A preventive intervention for disruptive boys. 15 year follow-up.
Boisjoli R, Vitaro F, LaCourse E, Barker E, Tremblay R.
The Issue
Young children whose parents have low levels of education and employment have many disadvantages that impact on how well they will do in adulthood. If they are also subjected to harshly critical parenting, they are likely to show aggression and a lack of ability to make and maintain friendships with other children. Young children who behave badly tend to be rejected by their more sociable peers. They then begin to associate only with other children who have the same antisocial attitudes. All of these factors mean that they are at increased risk of leaving school early and becoming involved in criminal activity as young adults.
The Research
The study began by identifying kindergarten age boys at risk for poor outcomes because of their disruptive behaviour. The intervention component 1) taught social skills to at-risk boys; 2) provided training in effective child-rearing to their parents; and 3) provided information and support to teachers around the behavior of at-risk children. The study was conducted during two school years beginning in 1984. Most of the kindergarten teachers (87%) in 53 schools in Montreal, Canada rated a total of 1161 boys in their classes, of whom 895 were found eligible for the study. Of these, 250 were rated as being at-risk. The parents of 172 of these boys agreed to participate in the study. All of the other children served as control groups, including those at high risk but whose parents didn’t agree to participate, and those considered low risk because they did not show aggression and difficult behaviours. In 2003, the school and police records of all of the participants were examined to determine rates of high school graduation and arrest.
The Outcome
Nearly half of all the study participants, including both the high-risk and low-risk groups, had earned a high school diploma by age 24, and had similar arrest rates.. However, there were differences between them. At-risk children in the intervention group were more than twice as likely to get a high school diploma compared to at-risk boys who did not participate. The likelihood of having a criminal record was twice as high for the at-risk control group compared to the intervention group.
Conclusions
All of the children who took part in this study had social disadvantages related to low income. If their families had taken part in the intervention, the initially disruptive children had adult outcomes that were similar to their low-risk peers. Further intervention at high school entry might improve their outcomes even more. However, improving the life circumstances of all low income children would improve adult outcomes for many more people.
The preceding is a summary of:
Boisjoli R, Vitaro F, LaCourse E, Barker E, Tremblay R. Impact and clinical significance of a preventive intervention for disruptive boys. British Journal of Psychiatry. 2007; 191: 415-419.
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