Background: Controlled evaluations of psychosocial interventions for young children with behavioural problems are sparse. However, in a series of experimental studies, professor Webster- Stratton and her collaborators in Seattle have examined the effects of various forms of parent and child therapy for 4-8 year-old children with aggressive and noncompliant behaviours. In the studies various forms of basic parent and child training have been compared to waiting-list controls, a more comprehensive parent training program, and in addition to a school-based (teacher) intervention. No previous replications have been made in Scandinavia, but two such studies have been conducted in Canada and one recently in England, both with positive outcomes.
Aims and study design: To replicate one of Webster-Stratton's studies comparing the basic training program for parents, PT (12 sessions) with parent training and child therapy, PT+CT("The Dinosaur School")(18 sessions) and waiting-list controls,WLC in an experimental study including a total of 127 Norwegian children aged 4-8 years. 99 families were randomized into each of the active treatment groups and 28 families to the waiting-list. To examine the maintenance of treatment effects follow-up measures were performed one year after treatment, in addition to generalisation of treatment effects from home to school settings.
Measures: After screening for children' s noncompliant and aggressive behaviours as rated by parents and teachers (Eyberg Child Behavior Inventory-EBCI), parents of children with high scores were interviewed to obtain psychiatric diagnoses of either oppositional defiant disorder (ODD) or conduct disorder (CD). Parents rated their practices, involvement in child care and rearing disagreement, in addition to their own anger, depression and stress. Observations of child and parent interaction were made at home and in the clinic. In the school and preschool the children's behavioural problems were observed and compared with children with no such problems. The child reported on its feelings of loneliness and took a problem-solving test. School and day care teachers assessed the children' s behaviour and social competence, in addition to their own home involvement.
Implementation and intervention: The planning of the project started 1998 and has been subjected to an evaluation by the Norwegian Research Council before implementation. Extensive contacts were established with professor Carolyn Webster-Stratton, who helped training of therapists and the mentor. Because no normative data existed for the screening measure (EBCI), it was first standardised in a survey including about 640 children aged 4-8 years from Trondheim and Tromsø, later expanded to 4014. Many of the assessment instruments and the video vignettes were translated into Norwegian.
Since the fall of 200l recruitment of children and families has taken place. Treatment is administered to parents and children in groups over a 3-4 rnonth period. Two therapists conduct the group treatment, which is highly structured and manual.
Main results. Some differences between groups: The PT and PT+CT improved significantly better than WLC, measured by ECBI Intensity score. The same results were obtained measured with CBCL Total score, Externalizing score and Aggression score. There were no differences between the groups measured with CBCL Delinquency score probably due to the children's low age. Interesting enough, the same findings were found in CBCL Internalizing score. The amount of positive parenting and monitoring increased in the active treatment groups, negative parenting and inconsistent parenting decreased significantly compared to control measured with PPI (Parenting Practices Interview). We found a decrease in TRF Total score and Externalizing score (Teacher Report Form) indicating a generalization effect from home to school.
The results are under preparation for publication.