Developmental Models

1
Fast Track A
Multi-Component, Longitudinal Prevention Program
Targeting Early-Starting Conduct
Problems Conduct Problems Prevention Research
Group
Karen L. Bierman, Mark T. Greenberg, E. Michael
Foster, Linda M. Collins Pennsylvania State
University Kenneth A. Dodge John D.
Coie Duke University John E. Lochman University
of Alabama Robert J. McMahon University of
Washington Ellen E. Pinderhughes Tufts
University Fast Track is funded by the National
Institute of Mental Health with additional
support from the National Institute on Drug
Abuse, the Department of Education, and the
Center for Substance Abuse Prevention.
TIT
2
GOALS OF PRESENTATION

• Describe the prevention science approach How
  developmental research on early starting
  conduct problems informed the Fast Track
  prevention program
• Explain the Fast Track intervention components
  and research design
• Provide an update on Fast Track effects through
  middle childhood, and illustrate effects on
  developmental trajectories
• Demonstrate how the Fast Track longitudinal
  design identifies links between targeted
  protective competencies and reductions in later
  risk

DEM5
3
Early StarterDevelopmental Pathway

• Preschool/Early
• School-age Onset
• Overt And Covert Behaviors
• High Degree Of Continuity
• Poor Prognosis

DEM2
4
Developmental Research Risk and Protective
Factors

• Based upon longitudinal studies
• Risk factors increase the chance of mental
  (behavioral and emotional) disorders
• Protective factors buffer the effects of risk
  factors
• Effective prevention programs reduce exposure to
  risk factors and increase access to protective
  factors

5
Developmental Model

• Preschool Years
• Early Child, Family, Community Factors
• Contribute to
• Cross-situational Conduct Problems at School
  Entry
• Elementary Years
• Ineffective Parenting
• Inadequate Home-School Communication
• Aggressive-Disruptive Behavior at School
  Home
• Disruptive Class Environment
• Low Academic Achievement
• Poor Social Competence Poor Peer Relations
• Adolescence

DEM1a
6
Implications of the Developmental Model for
Intervention Design

• Multiple Skill Domains
• Multiple Socialization Support Systems
• Sustained,
• Well-integrated
• Developmentally And Culturally Informed

DEM5
7
Prevention Model

• Target High-Risk Schools and Select First Graders
  
• With Pervasive Conduct Problems
• Promote Competency in
• Academic Achievement
• Child Coping/Problem Solving
• Peer Relations
• Parenting and Socialization
• Home-School Partnership
• Classroom Atmosphere

INT1
8
AREAS OF INTERVENTION(ELEMENTARY SCHOOL PHASE)
Academic Achievement
Peer Relations
Child Coping/ Problem- Solving
Home-School Partnership
Parenting Socialization
Classroom Atmosphere
INT4
9
INTERVENTION COMPONENTS (ELEMENTARY SCHOOL PHASE)
Family
School

• PATHS
• Tutoring
• Peer Pairing

• Home Visiting

Enrichment Program

• Parent Groups
• Friendship Groups
• Parent-Child
• Sharing Time

INT5
10
Study Participants

• N 891
• Behavioral and adjustment problems at home and
  school when screened in kindergarten
• Approximately 47 European-American, 51
  African-American, 3 Other ethnic groups
• 69 BOYS 31 GIRLS
• Economically disadvantaged, multi-stressed
  families
• Randomized, controlled design (by school)

RD3
11
Assessment Model

• Annual Assessments
• Multiple Informants
  (Parent, Teacher, Youth, Peers)
• Multiple Methods
  (Ratings, Direct Observations, Achievement
  Tests, Psychiatric Interviews, Sociometrics,
  School Records, Court Records)
• Standard Measures Shared with Other National
  Studies
• (CBC/TRF/YSR, National Youth Survey,
  C-DISC-4, SACA)

ADOL9a
12
INTERVENTION
IMPLEMENTATION
OUTG3-4
13
End of Grade 1 INTERVENTION EFFECTS
Promoting Emotional and Social Understanding
Emotion Recognition (.54) Emotion
Coping (.25) Social Problem-solving (.33) Aggre
ssive Retaliation (.23) Promoting Language and
Reading Skills Word Attack Skills (.56) Languag
e Arts Grades (.29)
14
End of Grade 1 INTERVENTION EFFECTS
Promoting Parenting Skills Parent Report of
Change (.70) Physical Punishment
(.23) Positive Parent-Child Interaction
(.37) Promoting Positive Peer RelationsObserved
Positive Peer Interaction (.27) Peer Social
Preference (.28)
OUTG3-4
15
End of Grade 3
INTERVENTION EFFECTS
Promoting Emotional and Social Understanding
Social Problem-solving (.14)Aggressive
Retaliation (.14) Promoting Language and Reading
SkillsSpecial Education (.14) Promoting
Parenting Skills Parent Report of
Change (.20)Physical Punishment (.19) Promoting
Positive Peer RelationsChild Prosocial
(.27)
16
Reducing Aggressive BehaviorINTERVENTION
EFFECTS
Context Grade Effect size Grade
1 Observer rating _at_ home .34 Observer rating _at_
school .31 Grade 3 Parent rating
(PDR) .15 Teacher rating (TOCA) .19
OUTG3-4
17
Middle Childhood Outcomes (End of
Grade 4)Parent Daily Report of Child Aggression
OUTG3-4
18
Middle Childhood Outcomes (End of
Grade 4) Peer Social
Preference
OUTG3-4
19
Middle Childhood Outcomes (End of
Grade 4) Deviant Peer Affiliation
OUTG3-4
20
Examining Change Over Time

• Examine the impact of preventive interventions on
  developmental trajectories
• Identify sub-groups who may be most responsive
  to the preventive intervention

INT15
21
INTERVENTION EFFECTSOVER TIMESurvivor Function
for Grade at First IEP (Journal of Abnormal
Child Psychology, 2002b)
22
INTERVENTION EFFECTSOVER TIMESix-Year
Trajectory Class Proportions (2002, unpublished)
23
Understanding Mechanisms of
Change

• Test models regarding the mechanisms and
  mediators of change
• Identify moderators of intervention impact
• Foster a fuller understanding of developmental
  processes associated with mental illness/mental
  health
• Clarify the impact of dose and fidelity on
  intervention outcomes

INT15
24
MEDIATION OF INTERVENTIONEFFECT ON CHILD
AGGRESSION (Development Psychopathology, in
press)
Intervention (YES or NO)
Grade 4 PDR Aggression
Grade 3 Mediators
Parent Behavior Change Special Education
Placement Child Aggression Gr.3
25
MEDIATION OF INTERVENTIONEFFECT ON CHILD SOCIAL
PREFERENCE (Development Psychopathology, in
press)
Intervention (YES or NO)
Grade 4 Social Preference
Grade 3 Mediators
Prosocial Behavior Classroom Aggression
26
MEDIATION OF NTERVENTIONEFFECT ON DEVIANT PEER
AFFILIATION (Development Psychopathology, in
press)
Intervention (YES or NO)
Grade 4 Peer Deviance

Grade 3 Mediators Hostile Attributions Toward
Peers
27
Conclusions

• The Fast Track preventive components were
  derived from longitudinal research documenting
  risk factors and protective factors in the
  developmental course of conduct disorders.
• Fast Track involves school-based curricula that
  provide direct instruction and support for child
  skill development , coordinated with teacher and
  parent training to enhance support for child
  competencies across settings.

28
Conclusions

• In a randomized trial currently underway, the
  Fast Track program has successfully promoted key
  child and family competencies child emotional
  and social understanding, language and reading
  skills, parenting skills, and positive peer
  relations.
• Increases in these protective competencies are
  related directly to improved developmental
  trajectories with reductions in aggressive
  behavior and improvements in positive social
  adjustment.
• Our expectation (and preliminary analyses)
  suggest significant decreases in adolescent
  conduct disorder will follow.