A new Finnish study finds that Internet- and telephone-assisted training for parents can be an effective approach for reducing disruptive behavior in children at age 4, according to a new study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).
Positive long-term outcomes after a 24-month period include a reduction in child disruptive behavior and increased parental skills.
Untreated disruptive behavior disorders in children are some of the most costly early childhood psychiatric disorders. A number of studies have shown that this type of behavior can lead to long-term harmful outcomes, including mental and physical health problems, crime, substance abuse and increased risk of suicidality later in life.
Although parental training is one of the most effective approaches for the psychosocial treatment of disruptive behavioral problems in young children, no previous randomized controlled trial has been conducted on an intervention offering remote or internet-assisted parental training and population-based screening.
The new study reports on two-year outcomes from preschool children with disruptive behavioral problems who were randomized to receive either an 11-week Internet-assisted parental training or an educational control condition.
Altogether, 730 of the 4,656 four-year-old children who attended annual child health clinic check-ups in southwest Finland met the criteria for high level disruptive behavioral problems. A total of 464 parents took part in the 11-week Strongest Families Smart Website (SFSW) intervention program, or an educational control (EC) group.
When the SFSW and EC groups were compared between baseline and after the 24-month follow-up, the findings showed significantly higher improvements in the SFSW group.
In addition, most of the child psychopathology measures, including aggression, sleep problems, anxiety and other emotional problems decreased significantly more in the SFSW group than in the EC group. Similarly, parental skills increased more in the SFSW group than in the EC group.
The findings also show that the SFSW children made significantly less use of child mental health services than the EC group during the 24-month follow-up period (17.5 percent vs. 28.0 percent).
“Our findings address some key public health challenges in delivering parent training programs,” said lead author Andre Sourander, M.D., Ph.D., of the University of Turku, Finland, and leader of the research group.
“When traditional parental training requires referral to clinical services, it often results in substantial delays, and older children are more likely to require adjunctive treatment to parental training.”
“Studies have identified that Internet-assisted treatment programs may offer certain benefits over traditional interventions: these include high levels of support, greater accessibility, convenience and reduced costs.”