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 These disorders, which include behaviors such as temper tantrums,
interpersonal aggression and defiance, impact an estimated 3.5
percent of kids and teens, researchers note in the journal
Pediatrics.
In their analysis of previous studies of interventions, they found
that while any therapy was better than none, the children didn’t
respond as well to treatment on their own as they did to approaches
focused on their parents.
“Common sense and research evidence suggest that parent involvement
is important to a wide range of psychosocial interventions for
children, not just those aimed at alleviating disruptive child
behavior,” said lead author Richard Epstein, a research fellow at
the Chapin Hall Center for Children at the University of Chicago,
who did the analysis while at Vanderbilt University in Nashville.
Parents had the biggest impact on the outcomes of therapy for
preschoolers and for kids in elementary school, rather than for
teenagers, the study found.
Many studies included in the analysis lacked outcomes data from
independent observations of children by researchers who didn’t know
what type of treatment the kids received, the authors acknowledge.
And few of the studies directly examined child-only approaches.
Even so, the authors conclude that parent involvement, either alone
or in combination with other components of therapy, is more likely
to help children improve their behavior than leaving parents out of
the mix.
“Disruptive child behavior doesn’t occur in a vacuum, and
parent-child interactions are the primary context within which child
development unfolds,” Jonathan Comer, a researcher at the Center for
Children and Families at Florida International University in Miami,
said by email.
“When it comes to treating child defiance, aggression, and other
related symptoms, you just don’t get much traction without working
on how the adults in children’s lives respond to children’s
disruptive behaviors,” Comer added by email.
The findings should offer some reassurance to parents who want to
try therapy for their children before turning to medication to
address behavioral disorders, noted Daniel Bagner, also of the
Center for Children and Families.
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“While medication can sometimes be helpful when problems are complex
and include extremely challenging behaviors (e.g. severe
aggression), it should only be used in conjunction with psychosocial
treatment,” Bagner, who wasn’t involved in the study, said by email.
Parents can make therapy more successful for their children because
when kids are treated on their own, the lessons may be hard for them
to apply in the settings where they have behavior problems, like
home, school or the playground, said Ricardo Eiraldi, a researcher
in pediatric psychology at the University of Pennsylvania Perelman
School of Medicine in Philadelphia.
When parents are involved, therapy can help them learn behavior
management strategies to help their children improve, Eiraldi, who
wasn’t involved in the study, added by email. Successful approaches
might include praise for good behavior, ignoring minor misbehavior,
giving effective commands, and letting the child earn rewards for
behaving according to expectations, he said.
The paper also offers more evidence that parents can help kids most
by getting involved in therapy sooner, Matt Burkey, a researcher at
Johns Hopkins University who wasn’t involved in the study, said by
email.
“The findings of this analysis support the idea that earlier
interventions, especially in the preschool period, are more
effective,” Burkey said. “Once children are older, parents have
somewhat less influence over children’s behavior.”
SOURCE: http://bit.ly/1kmZFpF Pediatrics, online October 19, 2015.
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