Early Intervention with Children at Risk of Emotional/behavioral Disorders: A Critical Examination of Research Methodology and Practices

Abstract Children's behavior problems pose challenges to families, schools, and society. The research literature argues that early detection/intervention is the most powerful course of action in ameliorating these problems in children at risk of emotional/behavioral disorders. However, specifying precisely what constitutes a quality program of early intervention is not a simple task. Current conceptualizations suggest that successful early intervention cannot be unidimensional in nature, but must consist of a complex series of interactions and transactions that synergistically serve to nurture and enhance both the development of the child and family. In this paper, we reviewed the accumulated research to learn more about the critical elements of early intervention. Specifically, we examined three major areas addressed in the literature. First, we describe literature search procedures and criteria for study inclusion, along with methods for analyzing these early intervention studies. Second, we examine the conduct of the intervention, including characteristics of study participants, types of interventions, types of measures, age of onset and length of intervention, treatment fidelity, and social validity measures. Finally, we draw upon that review to offer recommendations for future research. ********** Children's behavior problems can pose tremendous challenges to families, schools, and society. Once established, problem behavior tends to persist (e.g., Campbell & Ewing, 1990; Loeber & Dishion, 1983; Patterson, Capaldi, & Bank, 1989; Webster-Stratton, 2000). Left untreated, children's behavior problems typically multiply, intensify, and diversify over time (Campbell & Ewing, 1990), thus putting the child at increased risk for academic failure, social isolation, and peer rejection. These, in turn, accelerate the likelihood of school avoidance, alcoholism and drug abuse, and lifespan antisocial behavior (Asher & Coie, 1990; Dodge, 1993; Kazdin, 1993; Loeber & Dishion, 1983; Walker & Severson, 1990). Given the pernicious effects of children's behavior disorders, early intervention to prevent the development of such disorders is a judicious alternative to intervening after the behavior is well entrenched (e.g., Dodge, 1993; Kaiser & Hester, 1997; Kauffman, 1999; Kazdin, 1993; Webster-Stratton, 2000). By most accounts, early detection/intervention is the most powerful course of action in ameliorating life long problems associated with children at risk for emotional/behavioral disorders (cf. Hester & Kaiser, 1998; Kauffman, 1999; Serna, Nielsen, Lambros, & Forness, 2002). Indeed, a growing body of empirical research supports the positive impact of early intervention (e.g., Del'Homme, Kasari, Forness, & Bagley, 1996: Forness et al., 1998; Kaiser & Hester, 1997; Kamps & Tankersley, 1996; McEvoy, Davis, & Reichle, 1993). Moreover, recent legislation, such as the No Child Left Behind Act, The Good Start, and the Grow Smart initiatives, has reemphasized the critical role that early intervention plays in promoting the social/ emotional development of young children. Notwithstanding the unanimity of support for early intervention, specifying precisely what constitutes a quality program of early intervention is not a simple task (Bailey, Aytch, Odom, Symons, & Wolery, 1999). Most experts agree that prevention of children's emotional/behavioral disorders requires intervention in multiple environments, by multiple agents over time, with continued intervention, support, and transition services as children move from setting to setting (Hamblin-Wilson, & Thurman, 1990; Hester & Kaiser, 1998; Rule, Fietchtl, & Innocenti, 1990; Rous, Hemmeter, & Schuster, 1994). For example, effective intervention might include intervention in the home environment, as well as the school and community, with a focus not only on child behavior, but intervention with parents, teachers, and peers. …