Preventing Problems in Children's Social Behavior
Condition: Behavior Disorders
MeSH terms: Mental Disorders
Study type: Interventional

Summary: 
      Children who are at risk for problems in school may do better if they and their parents are
      taught how to communicate with each other between age 3 and 6 when the children enter
      kindergarten. Three groups of 3 year olds who are in Head Start in the Nashville area will be
      randomized with their parents to either a 3 year program of skill building or to a control
      (Head Start only). The children will be tested at the end of the 3 year study and 6 months, 1
      year and 2 years later.
    

Detailed description: 
      Once established, childhood conduct and behavior disorders are robust and have consistently
      negative effects on the social and academic behavior of children and adolescents. Early
      intervention to prevent the development of these disorders is an important alternative to
      intervention after problem behaviors are well established. Two factors, negative patterns of
      parent-child interaction associated with poor parenting skills and significant communication
      deficits, are strongly associated with childhood conduct and behavior disorders.

      This study is an experimental investigation of a multicomponent, longitudinal intervention
      with families and children to prevent conduct and behavior disorders in children at high risk
      for these disorders. The goals of this study are to 1) describe the incidence of significant
      social problems related to conduct disorders among 3-year old children enrolled in Head Start
      and 2) examine the effectiveness of an intervention on the behavior of children identified
      with emergent behavior problems or at highest risk for these problems.

      There are two phases within this study. In the first phase, 750 three-year-olds will be
      screened for early indicators of behavior problems and communications deficits using reports
      of child behavior from parents and teachers, direct assessment of children, and assessments
      of family support and stress that signal risk for conduct disorder to identify children at
      highest risk. Data from the first phase will provide information regarding the incidence of
      behavior problems, allow determination of the most reliable indicators of increased risk
      status and to explore the specific relationship between early communication development and
      increased risk for behavior problems.

      The second phase examines the immediate and longer term effects of prevention intervention to
      improve children's social behavior and communication skills. Three-year-old children (n=180)
      that are attending community daycares or therapeutic nurseries serving low-income families,
      and that have mild to moderate language delays and patterns of parent-child interaction
      associated with poor behavioral outcomes will be recruited. One hundred and eighty children
      at high risk for development of conduct disorders and related behavioral problems will be
      randomized to either an intervention group (n=90) or an untreated control group (n=90). Three
      successive cohorts of children and families will be randomly assigned to treatment or control
      groups; each cohort will be followed three years until the child enters kindergarten. The
      primary intervention will include parent training in communicative interactions and behavior
      management and direct intervention with the child to teach social communication skills in
      peer interactions. Secondary intervention will include classroom consultation, maintenance of
      parent training and child intervention as needed, family support and liaison services, and
      assistance during child transition into kindergarten. Local Head Start collaborators are
      included in all phases of the trial. The outcomes of the trial will be examined at four
      points - immediately after the study period is completed, 6 months later, 1 year later, and 2
      years later. The last assessment will focus on academic, social, and mental health outcomes
      at the end of the children's kindergarten year. Positive effects on children's problem
      behaviors, social skills, and overall development and positive effects on parent-child
      interaction are expected to be associated with participation in the treatment condition.
    

Intervention name(s): Training in parenting skills and communication
Intervention type(s): Procedure
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Behavioral disorders; Parenting skills and communication; Parent-child interactions; At-risk preschooler; Head Start