Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice Commentary: nipping conduct problems in the

Abstract

Objective To see whether a behaviourally based group parenting programme, delivered in regular clinical practice, is an effective treatment for antisocial behaviour in children. Design Controlled trial with permuted block design with allocation by date of referral. Setting Four local child and adolescent mental health services. Participants 141 children aged 3-8 years referred with antisocial behaviour and allocated to parenting groups (90) or waiting list control (51). Intervention Webster-Stratton basic videotape programme administered to parents of six to eight children over 13-16 weeks. This programme emphasises engagement with parental emotions, rehearsal of behavioural strategies, and parental understanding of its scientific rationale. Main outcome measures Semistructured parent interview and questionnaires about antisocial behaviour in children administered 5-7 months after entering trial; direct observation of parent-child interaction. Results Referred children were highly antisocial (above the 97th centile on interview measure). Children in the intervention group showed a large reduction in antisocial behaviour; those in the waiting list group did not change (effect size between groups 1.06 SD (95% confidence interval 0.71 to 1.41), P < 0.001). Parents in the intervention group increased the proportion of praise to ineffective commands they gave their children threefold, while control parents reduced it by a third (effect size between groups 0.76 (0.16 to 1.36), P = 0.018). If the 31 children lost to follow up were included in an intention to treat analysis the effect size on antisocial behaviour was reduced by 16%. Conclusions Parenting groups effectively reduce serious antisocial behaviour in children in real life conditions. Follow up is needed to see if the children's poor prognosis is improved and criminality prevented.

Autism symptoms in Attention-Deficit/Hyperactivity Disorder: A Familial trait which Correlates with Conduct, Oppositional Defiant, Language and Motor Disorders

“…An assessment of symptoms of autism at initial presentation may identify children at increased risk of developing ODD/CD. Intensive parent training and family based interventions of proven efficacy in antisocial disorders such as the WebsterStratton programme (Scott et al 2001;Webster-Stratton and Hancock 1998) could be planned for the child. Future research could compare the efficacy of child-based social skills training with parenting programmes in the prevention of progression to ODD/CD in those with high autism symptoms in ADHD.…”

Transporting Evidence-Based Parenting Programs for Child Problem Behavior (Age 3–10) Between Countries: Systematic Review and Meta-Analysis

“…The primary caregiver was normally the mother, and only rarely was outcome data reported from fathers. Socioeconomic status (SES) of participants varied widely among studies: Four described participant families as low income (Gardner et al, 2006;Hutchings et al, 2007;Scott et al, 2001), and four as median income to low income or status (Leung & Tsang, 2012;Leung, Tsang, Heung, & Yiu, 2009;Ogden & Hagen, 2008;Sigmarsdóttir, Degarmo, Forgatch, & GuÞmundsdóttir, 2013). Two studies described families as middle to high status (Jalali, Shaeeri, Tahmasian, & Pourahmadi, 2009;Leung et al, 2003).…”

“…Five trials provided no information about income or SES Larsson et al, 2009;Matos, Bauermeister, & Bernal, 2009;Posthumus, Raaijmakers, Maassen, van Engeland, & Matthys, 2012). In all but three studies Scott et al, 2001), the great majority of families were ethnically native to the country in which the trial took place. This homogeneity across studies limited the ability to make comparisons by ethnicity.…”

A parenting intervention for childhood behavioral problems: A randomized controlled trial in disadvantaged community-based settings.

“…Furthermore, reviewers have pointed out that only a small number of parenting program trials meet the methodological (Serketich & Dumas, 1996) or clinical criteria for inclusion in meta-analyses aimed at exploring the clinical effectiveness of parenting programs (Furlong et al, 2010). For example, many trials in this area do not use adequate randomization procedures (e.g., Scott, Spender, Doolan, Jacobs, & Aspland, 2001) and/or appropriate methods for dealing with incomplete or missing outcome data (e.g., Braet et al, 2009;Larsson et al, 2009); other studies do not include children with clinically significant conduct problems (e.g., Dionne, Davis, Sheeber, & Madrigal, 2009;Patterson et al, 2002). These limitations may compromise the understanding of the clinical effectiveness of parenting interventions under real-world conditions.…”