Tuesday, September 16, 2014

Early Intervention in At-Risk Children Can Reduce Psychiatric Problems in Adulthood.


Early and sustained intervention of children with conduct problems can lower the chances that those problems will extend into adulthood, reports a new study published in AJP in Advance titled “Impact of Early Intervention on Psychopathology, Crime, and Well-Being at Age 25.”

Known as Fast Track, this project enrolled kindergarteners who displayed aggressive or disruptive behaviors into a multi-component, 10-year, manualized program aimed at instilling social competencies that would extend throughout their lifetimes "through social skills training, parent behavior-management training with home visiting, peer coaching, reading tutoring, and classroom social-emotional curricula," the researchers noted. The program took place in four communities: Durham, N.C., Nashville, Seattle, and rural Pennsylvania. A similar set of at-risk children receiving only the standard interventions in their community were followed as a control group.

There has not been much evidence showing that behavioral improvements in children translate into adulthood, but so far, the Fast Track study seems to suggests that such an intervention can have an impact, finding that while 69% of the adults in the control group displaying at least one psychiatric problem at age 25, only 59% of Fast Track participants displayed a psychiatric problem at the same age. Fast Track participants also displayed decreased rates of substance abuse crimes, violent crimes, and risky sexual behavior compared with controls, as well as higher levels of happiness and well-being.

“This shows that we can go a full eight years after last seeing these children and still see reductions in the rates of problem outcomes for this group as young adults,” said study author Kenneth Dodge, Ph.D., director of the Center for Child and Family Policy at Duke University.

The improvements in behavior were consistent among each of the 13 subgroups assessed (including those defined by gender, ethnicity, study site, etc.), demonstrating that this approach has potential for a wide range of children and risk levels.

To read about a promising early-intervention effort with children in Australia, known as Headspace, see the Psychiatric News article “Australian Youth Get a ‘Soft Entry’ Into Mental Health System.”

(image: PathDoc/Shutterstock)