Program

Untitled Preventive Intervention for Urban, Low-Income Preschoolers at Familial Risk for Conduct Problems

Nov 01, 2013

OVERVIEW

The Preventive Intervention for Urban, Low-Income Preschoolers at Familial Risk for Conduct Problems is an intervention that combines the Incredible Years Parent Program with additional components.  The program attempts to prevent the development of conduct disorder among preschool children with a family history of antisocial behavior.  The pilot evaluation outlined below found that the intervention reduced externalizing behaviors among preschoolers; however there was no difference in internalizing behaviors.  The study also found that the intervention increased parents’ responsiveness and demonstrations of physical affection towards their children; however it seemed to have no impact on negative parenting behaviors.

DESCRIPTION OF PROGRAM

Target population: Low-income toddlers and preschoolers with a family history of antisocial behavior residing in urban communities.

The intervention is an adaptation of the Incredible Years Parenting Program, an empirically supported, fully manualized parenting program that uses videotaped parent-child interactions to model positive parenting behaviors.  Adaptations include extending the duration of the intervention to a total of 50 bi-weekly sessions over 9 months. Weekly sessions consist of concurrent 60-minute parent and child group sessions followed by 30-minute joint parent-child sessions. Additionally, ten 90-minute home visits are conducted over the course of 1 year. Parent sessions are designed to strengthen parenting competencies, such as reinforcing positive child behavior, and using consistent, non-physical discipline for non-compliance. Child sessions are intended to promote children’s social competencies. Parent-child sessions and home visits are intended to allow group leaders and home visitors to coach parents in skills related to the content of the parent sessions.

EVALUATION(S) OF PROGRAM

Botman, L.M., Klein, R.G., Kamboukos, D., Brown, E.J., Coard, S.I, Sosinsky, L.S. (2003). Preventive Intervention for Urban, Low-Income Preschoolers at Familial Risk for Conduct Problems: A Randomized Pilot Study. Journal of Clinical Child and Adolescent Psychology, 32(2), 246-257.

Evaluated population: 30 children between the ages of 2½ and 5 years with older relatives with a criminal record or with a diagnosis of either conduct disorder or oppositional defiant disorder. The final sample of 30 preschoolers was two-thirds African American and one-third Hispanic, 63 percent were male.  Twenty-seven percent had a history of residing in a homeless shelter and 67 percent did not reside with both biological parents at baseline. The mean age was 44 months for children and 36 years for mothers in the final sample. Of the family members with a history of antisocial behavior, 20 were siblings of the child, 5 were fathers, and 5 were either cousins or uncles. Sixteen families were randomized to the intervention group and 14 to the control group.  Families in the control condition received no intervention and no contact beyond assessments.

Approach: Families were recruited from three sources from 1994 to 1995: a) family court records of adjudicated youth with guilty findings, b) pediatric psychiatry outpatient clinic for disruptive behavior disorders, and c) aftercare services for first-time adult offenders.  Fifty families were identified and deemed eligible for the study. Thirty eligible families (60 percent) provided informed consent and completed the assessment battery.  The goal of the evaluation was to understand whether the intervention improved parenting behaviors and prevented behavior problems among preschool children.  Outcomes were assessed at baseline, at the end of the intervention, and at a 6-month follow-up.  Parent behaviors were assessed using videotaped parent-child interaction sessions that were coded using the Global Impressions of Parent-Child Interactions (GIPCI) and the Dyadic Parent-Child Interaction Coding System (DPICS). Child behavior problems were assessed with the age-appropriate Child Behavior Checklist (CBCL) which were completed by the parent.

Results: A total of 16 families (100 percent) in the intervention condition and 14 control families (88 percent) were assessed at post-intervention.  The intent-to-treat analysis found a moderate effect on externalizing behaviors, with behaviors decreasing over time among children who participated in the intervention while behaviors increased for children in the control group; there was no difference in internalizing behaviors over time for either group.  There was a large effect on positive parenting practices, with parents in the intervention group displaying an increase in positive parenting practices over time while parents in the control group displayed a decrease; however, parents in both groups displayed an increase in negative parenting behaviors over time.

Six months after the post-intervention assessment, 14 intervention families (88 percent) and 6 control families (43 percent) participated in the follow-up. Parents who dropped out of the study by follow-up were more likely to than those who were retained to have a higher education (11 years vs. 10 years) and to be older (39 years vs. 33 years). The results of the follow-up were inconclusive due to the small number of parents from the control group who participated.

SOURCES FOR MORE INFORMATION

Manual is available

For more information: http://www.aboutourkids.org/research/institutes_programs/institute_prevention_science/programs

References

Botman, L.M., Klein, R.G., Kamboukos, D., Brown, E.J., Coard, S.I, Sosinsky, L.S. (2003). Preventive Intervention for Urban, Low-Income Preschoolers at Familial Risk for Conduct Problems: A Randomized Pilot Study. Journal of Clinical Child and Adolescent Psychology, 32(2), 246-257.

KEYWORDS: Toddlers, Children, Preschool, Males and Females, High-Risk, Black/African American, Hispanic/Latino, Urban, Clinic/Provider-based, Home-based, Home visitation, Parent or Family Component, Parent Training/Education, Skills Training, Conduct/Disruptive Disorders, Social Skills/Life Skills, Parent-Child Relationship, Manual is available

Program information last updated 8/22/13