Disruptive behaviour problems (DBPs) during childhood exert a high burden on individuals, families and the community as a whole. Reducing this impact is a major public health priority. Early parenting interventions are recommended as valuable ways to target DBPs; however, low take-up of, and high drop-out rates from, these programmes seriously reduce their effectiveness. We present a review of published qualitative evidence relating to factors that block or facilitate access and engagement of parents with such programmes using a thematic synthesis approach. 12 papers presenting views of both parents and professionals met our inclusion and quality criteria. A large number of barriers were identified highlighting the array of challenges parents can face when considering accessing and engaging with treatment for their child with behavioural problems. Facilitating factors in this area were also identified. A series of recommendations were made with regard to raising awareness of programmes and recruiting parents, providing flexible and individually tailored support, delivering programmes through highly skilled, trained and knowledgeable therapists, and highlighting factors to consider when delivering group-based programmes. Clinical guidelines should address barriers and facilitators of engagement as well as basic efficacy of treatment approaches.Electronic supplementary materialThe online version of this article (doi:10.1007/s00787-013-0401-2) contains supplementary material, which is available to authorized users.

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5ADHD is a high cost/high burden disorder. Early detection and intervention may prevent 6 or ameliorate the development of the disorder and reduce its long term impact. Here we set out a 7 rationale for an early detection and intervention programme. First, we highlight the costs of the 8 condition. Second, we discuss limitations of the current treatments. We then outline the potential 9 value of an early detection and intervention programme. We review evidence on predictors of 10 poor outcomes for early ADHD signs and discuss how these might allow us to target early 11 intervention more cost-effectively. We then examine potential barriers to engagement with at-risk 12samples. This leads to a discussion of possible intervention approaches and how these could be 13improved. Finally we describe the PEDIA (Programme for Early Detection and Intervention for 14 ADHD) a five year programme of research supported by the National Institute for Health 15Research and conducted at the University of Southampton which aims to develop and evaluate a 16 strategy for early intervention. 17 Peer Review PaperPlease return your comments for the attention of the Assistant Commissioning Editor at l.rishton@expert-reviews.com Many thanks in advance for your kind assistance. ADHD are likely to use medical services [9] and no account is taken of the costs due to family 36 member stress [10]. Furthermore, children with ADHD suffer a wide range of impairments that 37 impinge on social and health care systems at a number of levels (education, criminal justice, 38 mental health, social services etc) [11]. It has been estimated that 45 percent of the young male 39 prison population have ADHD ([12], see also [13] and [14]

BackgroundThe importance of early intervention approaches for the treatment of attention-deficit hyperactivity disorder (ADHD) has been increasingly acknowledged. Parenting programmes (PPs) are recommended for use with preschool children with ADHD. However, low ‘take-up’ and high ‘drop-out’ rates compromise the effectiveness of such programmes within the community.MethodsThis qualitative study examined the views of 25 parents and 18 practitioners regarding currently available PPs for preschool children with ADHD-type problems in the UK. Semi-structured interviews were undertaken to identify both barriers and facilitators associated with programme access, programme effectiveness, and continued engagement.Results and conclusionsMany of the themes mirrored previous accounts relating to generic PPs for disruptive behaviour problems. There were also a number of ADHD-specific themes. Enhancing parental motivation to change parenting practice and providing an intervention that addresses the parents' own needs (e.g. in relation to self-confidence, depression or parental ADHD), in addition to those of the child, were considered of particular importance. Comparisons between the views of parents and practitioners highlighted a need to increase awareness of parental psychological barriers among practitioners and for better programme advertising generally. Clinical implications and specific recommendations drawn from these findings are discussed and presented.

Children's sexuality education continues to be plagued with tensions and controversies. In consequence, children's access to sexuality education is severely compromised, especially in terms of the time dedicated to this topic, the content addressed, how it is taught and by whom. Based on a study of 342 Australian parents of primary school aged children we explore: (i) parents' perceptions of the relevance and importance of sexuality education to their primary school aged children and the discourses that inform their perspectives; (ii) parents' views on who should be responsible for the sexuality education of young children; (iii) whether there are certain aspects of sexuality education considered more appropriate for the family to address with children; and (iv) what the implications of these findings are for sexuality education policy and practice in Australian primary schooling. Despite the controversial nature of the topic, the majority of parents in this study believed sexuality education was relevant and important to primary school children and that it should be a collaborative approach between families and schools. However, some parents/carers acknowledged that while that they believed that some topics should only be addressed at home they also indicated that this often does not happen.