Evaluation of a community-based program for young boys at-risk of antisocial behaviour: results and issues.

OBJECTIVE: We assess the impact of a community-based intervention program for boys 6-11 years old at-risk of antisocial behaviour, and compare changes in behaviour and competence pre-post for intervention and wait-list comparison group. METHOD: Interested parents called for enrolment. Inclusion required police contact and/or clinical scores (T>69) on Child Behaviour Checklist (CBCL) or Teacher Report Form (TRF), no developmental delay and English speaking. The program included two core 12-week groups (children's, parents') and optional additional services. Twelve sessions (February 2002-December 2005) provide pre-post intervention data, boys waiting at least 6 months formed a comparison group (starting April 2005). Outcomes included CBCL and TRF behaviour scales (rule-breaking, aggression, conduct, total problems) and competence. Repeated measures analysis of variance was done. RESULTS: Pre-post outcome comparisons indicated improvements among all boys, with significant differences favouring intervention boys on CBCL behaviour scales, but not TRF outcomes. Effect sizes were small to medium. Persisting high post-behaviour levels, unmeasured variation in additional services, and other design and sampling issues are noted. CONCLUSIONS: More rigorously designed program evaluation is required.

Testing effectiveness of a community-based aggression management program for children 7 to 11 years old and their families.

OBJECTIVE: There are few well-evaluated uncomplicated community-based interventions for childhood aggression. The authors assess the impact of a community-based anger management group on child aggressive behaviors, using a randomized, controlled trial (RCT). METHOD: Families with children 7 to 11 years old were recruited through advertisements and randomized (N = 123). Inclusion required parent concern about anger/aggressive behavior, RCT agreement, and a telephone behavior screen. Intervention participants were offered three parent education/skill-building group sessions, 10 weekly child group sessions, and three in-home family practice sessions. Nine groups ran from August 2002 to August 2004. Interviewers naïve to randomization collected data on all participants pre- and postgroup. Outcomes included child-rated anger and parent-rated child aggressive behavior, externalizing behavior and hostility, parent-child relationship, and parenting stress. Intent-to-treat analyses were done. RESULTS: Pre/postoutcome comparisons indicated no significant differences between intervention versus control, with small effect sizes for most outcomes (0.27-0.29). Although not significant, the magnitude of improvement favored intervention families on all parent-rated measures. CONCLUSIONS: Overall, there was no differential impact of participating in a community-based anger management group versus control on child aggressive behaviors and other associated measures. The impact of regression to the mean, effect, and sample size estimates; child comorbidity; and programmatic and methodological issues are discussed.