The broad aim of this proposal is to determine whether Type I diabetic children's metabolic control as measured by Hemoglobin A1 is significantly improved when child and family are trained to resolve school, home, and diabetes-management problems. To achieve these aims, the proposed study will use these methods: (1) Identify and recruit for participation 135 Insulin-Dependent Diabetes Mellitus (IDDM youth), aged 5 to 18. (2) Stratify as to age (5-9, 10-13, 14-18 years) and randomly assign Ss to FST, an Attention-Placebo Control (APC), or a Standardized Care Control (SCC). (3) Measure attrition from each condition during the three intervention months. (4) Measure the effects of each condition on the diabetic child's metabolic control, knowledge of diabetes, self-injection skills, behavior problems, self-perceived competence and depression; parental depression; and, family problem-solving effectiveness: when pretreatment levels are compared to posttreatment and a six-month follow-up. (5) Using MANOVA, determine whether FST produced more short- and long-term change on all dependent measures than the two control conditions. (6) Using MANOVA, determine the influence of the child's age on the effectiveness of FST in enhancing self-management. (7) Using multiple regression, determine how well pretreatment family problem-solving effectiveness, family demographics, and child's competence, depression, and behavior problems predict posttreatment metabolic control.
