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Abstract
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VioLit summary:
OBJECTIVE:
The purpose of this research conducted by Patterson et al. was to compare the effects of a program that trained parents to deal with their socially aggressive children with other treatment programs.
METHODOLOGY:
This study was quasi-experimental in design. The research consisted of a comparison of the parent training program at the Oregon Social Learning Center (OSLC) with a variety of other community treatment programs. Aggressive children were referred to the OSLC for treatment by pediatricians, teachers, mental health personnel, and parents. The sample in this study was comprised of those referrals who met several criteria: the children were between 3 and 12 years old, the families resided within a 25 minute drive from the Center, and the children were referred for social aggression (e.g., temper tantrums, hitting). The children included in the sample also displayed Total Aversive Behavior (TAB) rates that were at or above the 90th percentile (TAB scores were derived from observations of children interacting with their parents at home). Only children whose parents agreed to allow home observations, participate in telephone interviews and attend therapy sessions were included in the study. Finally, families were included if neither the parents nor the child had been diagnosed as psychotic, severely retarded or autistic. Of the 46 families referred to the clinic, 19 met these criteria.
The 19 families were randomly assigned to experimental (N=10) and comparison groups (N=9). Families in the experimental group were treated by staff at the OSLC. Treatment included individual weekly sessions with trained therapists as well as biweekly telephone calls during the first two weeks of treatment. Families in this group received an average of 17 hours of treatment.
Families in the comparison group were referred to treatment elsewhere in the community. Treatment types varied, with three receiving treatment using "an eclectic approach, two using behavior modification, one with an Adlerian approach, one with a structural family systems approach, and one with a combination of relaxation and physical exercise" (p 642). The number of therapy sessions participated in by families in the comparison group ranged from one to thirty-two (average=11.75 sessions).
The researchers were interested in whether or not children in the experimental group would show decreases in their rates of aggressive behavior that were greater than the changes for children in the comparison group. Several measures were used to answer this question, including the Family Interaction Coding System (FICS), a 29-category observation instrument for measuring ongoing family interactions. This instrument was used at the beginning of the experiment and again after treatment was completed. Entry-by-entry agreement was assessed during 12% of the observations and found to be 83%.
The Total Aversive Behavior score (TAB) was used in conjunction with the FICS. Observations made with the FICS were coded into 14 noxious-behavior (meaning aggressive or harmful) categories and added together to comprise the TAB score. Reliability for TAB scores have been assessed at .78 (p<.01) for measures at two week intervals and .74 (p<.05) for measures one year apart.
The third instrument used was the Parent Daily Report (PDR), a 34-item checklist which measured the frequency of the occurrence of problem behaviors during a previous 24-hour period. The checklist was administered by telephone interviewers 5 times weekly for two weeks before treatment and 3 times weekly for 2 weeks at the end of treatment. Previous studies have found the reliability of this measure to range from .60 to .82.
Data were analyzed using analysis of variance (ANOVA) statistics and Fisher Exact tests.
FINDINGS/DISCUSSION:
Before treatment began, TAB scores for the experimental and comparison group were not significantly different. At the end of treatment, however, clear differences emerged. The comparison group showed a 17% reduction in TAB scores at the end of treatment while the treatment group showed a 63% reduction, a significant finding. The authors used this finding to conclude that the OSLC program was more effective at reducing aggressive behavior in children than other programs in their study.
Data from the PDR also revealed the similarity of the two groups before treatment began. The experimental and comparison groups were almost identical in their average number of parent-reported problem behaviors before treatment, with averages of 3.19 and 3.20, respectively. At the end of treatment, these numbers decreased to 1.66 for the experimental group and 1.96 for the comparison group. While the difference between the after treatment PDR scores for the two groups was not found to be significant, it was found that the difference between the before treatment and after treatment averages for both groups were significant (p<.001).
The authors concluded that their study demonstrated strong support for the OSLC program in particular, and in general for the idea that family intervention was effective in reducing aggressive behavior in children.
AUTHORS' RECOMMENDATIONS:
The authors suggested that future studies of the effectiveness of parent training should include more subjects and involve random assignment to experimental and control groups. They noted that previous studies which have followed this advice have failed to produce significant findings, but attributed this problem to other methodological issues, such as using student therapists instead of trained professionals to treat families.
(CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)
Oregon
Program Evaluation
Parent Training
Family Based
Training Program
Child Aggression
Child Treatment
Aggression Treatment
Early Childhood
Late Childhood
Middle Childhood
Treatment Program
Family Treatment
Child Behavior
Child Problem Behavior
Behavior Treatment
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