How Common are Behaviour Disorders?

Mental Health QuarterlyThe winter 2016 edition of the Children’s Mental Health Research Quarterly focuses on children’s conduct difficulties and behaviour problems and notes that “30% to 50% of referrals to children’s mental health services are for behaviour problems”

The following are quotes from this edition:

“According to rigorous epidemiological surveys, approximately 2.4% of children meet criteria for oppositional defiant disorder at any given time. Similarly, a review of nine high-quality surveys found that approximately 2.1% of young people meet diagnostic criteria for conduct disorder at any given time. Extrapolating from BC and Canadian population figures, an estimated 30,000 children and youth in BC and 240,000 in Canada are likely experiencing one or both of these conditions at any given time.”

“Policy-makers, practitioners and members of the public can make a difference for young people by enacting and supporting policies that address socio-economic disadvantage, including overall child poverty levels. For example, evaluations of income-supplement programs have suggested that increasing the incomes of poor families by just $5,000 a year for two or three years could produce large improvements in children’s behaviour. And, given that living in poverty poses multiple risks for child well-being, poverty reduction may also avert other risks. For example, family socio-economic disadvantage has also been linked to children having chronically activated stress pathways, with consequent effects on their immune systems.

The available causal evidence also suggests that practitioners may have an added role to play by directly helping parents — given that parenting appears to be another important modifiable factor in the development of children’s behavioural problems”

Two Generation Programming

YPSN_2The following is a summary of a University of Oregon study published in Proceedings of the National Academy of Sciences of the United States of America that describes outcomes from ‘two generation programming’.

After only 8 weeks, children in families that received the Parents Making Connections– Highlighting Attention program outdistanced children in the two other groups in the study in the areas of language, cognition and behavior. In the same time frame, this program is also credited with improving parents’ caregiving behaviors and reducing parental stress.

Find the full paper here.

Why two generations?

The Stress Connection…

“Decades of research indicate that children from lower socioeconomic status backgrounds are more likely to grow up in homes that are more stressful and less cognitively stimulating than their higher socioeconomic peers. Such disparities have been shown to account for up to half of the academic disparity associated with socioeconomic status” (p. 12138).

“The home environment contains multiple pathways that may impact children’s attention development, perhaps most importantly, stress and parent-child interaction patterns” (p. 12138).

“Parent training can reduce stress and cortisol levels in children” (p. 12138).

“Acute and chronic stress adversely affect brain development, particularly the prefrontal cortex and hippocampus, which are central to many aspects of attention, working memory, and executive function.” (p. 12138).

“Stress pathways have been identified as a major risk factor for children growing up in lower socioeconomic status or adverse environments and the effects of chronic stress on the structure and function of brain areas such as the hippocampus and prefrontal cortex are well-documented” (p. 12141).

The Study

“The present study sought to examine whether an 8-week family-based training program could improve the neural systems meditating selective attention in in lower socioeconomic status preschool children” (p. 12140).

“Developmental cognitive neuroscience now permits the identification of candidate neurobiological targets for training programs. One such neurobiological target is selective attention, a foundational developmental skill important for academic outcomes, sensitive to environmental differences associated with socioeconomic status, and capable of considerable neuroplasticity” (p. 12138).

“Considerable evidence documents the central role of selective attention in all aspects of learning and memory, and school readiness in particular” (p. 12138).

Implications for Practice

This research “supports the design of programs that efficiently build on evidence from basic research on neuroplasticity and on evidence-based practices that can be delivered in relatively short time frames” (p. 12140).

“Classroom-based models with little involvement of parents are less likely to realize large gains for young children” (p. 12141).

“The cost of [the two generation program] is estimated to be only approximately $800 per child” (p. 12142).

In an earlier summary of a paper How Early Experiences Shape Executive Function we learned that executive function effectively inoculates against stress & trauma. And likewise, Toxic Stress inhibits the development of executive function.  That paper, like this one, suggested that intervention into this cycle is effective.

Reference

Neville H JStevens CPakulak EBell T EFanning JKlein S, and Isbell E. Family-based training program improves brain function, cognition, and behavior in lower socioeconomic status preschoolers. Proceedings of the National Academy of Sciences of the United States of America 2013 110 (29) 1213812143; doi:10.1073/pnas.1304437110