This slide presentation shows the data on the short-term (in one year) and long-term (two decades) later outcomes of the PAX Good Behavior Game on multiple mental, emotional and behavioral disorders. This graphically shows the power of this simple strategy invented by a 4th grade teacher, and favored heavily in the Institute of Medicine Report on Prevention in 2009. You can watch the video of the principal by clicking http://slidesha.re/principalgbg If you wish to use the PAX GBG Savings estimators for a state or school/district, please go to http://bit.ly/hullCT

1. The Science and Sense of
The PAX Good Behavior Game

2. Meet Muriel Saunders, the 4th-grade teacher who
invented the Good Behavior Game in 1967
JOURNAL OF APPLIED BEHAVIOR ANALYSIS 1969, 2, 119-124 NUMBER 2 (SUMMER 1969)
GOOD BEHAVIOR GAME: EFFECTS OF INDIVIDUAL
CONTINGENCIES FOR GROUP CONSEQUENCES ON
DISRUPTIVE BEHAVIOR IN A CLASSROOM'
HARRIET H. BARRISH, MURIEL SAUNDERS, AND MONTROSE M. WOLF
UNIVERSITY OF KANSAS
Out-of-seat and talking-out behaviors were studied in a regular fourth-grade class that in-
cluded several "problem children". After baseline rates of the inappropriate behaviors were
obtained, the class was divided into two teams "to play a game". Each out-of-seat and talking-
out response by an individual child resulted in a mark being placed on the chalkboard, which
meant a possible loss of privileges by all members of the student's team. In this manner a
contingency was arranged for the inappropriate behavior of each child while the consequence
(possible loss of privileges) of the child's behavior was shared by all members of this team
as a group. The privileges were events which are available in almost every classroom, such
as extra recess, first to line up for lunch, time for special projects, stars and name tags, as
well as winning the game. The individual contingencies for the group consequences were
successfully applied first during math period and then during reading period. The experi-
mental analysis involved elements of both reversal and multiple baseline designs.
Researchers have recently begun to assess Hall and Broden, 1967; Becker, Madsen,
the effectiveness of a variety of behavioral Arnold, and Thomas, 1967; Hall, Lund, and
procedures for management of disruptive class- Jackson, 1968; Thomas, Becker, and Arm-
room behavior. Some investigators have ar- strong, 1968; Madsen, Becker, and Thomas,
ranged token reinforcement contingencies for 1968). Even so, at least one group of investi-
appropriate classroom behavior (Birnbrauer, gators (Hall et al., 1968) encountered a teacher
Wolf, Kidder, and Tague, 1965; O'Leary and who apparently did not have sufficient social
Becker, 1967; Wolf, Giles, and Hall, 1968). reinforcers in her repertoire to apply social
However, these token reinforcers often have reinforcement procedures successfully. The
been dependent upon back-up reinforcers that present study investigated the effects of a class-
were unnatural in the regular classroom, such room behavior management technique based
as candy and money. On the other hand, on reinforcers natural to the classroom, other
several investigators have utilized a reinforcer than teacher attention. The technique was
intrinsic to every classroom, i.e., teacher at- designed to reduce disruptive classroom be-
tention (Zimmerman and Zimmerman, 1962; havior through a game involving competition
for privileges available in almost every class-
'This study is based upon a thesis submitted by the room. The students were divided into two
senior author to the Department of Human Develop- teams and disruptive behavior by any member
ment in partial fulfillment of the requirements for the of a team resulted in possible loss of privileges
Master of Arts degree. The research was supported by for every member of his team.
a Public Health Service Fellowship IFI MH-36, 964-01
from the National Institute of Mental Health and by
a grant (HD 03144) from the National Institute of METHOD
Child Health and Human Development to the Bureau
of Child Research and the Department of Human Subjects and Setting
Development, University of Kansas. The authors wish The study was conducted in a fourth-grade
to thank Drs. Donald M. Baer and Don Bushell, Jr.,
for helpful suggestions in preparation of the manu- classroom of 24 students. Seven of the students
script; Mr. Rex Shanks, Mr. Frank A. Branagan, and had been referred several times by the teacher
Mrs. Betty Roberts for their invaluable help in con- to the school principal for such problems as
ducting the study; and Mrs. Susan Zook, Mrs. Sue out-of-seat behavior, indiscriminate noise and
Chen, and Mr. Jay Barrish for their contributions of talking, uncooperativeness, and general class-
time for reliability checks. Reprints may be obtained
from the authors, Department of Human Development, room disruption. Further, the school principal
University of Kansas, Lawrence, Kansas 66044. reported that a general behavior management
119
Barrish, H. H., Saunders, M., & Wolf, M. M. (1969). Good behavior game: Effects of individual contingencies for group
consequences on disruptive behavior in a classroom. Journal of Applied Behavior Analysis, 2(2), 119-124

3. C linical C hild and Family P sychology R eview, Vol. 5, N o. 4, D ecember 2002 ( C 2002)
pages 273-297
T he G ood B ehavior G ame: A B est P ractice C andidate
as a U niversal B ehavioral V accine
Key findings in the first 50 D ennis D . E mbry1
A “ behavioral vaccine” provides an inoculation against morbidity or mortality, impactingphys-
ical, mental, or behavior disorders. A n historical example of a behavioral vaccine is antiseptic
hand washing to reduce childbed fever. I n current society, issues with high levels of morbidity,
LY
studies of the GBG
such as substance abuse, delinquency, youth violence, and other behavioral disorders ( multi-
problems) , cry out for a low-cost, widespread strategy as simple as antiseptic hand washing.
C ongruent research findings from longitudinal studies, twin studies, and other investigations
N
suggest that a possibility might exist for a behavioral vaccine for multiproblem behavior. A
O
simple behavioral strategy called the G ood B ehavior G ame ( G B G ) , which reinforces inhibi-
tion in a group context of elementary school, has substantial previous research to consider
its use as a behavioral vaccine. T he G B G is not a curriculum but rather a simple behavioral
procedure from applied behavior analysis. A pproximately 20 independent replications of the
G B G across different grade levels, different types of students, different settings, and some
with long-term follow-up show strong, consistent impact on impulsive, disruptive behaviors
of children and teens as well as reductions in substance use or serious antisocial behaviors.
T he G B G , named as a “ best practice” for the prevention of substance abuse or violent be-
havior by a number of federal agencies, is unique because it is the only practice implemented
by individual teachers that is documented to have long-term effects. Presently, the G B G is
๏ This was the first widely replicated scientific
only used in a small number of settings. H owever, near universal use of the G B G , in major
political jurisdictions during the elementary years, could substantially reduce the incidence of
substance use, antisocial behavior, and other adverse developmental or social consequences
at a very modest cost, with very positive cost-effectiveness ratios.
K E Y W O R D S: substance abuse prevention; violence prevention; public policy; best practice.
demonstration that disturbing, disruptive, INT R OD U CT ION
A behavioral vaccine is a simple, scientifically
I n the late 1840s, D r I gnaz Semmelweis worked in
the maternity wards of a V ienna hospital. B y metic-
ulous observation, he discovered that the mortality
proven routine or practice put into widespread daily
destructive and inattentive behaviors of
rate in a delivery room staffed by medical students
use that reduces morbidity and mortality. A powerful was up to three times higher than in a second deliv-
example comes from an epidemic that occurred 150 ery room staffed by midwives. Semmelweis postulated
years ago. that the students might be carrying the infection from
D uring the nineteenth century, women died in their dissections to mothers giving birth. H e tested the
children from preschool through secondary childbirth at alarming rates in E urope and the U nited
States. U p to 25% of women who delivered their ba-
bies in hospitals died from childbed fever ( puerperal
sepsis) , discovered later to be caused by Streptococcus
hypothesis by having doctors and medical students
wash their hands with a chlorinated solution before
examining women in labor. T he mortality rate in his
maternity wards eventually dropped to less than 1% .
education could be reliably reduced by pyogenes bacteria.
1 PA
X I S I nstitute, PO B ox 68494, Tucson, A rizona 85737; e-mail:
dde@paxis.org.
Washing of hands with antiseptic solution—a behav-
ioral vaccine—now saves millions of lives every year.
Today, the C enters of D isease C ontrol and Prevention
( C D C ) web site states, “ [A ntiseptic] hand washing is
individual teachers using a simple behavioral 273
1096-4037/02/1200-0273/0 C 2002 Plenum Publishing C orporation
recipe—a daily behavioral vaccine. 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.

4. How does the Good Behavior Game work?

5. This is “Johnny Good” in a classroom anywhere…

6. This is “Johnny Good” in a classroom anywhere…
How often will the other students in the
classroom reinforce him for being good during
one hour?
In hundreds of workshops with teachers and
school staff all across North America, they say…

7. This is “Johnny Good” in a classroom anywhere…
How often will the other students in the
classroom reinforce him for being good during
one hour?
In hundreds of workshops with teachers and
school staff all across North America, they say…
“Never or almost never…”

8. This is “Johnny Good” in a classroom anywhere…
How often will the other students in the
classroom reinforce him for being good during
one hour?
In hundreds of workshops with teachers and
school staff all across North America, they say…
“Never or almost never…”
“They’ll probably tease him for being good…”

9. This is “Johnny Bad” in a classroom anywhere…

10. This is “Johnny Bad” in a classroom anywhere…
How often will the other students in the
classroom reinforce him for being bad during one
hour?
In hundreds of workshops with teachers and
school staff all across North America, they say…

11. This is “Johnny Bad” in a classroom anywhere…
How often will the other students in the
classroom reinforce him for being bad during one
hour?
In hundreds of workshops with teachers and
school staff all across North America, they say…
“10 to 20 times at least”

12. This is “Johnny Bad” in a classroom anywhere…
How often will the other students in the
classroom reinforce him for being bad during one
hour?
In hundreds of workshops with teachers and
school staff all across North America, they say…
“10 to 20 times at least”
“They’ll probably laugh, giggle and smile at him

13. Teacher attention
for being good or all the “consequences”
for being bad from adults cannot
compete with the accidental attention
from peers for being “bad.”
Great teachers and grandmothers have
know this forever, and so have
scientists.
The Good Behavior Game turns all this

14. The “recipe” for the PAX (Good Behavior) Game
1. The class defines the “good” to be achieved = PAX
2. The class defines the “bad” to be reduced = Spleems
3. Teacher forms 3-5 teams in the class (based on a
formula).
4. A Spleem (a disturbing, disruptive, destructive or
inattentive behavior) is counted against the team.
5. A game is played three (3) times per day for increasing
number of minutes as successful. The Games are played
during demanding times for instruction.
Note: The game is NOT called the 6. Teams have a PAX WIN if they score three (3) or fewer
Good Behavior Game to students. Spleems.
It is called the PAX Game. 7. The wins are reinforced by silly activities normally
forbidden for a few seconds or minutes at most, based
on a scientific principle called “Grandmother’s Law”.
8. And there is more…

15. So what happens to disturbing, disruptive,
destructive or inattentive behavior with the
PAX (Good Behavior) Game?

16. Behavior Tracking Results in Baltimore 150+ classrooms
No or Low Implementation
of PAX (Good Behavior) Game
17 per/hr X 5.5
class hours X 30
students =
2,805
disruptions per
school day per
classroom

17. Behavior Tracking Results in Baltimore 150+ classrooms
No or Low Implementation High Implementation
of PAX (Good Behavior) Game of PAX (Good Behavior) Game
17 per/hr X 5.5
class hours X 30
students =
2,805
disruptions per
school day per
classroom

18. Behavior Tracking Results in Baltimore 150+ classrooms
No or Low Implementation High Implementation
of PAX (Good Behavior) Game of PAX (Good Behavior) Game
17 per/hr X 5.5
class hours X 30
students =
2,805
6 per/hr X 5.5
disruptions per
class hours X 30
school day per
students =
classroom
990 disruptions
per school day
per classroom

19. Behavior Tracking Results in Chicago in 43 classrooms

20. Johns Hopkins Center for
Prevention and Early
Intervention
๏ Five longitudinal studies of the effects of the Good
Behavior Game now being studied
๏ All involve random assignment of teachers in schools
and schools to use or not use GBG
๏ Here are data from Cohort 1 and 2 studies showing
effects 20 years later, after just getting GBG in 1st
grade ONLY

21. Why might the PAX (Good
Behavior) Game have
lifetime benefits?
๏ GBG teaches voluntary control of attention in the brain.
๏ GBG teaches accidental negative attention from adults
in authority.
๏ GBG teaches children how to stay focused on valued
goal—even when taunted, teased, or distracted by
peers (negative peer pressure).
๏ GBG protects against adversity and increases
resiliency, strengthening inhibition and self control in the

22. Does the PAX (GBG) change lives?

23. GBG reduces lifetime special services
NO GOOD BEHAVIOR GAME in 1st Grade
For children at the highest levels of
aggression in 1st grade, more than 80% of
those children received special education
services by age 21.
Control
GBG
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.

24. GBG reduces lifetime special services
NO GOOD BEHAVIOR GAME in 1st Grade
For children at the highest levels of
aggression in 1st grade, more than 80% of
those children received special education
services by age 21.
GOOD BEHAVIOR GAME in 1st Grade
Control Only
GBG For children rated at the highest levels of
aggression in 1st grade, only 40% of those
children received any special education services
by age 21.
And, GBG reduced special education needs for all
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.

25. GBG reduces lifetime alcohol addictions
NO GOOD BEHAVIOR GAME in 1st Grade
For children at the highest levels of
aggression in 1st grade, more than 60% of
those children developed an alcohol
addiction by age 21.
Control
GBG
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.

26. GBG reduces lifetime alcohol addictions
NO GOOD BEHAVIOR GAME in 1st Grade
For children at the highest levels of
aggression in 1st grade, more than 60% of
those children developed an alcohol
addiction by age 21.
Control
GOOD BEHAVIOR GAME in 1st Grade Only
GBG For children rated at the highest levels of
aggression in 1st grade, 50% of those children
developed an alcohol addiction by age 21.
And, GBG helped all children from 1st grade have
less lifetime alcohol addiction
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.

27. GBG reduces lifetime drug addictions
NO GOOD BEHAVIOR GAME in 1st Grade
For children at the highest levels of
aggression in 1st grade, 60% of those
children developed an drug addiction by
age 21.
Control
GBG
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.

28. GBG reduces lifetime drug addictions
NO GOOD BEHAVIOR GAME in 1st Grade
For children at the highest levels of
aggression in 1st grade, 60% of those
children developed an drug addiction by
age 21.
Control GOOD BEHAVIOR GAME in 1st Grade Only
For children rated at the highest levels of
aggression in 1st grade, 40% of those children
GBG developed a drug addiction by age 21.
And, GBG helped all children from 1st grade have
less lifetime alcohol addiction
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.

29. GBG reduces lifetime anti-social personality disorder
NO GOOD BEHAVIOR GAME in 1st Grade
For children at the highest levels of
aggression in 1st grade, 60% of those
children developed a serious antisocial
personality disorder by age 21.
Control
GBG
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.

30. GBG reduces lifetime anti-social personality disorder
NO GOOD BEHAVIOR GAME in 1st Grade
For children at the highest levels of
aggression in 1st grade, 60% of those
children developed a serious antisocial
personality disorder by age 21.
Control GOOD BEHAVIOR GAME in 1st Grade Only
GBG For children rated at the highest levels of aggression
in 1st grade, 40% of those children developed a
serious anti-social personality disorder by age 21.
And, for lowers levels of early aggression, there is no
statistical significant difference. That is, GBG does
not make children better or worse on this disorder.
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.

31. GBG reduces regular smoking
NO GOOD BEHAVIOR GAME in 1st Grade
For children at every level of aggression,
20% of those children were regular smokers
by age 21.
Control
GBG
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.

32. GBG reduces regular smoking
NO GOOD BEHAVIOR GAME in 1st Grade
For children at every level of aggression,
20% of those children were regular smokers
by age 21.
GOOD BEHAVIOR GAME in 1st Grade Only
For children at all level of teacher rated aggression,
Control the percentage of regular smokers was about 5% or
less by age 21.
GBG
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.

33. GBG increases high school graduation
GBG
NO GOOD BEHAVIOR GAME in 1st Grade
Control
For children at the higest level of
aggression, just 30% of those children
graduated from high-school by age 21.
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.

34. GBG increases high school graduation
GOOD BEHAVIOR GAME in 1st Grade
Only
For children at all level of teacher rated aggression,
80%+ of them graduated from high-school by age
21.
For children of other levels of aggression, it
increased high-school graduation or had no
GBG significant statistical impact on high school
NO GOOD BEHAVIOR GAME in 1st Grade
Control
For children at the higest level of
aggression, just 30% of those children
graduated from high-school by age 21.
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.

35. GBG reduces suicidal actions & thoughts
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, 95(Suppl 1), 60-73.

36. Author's personal copy
B e h a v i o r a l Va c c i n e s a n d
Evidence-Based Kernels: The cost per lifetime
Nonpharmaceutical
A p p ro a c h e s f o r th e
P re v e n t i o n o f M e n t a l ,
to administer PAX
Emotional, and
B e h a v i o r a l D i s o rd e r s GBG is $62 per
Dennis D. Embry,
KEYWORDS
PhD
child’s lifetime
Evidence-based kernels Behavioral vaccines Prevention
Public health
This article appeared in a journal published by Elsevier. The attached
This is less than cost of administering ANY
copy is furnished to the author for internal non-commercial research
and education use, including for instruction at the authors institution
and sharing with colleagues.
The Institute of Medicine Report on the Prevention of Mental, Emotional and Behav-
ioral Disorders Among Young People1 (IOM Report) provides a powerful map for how
the United States might significantly prevent mental illnesses and behavioral disor-
childhood medical vaccine that most developed
Other uses, including reproduction and distribution, or selling or
licensing copies, or posting to personal, institutional or third party
websites are prohibited.
ders like alcohol, tobacco, and other drug use among America’s youth. This docu-
ment is already shaping United States policies, and will almost certainly affect
Canada and other countries’ policies. Mental, emotional, and behavioral disorders
countries now give routinely to protect the health
In most cases authors are permitted to post their version of the
article (e.g. in Word or Tex form) to their personal website or
institutional repository. Authors requiring further information
regarding Elsevier’s archiving and manuscript policies are
(MEBs) among America’s youth and young adults present a serious threat to the
country’s national security2 and to our economic competitiveness compared with
22 other rich countries.3–7 Such MEBs are also the leading preventable cost center
and wellbeing of the whole population.
encouraged to visit:
http://www.elsevier.com/copyright
for local, state, and the federal governments.1,4 Further, safe schools, healthy
working environments, and public events or places are seriously compromised by
MEBs as well. Why doesn’t every 1st grader get PAX GBG?
Psychiatr Clin N Am 34 (2011) 1–34
A grant from the National Institute on Drug Abuse (DA028946) for the Promise Neighborhood
Research Consortium provided support to the author for work on this article.

37. The PAX Good Behavior Game is a “Game
Changer” in children’s lives
Resiliency Trajectory GB GAME
Infancy 2-3- Years Old 5- Years Old 11- Years Old 13- Years Old 15-18 Years Old
Fussy, irritable, Impulsive, Impulsive Self regulation School success No drug use
diffuclt to Emotionally Hyperactive, Attention Positive peers No alcohol use
consol; may not dysregulated, Disruptive, Positive Adult praise Graduaiton
engage well non-compliant Emotional attention
Resiliency

38. What to know what
people say who have
used PAX GBG?
Watch the the impromptu interview a principal,
http://slidesha.re/principalgbg

39. You can calculate PAX GBG Cost Savings
Down load these spreadsheets @ http://bit.ly/hullCT The spreadsheets allow customizing to your site.

40. For more info about
bringing the PAX GBG to
your location, contact
Claire Richardson
Director of School and Community Programs
PAXIS Institute, PO 31205, Tucson, AZ 85751
Direct: 520-907-5240 • claire@paxis.org