The Fast Track Intervention Trial to Prevent Antisocial Behavior
Conduct Problems Prevent Research Group
The Issue
The risk factors that contribute to the development of serious behavior disorders have been known for many years. For many children, treatment of oppositional defiant disorder (ODD), conduct disorder (CD), and attention deficit hyperactivity disorder (AD/HD) may, in some cases, have only limited success. Treatment is costly and resources in many areas are scarce, putting it out of reach of many families. It would be far better to attempt to prevent these problems from starting, than waiting until they are established. Prevention would reduce suffering in the children and their families and reduce the negative social consequences for communities.
The Research
The Fast Track Program is a long-term intervention with the aim of preventing antisocial behavior and psychiatric disorders in children and youth. It consists of several parts: parent training, social skills and social understanding training, reading tutoring, child and youth mentoring, home visitation, and classroom programming given to all students not just those at risk for problem behaviours. The program started with a screening of all kindergartners in schools in four American cities who were identified as being high risk institutions because of both local crime and poverty levels. Children who were considered at moderate or high risk of developing behavior problems were randomly assigned to receive either the Fast Track Program or to serve as the control group. The data from a low-risk group of children were used to determine how strong the effect of the intervention was. The study looked at diagnoses made of AD/HD, CD, ODD, or other antisocial behaviour, after grades 3, 6, and 9.
The Outcome
Only the high-risk children got significant benefit from the program. The effects were found by grade 3 in some children and were maintained through to grade 9. Their risk for CD was reduced by 75%, for ADHD by 53%, and by 43% for all psychiatric disorders related to antisocial behavior.
Conclusions
This study demonstrated that a high-quality, multi-component intervention can reduce the likelihood that high-risk children will develop serious behavior disorders. Screening is essential to identify those at high risk since those at moderate risk did not benefit.
The preceding is a summary of:
The preceding is a summary of: The Conduct Problems Prevention Research Group. Fast Track fandomized controlled trial to prevent exernalizing psychiatric disorders: Findings from Grades 3 to 9. Journal of the American Academy of Child and Adolescent Psychiatry. 2007; 46(10): 1250-1262.
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