An efficacy study of a combined parent and teacher management training programme for children with ADHD Source-Specific Oppositional Defiant Disorder Among Inner-City Children: Prospective Prediction and Moderation Effectiveness of the Incredible Years Parenting Program for Families with Socioeconomically Disadvantaged and Ethnic Minority Backgrounds Clinical efficacy of methylphenidate in conduct disorder with and without attention deficit hyperactivity disorder. The clinical effectiveness of different parenting programmes for children with conduct problems: a systematic review of randomised controlled trials Treating Children With Early-Onset Conduct Problems: Intervention Outcomes for Parent, Child, and Teacher Training Psychological Adjustment and Asthma in Children and Adolescents: The UK Nationwide Mental Health Survey Reducing child conduct problems and promoting social skills in a middle-income country: cluster randomised controlled trial† Randomised comparison of the effectiveness and costs of community and hospital based mental health services for children with behavioural disorders Evaluation of a Booster Intervention Three Years After Acute Treatment for Early-Onset Disruptive Behavior Disorders Preventing conduct problems and improving school readiness: evaluation of the Incredible Years Teacher and Child Training Programs in high-risk schools. Combining Parent and Child Training for Young Children with ADHD Integrating Children with Psychiatric Disorders in the Classroom: A Systematic Review Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort? Changes in social competence in young children treated because of conduct problems as viewed by multiple informants A randomized trial of group parent training: reducing child conduct problems in real-world settings. Adolescent Outcomes of Childhood Conduct Disorder Among Clinic-Referred Boys: Predictors of Improvement Detecting effects of the indicated prevention Programme for Externalizing Problem behaviour (PEP) on child symptoms, parenting, and parental quality of life in a randomized controlled trial.
Background : Several parent training programmes and behavioural teacher training programmes built on learning theory have been developed for problem prevention and treatment of attention-deficit/hyperactivity disorder ( ADHD ) and /or oppositional defiant disorder ( ODD ) during the last few decades . Group format has often been used for parent training but single-subject design s are more common in teacher training . More studies have focussed on pre-school children than on older children , and a minority have been conducted in public mental health setting s. Aim : This study aim ed to evaluate a combined parent and teacher manual-based group training programme for children with ADHD conducted by the staff at a child and adolescent psychiatric clinic in Sweden . Method : The intervention was a modified version of Barkley 's programme .  Children were r and omized to an Intervention or a Control group .  Sixty-one parents and 68 teachers answered questions about ADHD and ODD symptoms , and about behavioural problems when the study started and at a 3-month follow-up . Results : Results showed that the intervention result ed in a reduction of the number of children who met DSM-IV criteria for ADHD and /or ODD . Effects were more pronounced in the home setting than in the school setting , and were further accentuated when both parents and teachers of the same child took part in the intervention . Teachers with more problematic classroom situations benefited most from the intervention . Conclusion : The programme , “ Strategies in Everyday Life ” , has , in a regular clinical setting , demonstrated promising effects on children 's disruptive behaviour , and a clinical implication was to recommend involving both parents and teachers in the programme We examined prospect i ve prediction from  parent- and teacher-reported oppositional defiant disorder ( ODD ) symptoms to parent-reported ODD , conduct disorder ( CD ) , major depressive disorder ( MDD ) , and generalized anxiety disorder symptoms and whether child executive functioning abilities moderated these relations among an urban , low-income sample of first- to third- grade children ( N = 87 ) .  Time 1 parent-reported ODD predicted each Time 2 outcome . Time 1 teacher-reported ODD predicted Time 2 CD and MDD symptoms . After controlling for Time 1 co-occurring symptoms , only prediction from Time 1 teacher-reported ODD to CD and MDD symptoms remained significant . Child executive functioning abilities moderated relations between Time 1 parent-reported ODD and Time 2 ODD , and Time 1 teacher-reported ODD and Time 2 CD and MDD . Among children with better executive functioning abilities , higher Time 1 ODD was associated with higher Time 2 symptoms Families with socioeconomically disadvantaged and ethnic minority background s are often hard to reach for the prevention and treatment of  disruptive child behavior problems . We examined whether the Incredible Years parenting intervention can successfully reach and benefit families with socioeconomic disadvantaged and ethnic minority background s in the Netherl and s. One hundred fifty-four families from a wide range of socioeconomic and ethnic background s were recruited in an outpatient clinic for child and adolescent psychiatry and in elementary schools serving deprived neighborhoods . Families were r and omly assigned to the BASIC Incredible Years parenting intervention or a waiting list control condition .  Children were 3–8 years old ( M = 5.59 , SD = 1.35 ; 62 % boys , 66 % ethnic minorities ) and 65 % of the children met Diagnostic and Statistical Manual of Mental Disorders ( 4th ed . , text rev . ) criteria for oppositional defiant disorder , conduct disorder , and /or attention-deficit hyperactivity disorder . Incredible Years reduced parent-reported disruptive child behavior and teacher-reported hyperactive and inattentive child behavior and increased parent-reported use of praise and incentives and reduced harsh and inconsistent discipline . Incredible Years did not affect parent-reported hyperactive and inattentive child behavior ; teacher-reported child conduct problems ; and parent-reported use of appropriate discipline techniques , clear expectations , physical punishment , and parenting stress . Of importance , the effectiveness of Incredible Years did not differ across families with different socioeconomic and ethnic background s. Effects were maintained at 3-month follow-up . This study shows that socioeconomically disadvantaged and ethnic minority families in disadvantaged neighborhoods can be engaged in and benefit from parenting interventions to reduce disruptive child behavior BACKGROUND Stimulants are not considered appropriate for the treatment of children with conduct disorders ( CDs ) . The postulated differences in stimulant effect between children with attention deficit hyperactivity disorder ( ADHD ) and CD led to the hypothesis that methylpheni date hydrochloride , which is effective in ADHD , would not significantly improve symptoms of CD . METHODS We r and omly assigned 84 children with CD , between the ages of 6 and 15 years , to receive methylpheni date hydrochloride ( up to 60 mg/d ) or placebo for 5 weeks . Behavior was evaluated by parent , teacher , and clinician reports and by direct classroom observations . Two thirds of the children also met criteria for ADHD . RESULTS Contrary to prediction , ratings of antisocial behaviors specific to CD were significantly reduced by methylpheni date treatment . The magnitude of methylpheni date effect indicated meaningful clinical benefit . Partialling out severity of ADHD did not alter the significant superiority of methylpheni date on CD ratings specifically ( P < .001 ) . CONCLUSIONS Methylpheni date has short-term positive effects on children and adolescents with CD . Key aspects of antisocial adjustment appear to be treatment responsive . This effect was independent of severity of the children 's initial ADHD symptoms Background Conduct problems are common , disabling and costly . The prognosis for children with conduct problems is poor , with outcomes in adulthood including criminal behaviour , alcoholism , drug abuse , domestic violence , child abuse and a range of psychiatric disorders . There has been a rapid expansion of group based parent-training programmes for the treatment of children with conduct problems  in a number of countries over the past 10 years . Existing review s of parent training have method ological limitations such as inclusion of non-r and omised studies , the absence of investigation for heterogeneity prior to meta- analysis or failure to report confidence intervals . The objective of the current study was to systematic ally review r and omised controlled trials of parenting programmes for the treatment of children with conduct problems .  Methods St and ard systematic review methods were followed including duplicate inclusion decisions , data extraction and quality assessment . Twenty electronic data bases from the fields of medicine , psychology , social science and education were comprehensively search ed for RCTs and systematic review s to February 2006 . Inclusion criteria were : r and omised controlled trial ; of structured , repeatable parenting programmes ; for parents/carers of children up to the age of 18 with a conduct problem ; and at least one measure of child behaviour . Meta- analysis and qualitative synthesis were used to summarise included studies . Results 57 RCTs were included . Studies were small with an average group size of 21 . Meta-analyses using both parent ( SMD -0.67 ; 95 % CI : -0.91 , -0.42 ) and independent ( SMD -0.44 ; 95 % CI : -0.66 , -0.23 ) reports of outcome showed significant differences favouring the intervention group . There was insufficient evidence to determine the relative effectiveness of different approaches to delivering parenting programmes . Conclusion Parenting programmes are an effective treatment for children with conduct problems . The relative effectiveness of different parenting programmes requires further research Families of 159 , 4- to 8-year-old children with oppositional defiant disorder ( ODD ) were r and omly assigned to parent training ( PT ) ; parent plus teacher training ( PT + TT ) ; child training ( CT ) ; child plus teacher training ( CT + TT ) ; parent , child , plus teacher training ( PT + CT + TT ) ; or a waiting list control . Reports and independent observations were collected at home and school . Following the 6-month intervention , all treatments result ed in significantly fewer conduct problems with mothers , teachers , and peers compared to controls . Children 's negative behavior with fathers was lower in the 3 PT conditions than in control . Children showed more prosocial skills with peers in the CT conditions than in control . All PT conditions result ed in less negative and more positive parenting for mothers and less negative parenting for fathers than in control . Mothers and teachers were also less negative than controls when children received CT . Adding TT to PT or CT improved treatment outcome in terms of teacher behavior management in the classroom and in reports of behavior problems Objective : Data from a nationwide child mental health survey were analyzed to examine relationships between asthma and psychological adjustment . Methods : Survey design with r and om selection based on national computer records of 10,438 children aged 5 to 15 from 12,529 eligible families ( 83 % ) .  Strengths and Difficulties Question naire ( SDQ ) was completed by parents , teachers , and 11- to 17-year-olds , providing scores for total difficulties , emotional symptoms , conduct problems , hyperactivity , peer problems , social behavior , and total impact . The Development and Well-Being Assessment ( DAWBA ) generated ICD-10 diagnoses . Parents reported physical disorders and disabilities , other child mental health risk factors , and rated child ’s general level of health . Results : Children with organic conditions other than asthma were excluded , leaving 9,834 children , 49.9 % male . Preliminary comparisons indicated higher parent and teacher rated scores for children with asthma . New variables combined asthma and general health to produce four groups . Logistic regressions were conducted with children without asthma and in good health as the reference group . Children with asthma in good health showed greater parent-rated emotional problems , but otherwise , few elevated odds ratios . Children without asthma in poor health were at significantly greater risk of disorder , as were children with asthma in poor health . Findings on ratings of hyperactivity are discussed . Conclusion : Findings that children with asthma have elevated psychological difficulties may result from poor health rather than asthma itself . SDQ = Strengths and Difficulties Question naire;DAWBA = Development and Well-Being Assessment Background There is an urgent need for effective , affordable interventions to prevent child mental health problems in low- and middle-income countries . Aims To determine the effects of a universal pre-school-based intervention on child conduct problems and social skills at school and at home . Method In a cluster r and omised design , 24 community pre-schools in inner-city areas of Kingston , Jamaica , were r and omly assigned to receive the Incredible Years Teacher Training intervention ( n = 12 ) or to a control group ( n = 12 ) . Three children from each class with the highest levels of teacher-reported conduct problems were selected for evaluation , giving 225 children aged 3–6 years . The primary outcome was observed child behaviour at school . Secondary outcomes were child behaviour by parent and teacher report , child attendance and parents ’ attitude to school . The study is registered as IS RCT N35476268 . Results Children in intervention schools showed significantly reduced conduct problems ( effect size ( ES ) = 0.42 ) and increased friendship skills ( ES = 0.74 ) through observation , significant reductions to teacher-reported ( ES = 0.47 ) and parent-reported ( ES = 0.22 ) behaviour difficulties and increases in teacher-reported social skills ( ES = 0.59 ) and child attendance ( ES = 0.30 ) . Benefits to parents ’ attitude to school were not significant . Conclusions A low-cost , school-based intervention in a middle-income country substantially reduces child conduct problems and increases child social skills at home and at school Abstract Objective : To test the hypothesis that a community based intervention by secondary child and adolescent mental health services would be significantly more effective and less costly than a hospital based intervention . Design : Open study with two r and omised parallel groups . Setting : Two health districts in the north of Engl and . Participants : Parents of 3 to 10 year old children with behavioural disorder who had been referred to child and adolescent mental health services . Intervention : Parental education groups . Main outcome measures : Parents ' and teachers ' reports of the child 's behaviour , parental depression , parental criticism of the child , impact of the child 's behaviour on the family . Results : 141 subjects were r and omised to community ( n=72 ) or hospital ( n=69 ) treatment . Primary outcome data were obtained on 115 ( 82 % ) cases a year later . Intention to treat analyses showed no significant differences between the community and hospital based groups on any of the outcome measures , or on costs . Parental depression was common and predicted the child 's outcome . Conclusions : Location of child mental health services may be less important than the range of services that they provide , which should include effective treatment for parents ' mental health problems This study examines the impact of a brief booster treatment administered 3 years after the delivery of an acute treatment in a group ( n = 118 ) of clinical ly referred boys and girls ( ages 6 to 11 ) originally diagnosed with Oppositional Defiant Disorder ( ODD ) or Conduct Disorder ( CD ) . At the conclusion of the acute treatment and three-year follow-up period ( i.e. , study month 42 ) , the sample was re-r and omized into Booster treatment or Enhanced Usual Care and then assessed at four later timepoints ( i.e. , post-booster , and 6- , 12- and 24-month booster follow-up ) . Booster treatment was directed towards addressing individualized problems and some unique developmental issues of adolescence based on the same original protocol content and treatment setting , whereas the Enhanced Usual Care condition involved providing clinical recommendations based on the assessment and an outside referral for services . HLM analyses identified no significant group differences and few time effects across child , parent , and teacher reports on a broad range of child functioning and impairment outcomes . Analyses examining the role of putative moderators or predictors ( e.g. , severity of externalizing behavior , dose of treatment ) were likewise non-significant . We discuss the nature and implication s of these novel findings regarding the role and timing of booster treatment to address the continuity of DBD over time BACKGROUND School readiness , conceptualized as three components including emotional self-regulation , social competence , and family/school involvement , as well as absence of conduct problems play a key role in young children 's future interpersonal adjustment and academic success . Unfortunately , exposure to multiple poverty-related risks increases the odds that children will demonstrate increased emotional dysregulation , fewer social skills , less teacher/parent involvement and more conduct problems . Consequently intervention offered to socio-economically disadvantaged population s that includes a social and emotional school curriculum and trains teachers in effective classroom management skills and in promotion of parent-school involvement would seem to be a strategic strategy for improving young children 's school readiness , leading to later academic success and prevention of the development of conduct disorders . METHODS This r and omized trial evaluated the Incredible Years ( IY ) Teacher Classroom Management and Child Social and Emotion curriculum ( Dinosaur School ) as a universal prevention program for children enrolled in Head Start , kindergarten , or first grade classrooms in schools selected because of high rates of poverty . Trained teachers offered the Dinosaur School curriculum to all their students in bi-weekly lessons throughout the year . They sent home weekly dinosaur homework to encourage parents ' involvement . Part of the curriculum involved promotion of lesson objectives through the teachers ' continual use of positive classroom management skills focused on building social competence and emotional self-regulation skills as well as decreasing conduct problems . Matched pairs of schools were r and omly assigned to intervention or control conditions . RESULTS Results from multi-level models on a total of 153 teachers and 1,768 students are presented . Children and teachers were observed in the classrooms by blinded observers at the beginning and the end of the school year . Results indicated that intervention teachers used more positive classroom management strategies and their students showed more social competence and emotional self-regulation and fewer conduct problems than control teachers and students . Intervention teachers reported more involvement with parents than control teachers . Satisfaction with the program was very high regardless of grade levels . CONCLUSIONS These findings provide support for the efficacy of this universal preventive curriculum for enhancing school protective factors and reducing child and classroom risk factors faced by socio-economically disadvantaged children The efficacy of the Incredible Years parent and child training programs is established in children diagnosed with oppositional defiant disorder but not among young children whose primary diagnosis is attention-deficit/hyperactivity disorder ( ADHD ) . We conducted a r and omized control trial evaluating the combined parent and child program interventions among 99 children diagnosed with ADHD ( ages 4–6 ) . Mother reported significant treatment effects for appropriate and harsh discipline , use of physical punishment , and monitoring , whereas fathers reported no significant parenting changes . Independent observations revealed treatment effects for mothers ' praise and coaching , mothers ' critical statements , and child total deviant behaviors . Both mothers and fathers reported treatment effects for children 's externalizing , hyperactivity , inattentive and oppositional behaviors , and emotion regulation and social competence . There were also significant treatment effects for children 's emotion vocabulary and problem-solving ability . At school teachers reported treatment effects for externalizing behaviors and peer observations indicated improvements in treated children 's social competence Background : The school setting may be the optimal context for early screening of and intervention on child mental health problems , because of its large reach and intertwinement with various participants ( child , teacher , parent , other community services ) . But this setting also exposes children to the risk of stigma , peer rejection and social exclusion . This systematic literature review investigates the efficacy of mental health interventions addressed to children and adolescents in school setting s , and it evaluates which programs explicitly take into account social inclusion indicators . Method : Only r and omized controlled trials conducted on clinical population s of students and carried out in school setting s were selected : 27 studies overall . Most studies applied group Cognitive Behavioural Therapy or Interpersonal Psychotherapy . Results : Findings were suggestive of the effectiveness of  school-based intervention programs  in reducing symptoms of most mental disorders . Some evidence was found about the idea that effective studies on clinical population s may promote the social inclusion of children with an ongoing mental disorder and avoid the risk of being highly stigmatized . Conclusion : School programs are still needed that implement st and ardized models with verifiable and evidence -based practice s involving the whole school community Background Approximately 20 % of children experience internalizing or externalizing DSM-IV-TR disorders . This prevalence rate can not be reduced through treatment only . Effective preventive interventions are therefore urgently needed . The aim of the current investigation is to evaluate the two-year efficacy of the group Triple P parenting program administered universally for the prevention of child behavior problems . Methods Based on their respective preschool , N = 280 families were r and omly assigned either to the parent training or to the control group . The efficacy was analyzed using multi- source assessment s , including question naires by mother and father , behavioral observation of mother-child interaction , and teacher evaluations . Results At the 2-year follow-up , both parents in the Triple P intervention reported significant reductions in dysfunctional parenting behavior , and mothers also an increase in positive parenting behavior . In addition , mothers reported significant reductions in internalizing and externalizing child behavior .  Single-parent mothers in the Triple P intervention did not report significant changes in parenting or child problem behavior which is primarily due to inexplicable high positive effects in single parent mothers of the control group . Neither mother-child interactions nor teacher ratings yielded significant results . Conclusions The results support the long-term efficacy of the Triple P - group program as a universal prevention intervention for changing parenting behavior in two-parent households , but not necessarily in single-parent mothers In the present study changes in social competence were examined in a clinic sample of 127 children aged 4–8 . The children were recruited to a controlled treatment study because of conduct problems at home and were r and omised to the Incredible Years parent training ( PT ) , combined PT and child therapy ( CT ) or a waiting-list control-group . Assessment s were conducted pre- and post-treatment and at a one-year follow-up by multiple informants ( mother , father , teacher and child ) . Parent training combined with child treatment showed most improvement in child social competence based on mother , father and child reports , however , father reports showed positive results for children treated with PT only . Treated mothers and fathers showed a decrease in correlations in their reports of social competence in the child after treatment as compared to parents in the waiting-list condition . No generalisation effects to peer-relationships in day-care/school were found , neither on teacher or child reports . A broad perspective using multiple informants from different setting s is needed when effects of treatment of young children with conduct problems are evaluated and should include various aspects of social competence OBJECTIVE Group-based Parent Management Training , the Oregon model ( PMTO , 12 sessions ) was delivered by the regular staff of municipal child and family services . PMTO is based on social interaction learning theory and promotes positive parenting skills in parents of children with conduct problems . This study examined the effectiveness of the group-based training intervention in real world setting s both immediately following and six months after termination of the intervention . METHODS One hundred thirty-seven children ( 3 - 12 years ) and their parents participated in this study . The families were r and omly assigned to group-based training or a comparison group . Data were collected from parents and teachers . RESULTS The caregiver assessment s of parenting practice s and child conduct problems and caregiver and teacher reported social competence revealed immediate and significant intervention effects . Short- and long-term beneficial effects were reported from parents , although no follow-up effects were evident on teacher reports . CONCLUSIONS These effectiveness findings and the potential for increasing the number of families served to support the further dissemination and implementation of group-based parent training Much remains to be learned about the adolescent outcomes of clinic-referred boys whose childhood conduct problems are serious enough to meet diagnostic criteria for conduct disorder ( CD ) .  Six structured diagnostic assessment s were conducted over 7 years of 73 clinic-referred 7–12-year-old boys who met criteria for CD in Wave 1 . There were substantial individual differences in the adolescent outcomes of CD , ranging from worsening to sustained recovery , with most boys showing persistent , but fluctuating levels of CD . Improvement in CD was not accounted for by treatment or incarceration , but more positive outcomes over Waves 2–7 were predicted prospect ively with substantial accuracy , using a combination of baseline predictors : less initial severity of CD , fewer symptoms of attention-deficit hyperactivity disorder , higher child verbal intelligence , greater family socioeconomic advantage , and not having antisocial biological parents BACKGROUND Behavioural parent training is effective in improving child  disruptive behavioural problems in preschool children by increasing parenting competence . The indicated Prevention Programme for Externalizing Problem behaviour ( PEP ) is a group training programme for parents and kindergarten teachers of children aged 3 - 6 years with externalizing behavioural problems . AIMS To evaluate the effects of PEP on child problem behaviour , parenting practice s , parent-child interactions , and parental quality of life . METHOD Parents and kindergarten teachers of 155 children were r and omly assigned to an intervention group ( n = 91 ) and a nontreated control group  ( n = 64 ) . They rated children 's problem behaviour before and after PEP training ; parents also reported on their parenting practice s and quality of life . St and ardized play situations were video-taped and rated for parent-child interactions , e.g. parental warmth . RESULTS In the intention to treat analysis , mothers of the intervention group described less disruptive child behaviour and better parenting strategies , and showed more parental warmth during a st and ardized parent-child interaction . Dosage analyses confirmed these results for parents who attended at least five training sessions . Children were also rated to show less behaviour problems by their kindergarten teachers . CONCLUSIONS Training effects were especially positive for parents who attended at least half of the training sessions . ABBREVIATIONS CBCL : Child Behaviour Checklist ; CII : Coder Impressions Inventory ; DASS : Depression anxiety Stress Scale ; HSQ : Home-situation Question naire ; LSS : Life Satisfaction Scale ; OBDT : observed behaviour during the test ; PCL : Problem Checklist ; PEP : prevention programme for externalizing problem behaviour ; PPC : Parent Problem Checklist ; PPS : Parent Practice s Scale ; PS : Parenting Scale ; PSBC : Problem Setting and Behaviour checklist ; QJPS : Question naire on Judging Parental Strains ; SEFS : Self-Efficacy Scale ; SSC : Social Support Scale ; TRF : Caregiver-Teacher Report Form
Comorbidity , gender , age , number of sessions , duration , intervention type , setting , medication use or dropout percentage did not influence the effect of treatment .
CONCLUSIONS Psychological treatments have a small effect in reducing parent- , teacher- and observer-rated CD problems  in children and adolescents with clinical CD problems/diagnosis .
There is not enough evidence to support one specific psychological treatment over another .
Many reports failed to provide detailed information to allow optimization of psychological treatment strategies
BACKGROUND This meta- analysis evaluates the efficacy of nonpharmacological treatments for conduct disorder ( CD ) problems in children and adolescents , based on child , parent and teacher report .