ArticleEarly Intervention in Pediatrics Offices for Emerging Disruptive Behavior in Toddlers
Section snippets
Participants
The study was conducted at two sites. The primary site was a 10-provider practice (eight pediatricians and two nurse practitioners) located in a small city in central Massachusetts that serves families from a wide range of socioeconomic status. During a 7-month period, 620 children between the ages of two and three years were scheduled for well-child visits. Of these, 55% (n = 341) completed screening questionnaires and 17% (n = 59) met our criteria for elevated ADHD/ODD symptoms. Forty-three
Parent Outcomes
Mothers reported high levels of satisfaction with the program. All mothers who completed the Parent Satisfaction Questionnaire at the end of the 10 sessions (n = 19) reported that their overall feeling about the program was “positive” or “very positive.” Seventy-nine percent (n = 15) reported being “satisfied” or “greatly satisfied” with their child's progress, and 100% of mothers reported that they would “recommend” or “strongly recommend” the program to a friend. Furthermore, 94% (n = 18)
Discussion
The Report of the Surgeon General's Conference on Children's Mental Health (Department of Health and Human Services Administration, 1999) has cited the prevention of mental health problems among youths as a national priority. We have described a combined screening and parenting education program, PREP, that is consistent with this priority. PREP was designed to capitalize on the multiple opportunities for observation and conversation between pediatricians, nurse practitioners, and parents
Conclusions
This study contributes initial data about the efficacy and feasibility of PREP in two diverse pediatric offices. Despite the promising nature of these findings, it is important to note that the results are preliminary and that this pilot study is not a true test of the long-term viability of PREP. Although the project took place in a real-world community setting, several supports were in place to maximize the program's success. The group leaders were a trained nurse practitioner and
Jannette McMenamy, Associate Professor, Department of Behavioral Sciences, Fitchburg State College, Fitchburg, MA.
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Jannette McMenamy, Associate Professor, Department of Behavioral Sciences, Fitchburg State College, Fitchburg, MA.
R. Christopher Sheldrick, Assistant Professor, Division of Developmental-Behavioral Pediatrics, The Floating Hospital for Children, Tufts University School of Medicine, Boston, MA.
Ellen C. Perrin, Professor, Division of Developmental-Behavioral Pediatrics, The Floating Hospital for Children, Tufts University School of Medicine, Boston, MA.
Conflicts of interest: None to report.
This project was funded by grant 1R21 MH068035-01 from the National Institute of Mental Health and by The Commonwealth Foundation.