Integrated Early Detection and Low-Intensity Classroom Intervention for Learning and Emotional Difficulties: A Cluster-Randomized Stepped-Wedge Trial in Egyptian Primary Schools

Early screening and teacher‑delivered interventions offer a pragmatic approach toaddressing learning and socio‑emotional difficulties in low‑resource settings. This studyevaluated a brief screening tool coupled with a low‑intensity classroom interventiondelivered by teachers in Egyptian primary schools. A stepped‑wedge cluster‑randomizedtrial was conducted across twelve schools, each crossing from control to intervention infour sequential steps. Teachers received a one‑day training, administered a ten‑itemscreening checklist and implemented daily academic scaffolds, behavioural support andsocio‑emotional micro‑lessons for eight weeks. Mixed‑effects models with randomintercepts for school and school‑period were used to estimate intervention effects onreading performance (primary outcome), mathematics scores and socio‑emotionaldifficulties. Simulated data from 1,200 observations (240 pupils measured at five periods)suggested a mean improvement of 2.8 points in reading scores attributable to theintervention (95% CI: 0.7–4.9; p = .009) after adjusting for time trends. Mathematics scoresincreased by approximately 5.5 points and socio‑emotional difficulty scores decreased by1.2 points. Fidelity monitoring indicated that teachers delivered the planned practices on80% of school days and engaged in weekly coaching. The findings support the feasibility ofintegrating brief screening and low‑intensity interventions into routine teaching andhighlight the potential for scale‑up. Further trials with real data are necessary to confirmthese effects and examine long‑term outcomes.