Behavior Disorders Clinical Trial
Official title:
John F. Kennedy Center for Mental Retardation at Vanderbilt University: Preventing Problems in Children's Social Behavior
Children who are at risk for problems in school may do better if they and their parents are taught how to communicate with each other between age 3 and 6 when the children enter kindergarten. Three groups of 3 year olds who are in Head Start in the Nashville area will be randomized with their parents to either a 3 year program of skill building or to a control (Head Start only). The children will be tested at the end of the 3 year study and 6 months, 1 year and 2 years later.
Once established, childhood conduct and behavior disorders are robust and have consistently
negative effects on the social and academic behavior of children and adolescents. Early
intervention to prevent the development of these disorders is an important alternative to
intervention after problem behaviors are well established. Two factors, negative patterns of
parent-child interaction associated with poor parenting skills and significant communication
deficits, are strongly associated with childhood conduct and behavior disorders.
This study is an experimental investigation of a multicomponent, longitudinal intervention
with families and children to prevent conduct and behavior disorders in children at high
risk for these disorders. The goals of this study are to 1) describe the incidence of
significant social problems related to conduct disorders among 3-year old children enrolled
in Head Start and 2) examine the effectiveness of an intervention on the behavior of
children identified with emergent behavior problems or at highest risk for these problems.
There are two phases within this study. In the first phase, 750 three-year-olds will be
screened for early indicators of behavior problems and communications deficits using reports
of child behavior from parents and teachers, direct assessment of children, and assessments
of family support and stress that signal risk for conduct disorder to identify children at
highest risk. Data from the first phase will provide information regarding the incidence of
behavior problems, allow determination of the most reliable indicators of increased risk
status and to explore the specific relationship between early communication development and
increased risk for behavior problems.
The second phase examines the immediate and longer term effects of prevention intervention
to improve children's social behavior and communication skills. Three-year-old children
(n=180) that are attending community daycares or therapeutic nurseries serving low-income
families, and that have mild to moderate language delays and patterns of parent-child
interaction associated with poor behavioral outcomes will be recruited. One hundred and
eighty children at high risk for development of conduct disorders and related behavioral
problems will be randomized to either an intervention group (n=90) or an untreated control
group (n=90). Three successive cohorts of children and families will be randomly assigned to
treatment or control groups; each cohort will be followed three years until the child enters
kindergarten. The primary intervention will include parent training in communicative
interactions and behavior management and direct intervention with the child to teach social
communication skills in peer interactions. Secondary intervention will include classroom
consultation, maintenance of parent training and child intervention as needed, family
support and liaison services, and assistance during child transition into kindergarten.
Local Head Start collaborators are included in all phases of the trial. The outcomes of the
trial will be examined at four points - immediately after the study period is completed, 6
months later, 1 year later, and 2 years later. The last assessment will focus on academic,
social, and mental health outcomes at the end of the children's kindergarten year. Positive
effects on children's problem behaviors, social skills, and overall development and positive
effects on parent-child interaction are expected to be associated with participation in the
treatment condition.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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