Preventie van agressie en gedragsstoornissen bij basisschoolkinderen door middel van een geïntegreerde set van universele, selectieve en geïndiceerde interventies
01 / 2002 - onbekend
Database Zorg Onderzoek Nederland ZON
The overall aim of the interventions in this programme is to divert the developmental pathways of elementary school children at risk for high levels of aggression and conduct disorder and subsequently for substance abuse through a set of universal interventions (behavioral management program in classroom and playground, social skills training) followed by a selective intervention (parent-management training) followed by an indicated intervention (social skills training and cognitive behavioral therapy integrated with parent-management training) towards lower level. Childhood aggression is a strong predictor of later antisocial and criminal behavior, and substance abuse (e.g. Farrington, 1991; Huesmann, Eron, & Yarmel, 1987; Loeber, 1990). The more serious and the greater the variety and frequency of early aggressive behavior, the greater the risk that antisocial and criminal behavior will continue into later adolescence and adulthood (Blumstein, Farrington & Moitra, 1995). Farrington (1991), forinstance, reported that boys rated by teachers as aggressive in childhood and adolescence were more likely than non-aggressive boys to smoke and drink heavily, to drive drunk, and to commit more criminal offences as adults. High-aggressive children were also more often diagnosed as conduct disordered later in life. Antisocial behavior in children at risk for conduct disorder is typically a chronic pattern of psychopathology that is highly stable over time and that further along the trajectory o conduct disorder (e.g. Loeber, 1990; Loeber, Wung, Keenan, Giroux, & et al., 1993). Children or adolescents with conduct problems may exhibit some of the following behaviors: aggression to people and animals, destruction of property, deceitfulness, lying, or stealing, serious violations of rules. The prevalence of conduct disorder at age 6-7 is 4-10%. In the proposed study, a systematic attempt will be made to divert the developmental trajectories of aggressive children towards lower levels of aggression thereby reducing subsequent risks for high aggression, conduct disorder and substance abuse. However, different from previous studies, an integrated set of universal, selective and indicated interventions will be carried out in sequential order. The response to a previous intervention is thereby used to understand the recruitment, participation and response to the next intervention. Screening-instruments at the beginning and the end of each intervention phase will identify (non-)responders and their characteristics. This will allow for a rational and cost-effective use of the different types of interventions in the future. The aim of the proposed program is to divert the developmental pathway of children at risk for high levels of aggression and conduct disorder towards lower levels of risk through an integrated set of universal, selective and indicated interventions. Interventions were chosen on the premise that the levels of aggression in a population can be reduced by improving the behavioural management techniques and quality of child-rearing practices of those who are in interaction with children. Therefore, the study focuses firstly on teachers in elementary school, secondly on parents, and only then on mental health professionals. Further, the integrated set of interventions is presented to the children in sequential order. The reasons for this are twofold: the interventions are increasingly demanding in terms of costs and manpower, and the (non-) response to one intervention can de used to understand the response to subsequent intervention. The entire study will be called "Project Spelregels" (PS).