The 28 second-graders in Wayne Larrivey's class at Govans Elementary School sat quietly on the floor, legs crossed and eyes focused on him as he read a story about feelings.
Afterward, they thoughtfully participated in a discussion about the lesson. In exchange for their good behavior, they were allowed to make loud animal noises for 10 seconds.
Could these little model students one day drop out of school, develop a drug or alcohol problem or become violent as some students clearly do? Data collected over three decades suggests it's much less likely.
That's because the children are among thousands of students at dozens of schools in the region who have learned to control potentially destructive behavior through a program called the Good Behavior Game, which ongoing research at Johns Hopkins Bloomberg School of Public Health has shown has immediate rewards in the classroom and long-lasting public health benefits.
"We've followed several thousand children over time," said Dr. Sheppard Kellam, a public health psychiatrist and a pioneer in behavior prevention research who has studied the game since the 1980s. "Turns out it really affected long-term outcomes."
There are many school and community-based prevention programs aimed at helping youths focus and learn, as well as avoid pitfalls down the road. And Kellam, a professor emeritus at Hopkins, said tapping more than one technique could help all kinds of kids.
But he and other researchers say the Good Behavior Game, developed by educators in Kansas in the 1960s, is perhaps the longest-studied of these preventive programs, and seems to curb bad habits even in the most aggressive children.
The kids who played the game in kindergarten, first or second grade fared better in many ways than their peers who didn't participate, the research shows.
They were more likely to graduate from high school and attend college — 31 percent attended college compared to 19 percent a group that didn't play the game. Boys, particularly, were two times less likely to abuse drugs or smoke. They also were more likely to have fewer sexual partners and to use condoms — nearly 90 percent compared to just over 40 percent in the control group.
About a third fewer boys who were identified as disruptive or aggressive become incarcerated for violent or criminal acts.
All the children who participated were somewhat less likely to abuse alcohol or suffer antisocial personality disorder, and half as likely to attempt suicide.
A recent report on alcohol, drugs and health by the U.S. surgeon general praised such programs generally for reducing substance abuse at a time when the nation is in the grips of an opioid crisis. The report specifically cited the Good Behavior Game as an especially good value because of the minimal costs to train teachers to use it and provide supplies such as posters with positive messages and scorecards.
For every dollar spent on the game, there was a $64.18 public health benefit over the life of a participant, far more than nine other behavior-related programs, according to the surgeon general's report, citing figures from the Washington State Institute for Public Policy.
Researchers are still investigating why the program works in the long term, said Nicholas Ialongo, a Hopkins public health professor who is leading ongoing studies. But they believe children learn to control negative impulses and emotions when they are rewarded for good behavior for specific periods of time, and those abilities stay with them over time. Their reactions become automatic, even when they no longer are collecting a prize, he said.
"You start early and get kids to inhibit inappropriate behavior," he said. "It can be a building block or foundation for early learning and positive social development."
Variations of the Good Behavior Game are used in many schools locally and across the country.
The game works by rewarding students with a brief activity for behaving properly during a session lasting five to 15 minutes in class. Larrivey's students, for example, were allowed to make animal noises for acting appropriately during the lesson on feelings. Other times kids are allowed a few jumping jacks or to throw wads of paper at each other.
The game has been used at Govans off and on for a decade, and Larrivey, who went to work there last year, found students caught on quickly that they got a prize for following instructions and engaging in class. It was also less costly than a system he developed that relied on handing out trinkets he bought with his own money.
In the game, the children are divided into teams and assessed a point — called a "spleem" — each time a teammate talks out of turn, plays with a shoelace, ignores instructions, touches someone when they aren't supposed to or otherwise acts inappropriately. Teams with three spleems are not allowed to partake in the activity.
Classrooms typically play a few times a day, sometimes during a lesson and other times between lessons.
The kids confirm they work hard for the prize. Second-grader Noah Crider was excited to bray like a donkey. Classmate Clara Johnson wanted to quack like a duck. They declared that the game is "good."
As they compete, they also encourage each other to stay in line, said Kelly Schaffer, who coaches teachers in four city schools and collects data as a research associate at Hopkins. Eventually the children don't need the game to encourage them to act appropriately. The good behavior becomes ingrained.
Govans has used other behavior programs over the years, including a conflict resolution program for older kids and another program popular in the state called Positive Behavioral Interventions and Supports.
Bill Reinhard, spokesman for the Maryland Department of Education, said the programs' goals include helping schools improve overall learning and school climate, and reduce suspensions.
Linda Taylor, principal of Govans for the past 11 years, agreed that layering programs can help schools tackle behavioral issues as the students age.
"We are always looking for ways to get the kids engaged," she said. "These crazy little rewards in the Good Behavior Game really motivates them to participate."
Raimee Eck, president of the Maryland Public Health Association, said teachers don't receive much training in behavioral management despite the pressing need for such coaching. That makes the Good Behavior Game and similar programs helpful in aiding those who come ready to teach but not necessarily ready to handle kids who act out.
These low-cost interventions "can assist teachers in maintaining a healthy classroom environment and improve long-term outcomes for not only potentially disruptive students, but for the class as a whole," she said.
The Hopkins researchers acknowledge the program won't address every societal ill. The game also requires commitment by teachers and administrators and system funding. The Good Behavior Game costs about $500 a classroom, mainly for coaches to work with teachers. Teachers don't always continue with the program in subsequent years without such coaches.
Hopkins currently receives U.S. Department of Education funding to train early-career teachers in Baltimore City, Baltimore County and Prince George's County. Researchers also have funding from the National Institute on Drug Abuse to train early-education teachers in 48 Baltimore City schools over four years.
Ialongo said his team hopes to continue gathering evidence that the program is worthwhile.
"It's not a panacea, but is one tool that can be of potential use in disruptive and aggressive behavior," he said. "And long-term benefits for young people are many."