Michael L. Bloomquist

An integrated components preventive intervention for aggressive elementary school children: the early risers program.

The Early Risers prevention program aims to alter the developmental trajectory of children with early onset aggressive behavior. The program features 4 CORE components: (a) an annual 6-week summer school program, (b) a teacher consultation and student mentoring program, (c) child social skills groups, and (d) parent education and skills-training groups, all delivered in tandem with a FLEX family support program individually tailored to address the unique needs of families. At baseline, the mean age of the sample was 6.6 years. Following 2 years of intervention, program children showed significant improvement relative to controls in academic achievement and school behaviors. Change on behavioral self-regulation was moderated by level of child aggression, with intervention effects found for only the most severely aggressive children. Parents with high program attendance rates showed improvement in discipline methods.

Effects of a school-based cognitive-behavioral intervention for ADHD children

Two variations of school-based cognitive-behavioral training (CBT) program were compared to each other and to a waiting-list control condition in the treatment of children with attention-deficit hyperactivity disorder (ADHD). The experimental interventions included a multicomponent condition that provided coordinated training programs for parents, teachers, and children and a teacher-only condition that offered training for classroom teachers only. Evaluation of outcome occurred at pre-intervention, post-intervention and at 6-week followup periods. Depedent measures included classroom behavior observations, teacher ratings of child behavior, child self-report, and teacher ratings of adjustment. The multicomponent CBT condition was significantly better than the other conditions at improving observed off-task/disruptive behavior at post-test. This improvement was maintained at followup, although treatment condition differences were no longer significant. There were no treatment condition differences on any other measures at postintervention or followup. It was concluded that the intervention had minimal short-term effects on the ADHD children. The results are discussed within the context of several methodological limitations of the study which serve as proposals for continued research in this area.

Dissemination of an evidence-based prevention innovation for aggressive children living in culturally diverse, urban neighborhoods: the Early Risers effectiveness study

This study evaluated the effectiveness of the Early Risers “Skills for Success” Program when implemented by neighborhood family resource centers available to urban children and their families. Kindergarten and first-grade children (n=327) enrolled in 10 schools were screened for aggressive behavior, and randomized to two model variations of the Early Risers Program or a no-intervention control condition. The full-strength model (CORE + FLEX) included child and parent/family components whereas the partial model (CORE-only) offered only the child component. The intervention was delivered over two continuous years. CORE + FLEX children showed higher levels of program attendance than their CORE-only counterparts but no differences on outcomes measures were observed between models. When both program models were collapsed and compared to controls, program children showed significant gains on measures of school adjustment and social competence, the most aggressive program children showed reductions in disruptive behavior, and program parents reported reduced levels of stress.

Can Evidence-Based Prevention Programs be Sustained in Community Practice Settings? The Early Risers’ Advanced-Stage Effectiveness Trial

This study evaluated institutional sustainability of the Early Risers “Skills for Success” conduct problems prevention program. In a previous early-stage effectiveness trial Early Risers had been successfully implemented by a nonprofit community agency with guidance, supervision, technical assistance and fiscal support/oversight provided by program developers. The current advanced-stage effectiveness trial applied a randomized, control group design to determine whether this community agency could replicate earlier positive findings with a new cohort of participants, but with less direct involvement of program developers. An intent-to-intervene strategy was used to compare children randomly assigned to Early Risers or a no-intervention comparison group. Compared to results obtained in an early-stage effectiveness trial, program attendance rates were much lower and only one positive outcome was replicated. Failure to replicate program effects was not attributed to poor program implementation, because data collected pertaining to exposure, adherence and quality of delivery were acceptable, and a participation analysis showed that families who attended at higher levels did benefit. It was difficulties that the community agency experienced in engaging families in program components at recommended levels that primarily accounted for the results. Possible organizational barriers that impeded sustainability included unreliable transportation, poor collaboration between the agency and the local public school system, high staff turnover, agency downsizing, and fiduciary responsibility and accountability. It was concluded that both program developers and program providers need to be proactive in planning for sustainability.

School-based secondary prevention for children with disruptive behavior: Initial outcomes

First through fourth graders from 22 suburban elementary schools were screened for cross-setting disruptive behavior as eligibility criteria for participation in a longitudinal secondary prevention study aimed at reducing the risk for serious externalizing behavioral disorders. Three hundred nine subjects participated in either a multicomponent competence enhancement intervention (MCEI) or an information/attention control (IAC) condition over a 2-year period. Following baseline measurements, initial intervention effects were assessed at the end of intervention Year 1, at the beginning of intervention Year 2 (fall of the next school year), and at the end of intervention Year 2. Multisource assessments were not supportive of the efficacy of the MCEI over the IAC condition. Children in both groups rated themselves as improved over time in terms of increased adaptive skills and decreased school problems and internalizing symptoms. Teacher and parent ratings of externalizing behavior did not yield evidence of positive change, but teachers noted improved problem solving and observers noted a decrease in behavioral interference in both groups over time, possibly as a result of maturation.

Processing of emotional information in children with attention‐deficit hyperactivity disorder

A possible etiological factor for the social disability described in children with attention‐deficit hyperactivity disorder (ADHD) is a deficit in the ability to accurately evaluate emotional stimuli. Children with ADHD were compared to normal controls on a battery of emotional processing. This battery, the Minnesota Tests of Affective Processing (MNTAP), measures face perception and recognition of affective stimuli as conveyed via facial expression, language, and speech prosody. Overall, children with ADHD were found to be no different from normal children in their ability to process emotional cues. A subgroup of younger children with ADHD were found to have modest difficulties on a test of decoding facial affective stimuli. Significant differences were found between ADHD and normal control groups on those tasks requiring complex auditory processing and extensive use of working memory. Additional analyses found significant effects on affective processing for children with nonverbal impairment We conclude...

Fidelity at a Distance: Assessing Implementation Fidelity of the Early Risers Prevention Program in a Going-to-Scale Intervention Trial

The present study examined the feasibility of an innovative technology designed to assess implementation fidelity of the Early Risers conduct problems prevention program across 27 geographically dispersed school sites. A multidimensional construct of fidelity was used to assess the quantity of services provided (exposure), the degree to which program strategies conformed to the manual (adherence), and how well implementers delivered the program (quality of delivery). The measurement technology featured a fidelity monitoring system that required (a) weekly reporting on a web-based documentation system to assess program exposure and adherence, and (b) five annually administered telephone interviews with a technical assistant to assess quality of program implementation. The results showed that the fidelity monitoring system was feasible, with all sites achieving 100% compliance in completion of their required on-line reporting and on average over 80% of the required teleconference interviews. User feedback indicated satisfaction with the web-based program. The system was successful in measuring multiple indices of fidelity. The strengths and limitations of measuring fidelity at a distance with web-based and teleconferencing technologies are discussed.

The early risers longitudinal prevention trial: examination of 3-year outcomes in aggressive children with intent-to-treat and as-intended analyses.

The effects of participation following a 3-year preventive intervention trial targeting elementary school children with early-onset aggressive behavior were evaluated. Intent-to-treat analyses revealed that program participants, compared with controls, showed greater gains in social skills, academic achievement, and parent discipline, with mean scores in the normative range on the latter two constructs. As-intended participation in the Family Program, which included separate parent and child education and skills-training groups, was associated with improved parent discipline practices and gains in childrens social skills, with level of child aggression moderating gains in academic achievement. Recommended level of FLEX family support contact time was associated with gains in academic achievement, concentration problems, and social skills, with parents of severely aggressive children showing greater reductions in parent distress.

Identifying Unmet Mental Health Needs in Children of Formerly Homeless Mothers Living in a Supportive Housing Community Sector of Care

This study reports psychosocial characteristics of a sample of 111 children (K to 2nd grade) and their mothers who were living in urban supportive housings. The aim of this study was to document the various types and degree of risk endemic to this population. First, we describe the psychosocial characteristics of this homeless sample. Second, we compared this homeless sample with a grade-matched, high-risk, school-based sample of children (n = 146) who were identified as showing early symptoms of disruptive behaviors. Third, we compared the parents in both samples on mental health, parenting practices, and service utilization. Results showed that children living in supportive housing were in the at-risk range and had comparable levels of externalizing problems, internalizing problems, school problems and emotional strengths with the school-based risk sample receiving prevention services at a family support community agency. Mothers in supportive housing reported significantly higher psychological distress, less optimal parenting practices and greater service utilization. These findings are among the first to provide empircal support for the need to deliver prevention interventions in community sectors of care.

Measuring family functioning with the MMPI: a reliability and concurrent validity study of three MMPI family scales.

Examined the utility of three MMPI family scales. Three MMPI family scales and three criterion family scales were administered to 110 undergraduates. Internal consistency coefficients were calculated for each MMPI family scale. Relationships between the MMPI family scales and the criterion scales are examined by a correlational analysis. Findings suggest that the MMPI family scales are reliable and concurrently valid measures of an individuals perception of interpersonal family relationships. Procedures for scoring and interpreting the MMPI family scales are examined. The findings also indicate which MMPI family scale is the overall best scale.