Multisite Prevention of Conduct Problems (Fast Track)

This study is a comprehensive intervention project designed to look at how children develop
across their lives by providing academic tutoring and lessons in developing social skills and
regulating their behaviors. There can be multiple stressors and influences on children and
families that increase their risk levels. In such contexts, some families that experience
marital conflict and instability can cause inconsistent and ineffective parenting. These
children can sometimes enter school poorly prepared for the social, emotional, and cognitive
demands of this setting. Often the child will then attend a school with a high number of
other children who are similarly unprepared and are negatively influenced by disruptive
classroom situations and punitive teacher practices. Over time, children in these
circumstances tend to demonstrate particular behaviors, are rejected by families and peers,
and tend to receive less support from teachers, further increasing aggressive exchanges and
academic difficulties. Thus, this project is based on the hypothesis that improving child
competencies, parenting effectiveness, school context and school-home communications will,
over time, contribute to preventing certain behaviors across the period from early childhood
through adolescence.

Four geographic sites were selected for the study: Durham, NC, a small city with a large
low-income population that is primarily African American; Nashville, TN, a moderated-sized
city with a mix of low-to-middle income and African American and European-American
population; Seattle, WA, a moderate-sized city with a low-to-middle ethnically diverse
population; and central PA, a mostly rural area with low-to-middle income European American
population. These sites varied widely in ethnicity (most minorities were African American,
with some Latino) and poverty (as measured by free/reduced lunch rates) as follows: Durham,
NC, 90% minority and 80% reduced lunch; Nashville, TN, 54% minority and 78% reduced lunch;
rural PA; 1% minority and 39% reduced lunch; and Seattle, WA, 52% minority and 46% reduced
lunch. "High risk" schools within each site (12 in Durham, 9 in Nashville, 18 in PA, and 16
in Seattle) were selected based on crime and poverty statistics of the communities that they
served. Within each site, schools were divided into one to three paired sets matched for
demographics (size, percentage free or reduced lunch, and ethnic composition), and one set
within each pair was randomly assigned to intervention and one to control condition. Students
at these elementary schools moved into middle school at grade 5, 6 or 7. A multiple-gating
screening procedure that combined teacher and parent ratings of disruptive behavior was
applied to all kindergarteners across three cohorts (1991-93) in these 55 schools. Children
were screened initially for classroom conduct problems by teachers, using the Teacher
Observation of Child Adjustment-Revised (TOCA-R) Authority Acceptance Score. Those children
scoring in the top 40% within cohort and site were then solicited for the next stage of
screening for home behavior problems by the parents, using a novel 22-item instrument that
included items from the Child Behavior Checklist (Achenbach, 1991a), the Revised Behavior
Problem Checklist, and novel items that we created for this study. 91% (n=3,274) completed
the home-behavior screen. The teacher and parent screening scores were then standardized
within site, based on screening a representative sample of approximately 100 children within
each site (which also served as a normative comparison), and then summed to yield a total
severity-of-risk screen score. Children were selected for inclusion into this study based on
this screen score, moving from the highest score downward until desired sample sizes were
reached within sites, cohorts, and conditions. Exceptions to this inclusion rule were made
when a child failed to matriculate in the first grade at a core school (n=59) or refused to
participate (n=75), or to accommodate a superceding rule that no child would be the only
female in an intervention group. The outcome was that three successive cohorts were recruited
in 1991, 1992, and 1993 to yield a sample of 891 children (445 in the intervention group and
446 in the control group).

Inclusion Criteria:

- must be in public schools in 4 study sites

- must be in 1st grade

Exclusion Criteria:

- cannot be older than 1st grade

- could not score in the top 40% on the TOCA-R