Description and Immediate Impacts of a Preventive Intervention for Conduct Problems

Abstract

A population-based randomized intervention trial for the prevention of conduct problems (i.e., oppositional defiant disorder and conduct disorder) is described. The LIFT (Linking the Interests of Families and Teachers) intervention was designed for all first- and fifth-grade elementary school boys and girls and their families living in at-risk neighborhoods characterized by high rates of juvenile delinquency. The 10-week intervention strategy was carefully targeted at proximal and malleable antecedents in three social domains that were identified by a developmental model of conduct problems. From 12 elementary schools, 671 first and fifth graders and their families participated either in the theory-based universal preventive intervention or in a control condition. The intervention consisted of parent training, a classroom-based social skills program, a playground behavioral program, and systematic communication between teachers and parents. A multiple measure assessment strategy was used to evaluate participant satisfaction and participation, fidelity of implementation, and the immediate impacts of the program on targeted antecedents.

Early intervention for at risk children: 3-year follow-up

“…6,7,8,9 Others have demonstrated a similar phenomenon. 10,11,12 Although often effective, universal interventions have the disadvantage that most children participating are low-risk and do not require intervention.…”

“…23 The data also showed that the higher the initial problem score, the steeper was the decline, consistent with findings elsewhere. 6,7,8,9,49 This may be attributable to so-called 'discrepancy proportional peer influence' so that the behaviour of those at the extremes is drawn toward the group mean. 50 If this is true, it requires the presence of some less overtly deviant peers in the therapeutic group.…”

“…If a parent refused to complete a follow-up questionnaire, we did not seek teacher or self reports, taking refusal to mean withdrawal from the trial. Of the 120 children initially entering the trial, 27 were lost to follow up due to moving away (8), leaving school (12) or refusing (7). Of those remaining, teacher data (the most complete) was available on 82% at two years and 69% at three years follow up.…”

“…A more recent example, the 'LIFT' program, evaluated a brief parenting and school based intervention conducted over ten weeks involving all children in 1 st or 5 th grade in schools drawn from areas of higher than average delinquency. 7 The authors reported reduced playground-observed aggression in the year after intervention.…”

Methods for testing theory and evaluating impact in randomized field trials: Intent-to-treat analyses for integrating the perspectives of person, place, and time

“…Continuing with variation in impact in universal preventive interventions, the work that our group and others (Hawkins et al, 2005;Reid et al, 1999) have done in early prevention of aggression, conduct disorder, delinquency and other externalizing behaviors, strongly suggests that prevention programs aimed at integrating and socializing children who exhibit externalizing behaviors into successful roles in the classroom, school, and family, can have major impacts on this high risk group and have beneficial or at least no harmful effects on those at much lower risk. Compared to programs that isolate and concentrate poorly behaving youth (Dishion et al, 1996(Dishion et al, , 1999(Dishion et al, , 2001, such approaches provide benefit by shaping behaviors within the most relevant social fields in their lives, thereby avoiding issues of labeling children as different and requiring a different intervention to adjust for reentry.…”