TABLE 1

Evidence-Based Interventions Shown To Reduce Existing Disruptive Problems in Preschoolers

ProgramAge Range Supported by DataPatient PopulationNo. of Children in Randomized Controlled TrialsFormal Psychoeducation for ParentsReal-Time Observed Parent–Child InteractionsSpecial CharacteristicsDurationFollow-up Duration (If Applicable)Evidence Reflecting Efficacy for ADHD (Effect Size)Evidence Demonstrating Efficacy for ODD and CD (Effect Size)
New Forest32,3530–77 moChildren with ADHD202YesYes• Parent–child tasks are specifically intended to require attention5 weekly sessionsn/aYes (1.9)Yes (0.7)
• Occurs in the home
• Explicit attention to parental depression
IYS parent training, teacher training, and child training32,53,57593–8 yChildren with CD, ODD, and ADHD677YesNo• Separate parent and child groups20 weekly 2-h sessionsYes (0.8)Yes (home behavior, 0.4–0.7; school behavior, 0.7–1.25)
• Parent training uses video vignettes for discussion
• Child training includes circle time learning and coached free play
Triple P,55,60,61 (levels 3 and 4)36–48 moChildren at high risk with parental concerns about behavioral difficulties (level 4)330YesYes• Multiple levels of intervention• Primary care = 4 sessions of 15 min6 and 12 mo: effect size, 0.66 for children <4 y, 0.65 for children >4 y62NoYes (level 3: 0.69, level 4: 0.96; lower for children <4 y)63
• Primarily training parents with some opportunities to observe parent–child interactions• Standard treatment is 10 sessions
• Handouts and homework supplement the treatment
Triple P online592–9 yChildren with CD and ODD116NoNo• Interactive self-directed program delivered via the internet8 modules (45–75 min)6 mo: effect size from baseline, 0.6–0.7 on ECBI, no effect on SDQNo effectYes (1.0; by parent report)
• Instruction in 17 core positive parenting skills
PCIT37,64,652–7 yChildren with clinical level disruptive behavior symptoms358Yes, minimalYes• Through a 1-way mirror, therapist coaches parent during in vivo interactions with childDepends on parent skill developmentUp to 6 y after treatment, fewer signs of disruptive behavior disorder than baselineMinimalYes (1.45)58
• Homework requires parent–child interactions
• Progress through therapy determined by parents’ skill development
Helping the Noncompliant Child573–8 yChildren with noncompliant behaviors350YesYesInvolves two phases 1) Differential Attention 2) Compliance training using demonstration, role plays, and in-office and at home practiceDepends on parent skill development 6.8 moEffect size 1.24; inattention 1.09; hyperactivity/impulsivity: 1.21Yes (but no ES reported)
  • n/a, not available; ECBI, Eyberg Child Behavior Inventory; SDQ, Strengths and Difficulties Questionnaire; CD, conduct disorder; ODD, oppositional defiant disorder.