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Parent management training efficacy for children with externalizing behavior in latent subgroups: Comorbidity matters
S114
IACAPAP 2012 – 20th World congress / Neuropsychiatrie de l’enfance et de l’adolescence 60S (2012) S64–S126
sive behaviour, which results in a persistent impairment of the relationships to other children. Contrary to other treatment approaches, this intervention aims at the individual treatment of problem maintaining and moderating factors of aggressive behaviour. Depending on the individual problem maintaining factors, the treatment aims to modify social cognitive information processing, impulse control, social problem solving, social skills and social interactions in specific situations. Methods.– The efficacy is evaluated in a partial randomized control group design with n = 100 children. We note that n = 60 children are treated for about half a year with the modules of THAV in weekly individual sessions. The control group of n = 40 children receives alternative interventions with group play and techniques to activate resources of the child. These interventions give the children the opportunity to train pro-social interactions. Outcome parameters are aggressive behaviour and comorbid symptoms as well as problem maintaining factors, psychosocial functioning, family burden and treatment satisfaction. Moreover, variables of the treatment process are assessed. Questionnaires, tests and individual problem checklist were used to assess these outcome and process parameters. Results.– The preliminary analysis is conducted in a sample of n = 90 children who finalized the treatment meanwhile. The results show reductions of aggressive behaviour, comorbid symptoms and problem maintaining factors. Clinical experiences with the treatment will be discussed.
Objective.– Parent training for children with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) has demonstrated to be effective in many trials. Much less is known if comorbidity of ADHD with ODD moderates treatment success. This analysis aimed to test for latent subgroups with differential treatment outcome. Method.– The parent management training under investigation is part of the Prevention Program for Externalizing Problem Behavior (PEP). We note that 270 families with children aged 3–10 years and externalizing problem behavior were included. Data were analyzed by mixture Markov models. Results.– Two subgroups were detected. First group comprised children that were less affected at study intake or who had a great chance to be unaffected at the end of treatment. For children of the second subgroup likelihood to be unaffected after intervention was low. This group was particularly characterized by children with comorbid ADHD and ODD symptoms. Yet, also for this subgroup treatment effects were found. Conclusions.– There was indication that among children with externalizing problem behavior two subpopulations with varying treatment effects exist. Children with comorbid disorders in general felt into a subgroup that is harder to treat. http://dx.doi.org/10.1016/j.neurenf.2012.05.483 We-S-508
http://dx.doi.org/10.1016/j.neurenf.2012.05.481
School interventions for children with externalizing problem behavior
We-S-506
a
Guided self-help for parents of children with ADHD: Concept and effectiveness C. Kinnen a,∗ , N. Benien a , C. Hautmann a , L. Mokros a , A. Mütsch a , M. Döpfner b a Department of Child and Adolescent Psychiatry, University of Cologne, Cologne, Germany b School for Child and Adolescent Psychotherapy (AKIP), University Cologne, Cologne, Germany ∗ Corresponding author. Objectives.– In randomized controlled trials Guided Parental Self-Help (GPSH) resulted in significant diagnosis decreases among children with ADHD and oppositional behaviour. In the present study, the effectiveness of GPSH for parents of children with ADHD is investigated under routine-care conditions. Parents receive manuals with contents based on a German self-help book (Wackelpeter und Trotzkopf) and additionally a biweekly counselling telephone call. About 200 parents have already finished the program. The objective of the presentation is an interim analysis of the pre-post-effects of GPSH. Method.– About 200 parents of 6–12 year old children with ADHD are investigated in a one-group pre-post design. Physicians from private practices across Germany enrolled parents of children with a diagnosis of ADHD. Results.– The sample was analyzed regarding sociodemographic factors, medication characteristics, ADHD-symptoms and comorbid symptoms as well as quality of life at pre-assessment and on ADHD-symptoms, comorbid symptoms, quality of life and parents and physicians satisfaction with the program as outcome variables. Statistically significant decrease of ADHD- and comorbid symptoms and increase of quality of life were found. The satisfaction of parents and physicians with the program was high. Conclusions.– Preliminary findings of GPSH are promising. Yet, more research is needed to provide GPSH for parents of children with ADHD in a broader context. http://dx.doi.org/10.1016/j.neurenf.2012.05.482 We-S-507
Parent management training efficacy for children with externalizing behavior in latent subgroups: Comorbidity matters C. Hautmann Department of Child and Adolescent Psychiatry, University of Cologne, Cologne, Germany
C. Hanisch a,∗ , I. Eichelberger b , S. Richard a , M. Döpfner c Social Studies, University of Applied Sciences, Duesseldorf, Germany b Department of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany c Department of Child and Adolescent Psychiatry, University of Cologne, Cologne, Germany ∗ Corresponding author.
Attention problems and attention deficits are very common. Children with attention problems experience significantly more homework difficulties than their classroom peers. More than half of all grade- school children in Germany do their homework with their classroom peers in school settings. Here, even children without attention problems report feeling distracted by the presence of their peers implicating that doing homework in a group of children is very challenging for children with attention problems. Effective school interventions for children with attention deficits combine behaviour modification with cognitive strategies. The indicated prevention programme “concentration in school” aims at decreasing problem behaviour and enhancing attention span and work habits during homework. First homework teachers are trained in using behaviour modification techniques. Secondly children with attention problems participate in an eightweek group training teaching them to use cognitive behavioural strategies for enhancing attention and self-regulated learning. Training effects are tested in a within-subject control group design. Dependent measures are teacher rated child behaviour during homework and during regular school hours and computerized attention tests. Preliminary data of 71 children with attention problems suggest that child problem behaviour during homework decreases after teachers participated in the behaviour modification training. The child group training does not further improve child behaviour. School setting factors as well as aspects of training content and methods might account for children’s difficulties to transfer strategies from the training session into the homework situation. http://dx.doi.org/10.1016/j.neurenf.2012.05.484
IACAPAP 2012 – 20th World congress / Neuropsychiatrie de l’enfance et de l’adolescence 60S (2012) S64–S126
sive behaviour, which results in a persistent impairment of the relationships to other children. Contrary to other treatment approaches, this intervention aims at the individual treatment of problem maintaining and moderating factors of aggressive behaviour. Depending on the individual problem maintaining factors, the treatment aims to modify social cognitive information processing, impulse control, social problem solving, social skills and social interactions in specific situations. Methods.– The efficacy is evaluated in a partial randomized control group design with n = 100 children. We note that n = 60 children are treated for about half a year with the modules of THAV in weekly individual sessions. The control group of n = 40 children receives alternative interventions with group play and techniques to activate resources of the child. These interventions give the children the opportunity to train pro-social interactions. Outcome parameters are aggressive behaviour and comorbid symptoms as well as problem maintaining factors, psychosocial functioning, family burden and treatment satisfaction. Moreover, variables of the treatment process are assessed. Questionnaires, tests and individual problem checklist were used to assess these outcome and process parameters. Results.– The preliminary analysis is conducted in a sample of n = 90 children who finalized the treatment meanwhile. The results show reductions of aggressive behaviour, comorbid symptoms and problem maintaining factors. Clinical experiences with the treatment will be discussed.
Objective.– Parent training for children with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) has demonstrated to be effective in many trials. Much less is known if comorbidity of ADHD with ODD moderates treatment success. This analysis aimed to test for latent subgroups with differential treatment outcome. Method.– The parent management training under investigation is part of the Prevention Program for Externalizing Problem Behavior (PEP). We note that 270 families with children aged 3–10 years and externalizing problem behavior were included. Data were analyzed by mixture Markov models. Results.– Two subgroups were detected. First group comprised children that were less affected at study intake or who had a great chance to be unaffected at the end of treatment. For children of the second subgroup likelihood to be unaffected after intervention was low. This group was particularly characterized by children with comorbid ADHD and ODD symptoms. Yet, also for this subgroup treatment effects were found. Conclusions.– There was indication that among children with externalizing problem behavior two subpopulations with varying treatment effects exist. Children with comorbid disorders in general felt into a subgroup that is harder to treat. http://dx.doi.org/10.1016/j.neurenf.2012.05.483 We-S-508
http://dx.doi.org/10.1016/j.neurenf.2012.05.481
School interventions for children with externalizing problem behavior
We-S-506
a
Guided self-help for parents of children with ADHD: Concept and effectiveness C. Kinnen a,∗ , N. Benien a , C. Hautmann a , L. Mokros a , A. Mütsch a , M. Döpfner b a Department of Child and Adolescent Psychiatry, University of Cologne, Cologne, Germany b School for Child and Adolescent Psychotherapy (AKIP), University Cologne, Cologne, Germany ∗ Corresponding author. Objectives.– In randomized controlled trials Guided Parental Self-Help (GPSH) resulted in significant diagnosis decreases among children with ADHD and oppositional behaviour. In the present study, the effectiveness of GPSH for parents of children with ADHD is investigated under routine-care conditions. Parents receive manuals with contents based on a German self-help book (Wackelpeter und Trotzkopf) and additionally a biweekly counselling telephone call. About 200 parents have already finished the program. The objective of the presentation is an interim analysis of the pre-post-effects of GPSH. Method.– About 200 parents of 6–12 year old children with ADHD are investigated in a one-group pre-post design. Physicians from private practices across Germany enrolled parents of children with a diagnosis of ADHD. Results.– The sample was analyzed regarding sociodemographic factors, medication characteristics, ADHD-symptoms and comorbid symptoms as well as quality of life at pre-assessment and on ADHD-symptoms, comorbid symptoms, quality of life and parents and physicians satisfaction with the program as outcome variables. Statistically significant decrease of ADHD- and comorbid symptoms and increase of quality of life were found. The satisfaction of parents and physicians with the program was high. Conclusions.– Preliminary findings of GPSH are promising. Yet, more research is needed to provide GPSH for parents of children with ADHD in a broader context. http://dx.doi.org/10.1016/j.neurenf.2012.05.482 We-S-507
Parent management training efficacy for children with externalizing behavior in latent subgroups: Comorbidity matters C. Hautmann Department of Child and Adolescent Psychiatry, University of Cologne, Cologne, Germany
C. Hanisch a,∗ , I. Eichelberger b , S. Richard a , M. Döpfner c Social Studies, University of Applied Sciences, Duesseldorf, Germany b Department of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany c Department of Child and Adolescent Psychiatry, University of Cologne, Cologne, Germany ∗ Corresponding author.
Attention problems and attention deficits are very common. Children with attention problems experience significantly more homework difficulties than their classroom peers. More than half of all grade- school children in Germany do their homework with their classroom peers in school settings. Here, even children without attention problems report feeling distracted by the presence of their peers implicating that doing homework in a group of children is very challenging for children with attention problems. Effective school interventions for children with attention deficits combine behaviour modification with cognitive strategies. The indicated prevention programme “concentration in school” aims at decreasing problem behaviour and enhancing attention span and work habits during homework. First homework teachers are trained in using behaviour modification techniques. Secondly children with attention problems participate in an eightweek group training teaching them to use cognitive behavioural strategies for enhancing attention and self-regulated learning. Training effects are tested in a within-subject control group design. Dependent measures are teacher rated child behaviour during homework and during regular school hours and computerized attention tests. Preliminary data of 71 children with attention problems suggest that child problem behaviour during homework decreases after teachers participated in the behaviour modification training. The child group training does not further improve child behaviour. School setting factors as well as aspects of training content and methods might account for children’s difficulties to transfer strategies from the training session into the homework situation. http://dx.doi.org/10.1016/j.neurenf.2012.05.484