg, J. K., Pas, E. T., Becker, K. D., Musci, R., . . . Ialongo, N. (2016). How Do School-Based Prevention Programs Impact Teachers? Findings from a Randomized Trial of an Integrated Classroom Management and Social-Emotional Program. Prev Sci, 17(3), 325-337. doi:10.1007/s11121-015-0618-z

Elswick, S., Casey, L. B., Zanskas, S., Black, T., & Schnell, R. (2016). Effective data collection modalities utilized in monitoring the good behavior game: Technology-based data collection versus hand collected data. Computers in Human Behavior, 54, 158-169. doi:http://dx.doi.org/10.1016/j.chb.2015.07.059

Embry, D. D. (2002). The Good Behavior Game: A Best Practice Candidate as a Universal Behavioral Vaccine. Clinical Child & Family Psychology Review, 5(4), 273-297.

Embry, D. D. (2004). Community-Based Prevention Using Simple, Low-Cost, Evidence-Based Kernels and Behavior Vaccines. Journal of Community Psychology, 32(5), 575.

Embry, D. D. (2011). Behavioral Vaccines and Evidence-Based Kernels: Nonpharmaceutical Approaches for the Prevention of Mental, Emotional, and Behavioral Disorders. Psychiatric Clinics of North America, 34(March), 1-34. doi:10.1016/j.psc.2010.11.003

Embry, D. D., & Biglan, A. (2008). Evidence-Based Kernels: Fundamental Units of Behavioral Influence. Clinical Child & Family Psychology Review, 11(3), 75-113. doi:10.1007/s10567-008-0036-x

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., . . . Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med, 14(4), 245-258.

Flannery, D. J., Vazsonyi, A. T., Liau, A. K., Guo, S., Powell, K. E., Atha, H., . . . Embry, D. D. (2003). Initial behavior outcomes for the PeaceBuilders universal school-based violence prevention program. Developmental Psychology, 39(2), 292-308.

Furr-Holden, C. D., Ialongo, N. S., Anthony, J. C., Petras, H., & Kellam, S. G. (2004). Developmentally inspired drug prevention: middle school outcomes in a school-based randomized prevention trial. Drug & Alcohol Dependence, 73(2), 149-158.

Ghaderi, A., Johansson, M., & Enebrink, P. (2017). Pilotstudie av PAX i skolan: En kulturanpassad version av PAX Good Behavior Game. Retrieved from Stockholm, Sweden: http://media.paxiskolan.se/2017/05/PAXGBG_rapport_FoHM_2017-05.pdf

Huber, M., Fruth, J.D., Avila-John, A. & Ramirez, E. (2016). Teacher self-efficacy and student outcomes: A transactional approach to prevention. Journal of Education and Human Development. 5(1).

Ialongo, N., Poduska, J., Werthamer, L., & Kellam, S. (2001). The distal impact of two first-grade preventive interventions on conduct problems and disorder in early adolescence. Journal of Emotional & Behavioral Disorders, 9(3), 146-160.

Ialongo, N., Werthamer, L., Kellam, S. G., Brown, C. H., Wang, S., & Lin, Y. (1999). Proximal impact of two first-grade preventive interventions on the early risk behaviors for later substance abuse, depression, and antisocial behavior. American Journal of Community Psychology, 27(5), 599-641.

Jiang, D., Santos, R., Mayer, T., & Boyd, L. (2015, 7/14/2015). Program Evaluation with Multilevel and Multivariate Longitudinal Outcomes. Paper presented at the International Meeting of the Psychometric Society, Beijing, China.

Jiang, D., Santos, R., Josephson, W., Mayer, T., Boyd, L. (2018). A comparison of variable- and person-orientied approaches in evaluating a universal preventive intervention. Prevention Science. 1-10.

Jones, D. E., Greenberg, M., & Crowley, M. (2015). Early Social-Emotional Functioning and Public Health: The Relationship Between Kindergarten Social Competence and Future Wellness. Am J Public Health, 105(11), 2283-2290. doi:10.2105/ajph.2015.302630

Kellam, S., Brown, C. H., Poduska, J., Ialongo, N., Wang, W., Toyinbo, P., . . . Wilcox, H. C. (2008). Effects of a universal classroom behavior management program in first and second grades on young adult behavioral, psychiatric, and social outcomes,. Drug & Alcohol Dependence(Special Issue), 24.

Kellam, S. G., Mackenzie, A. C., Brown, C. H., Poduska, J. M., Wang, W., Petras, H., & Wilcox, H. C. (2011). The good behavior game and the future of prevention and treatment. Addict Sci Clin Pract, 6(1), 73-84.

Kellam, S. G., Wang, W., Mackenzie, A. C., Brown, C. H., Ompad, D. C., Or, F., . . . Windham, A. (2012). The Impact of the Good Behavior Game, a Universal Classroom-Based Preventive Intervention in First and Second Grades, on High-Risk Sexual Behaviors and Drug Abuse and Dependence Disorders into Young Adulthood. Prev Sci. doi:10.1007/s11121-012-0296-z

Kellam, S. G., Wang, W., Mackenzie, A. C. L., Brown, C. H., Ompad, D. C., Or, F., . . . Windham, A. (2014). The impact of the good behavior game, a universal classroom-based preventive intervention in first and second grades, on high-risk sexual behaviors and drug abuse and dependence disorders into young adulthood. Prevention Science, 15(Suppl 1), S6-S18. doi:10.1007/s11121-012-0296-z

References

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Musci, R. J., Bradshaw, C. P., Maher, B., Uhl, G. R., Kellam, S. G., & Ialongo, N. S. (2013). Reducing aggression and impulsivity through school-based prevention programs: A gene by intervention interaction. Prevention Science, No Pagination Specified. doi:10.1007/s11121-013-0441-3

Musci, R. J., Masyn, K. E., Benke, K., Maher, B., Uhl, G., & Ialongo, N. S. (2015). The effects of the interplay of genetics and early environmental risk on the course of internalizing symptoms from late childhood through adolescence. Development and Psychopathology, No Pagination Specified. doi:10.1017/S0954579415000401

Musci, R. J., Masyn, K. E., Uhl, G., Maher, B., Kellam, S. G., & Ialongo, N. S. (2015). Polygenic Score × Intervention Moderation: An application of discrete-time survival analysis to modeling the timing of first tobacco use among urban youth. Development and Psychopathology, 27(1), 111-122. doi:10.1017/S0954579414001333

Musci, R. J., Uhl, G., Maher, B., & Ialongo, N. S. (2015). Testing gene × environment moderation of tobacco and marijuana use trajectories in adolescence and young adulthood. Journal of Consulting and Clinical Psychology, 83(5), 866-874. doi:10.1037/a0039537

O’Donnell, M., Morgan, M., Embry, D. D., O’Kelly, N., & Owens, C. (2016). Supporting the development of pupils’ self-regulation skills: Evaluation of the PAX GBG Programme in Ireland. Irish Teachers’ Journal, 4 (1), 9-29.

Pas, E. T., Bradshaw, C. P., Hershfeldt, P. A., & Leaf, P. J. (2010). A multilevel exploration of the influence of teacher efficacy and burnout on response to student problem behavior and school-based service use. School Psychology Quarterly, 25(1), 13-27. doi:10.1037/a0018576

Petras, H., Kellam, S., Brown, C. H., Muthen, B., Ialongo, N., & Poduska, J. (2008). Developmental epidemiological courses leading to antisocial personality disorder and violent and criminal behavior: Effects by young adulthood of a universal preventive intervention in first- and second-grade classrooms. Drug & Alcohol Dependence(Special Issue), 15.

Shoemaker, E. Z., Tully, L. M., Niendam, T. A., & Peterson, B. S. (2015). The Next Big Thing in Child and Adolescent Psychiatry: Interventions to Prevent and Intervene Early in Psychiatric Illnesses. Psychiatr Clin North Am, 38(3), 475-494. doi:10.1016/j.psc.2015.05.010

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Storr, C. L., Ialongo, N. S., Kellam, S. G., & Anthony, J. C. (2002). A randomized controlled trial of two primary intervention strategies to prevent early onset tobacco smoking. Drug & Alcohol Dependence, 66(1), 51.

Turkkan, J. (1988). The Good Behavior Game Manual. John Hopkins School of Hygiene and Public Health, Department of Mental Hygiene. Baltimore, MD.

Vazsonyi, A. T., Belliston, L. M., & Flannery, D. J. (2004). Evaluation of a School-Based, Universal Violence Prevention Program: Low-, Medium-, and High-Risk Children. Youth Violence and Juvenile Justice, 2(2), 185-206.

Weis, R., Osborne, K. J., & Dean, E. L. (2015). Effectiveness of a universal, interdependent group contingency program on children's academic achievement: A countywide evaluation. Journal of Applied School Psychology, 31(3), 199-218. doi:10.1080/15377903.2015.1025322

Wilcox, H. C., Kellam, S., Brown, C. H., Poduska, J., Ialongo, N., Wang, W., & Anthony, J. (2008). The impact of two universal randomized first- and second-grade classroom interventions on young adult suicide ideation and attempts. Drug & Alcohol Dependence(Special Issue), 14.

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Yan, W., Dorothy, C. B., Hanno, P., Elizabeth, A. S., Fernando, A. W., Sharon, F. L., . . . Nicholas, S. I. (2009). Depressed mood and the effect of two universal first grade preventive interventions on survival to the first tobacco cigarette smoked among urban youth. Drug and Alcohol Dependence, 100(3), 194-203.

ReferencesKelley, M. L. (1990). School-Home Notes: Promoting Children's Classroom Success: The Guilford Press Krug, E. G., Brener, N. D., Dahlberg, L. L., Ryan, G. W., & Powell, K. E. (1997). The impact of an elementary school based violence

prevention program on visits to the school nurse. American Journal of Preventive Medicine, 13(6), 459-463. Ludy-Dobson, C. R., & Perry, B. D. (2010). The role of healthy relational interactions in buffering the impact of childhood trauma

Working with children to heal interpersonal trauma: The power of play. (pp. 26-43). New York, NY, US: Guilford Press.

PAX = Peace rP oductivity Health Happiness

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As shown in the graphic, PAX GBG helps teachers and students create a Nurturing Environment4 in their class-rooms, using specific PAX Language, evidence-based kernels/cues, and the PAX Game itself.Within a semes-ter of exposure to well-implemented PAX GBG, there can be population-level treatment effects on psychiatric and behavioral disorders in children, as demonstrated by a public-health implementation of PAX GBG prov-ince-wide in Manitoba, Canada.23 These benefits persist at least into the 3rd grade, and are now to be examined in 5th grade. the impact of childhood trauma, and putting children on a resiliency path for positive developmental outcomes. PAX GBG has been shown to cause positive brain-gene expression, as predicted by Bruce Perry’s work about children with trauma histories.31,33,41,42

Getting PAX

PAX = Peace Productivity Health Happiness

The PAX Good Behavior Game provides the skills, strategies, & supplies necessary for correct implementation.

1. Connect with local schools and mental health/substance abuse boards toschedule “Welcome to PAX” webinar with a Certified PAX Trainer.Contact training@paxis.org to schedule.2. Identify school(s) and teachers who will be trained.3. Identify internal, building level teams that will support early adoption ofimplementation.4. Identify outside entities and individuals who will provide programmatic and/orfiscal support.5. Identify goals for sustainability and expansion.6. Contact training@paxis.org to schedule on-site, PAX Good Behavior GameTraining and PAX Kit for each teacher ($289) and school administrator ($149).

PAX GBG Training (up to 40 participants) $2900 + participant kits + trainer travel

7. Plan ongoing professional development for sustainability and support.

PAX Next Steps Training

Training for teachers trained in PAX GBG about PAX as Trauma-Informed Care and alignment with PBIS.PAX Partner Training

Training for PAX Partners to support adoption, expansion and sustainability of implementation.PAX Heroes Teacher Training

Professional Development for teachers trained in PAX GBG focusing on Tiered Intervention for selective/indicated students who continue to have difficulty in the classroom.PAX Heroes Partner Training

Professional Development for previously trained PAX Partners to support teacher implementation of PAX GBG for Tiered Intervention.