PAX IS Institute tm Dennis D. Embry, Ph.D. president/senior - - PowerPoint PPT Presentation

PAXIS Institute

passion into action science to practice promoting solutions

Ted talk: Testing a universal public-health approach to prevent psychiatric disorders…

Dennis D. Embry, Ph.D. president/senior scientist

Conflict of Interest

I own 100% PAXIS Institue, which designs, tests, and sells scientifically proven strategies to improve the wellbeing individuals, families, and communities—including PAX Good Behavior Game. We intend to to make money selling low-cost, powerful strategies to better the world. No apologies offered.

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If the Polio Epidemic of the 1950s happened today

There would be 6,000 deaths and 120,000 cases. How would America respond?

What if we could reduce mental, emotional & behavioral disorders like this?

The ROI was 3-to-1

Use Hashtag: #SaveAllKids

Remembering when America mobilized science for universal protection of children

epidemic

ecdemic endemic pandemic epizootic epiphytotic pestiferous plaguey pestilential pestilent eruption

• utbreak

irruption

(especially of medicine)

• f disease or anything

resembling a disease; attacking or affecting many individuals in a community or a population simultaneously "an epidemic outbreak of influenza"

Youthanasia

Use Hashtag: #SaveAllKids

Cumulative Lifetime Prevalence of Disorders in US Adolescents (N=10,123)

40% 35% 30% 25% 20% 15% 10% 5% 0% 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Age in Years

Anxiety

Substance

Behavior

Mood

Merikangas et al., 2010

1-out-2 USA young adults will be afflicted with

• ne or more of

these disorders by age 18

NOTE EARLY START

Use Hashtag: #SaveAllKids

Cumulative prevalence of psychiatric disorders by young adulthood: a prospective cohort analysis from the Great Smoky Mountains Study.

Youngest Cohort Middle Cohort Oldest Cohort

NOTE EARLIER START

Cumulative Prevalence

AGE

9 10 11 12 13 14 15 16 19 21

Use Hashtag: #SaveAllKids

The US had 75 million children and teens 2009

Wall Street Journal, 12-28-2010

40.4 million kids had

• ne psychotropic

med in 2009

Use Hashtag: #SaveAllKids

$0 Billion $3 Billion $6 Billion $9 Billion $12 Billion $15 Billion Mental Disorders Asthma/ COPD Trauma Acute Bronchitis & &URI Ottis Media

$3.20

Billion

$3.30

Billion

$5.80

Billion

$11.90

Billion

$13.80

Billion

$2.90

Billion

$3.10

Billion

$6.10

Billion

$8.00

Billion

$8.90

Billion

Medicaid Expenditures for the Five Most Costly Conditions in Children

Medicaid Expendures (In US$, Billions)

Fiscal Year Expenditures

FY 2006 FY 2006 FY 2011 FY 2011 FY 2011 FY 2011 FY 2011 FY 2006 FY 2006 FY 2006 Source: Center for Financing, Access, and Cost Trends, Agency for HealhCare Research and Quality, 2006, 2011

The cost of Mental Disorders is increasing $1 billion per year

bit.ly/TennTalkEmbryDay1

The Next Big Thing? Universal Prevention of Psychiatric Disorders

Wilson et al., 2014; Brain & Behavioral Sciences

Scaffolding with Nurturing Environment Framework & Evidence-Based Kernels PAX GBG scaffolds self-regulation in context of every classroom routine

Self-Regulation Co-Regulation Group-Regulation

Richly Reinforcing Prosocial Behaviors Reducing or Minimizing Toxic Influences Limiting Problematic Behaviors Increasing Psychological Safety & Flexibility

Tootles Notes PAX IT notes PAX Roles Granny’s Wacky Prizes PAX Minutes ABCD Pinch Slates PAX Vision I’m a PAX Leader PAX OK/ Spleems Not OK Predict, Monitor & Reflect PAX Quiet PAX Hands PAX Breath PAX Quiet PAX Hands PAX Voices PAX Roles PAX Feet Spleem Observations es s acky Not OK

• nitor

P PA PA

P A X G

• d

B e h a v i

• r

G a m e

Beyond Efficacy: Evidence of Scalability & Effectiveness Results

Province-wide policy evaluation with longitudinal follow up Testing rapid implementation in three diverse districts

Manitoba Randomize Policy Trial New Mexico Children’s Cabinet Policy

5 10 15 20 25 30 35 40 District #1 District #2 District #3 Baseline Post-PAX Good Behavior Game

Disruptive, Disturbing, Inattentive Behaviors per Student per Hour

• 38%
• 43%
• 35%

Students = 3,329

Changes In Observed Student Behaviors Within 90 Days

• 40%
• 35%
• 30%
• 25%
• 20%
• 15%
• 10%
• 5%

0% Moderate Problems Students Moving to Low Risk High Problem Students Moving to Moderate Risk High Problem Students Moving to Low Risk PAX GBG Control

Control

PAX

Control

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

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

N ≈ 5,000

(p<.01)

Improved Mental-Health =

• Fewer conduct problems
• Fewer emotional problems
• Less hyperactivity
• Fewer peer problems
• Better prosocial skills

A National Public-Health Test to Prevent Childhood Psychiatric Disorders n = 100,000

• All 50-states plus selected territories

and interested Tribal Sites.

• Randomize-trial each site of 40-60

classrooms per site, three conditions each site:

• 1. PAX GBG
• 2. PAX GBG + Potential

Enhancements or Other Strategy

• 3. Preserved Control, classrooms as

usual.

• Standardized measures across sites,

plus relevant local measures or strategy measures.

• National research team (e.g.

members of the 2009 IOM report).

• Site investigators and site

coordinators.

• National data repository for further

analyses and follow up.

Cost? $20 million

Further Reading

• Search www.pubmed.gov (National Library of Medicine) for the following:
• Good Behavior Game
• “Behavioral Vaccines”
• “Evidence-based kernels”
• “Nurturing Environments”
• www.researchgate.net/profile/Dennis_Embry/publications

Dennis D. Embry dde@paxis.org

Thank you