Children with oppositional defiant and conduct disorders (ODD/CD) are frequently encountered by nurses caring for pediatric populations. Without intervention, such children have a poor prognosis, with high rates of crime, drug abuse, and school dropout. The optimal therapy remains unclear. Additionally, the cost of most therapies severely limits their availability to parents in need. The long-term objective of this program of research is to develop, evaluate, and improve cost-effective, widely applicable, and sustaining early intervention programs of treatment for families with young children with ODD/CD. In prior studies we have documented that videotape modeling treatment for parents is highly effective. However, significant changes in child behavior at home were not necessarily accompanied by significant child behavior improvements at school. The major purpose of this continuation grant is to examine the additive effects of four models of intervention which target different combinations of antecedent risk factors. These new interventions are proposed for comparison, based on developmental theory concerning the role of multiple interacting risk factors (school, child and parents) in the development of antisocial behavior. We will be evaluating the additive effects of a new theory-based videotape intervention (PARTNERS) specifically targeted at school risk factors, combined with our family training model (FAMILY), in order to improve generalization of our existing treatment program's effectiveness from the home to school. We will also be evaluating the independent as well as the additive effects of a theory-based intervention targeted at child risk factors (KIDVID) to determine its ability to promote children's academic engagement and social competence. One hundred forty families will be randomly assigned to one of the following: (l) KIDVID only training, (2) FAMILY only training, (3) FAMILY training + PARTNERS teacher and parent school training, (4) TEAM (FAMILY training + PARTNERS training + KIDVID training), or (5) Waiting List Control (CON). Families will be assessed at baseline, l month, and l and 2 years post-treatment. Analyses will be conducted to compare intervention effects for 3 major intervening variables: (a) child social competence, (b) parenting competence and family school support networks, and (c) school environment. Our overall aim is to improve the long-term outcomes and the educational and social success of children with ODD/CD by combining more comprehensive interventions which target multiple risk factors and systems.
Our specific aim i s to determine whether families treated via the combined TEAM program, which addresses multiple risk factors, will show better generalization of improvements from home to school, as well as better long-term maintenance and reduction of ODD/CD, than families treated with interventions which address single categories of risk factors (KIDVID or FAMILY). The study also has important theory- testing implications and should increase our understanding of risk and protective factors involved in causes and treatment of ODD/CD. The format of all the programs is such as to significantly expand the ability of nurses to care for the increasing numbers of families with, and at risk for, ODD/CD.
Showing the most recent 10 out of 21 publications
