Conduct Problems Prevention Research Group Research Articles

Tailoring of evidence-based group intervention with children with disruptive behavior: Implications for therapists and researchers

The evidence-bas for cognitive-behavioral child interventions has continued to advance in the past several decades across many areas of psychopathology, including disruptive behavior problems. We know quite a bit about what works. However, despite earlier research efforts (e.g., Copeland & Hammel, 1981; Lochman, Lampron, Burch, & Curry, 1985; Conduct Problems Prevention Research Group, 2002), we are still in early stages of understanding “what works for whom.” Efforts to explore moderators of established interventions, rather than merely efficacy (La Greca, Silverman, & Lochman, 2009), can progressively help to identify how we can tailor interventions for different children, and tailor training for therapists. One example occurs in research efforts to clarify whether group-based interventions might have iatrogenic effects with some children with disruptive behavior problems.

Play-based Learning Activities for Creativity in Children's Dance Movements

Play-based learning activities are important programs throughout the world of children's education. Through play, children learn creatively and constructively. This study aims to solve the problem of creativity in early-childhood dance movements with the hope that there will be an increase in aspects of fluency, flexibility and elaboration through play activities related to educational dance. This action research uses an action research method which is carried out in three cycles. The subjects in this study were 19 children aged 5-6 years in Kindergarten in Central Jakarta. Data collection was carried out through observation, interviews, field notes, video documentation and photos. The findings show every child's creativity in dance movements can be improved through playing activities. Increased creativity in dance movements occurs in the aspects of fluency, flexibility, and elaboration. Another important finding, there is an increase in the optimal ability of dance creativity in the third cycle of this action research. The implication from this research is that play activities suitable for learning creative dance in early childhood must be designed as a program that emphasizes aspects of fluency, flexibility, and elaboration.
 Keywords: Early Childhood, Creativity in dance movements, Play based learning activities

A randomized controlled trial of the combination of two school-based universal preventive interventions.

The Good Behavior Game (GBG, Barrish, Saunders, & Wolf, 1969) and the PATHS Curriculum (Promoting Alternative Thinking Strategies; Greenberg, Kusche, Cook, & Quamma, 1995) represent 2 universal, elementary school, preventive interventions which have been shown in large-scale, randomized controlled trials to have an immediate and beneficial impact (GBG, Dolan et al., 1993; PATHS, Conduct Problems Prevention Research Group [CPPRG], 1999) on aggressive/disruptive and off-task behavior. Importantly, both risk behaviors are strong predictors of antisocial behavior, drug abuse, and low educational and occupational attainment in adolescence and young adulthood (Kellam et al., 2008). What has yet to be explored within a randomized controlled trial is whether the combination of these interventions would yield significantly greater impact on aggressive/disruptive and off-task behavior than the GBG alone. One reason for expecting additive if not synergistic effects as a result of combining the two interventions is that the GBG, by increasing attention to task and reducing disruptive behavior in the classroom, may facilitate the acquisition of the emotion regulation, social problem-solving, and conflict resolution skills taught in PATHS. To that end, a group randomized, effectiveness trial was carried out, wherein 27 schools were randomly assigned to one of 3 conditions, (a) the PAX GBG Alone (Embry, Staatemeier, Richardson, Lauger, & Mitich, 2003), (b) PATHS to PAX (that is, the PAX GBG + PATHS), or (c) a standard setting (control) condition. Classroom observations and teacher ratings of student behavior were carried out at pretest and 6 months later at posttest. Limited evidence of the superiority of the combined approach was found and potential reasons why and future directions are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Early Intervention for At-Risk Youth Has Benefits Into Adulthood

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessEarly Intervention for At-Risk Youth Has Benefits Into AdulthoodNick ZagorskiNick ZagorskiSearch for more papers by this authorPublished Online:16 Oct 2014https://doi.org/10.1176/appi.pn.2014.10b11AbstractA program called Fast Track shows the potential of early mental health interventions and could serve as a prototype for future models geared at specific ages and populations.There is solid evidence that children who display chronic conduct problems such as aggressive, disruptive, or antisocial behavior are at high risk to carry these issues into adulthood. There is no consensus, however, on how best to respond to these at-risk children. Early-intervention programs to foster proper social behavior in young children have shown some short-term benefits, but none yet have reported long-lasting effects. The Fast Track program, about which there have been previously published findings showing that early intervention starting in kindergarten improves behaviors in both elementary and high school students, has now released its latest results showing that getting an early start on prevention can reduce problem behaviors in adults. Compared with 25-year-olds who had been identified as problem children but received no special interventions, 25-year-olds who had been a part of Fast Track had a 10 percent lower prevalence of psychiatric problems (59 percent vs. 69 percent). Fast Track participants also had fewer convictions for violent or drug-related crimes.Kenneth Dodge, Ph.D., of Duke University notes that the latest Fast Track results demonstrate for the first time that early intervention can reduce the rates of problem outcomes for at-risk children years after they’ve finished the program.“Early-starter children are at high risk for problems that will cost themselves and society a tremendous amount of pain,” said Kenneth Dodge, Ph.D., director of the Center for Child and Family Policy at Duke University, one of the four sites participating in Fast Track. “These findings demonstrate for the first time that we can successfully reduce the rates of problem outcomes for this risk group, even years after we’ve last seen them.”Dodge added that Fast Track was not all about reducing the negative. “We saw positive improvements as well in the happiness and overall well-being of these children.”The findings were published September 15 in AJP in Advance.Fast Track began in 1991 and over the next three years enrolled about 900 kindergarteners identified with conduct problems from four communities: Durham, N.C.; Nashville; Seattle; and rural Pennsylvania. The children were then divided into two groups, with half receiving the Fast Track intervention while the others served as a control group that received standard interventions available in their community. The Fast Track enrollees then began a 10-year program aimed at instilling them with social competencies that would carry throughout their lifetimes. Fast Track took an all-inclusive approach, addressing multiple components of antisocial development and involving both the children and their families for the whole program. Dodge admitted it was not the most efficient method of designing a program, but as he stated, “Our goal, first and foremost, was to demonstrate that early intervention works.” The approach appeared to pay off; participants showed improvements in a diverse range of internal, external, and substance use problems, including significant decreases in antisocial or avoidant personality disorder, attention-deficit/hyperactivity disorder, binge drinking, serious drug use, and risky sexual behaviors.Improvements were also consistent among all 13 subgroups within the larger cohort (males and females, African Americans and those of European descent, high- and moderate-risk category, each of the four study sites, and each of the three enrolled years).“We view Fast Track as more of a prototype than a model,” Dodge said. “We hope that future research and development will continue to refine the program and hone in on the elements that work best for particular groups.” In the meantime, Fast Track is soldiering on, with the first enrollees now approaching their 30th birthdays and researchers hope that more positive data are on the horizon.As with other prototypes, cost will be an issue for any wide implementation, though Dodge noted that their comprehensive program cost only around $58,000 per child for the 10 years. “It may seem like a lot at first, but that is less expensive than sending a child to special education for 10 years, and certainly much cheaper than sending an adult to prison.” The Fast Track project is run by the Conduct Problems Prevention Research Group and is supported by grants from the National Institute of Mental Health, National Institute on Drug Abuse, and Department of Education. ■An abstract of “Impact of Early Intervention on Psychopathology, Crime, and Well-Being at Age 25” can be accessed here. ISSUES NewArchived

Toward the Development of Preventive Interventions to Reduce HRSB, HIV/AIDS, and Multiple Problem Behaviors

While we have witnessed tremendous progress in the field of prevention science over the years, some important gaps remain. This Supplemental Issue helps advance the field by focusing on preventive interventions for children and adolescents, and the potential for long-term effects on drug abuse and health-risking sexual behaviors (HRSB) in the late adolescent and young adult years. It not only expands our understanding of the etiology and prevention of HRSB and HIV/ AIDS but also has important implications for the development of interventions capable of widespread dissemination and an impact on multiple health risk behaviors. The six papers included in the Supplemental Issue represent a broad range of intervention strategies and methods, supported by diverse theoretical frameworks, and focus on target populations that vary in terms of demographic characteristics and level of baseline risk. One paper focuses on a school-based intervention targeting early aggressive behavior in children (Kellam et al. 2014). Two papers focus on universal interventions targeting drug use and associated risk factors using either a combined schooland family-based intervention implemented during childhood (Hill et al. 2014) or a familybased intervention implemented during early adolescence (Spoth et al. 2014). One paper focuses on universal and targeted interventions implemented during childhood to address conduct problems using both schooland family-based approaches (Conduct Problems Prevention Research Group 2014). Two others involve selective family-based interventions implemented either alone during childhood (Skinner et al. 2014) or as part of a multilevel strategy combining universal, selective, and indicated approaches implemented during early adolescence (Caruthers et al. 2014). The interventions were tested using different study designs, research methods, and data analysis approaches. Despite these notable differences and without any direct focus on sexual behavior, four of these long-term studies found significant (direct or indirect) reductions in HRSB for some or all of participants (Caruthers et al. 2014; Hill et al. 2014; Kellam et al. 2014; Spoth et al. 2014). Although the remaining two studies did not find intervention effects, they did provide etiologic data supporting the general thesis of this Supplemental Issue (Conduct Problems Prevention Research Group 2014; Skinner et al. 2014). As a group, this collection of papers makes an important contribution to the prevention literature by providing long-term intervention and/or etiologic evidence that early preventive interventions not explicitly targeting sexual behavior or HRSB can prevent risk behaviors associated with the acquisition of HIV/AIDS.Moreover, these papers provide additional evidence that preventive interventions targeting shared risk and protective factors can have an impact on multiple problem behaviors. The findings from this impressive collection of studies are consistent with a large body of research focusing on (1) epidemiology findings regarding the developmental course of risk behaviors, (2) research on common psychosocial risk and protective factors at multiple levels of influence that contribute to problem behaviors, and (3) research demonstrating that intervening on shared risk and protective factors can prevent multiple risk behavior outcomes.

Assessing findings from the fast track study

The aim of this paper is to respond to the Commentary, "Reassessing Findings from the Fast Track Study: Problems of Methods and Analysis" provided by E. Michael Foster (Foster, this issue) to our article "Fast Track Intervention Effects on Youth Arrests and Delinquency" (Conduct Problems Prevention Research Group 2010, Journal of Experimental Criminology, 6, 131-157). Our response begins with a description of the mission and goals of the Fast Track project, and how they guided the original design of the study and continue to inform outcome analyses. Then, we respond to the Commentary's five points in the order they were raised. We agree with the Commentary that efforts to prevent crime and delinquency are of high public health significance because the costs of crime and delinquency to society are indeed enormous. We believe that rigorous, careful intervention research is needed to accumulate evidence that informs prevention programs and activities. We have appreciated the opportunity to respond to the Commentary and to clarify the procedures and results that we presented in our paper on Fast Track effects on youth arrests and delinquency. Our response has clarified the framework for the number of statistical tests made, has reiterated the randomization process, has supported our tests for site-by-intervention effects, has provided our rationale for assuming missing at random, and has clarified that the incarceration variable was not included as a covariate in the hazard analyses. We stand by our conclusion that random assignment to Fast Track had a positive impact in preventing juvenile arrests, and we echo our additional caveat that it will be essential to determine whether intervention produces any longer-term effects on adult arrests as the sample transitions into young adulthood. We also appreciate the opportunity for open scientific debate on the values and risks associated with multiple analyses in long-term prevention program designs such as Fast Track. We believe that, once collected, completed longitudinal intervention datasets should be fully used to understand the impact, process, strengths, and weaknesses of the intervention approach. We agree with the Commentary that efforts to prevent crime and delinquency are of high public health significance because the costs of crime and delinquency to society are indeed enormous. As a result, we argue that it is important to balance the need to maintain awareness and caution regarding potential risks in the design or approach that may confound interpretation of findings, in the manner raised by the Commentator, with the need for extended analyses of the available data so we can better understand over time how antisocial behavior and violence can be effectively reduced.

Reassessing findings from the Fast Track study: problems of method and analysis

Objectives A 2010 article by the Conduct Problems Prevention Research Group considers an important social and public policy problem: can early psychosocial intervention prevent delinquency? The article examines the effects of the Fast Track preventive intervention on youth arrests and self-reported delinquent behavior through age 19. The article reports that the intervention reduced court-recorded juvenile arrest activity as well as a range of other disparate effects.

Social and Emotional Learning in Schools: From Programs to Strategies and commentaries

Social and Emotional Learning in Schools: From Programs to Strategies and commentaries

Maternal depressive symptoms as a predictor of alcohol use onset and heavy episodic drinking in youths.

The current study addressed a gap in the literature by investigating the association between maternal depressive symptoms and subsequent timing of their children's alcohol use onset and heavy episodic drinking (HED). Childhood depression/dysthymia symptoms, harsh discipline, and parental positive regard were examined as potential mediators of this relation. Longitudinal self- and parent-report data were collected annually from a community sample of 754 youths (50% male; 43% African American) from kindergarten to Grade 11 (ages 5-18 years). The measures administered were the Things That You Have Done scale (Conduct Problems Prevention Research Group [CPPRG], 1995a) and the Tobacco, Alcohol, and Drugs measure (CPPRG, 1995b), which assessed alcohol use behaviors; the Center for Epidemiological Studies-Depression Scale (Radloff, 1977); the Diagnostic Interview Schedule for Children (Costello, Edelbrock, & Costello, 1985); and the Parental Discipline Scale (CPPRG, 1994). Maternal depressive symptoms significantly predicted an earlier onset of alcohol use and HED in youths. Harsh parental discipline mediated the relation between maternal depressive symptoms and alcohol use onset as hypothesized; however, childhood depressive/dysthymia symptoms and parental positive regard did not. In the parallel analyses testing the 3 potential mediating variables in the prediction of HED, no significant mediation was found. These findings suggest the importance of intervening to prevent early and risky alcohol use among youths who have been identified as having a mother who is clinically depressed or is experiencing depressive symptoms; part of this intervention effort could involve working with depressed mothers to reduce their use of harsh discipline. These improved intervention and prevention strategies could have important implications for reducing the occurrence and early initiation of alcohol use and HED among at-risk youths.

Aggression, antisocial behavior, and violence among girls: a developmental perspective

Part I: Setting the Stage: Understanding the Development of Gender Differences in Aggression and Antisocial Behavior. Maccoby, Aggression in the Context of Gender Development. Susman, Pajer, Biology-behavior Integration and Antisocial Behavior in Girls. Zahn-Waxler, Polanichka, All Things Interpersonal: Socialization and Female Aggression. Part II: Aggression and Victimization Among Girls in Childhood. Crick, Ostrov, Appleyard, Jansen, Casas, Relational Aggression in Early Childhood: You Can't Come to My Birthday Party Unless.... Pepler, Craig, Yuile, Connolly, Girls Who Bully: A Developmental and Relational Perspective. Putallaz, Kupersmidt, Coie, McKnight, Grimes, A Behavior Analysis of Girls' Aggression and Victimization. Part III: Understanding Antisocial and Related Problem Behaviors in Adolescent Girls. Bierman, Bruschi, Domitrovich, Yan Fang, Miller-Johnson, and the Conduct Problems Prevention Research Group, Early Disruptive Behaviors Associated with Emerging Antisocial Behavior Among Girls. Trickett, Gordis, Aggression and Antisocial Behavior in Sexually Abused Females. Giordano, Cernkovich, Lowery, A Long-term Follow-up of Serious Adolescent Female Offenders. Chesney-Lind, Belknap, Trends in Delinquent Girls' Aggression and Violent Behavior: A Review of the Evidence. Part IV: Girls as Perpetrators and Victims of Abusive and Conflictual Relationships: Adolescence and Adulthood. Capaldi, Kim, Shortt, Women's Involvement in Aggression in Young Adult Romantic Relationships: A Developmental Systems Model. Zoccolillo, Paquette, Azar, Cote, Tremblay, Parenting as an Important Outcome of Conduct Disorder in Girls. Serbin, Stack, De Genna, Grunzeweig, Temcheff, Schwartzman, Ledingham, When Aggressive Girls Become Mothers: Problems in Parenting, Health, and Development across Two Generations, V. Implications for Policy and Prevention. Underwood, Coie, Commentary 1: Future Directions and Priorities for Prevention and Intervention. Dodge, Commentary 2: Public Policy and the Discovery of Girls' Aggressive Behavior.

Externalizing behavior disorders in child welfare settings: Definition, prevalence, and implications for assessment and treatment

The literature examining the externalizing behavior disorders of youth in child welfare settings reveals a general consensus regarding the severity and nature of these problems. Unfortunately, there is not agreement as to the operational definition of externalizing problems. The authors propose an operational definition in light of the existing literature and DSM-IV-TR criteria and then summarize the prevalence rates of externalizing problems in child welfare settings found across several investigations. The authors assert that this population is difficult to target for assessment and treatment due in part to the heterogeneity of the specific types of behavior problems exhibited by this group. A variety of behavior rating scales, diagnostic interviews, and instruments used for subtyping externalizing behavior disorders are reviewed with a discussion of their psychometric properties and practical utility in child welfare settings. The heterogeneity found among these youth suggests the need for a more comprehensive and dynamic assessment and treatment model, such as the multi-gating approach used by The Conduct Problems Prevention Research Group.

Contextual Factors in Risk and Prevention Research

This paper reviews how cascading levels of contextual influences, starting with family factors and extending to neighborhood and school factors, can affect children’s behavioral and emotional development. The ability of contextual factors to trigger or to attenuate children’s underlying temperament and biological risk factors is emphasized. Recognition of the powerful effects of an array of contextual factors on children’s development has clear implications for preventive interventions as well. Intervention research can explore the effects of multicomponent interventions directed at children’s family and peer contextual influences, can examine how contextual factors predict children’s responsivity to interventions, and can examine how contextual factors have effects on how, and how well, interventions are delivered in the real worlds of schools and community agencies. Efforts to understand the development of childhood psychopathology have placed growing emphasis on contextual factors that influence children’s developmental trajectories leading to antisocial outcomes. A child’s developmental course is set within the child’s social ecology, and an ecological framework is needed to understand these effects (Conduct Problems Prevention Research Group, 1992; Greenberg, Lengua, Coie, Pinderhughes, & Conduct Problems Prevention Research Group, 1999; Tolan, Gorman-Smith, Huesmann, & Zelli, 1997). Children not only have important interactions in their microsystems of growing social fields of child-family, child-peer, and teacherstudent interactions, but these social fields also relate to each other in

Direct and indirect reinforcement processes in parent training.

This paper reviews the recent parent training research in which parents are taught to use principles of operant learning as well as general principles of positive verbal discourse. While this combination of interventions has been shown to have greater impact than the operant guidelines used alone, a rationale for the discourse strategy is not clear. In this review, it is argued that the two interventions can be understood within an expanded view of reinforcement theory. It would seem that the interventions used in concert lead to improvement in children's and parents' observational skills, as well as in their willingness to cooperate. Keywords: parent training research; operant learning; positive verbal discourse; reinforcement theory; observational skills. ********** When parents seek professional help for their children's behavior, a majority of the referral problems amount to aggression and noncompliance (Denham, Workman, Cole, Weissbrod, Kendziora, & Zahn-Waxler, 2000; Heller, Baker, Henker, & Henshaw, 1996). These two child behaviors are clearly related as a class of disruptive actions, and it is often true that noncompliance sets the stage for aggression because troubled parents are apt to provoke their children into following acts of disobedience (Patterson, 1982). Thus, a child's chronic noncompliance with parent instructions and rules seems to be a keystone part of this disruptive class, suggesting that ways of teaching children to obey their parents might also weaken the entire class of problem behaviors. Because of the above findings and assumptions, it is not surprising to see that today's parent training programs for disruptive children target both components of this response class (Barkley, 1997; Bor, Sanders, & Markie-Dodds, 2002; Webster-Stratton, 1996). All of these programs follow principles of operant learning but also make use of adjunctive strategies aimed at verbal discourse exercises, designed to promote stronger positive connections between parents and their children (see Conduct Problems Prevention Research Group, 1999; Eyberg, 1988; Feinfield & Baker, 2004; Forehand & McMahon, 1981; Schoenwald, Sheidow, Letourneau, & Liao, 2003; Webster-Stratton, Reid, & Hammond, 2004). These exercises involve friendly talk, listening, feeling talk, problem-solving discussion, art projects, and appropriate expression of feelings. In some of the above listed studies, both the operant learning and the adjunctive strategies were shown to impact referral problems of the children. Regardless of whether or not the two strategies were assessed and analyzed as independent sources of change, the authors considered both interventions to be important components of the treatment process. Based on the conceptual arguments and research reviews by Cavell (2001), Strand (2000a and 2000b), and Cavell and Strand (2002), there is reason to view these disparate intervention strategies as more similar than they seem to be. These authors' expansion of reinforcement theory includes stimulus control constructs that could place both interventions within a broader conception of reinforcement theory. In this paper I hope to further develop these ideas and, in the process, to layout some suggested guidelines for clinicians who work with the parents of disruptive children. The Holistic Nature of Parent-Child Interactions When parents are taught to train their children to obey instructions, the clinical teaching and subsequent training are often based on direct reinforcement strategies. That is, child compliance is positively reinforced and noncompliance is either ignored (extinction) or timed out (absence of opportunity to obtain positive reinforcers). This intervention step is accompanied by similar contingency management of other responses in the class of disruptive behaviors, such as demands, nagging, hitting, and property destruction. While the treatment strategy makes sense if we view each response as independent, such a perspective overlooks the research evidence documenting functional connections across these topographically different responses. …

Anger management interventions.

Two anger management interventions for aggressive children, Anger Coping and Coping Power, are described in this review article, including conceptual underpinnings, session format and content, and outcome research findings. Important issues and considerations in the implementation of such interventions are also presented. Overall, Anger Coping and Coping Power have emerged as effective interventions for angry, aggressive children and represent useful resources for clinicians' work with this population. CONTEXTUAL SOCIAL-COGNITIVE MODEL OF ANGRY AGGRESSION The social-cognitive model serving as the conceptual framework for the Anger Coping Program and the Coping Power Program began as a model of anger arousal (Lochman, Nelson, & Sims, 1981). In this conceptualization of anger arousal, which stressed sequential cognitive processing, the child responded to problems such as interpersonal conflicts or frustrations with environmental obstacles (e.g., difficult schoolwork). However, it was not the stimulus event itself that provoked the child's anger and response, but rather the child's cognitive processing of and about that event. This first stage of cognitive processing (appraisal) consisted of labeling, attributions, and perceptions of the problem event, and of the child's subsequent anger. The second stage of processing (problem solution) consisted of the child's cognitive plan for his or her response to the perceived threat or provocation. This early anger arousal model indicated that the child's cognitive and emotional processing of the problem event and of his or her planned response led to the child's actual behavioral response and to the positive or negative consequences that the child experienced as a result. Our current Contextual Social-Cognitive model (Lochman & Wells, 2002a) includes a more comprehensive understanding of social-cognitive processes, maintains an emphasis on anger arousal, and includes recognition of the contextual factors which contribute to children's aggression. Social cognition. The current social-cognitive model of children's aggression (Lochman, Whidby, & Fitzgerald, 2000) underlying the child component of the Coping Power program evolved in large part because of research on aggressive children's social information-processing (Crick & Dodge, 1994). At the appraisal stage of processing, aggressive children have been found to recall fewer relevant cues about events (Lochman & Dodge, 1994), and to selectively attend to hostile rather than neutral cues (Gouze, 1987; Milich & Dodge, 1984). Aggressive children have been shown to have a hostile attributional bias, as they tend to excessively infer that others are acting toward them in a provocative and hostile manner (Katsurada & Sugawara, 1998; Lochman & Dodge, 1994, 1998). At the problem solution stage of social-cognitive processing, aggressive children offer fewer competent verbal problem solutions (Dunn, Lochman, & Colder, 1997), including verbal assertion and compromise solutions (Joffe, Dobson, Fine, Marriage, & Haley, 1990; Lochman & Dodge, 1994; Lochman & Lampron, 1986), and more aggressive and direct action solutions (Lochman & Lampron, 1986; Pepler, Craig, & Roberts, 1998; Waas & French, 1989) to hypothetical vignettes describing interpersonal conflicts. Aggressive children cognitively generate more aggressive strategies in part because they expect that aggressive behavior will lead to desired outcomes (Lochman & Dodge, 1994; Zelli, Dodge, Lochman, Laird, & The Conduct Problems Prevention Research Group, 1999). Anger arousal. Anger is defined as an emotional response to situations that are perceived as threatening or offensive to oneself or others close to them (Lazarus, 1991). Anger can prove adaptive in that it is a motivator for action and tends to focus one's resources toward the threatening or offensive event (Goleman, 1995). …

Childhood depression – Part 1: Does it need to be dealt with only by health professionals?

The start of the new millennium promised a high profile for the promotion of the mental health of the nation’s children and young people. Initiatives have included the publication of national statistics on the mental health of 5–15-year old children (MHF, 1999; Meltzer et al., 2000) and several public awareness campaigns (e.g. Mental Health Action Week, The Psychologist, April 2001; Mental Health Week, The Sunday Times, October 2001). Nevertheless, two recent and important evaluations of well-established school and community based emotional literacy intervention programmes in the USA, The Conduct Problems Prevention Research Group (Bierman et al., 2002a,b), and Australia (Spence, 2002) have reported disappointing results so far. This raises important questions about current approaches to supporting emotional development and problems such a depression in children. Two papers exploring these issues have been prepared, with special reference to the increasing problem of childhood depression. Paper 1 clarifies the argument against a historical tendency for a medical hegemony of psychopathology in approaches to childhood mental health problems by: a) looking at the theoretical evidence of the nature of depression, and b) considering the relevance of recent legislation encouraging all professionals to work together in the interests of the whole child. Paper 2 considers the specific role of the educational psychologist.

Commentary: New Models for School-Based Mental Health Services

The potential of school-based delivery systems to dramatically improve access to and positive impact of mental health prevention and intervention services cannot be underestimated (Hoagwood & Erwin, 1997). Particularly when they involve coordinated collaboration with community-based agencies and stakeholders, school-based delivery systems can provide the backbone for accessible services that are integrated across the developmental spectrum from preschool through adolescence, and that span the continuum of service need, from mental health promotion and risk reduction to intensive intervention (Weissberg & Greenberg, 1998). As noted by Atkins and his colleagues (Atkins, Graczyk, Frazier, & Abdul-Adil, 2003), however, this potential cannot be realized without innovative models for school-based delivery system design and programmatic evaluation research. Three critical challenges for the design of effective school-based mental health delivery systems include: (a) supporting the high-fidelity implementation of empirically based practices, (b) sustaining effective programming over time, and (c) fostering local adaptations that enhance cultural and community fit and ownership (Biglan, Mrazek, Carnine, & Flay, 2003; Wandersman & Florin, 2003; Weissberg, Kumpfer & Seligman, 2003). Atkins et al. (2003) provide illustrative examples of how these challenges can be addressed in ways that can significantly increase children's access to empirically supported interventions (the PALS program), integrate programming into existing school leadership structures to support long-term sustainability (the use of Key Opinion Leaders), and foster close coordination and collaboration between school-based and community-based mental health services (the SOC-C mechanism). These models are best termed promising at this time, as empirical data on theft outcome effectiveness is not yet available, but the work of Atkins et al. (2003) suggests that they are each feasible and attractive models for schools and community partners. This commentary will focus on three complementary issues: (a) school-community adaptations of empirically based programs, (b) providing a continuum of care, and (c) researching sustainability. School-Community Adaptations of Empirically Based Programs One particular strength of the new models of Atkins et al. (2003) is the innovative use of indigenous resources and school-community partnerships to expand the responsiveness of programs to community values and priorities, thus enhancing parent engagement and community support. Debate exists concerning the optimal role for community members in prevention and intervention program design. For example, in the context of prevention design, Weissberg and Greenberg (1998) contrast the assumptions underlying the Prevention Science model and the Collaborative Community Action Research model. In the former model, program designs are based primarily upon research documenting the risk and protective factors associated with targeted mental health problems, combined with randomized-controlled efficacy trials that document the positive impact of specific intervention strategies on those outcomes. In this model, the dissemination challenge is to move the empirically validated procedures into the field. In contrast, the Collaborative Community Action Research model is based on an ecological perspective that emphasizes the critical involvement of community members in partnership with researchers in all phases of program development and design, assuming that effective program design requires local wisdom and engagement for success. Weissberg and Greenberg (1998) argue compellingly for the need to combine the strengths of these two approaches, developing program design and delivery strategies that involve community leaders and participants in all phases of decision making but that also make maximal use of available research regarding developmental patterns, risk and protective factors, and empirically proven intervention strategies (see also the Conduct Problems Prevention Research Group [CPPRG], 2002). …

Childhood ADHD and Later Antisocial Behavior and Drug Use

ADHD children, especially those with the Combined or Hyperactive Types, frequently demonstrate high levels of conduct problems or social aggression in their childhood years (Barkley, 1998; Hinshaw, 1987). Followed into adolescence, these children, particularly those with comorbid social aggression, have a significantly elevated risk for oppositional defiant disorder, conduct disorder (CD), and delinquent or antisocial activities (August, Stewart, & Holmes, 1983; Barkley et al., 1990; Klein & Mannuzza, 1991; Weiss & Hechtman, 1993). Along with those risks, there occurs a greater likelihood of being arrested (Satterfield, Swanson, Schell, & Lee, 1994) and a greater propensity for substance experimentation, use, and eventual abuse (Biederman, Wilens, et al., 1997; Lambert & Hartsough, 1998), particularly among that subset of ADHD children having CD by adolescence (Molina, Smith, & Pelham, 1999).

Emotions Matter: Making the Case for the Role of Young Children's Emotional Development for Early School Readiness

This Social Policy Report considers the importance of young children’s emotional development for their school readiness, suggesting that social scientists can provide policy makers with concrete ways to conceptualize, measure and target young children’s emotional adjustment in early educational and child care settings. This Report then reviews a recent and persuasive body of rigorous research, to determine whether children’s emotional adjustment can be significantly affected by interventions implemented in the preschool and early school years. Results of this review suggest that family early educational, and clinical interventions offer policy makers a wide array of choices in ways that they can make sound investments in young children’s emotional development and school readiness. This research suggests that, while young children’s emotional and behavioral problems are costly to their chances of school success, these problems are identifiable early, are amenable to change, and can be reduced over time. What kinds of investments should policy makers be advised to make, at what point in young children’s development, and in what settings? While modest investments in low-cost interventions initially may seem appealing, this report suggests that there are few bargains to be had when investing in young children’s emotional adjustment. With this caveat in mind, the findings of this report suggest that policy makers should broaden early elementary educational mandates for school readiness to include children’s emotional and behavioral adjustments as key programmatic goals. Policy makers should consider targeting young children’s emotional adjustment prior to school entry, in diverse settings such as Head Start, child care settings, as well as in the first few years of school. Finally, young children’s emotional adjustment can serve as an important benchmark of programmatic success in other policy arenas focusing on child welfare, family support, and economic self-sufficiency, as well as in education.

The implementation of the Fast Track program: an example of a large-scale prevention science efficacy trial.

In 1990, the Fast Track Project was initiated to evaluate the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders in four demographically diverse American communities (Conduct Problems Prevention Research Group [CPPRG], 1992). Representing a prevention science approach toward community-based preventive intervention, the Fast Track intervention design was based upon the available data base elucidating the epidemiology of risk for conduct disorder and suggesting key causal developmental influences (R. P. Weissberg & M. T. Greenberg, 1998). Critical questions about this approach to prevention center around the extent to which such a science-based program can be effective at (1) engaging community members and stakeholders, (2) maintaining intervention fidelity while responding appropriately to the local norms and needs of communities that vary widely in their demographic and cultural/ethnic composition, and (3) maintaining community engagement in the long-term to support effective and sustainable intervention dissemination. This paper discusses these issues, providing examples from the Fast Track project to illustrate the process of program implementation and the evidence available regarding the success of this science-based program at engaging communities in sustainable and effective ways as partners in prevention programming.

The Fast Track prevention programme improved classroom atmosphere and peer reported behaviour problems

Conduct Problems Prevention Research Group. Initial impact of the Fast Track prevention trial for conduct problems: II. Classroom effects. J Consult Clin Psychol1999 Oct; 67 : 648 –57. [OpenUrl][1][CrossRef][2][PubMed][3][Web of...