Paul Kelly

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

OBJECTIVE A community-based randomized controlled trial (RCT) was conducted in urban areas characterized by high levels of disadvantage to test the effectiveness of the Incredible Years BASIC parent training program (IYBP) for children with behavioral problems. Potential moderators of intervention effects on child behavioral outcomes were also explored. METHOD Families were included if the child (aged 32-88 months) scored above a clinical cutoff on the Eyberg Child Behavior Inventory (ECBI). Participants (n = 149) were randomly allocated on a 2:1 ratio to an intervention group (n = 103) or a waiting-list control group (n = 46). Child behavior, parenting skills, and parent well-being were assessed at baseline and 6 months later using parent-report and independent observations. An intention-to-treat analysis of covariance was used to examine postintervention differences between groups. RESULTS Statistically significant differences in child disordered behavior favored the intervention group on the ECBI Intensity (effect size = 0.7, p < .001) and Problem subscales (effect size = 0.75, p < .001). Intervention effects on child hyperactive-inattentive behaviors and social competence, as well as parent competencies and well-being, were also found. Moderator analyses showed that the effects of the IYBP intervention on the primary child outcomes were not moderated by child or family demographic characteristics or risk factors. CONCLUSION The results demonstrate the effectiveness of the IYBP in alleviating problem behavior among children and in improving well-being among families living in disadvantaged areas. The findings also highlight the importance of parental intervention in early childhood for parents and children most in need of support.

A cost-effectiveness analysis of the Incredible Years parenting programme in reducing childhood health inequalities

Early onset of behavioural problems has lasting negative effects on a broad range of lifetime outcomes, placing large costs on individuals, families and society. A number of researchers and policy makers have argued that early interventions aimed at supporting the family is the most effective way of tackling child behaviour problems. This study forms the economic component of a randomised evaluation of the Incredible Years programme, a programme aimed at improving the skills and parenting strategies of parents of children with conduct problems. Our results show that the programme provides a cost-effective way of reducing behavioural problems. Furthermore, our cost analysis, when combined with a consideration of the potential long-run benefits, suggests that investment in such programmes may generate favourable long-run economic returns.

Ongoing cocaine and benzodiazepine use: effects on acquisitive crime committal rates amongst opiate users in treatment.

Aims: Research has shown that treatment for opiate use reduces crime, however the extent to which this is maintained is open to question. The objective of this study was to measure the relationship between crime committal rates and ongoing benzodiazepine and cocaine use by clients in opiate drug treatment programs. Methods: A national, prospective, longitudinal, multi-site drug treatment outcome study was conducted, 404 participants were recruited from inpatient and outpatient settings and 97% were located at 3 years. Drug use and crimes committed were ascertained from the Maudsley Addiction Profile of Marsden et al. [Marsden, J., Gossop, M., Stewart, D., Best, D., Farrell, M., Lehmann, P., … Strang, J. (1998). The Maudsley Addiction Profile (MAP): A brief instrument for assessing treatment outcome. Addiction, 93, 1857–1867]. Findings: Analysis revealed that of those who had not committed an acquisitive crime at intake, those who used cocaine regularly at 1-year were 6.5 times more likely and those that used benzodiazepines regularly were eight times more likely to commit an acquisitive crime at 1-year. Of those who had committed an acquisitive crime at intake, those who used heroin regularly at 1-year were nine times more likely to commit acquisitive crime at 1-year than those who did not use heroin regularly at 1 year. Conclusions: Treatment must place greater emphasis on reducing substitute drug use if opiate treatment is to effectively sustain crime reduction.

Exploring the effects of a universal classroom management training programme on teacher and child behaviour: a group randomised controlled trial and cost analysis

Teachers frequently struggle to cope with conduct problems in the classroom. The aim of this study was to assess the effectiveness of the Incredible Years Teacher Classroom Management Training Programme for improving teacher competencies and child adjustment. The study involved a group randomised controlled trial which included 22 teachers and 217 children (102 boys and 115 girls). The average age of children included in the study was 5.3 years (standard deviation = 0.89). Teachers were randomly allocated to an intervention group (n = 11 teachers; 110 children) or a waiting-list control group (n = 11; 107 children). The sample also included 63 ‘high-risk’ children (33 intervention; 30 control), who scored above the cut-off (>12) on the Strengths and Difficulties Questionnaire for abnormal socioemotional and behavioural difficulties. Teacher and child behaviours were assessed at baseline and 6 months later using psychometric and observational measures. Programme delivery costs were also analysed. Results showed positive changes in teachers’ self-reported use of positive classroom management strategies (effect size = 0.56), as well as negative classroom management strategies (effect size = −0.43). Teacher reports also highlight improvements in the classroom behaviour of the high-risk group of children, while the estimated cost of delivering the Incredible Years Teacher Classroom Management Training Programme was modest. However, analyses of teacher and child observations were largely non-significant. A need for further research exploring the effectiveness and cost-effectiveness of the Incredible Years Teacher Classroom Management Training Programme is indicated.

A mixed-methods evaluation of the longer-term implementation and utility of a teacher classroom management training programme in Irish primary schools

Inappropriate, aggressive and disruptive behaviour in the classroom can be detrimental to child and teacher well-being. This study involved a longer-term evaluation of the Incredible Years Teacher [Classroom Management] programme (IYTP) undertaken mainly within disadvantaged schools in south-west Ireland. The IYTP is designed to strengthen teacher classroom management competencies. Eleven teachers, who had previously participated in a group-randomised control trial (RCT), took part in a 12-month post-baseline follow-up assessment. Psychometric and observational measures were administered to assess teachers when interacting with children (n = 217) in their classes. Qualitative data were collected from a sub-sample of teachers to explore their perceptions of programme impact and utility. The quantitative results showed some significant improvements in teachers’ classroom management, although few changes were recorded on teacher-child observation measures. Qualitative findings indicated continued implementation of proactive disciplining strategies and higher levels of teacher self-efficacy. These results suggest, albeit tentatively in view of the study limitations, that the IYTP can benefit teacher classroom management, as well as teacher well-being, particularly within disadvantaged schools where behavioural problems tend to be more prevalent. The IYTP could prove useful in improving teacher competencies and the classroom environment in the longer term, although a need for further research is indicated.