School-based intervention quells aggressiveness.
Elementary school children identified by their peers and teachers as aggressive have been shown to be at risk for later delinquency and substance use, according to John Lochman, Ph.D., professor and Saxon Chair of Clinical Psychology at the University of Alabama, Tuscaloosa. Exposing these moderate- to high-risk preadolescents to specific social-cognitive coping techniques in the classroom setting--while also engaging parents in the preventive intervention--can mitigate the potential for their developing conduct disorders in adolescence, Dr. Lochman reported at the 16th World Congress of the International Association for Child and Adolescent Psychiatry and Allied Professions.
Dr. Lochman and his colleagues evaluated the effects of a school-based aggression-intervention program on two samples of teacher-rated aggressive preteen children at the time of transition from elementary to middle school. The Coping Power program is based on an empirical model of substance abuse risk factors. It addresses high-risk children's deficits in social competence, self-regulation, school bonding, and positive parental involvement.
The first sample included 183 fourth- and fifth-grade boys from 17 elementary schools, and the second sample comprised 245 fifth-grade boys and girls from 17 elementary schools. The children in both samples were randomly assigned to one of three groups: the Coping Power child component, the full Coping Power program with a combined parent and child component, or a control group.
In the second sample, some classrooms were also randomly assigned to a universal intervention in which the teachers received special training to help foster Coping Power skills in all students within the class.
The child component of the Coping Power program included 33 1-hour group sessions (4-6 boys per group) in an after-school setting over a 15-month period.
The sessions, which were led by a family-school program specialist and a school guidance counselor, focused on behavioral and personal goal setting; awareness of feelings and their associated physiologic arousal; the use of coping self-statements, distraction techniques, and relaxation methods; the development of organizational and study skills, perspective-taking strategies, and social problemsolving skills; attribution retraining; and dealing with peer pressure and neighborhood-based problems.
During the same 15-month period, the parental component of the program included 16 group sessions, with four to six parents/couples per group. The program content was derived from social learning theory-based training programs and included skills for identifying both prosocial and disruptive behavioral targets in their children, rewarding appropriate child behaviors, giving effective instructions, establishing age-appropriate rules and expectations, applying effective consequences to negative child behavior, and establishing ongoing communication through weekly family meetings. Parents also learned to be supportive of the Coping Power skills their children were attaining, and they were introduced to stress management techniques to help them remain calm during difficult interactions with their children.
One year after the end of the intervention period, children in both samples who participated in the Coping Power program had lower rates of self-reported delinquent behavior. Children in the first group had lower parent-rated substance use, and children in the second group had lower self-reported substance use. Both intervention conditions (child-only and combined child and parent) produced positive effects on the children's social competence and self-regulation and the parents' parenting skills, Dr. Lochman reported. "The intervention effects were most apparent for the full Coping Power, with parent and child components," he said.
The intervention was also associated with teacher rated behavioral improvements in school during the follow-up year--effects that appeared to be primarily influenced by the child component of the program, Dr. Lochman said.
The follow-up measures also indicated that the universal intervention directly affected child substance use ratings and enhanced the Coping Power effects on delinquency. This finding suggests that providing teachers with the appropriate cognitive-behavioral techniques can have an effect on student aggression and antisocial behaviors, he said.
Although previous studies have linked the Coping Power program with lower rates of substance use and reductions in proactive aggression at the end of the intervention, the current study is the first to show that the effects of the intervention are maintained 1 year after the end of the program, and that an intervention that includes a combined parent and child component produces a greater improvement than does the Coping Power child component alone, Dr. Lochman noted. "The fact that behavioral improvements in school increased during the follow-up year suggests that the children's ability to cope effectively with difficult peer and adult conflicts--skills they developed through the intervention--continued to grow in the year following intervention," he said.
The findings of this study are also among the first to show that preadolescent children who are considered to be at high risk for conduct disorder and/or substance use can benefit from preventive interventions at the time of transition to middle school, partially deflecting a potentially dangerous developmental trajectory, he said. "Future research should examine the effects of booster interventions to maintain these follow-up effects," he concluded.
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|Title Annotation:||Behavioral Pediatrics|
|Date:||Oct 1, 2004|
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