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  1. Preventive Treatment Program

Preventive Treatment Program

Program Goals/Target Population

The Preventive Treatment Program (also known as the Montreal Longitudinal Study and as the Montreal Prevention Experiment) was a prevention program aimed at disruptive kindergarten boys and their parents, with the goal of reducing short- and long-term antisocial behavior. This program targeted white, Canadian-born, 7- to 9-year-old boys, from low-socioeconomic-status families, who were assessed as having high levels of disruptive behavior in kindergarten. The program provided training for both parents and boys with the long-term goal of decreasing delinquency, substance use, and gang involvement. The program was administered to treatment-group boys and their parents when the boys were 7 years old and lasted until they turned 9.



Program Theory

There is research literature that shows disruptive behavioral patterns that develop during the early school years dramatically increases the risk for later antisocial behavior (Farrington 1991; White et al. 1990). The primary “cause” of antisocial behavior has often been debated, with some arguing that ineffective parenting may lead to antisocial disorders, whereas others suggest genetic and perinatal factors increase the risk of criminality (Tremblay et al. 1995). Interventions that were designed to disrupt the development of antisocial behavior were often single-concentration programs that were either directed at parental practices or children’s social skills, but not both. However, it was proposed that interventions that attempt to change the course of disruptive behavior should concentrate on changing the different sources of influence that affect the development of antisocial behavior (Coie and Jacobs 1993). Based on this prior research, the Preventive Treatment Program was developed as a multimodal approach to reduce antisocial behavior through parent-focused and child-focused components.



Program Components

The program included a home-based parent training component and a school-based social skills training component. The parent-training component was based on a model developed at the Oregon Social Learning Center. Parents received an average of 17 sessions that concentrated on monitoring their children’s behavior, giving positive reinforcement for prosocial behavior, using punishment effectively, and managing family crises. Caseworkers helped parents generalize what they learned through home visits, and teachers were encouraged to cooperate with the intervention.



The school-based component emphasized promoting social competence and emotional regulation by stressing problem-solving skills, life skills, conflict resolution, and self-control. The training was provided in small groups, which included one or two disruptive boys with a group of three to five peers whom teachers identified as prosocial. Interactive learning methods and behavioral management techniques such as coaching, peer modeling, self-instruction, reinforcement contingency, and role-playing to build skills were used to promote positive change. Sessions during the first year concentrated on developing prosocial skills with themes such as “how to invite someone into a group” and “how to make contact.” The second year concentrated on promoting self-control skills with themes such as “what to do when I am angry” and “look and listen.”




Key Personnel

The program was implemented by a multidisciplinary team consisting of two university trained child-care workers, one psychologist, and one social worker. Each case worker was responsible for providing the home-based parent training component to parents of 12 families and the school-based component to 12 boys from 12 other families. This created a team approach whereby two professionals could coordinate their efforts with one family (one with the parents at home, the other with the child at school).

Intervention ID
232
Ages

7 to 9

Rating
Promising
Outcomes

Overall, Tremblay and colleagues (1995) found mixed results with regards to the effectiveness of the Preventive Treatment Program. There were some positive effects found in the short term, but the effects seemed to disappear by the time the boys were 15 years old (6 years after the end of the intervention). However, Boisjoli and colleagues (2007) found some positive effects by the time the boys were 24 years old (15 years after the end of the intervention).



Study 1

School Adjustment


Tremblay and colleagues (1995) found that although a larger proportion of boys in the treatment group were in an age-appropriate regular classroom during the elementary school years (ages 10 to 12) compared with boys in the control group, the group difference disappeared from age 13 onward (during the high school years). At age 15, approximately 40 percent of boys in both groups were in a regular third year of high school class as they should have been. Repeated log-linear analysis also detected no significant group differences.



Teacher-Rated Disruptiveness

In the overall sample of boys in the study, there was a significant decrease in teacher-rated disruptiveness over time. However, there were no significant differences between the treatment and control groups.



Self-Reported Delinquency

There were significant between-group differences on measures of self-reported delinquency, indicating that the treatment group was reporting significantly fewer delinquent behaviors 1 to 6 years after the end of the intervention. However, there were no significant differences between the treatment and control groups when the total self-reported delinquency score was broken down within the stealing, vandalism, and drug use subscales.



Juvenile Court Records

A total of 30 boys (3.3 percent of the total sample) were found to have been placed under the Juvenile Offenders’ Act from ages 12 to 15 (youths are placed under this act if they are arrested by the police, charged, and found guilty of having broken a Canadian law and are thus considered “delinquents”). Of the treatment group, 9.3 percent were placed under the Act, compared with 7.4 percent of the control group. This difference was not statistically significant.



Perceptions of Parenting

In the overall sample, the boys perceived that they were being punished less and less as they became older. However, there were no significant differences between the treatment and control groups. In addition, treatment group boys perceived more supervision from their parents than the control group boys did; however, the difference was not statistically significant.



Study 2

High School Graduation


At age 24, Boisjoli and colleagues (2007) found that the treatment group had a significantly higher rate of high school graduation compared with the control group. In the treatment group, 45.6 percent had graduated from high school, compared with 32.2 percent of the control group.



Criminal Record

The treatment group had a lower rate of criminal records compared with the control group (21.7 percent versus 32.6 percent), although the difference only approached statistical significance (p=0.06).

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