| The question arises of whether or not conduct | | | | combat the effects of poverty, parenting issues, |
| disorder can be prevented. Prevention would be | | | | educational issues, as well as whatever the family |
| the ideal situation as the costs have been | | | | needs to survive. Children attend Head Start |
| demonstrated to be very high later when the child | | | | when they are three years old. Parents play a big |
| with conduct disorder is out of control. Treatment | | | | role in the program. They are required to spend |
| after the fact is costly, not always effective, and | | | | some time in the center, volunteering their time. |
| reaches very few because of these limitations. | | | | They are also required to attend parenting classes |
| Most early intervention programs include parent | | | | while their child is receiving services. Head Start is |
| training toward consistency and fairness in | | | | a comprehensive program, and they examine |
| discipline techniques, positive reinforcement and | | | | other areas of the family where services may be |
| consequence techniques, information about abuse | | | | needed to assure the success of their students. |
| and neglect, and all of these effects on children. | | | | Frequently, it is found that there are other issues, |
| Overall, few prevention programs have been | | | | such as housing or lack, lack of job skills in the |
| evaluated for long-term effects (beyond 5 years), | | | | parents, that make the home life difficult for their |
| but those evaluations have been promising. Little is | | | | students. They make referrals to the family, not |
| known about the optimal intervention time or | | | | just the student. The also follow up with the |
| what mechanisms produce real change in children, | | | | family and require parental involvement in the |
| families, or communities. | | | | program. This increases the likelihood of success |
| Two types of prevention strategies have been | | | | after the program and increases the advantages |
| offered, both with good and bad features. | | | | the child receives that they otherwise would not |
| Universal programs are offered at the community | | | | have. |
| level for the benefit of all, regardless of risk | | | | Head Start mothers were examined for |
| assessment. By offering the program to | | | | effectiveness of their parenting program. After |
| everyone, labeling does not occur. Labeling can be | | | | intervention, mothers were observed to have |
| very destructive for some of the following | | | | significantly fewer critical remarks and commands, |
| reasons: | | | | moderated their discipline techniques, and were |
| | | | more confident and positive around their children. |
| 1. The label of abnormal falsifies reality by implying | | | | Mothers were also more involved in their children's |
| most abnormal behavior is qualitatively different | | | | education, and children were more socially |
| than normal behavior. | | | | competent with peers. Overall, children in the |
| 2. Diagnosis and labeling distort reality by applying | | | | intervention group showed fewer conduct |
| artificial criteria to meet the criteria. | | | | problems, less noncompliance, and appeared |
| 3. Labeling gives the illusion of explanation for | | | | happier. The effects were examined a year later, |
| behavior - an excuse. | | | | and most improvements were maintained. |
| 4. The label is harmful because it obscures | | | | Several other models have been used to prevent |
| individuality, such that mental health professionals | | | | conduct problems in children. Fast Track is a |
| treat the "illness" rather than the human being. | | | | multi-component intervention program based on a |
| This can be particularly harmful in the case of | | | | comprehensive developmental model. The |
| conduct disorder because the label becomes more | | | | intervention includes academic tutoring, parent |
| important than the child. | | | | training, home visits, and PATHS (Promoting |
| Universal programs also provide benefit to children | | | | Alternative Thinking Strategies), a universal |
| and families not at risk for conduct disorder by | | | | classroom-level program. These multi-year |
| providing tools for use in normal parenting. | | | | interventions were provided to identified at-risk |
| However, universal programs can be very | | | | kindergarten children to provide improvement in |
| expensive to run and maintain. A beneficial effect | | | | competencies and reduce conduct problems. |
| may also be a detriment. These programs may | | | | Findings at the end of Grade 1 were significant |
| not actually reach those who need them most. | | | | reduction of peer aggression and |
| Targeted programs depend on identification of | | | | hyperactive-disruptive behavior. Parents reported |
| at-risk children, which is difficult and potentially | | | | greater satisfaction, less need for discipline, more |
| labels these children. However, targeting is less | | | | involvement, and more consistent and appropriate |
| expensive as fewer families are involved (about | | | | discipline. Findings were consistent in that the level |
| 20% prevalence of childhood psychiatric disorders | | | | at which the intervention was applied and |
| in the general population). Targeting also provides | | | | participated in predicted success in outcome. |
| treatment for families that will really need the | | | | Several other programs were reviewed, and they |
| intervention. Currently, the programs that are | | | | have many common features. Parent training in |
| available target children and families that are at | | | | such issues such as discipline, plays a big role in |
| risk in general. | | | | prevention programs. Another facet of |
| There are already several programs available. The | | | | intervention appears to encompass multiple areas |
| treatment models generally include school, family, | | | | of the child's life - school, home, peers, and social |
| community, and the individual child. Head Start, a | | | | interactions. Diverting conduct problems by some |
| social program created in 1965 during President | | | | method of intervention needs to occur early in |
| Lyndon Johnson's administration, identifies at-risk | | | | the child's life, before life-long patterns are |
| children and families and offers intervention to | | | | developed. |