Program Profile: The Incredible Years–Child Training Program

This is a program that aims to reduce behavior problems in children and increase their social and problem-solving skills. The program is rated Effective. Treatment group children demonstrated statistically significant improvements in conduct problems, social competence, and problem-solving skills, compared with control group children, at the posttest.

An Effective rating implies that implementing the program is likely to result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

An Effective rating implies that implementing the program is likely to result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Goals/Target Population

The Incredible Years–Child Training Program aims to reduce problem behaviors in children and to increase their social and problem-solving skills. The program is designed for young children (ages 4 to 8) who are at high risk or diagnosed with Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and Attention Deficit Hyperactive Disorder (ADHD). The program specifically addresses interpersonal difficulties that are usually problematic for young children who have conduct problems, such as a lack of social and conflict resolution skills, loneliness, inability to empathize, problems communicating, and problems complying with parent or teacher requests.

Program Theory

The Incredible Years was developed based on the cognitive–social learning theory, and in particular Patterson’s theory of the coercive family process, which states that negative reinforcement causes and maintains deviant behavior in children (Webster-Stratton et al. 2004). The social learning model emphasizes the importance of the family as well as teacher socialization processes, especially those affecting young children. If parents and teachers can learn to deal effectively with children’s misbehavior and to model positive and appropriate problem-solving and discipline strategies, children can develop social competence, emotional regulation, and enhanced school readiness skills; they also can reduce aggressive behavior at home and at school (Webster-Stratton et al. 2004).

Program Components

The child training component of the Incredible Years, the Dina Dinosaur Social Skills, Emotion, and Problem-Solving Curriculum, emphasizes training children in skills such as emotional literacy, empathy (or perspective taking), friendship, anger management, interpersonal problem solving, school rules, and how to succeed at school. The series materials consist of a group leader’s manuals, DVDs, children’s and parents’ handouts, children’s books, detective home activities manuals, games, and activities.

The child training component is mostly performance-based and focuses on fantasy and imaginary play to appeal to the children’s imagination, such as life-size puppets (including dinosaurs) who present their ongoing interpersonal problems). Video scenes depict children coping with a variety of stressful situations such as problem solving at both home and school; making friends; coping with rejection; paying attention to teachers in school; and cooperating with family members, teachers, and classmates. Children collaborate with each other in small groups to develop a variety of acceptable solutions and coping skills for common situations. This collaboration encourages the discussion of feelings and social competence.

In addition to videos, weekly sessions include group activities such as art projects and games that involve new concepts, role plays through puppets to reenact conflict situations, and storytelling that depicts children solving social problems and discussing their feelings. If children are physically aggressive or noncompliant during the session, they are sent to Time Out. During early sessions, children are taught how to handle themselves in Time Out, specifically using self-talk, in which they are encouraged to cope by making positive statements such as “I can cope with this and calm down,” or “I can go back and be successful.” After each weekly session, homework exercises are sent home to remind children to practice key concepts. These homework assignments include cue cards, coloring books, cartoons, and stickers.

Study

Webster-Stratton and Hammond (1997) conducted a randomized controlled trial to evaluate the Incredible Years program for children with conduct issues. Participants were considered eligible if 1) the child was between the ages of 4 and 7; 2) the child had no debilitating physical or intellectual disability; 3) the child was not receiving any form of psychological treatment at the time of referral; 4) the primary referral problem was child misconduct; 5) the parents had reported a clinically significant number of child behavior problems; and 6) the child met criteria for oppositional defiant disorder (ODD) or conduct disorder (CD), according to the third edition of the Diagnostic and Statistical Manual (DSM-III). Families were recruited for the study following a 2-to-3-hour intake interview and were randomly assigned to one of four treatment conditions: 1) child training only (n = 27 children); 2) parenting training only (n = 26 mothers, 17 fathers); 3) a combination of child and parent training (n = 20 mothers, 16 fathers, 22 children); or 4) a control group (n = 22 mothers, 18 fathers, 22 children). The CrimeSolutions review focused on the differences between the child training only group (group 1) and the control group (group 4).

The child training group attended weekly 2-hour sessions in groups of five to six for a total of 22 sessions. Families in the control group received no treatment and had no contact with a therapist but were reassessed and randomly placed in one of the three interventions at the end of the study.

In the child training treatment group, 88.9 percent of the children, 92.8 percent of the mothers, and 100 percent of the fathers were white. The average age of the child was 5.9 years, the average age of the mother was 33.7 years, and the average age of the father was 36.5 years. In the control group, 86.4 percent of the children, 100 percent of the mothers, and 88.9 percent of the fathers were white. The average age of the child was 5.6 years, the average age of the mother was 34.4 years, and the average age of the father was 38.6 years. There were no statistically significant differences between the groups in baseline characteristics.

A four-group analysis of covariance (ANCOVA) was conducted to evaluate treatment effects. Outcomes of interest included child behavior problems, how often behavior problems occurred, how much child behavior impacted parental stress, child problem-solving skills, and child conflict-management skills. Outcome measures included the Child Behavior Checklist (CBCL), which assessed child behavior problems from both mothers’ and fathers’ reports; the Behar Preschool Behavior Questionnaire (PBQ), which measured total behavior problems from teacher reports; the Eyberg Child Behavior Inventory (ECBI), which measured the intensity of problem behavior (how often problem behavior occurs) from both mothers’ and fathers’ reports; the Parenting Stress Index (PSI), which measured the child domain that represented the amount of stress resulting from child behavior on the mother and father; and the Wally Child Social Problem-Solving Detective Game (WALLY), which assessed the problem-solving skills of the child. In addition, the ratio of positive-to-negative conflict management was measured though laboratory observation. These measures were conducted preintervention and 2 months postintervention. No subgroup analyses were conducted.

Study

Webster–Stratton, Reid, and Hammond (2004) used an experimental design to evaluate the Incredible Years program for children with ODD. Participants were recruited from families who had children (ages 4 to 8) with ODD and were requesting treatment at a university clinic. Families entered the study in three cohorts of 50 to 55 families per cohort in 1995, 1996, and 1997. Random assignment to one of six groups was conducted by lottery after completion of baseline assessments in November of each year. The six groups were: 1) parent training only (n = 31 families); 2) parent training plus teacher training (n = 24 families); 3) child training only (n = 30 families); 4) child plus teacher training (n = 23 families); 5) parent plus child plus teacher training (n = 25 families); and 6) waitlist control (n = 26 families). The CrimeSolutions review focused on the differences between the child training only group (group 3) and the waitlist control group (group 6).

The child training intervention included attendance at the clinic’s Dinosaur School in groups of five to six children for 2-hour weekly sessions over 18 to 20 weeks. Participants in the waitlist control group received no treatment from The Incredible Years program during the waiting period. At the posttest, families were offered the parent training program.

Child participants in the child training treatment group were mostly male (93.3 percent) and white (83.3 percent). The average age of the child was 6.12 years, the average age of the mother was 38 years, and the average age of the father was 39.84 years. Approximately 76 percent of the mothers had partners. Of the control group children, 88.5 percent were male, and 84.6 percent were white. The average age of the child was 5.86 years, the average age of the mother was 36.27 years, and the average age of the father was 38.44 years. Most of the mothers (88.5 percent) had partners. There were no statistically significant differences between the group on baseline characteristics.

To determine treatment effects, the study authors conducted a six-group ANCOVA using pretest scores as covariates for corresponding posttest scores. Outcomes of interest included child conduct problems (at home and at school) and child social competence with peers. Child conduct problems at home were reported by both the mother and the father through completing the Eyberg Child Behavior Inventory (ECBI). Child conduct problems at school were reported by the child’s teacher through completing the Teacher Assessment of School Behavior (TASB). Child social competence with peers was measured through a composite score of two teacher-reported variables, one classroom-reported variable, and one laboratory observation variable of the child with a peer. Subgroup analyses were not conducted.

All parent, teacher, and child programs use curricula that include extensive leader manuals, DVDs, books, and home or classroom activity assignments. The child training series materials consist of a leader’s manual, children’s and parents’ handouts, children’s books, detective home activities manuals, games and activities, and nine DVDs.

Training is provided by certified mentors or trainers in 3-day workshops. These are followed by telephone consultations, video review of intervention sessions delivered, and in-person group supervision. To ensure the fidelity of program delivery, it is highly recommended that group leaders become certified. Once certification is achieved, the group leaders are eligible to become certified as coaches and mentors. This allows agencies and schools to develop a supportive infrastructure and to set up methods for long-term sustainability.

More information can be found on the program’s website: http://www.incredibleyears.com/.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Miller Brotman, Laurie, Kathleen Kiely Gouley, Daniel Chesir–Teran, Tracy A. Dennis, Rachel G. Klein, and Patrick Shrout. 2005. “Prevention for Preschoolers at High Risk for Conduct Problems: Immediate Outcomes on Parenting Practices and Child Social Competence.” Journal of Clinical Child and Adolescent Psychiatry 34:724–34.

Webster–Stratton, Carolyn H. 1990b. “Long-Term Follow-Up of Families With Young Conduct-Problem Children: From Preschool to Grade School.” Journal of Clinical Child Psychology 19(2):144–49.

Webster–Stratton, Carolyn H. 1991. “Annotation: Strategies for Working With Families of Conduct-Disordered Children.” British Journal of Child Psychiatry and Psychology 32(7):1047–62.

Webster–Stratton, Carolyn H. 1992. The Incredible Years: A Trouble-Shooting Guide for Parents of Children Ages 3–8 Years. Toronto, Ontario: Umbrella Press.

Webster–Stratton, Carolyn H. 1997. “Early Intervention for Families of Preschool Children With Conduct Problems.” In Michael J. Guralnick (ed.). The Effectiveness of Early Intervention: Second Generation Research. Baltimore, Md.: Paul H. Brookes Company, 429–54.

Webster–Stratton, Carolyn H. 2000. “The Incredible Years Training Series.” Juvenile Justice Bulletin. Washington, D.C.: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.

Webster–Stratton, Carolyn H. 1997. “Treating Children With Early-Onset Conduct Problems: A Comparison of Child and Parent Training Interventions.” Journal of Consulting and Clinical Psychology 65(1):93–109.

Webster–Stratton, Carolyn H., M. Jamila Reid, and Mike Stoolmiller. 2008. “Preventing Conduct Problems and Improving School Readiness: Evaluation of the Incredible Years Teacher and Child Training Programs in High-Risk Schools.” Journal of Child Psychology and Psychiatry 49:471–88.

Webster–Stratton, Carolyn H. and Martin Herbert. 1994. Troubled-Families–Problem Children: Working With Parents: A Collaborative Process. Chichester, England: Wiley and Sons.

Webster-Stratton, Carolyn H., Terri Hollinsworth, and Mary Kolpacoff. 1989. “The Long-Term Effectiveness and Clinical Significant of Three Cost-Effective Training Programs for Families with Conduct-Problem Children.” Journal of Consulting and Clinical Psychology 57(4):550–53.

Webster–Stratton, Carolyn H., M. Jamila Reid, and Theodore P. Beauchaine. 2011. “Combining Parent and Child Training for Young Children With ADHD.” Journal of Clinical Child and Adolescent Psychology 40(2):1–13.

Webster–Stratton, Carolyn H., Julie Rinaldi, and M. Jamila Reid. 2010. “Long-Term Outcomes of the Incredible Years Parenting Program: Predictors of Adolescent Adjustment.” Child and Adolescent Mental Health 16(1):38–46.

Following are CrimeSolutions-rated programs that are related to this practice:

Preventive Child Maltreatment Programs

Preventive child maltreatment programs are designed to prevent physical child abuse or neglect by educating expectant and new parents in parenting skills, coping with stressors, and stimulating child development. This practice is rated Effective for preventing child abuse, neglect, and maltreatment.

Evidence Ratings for Outcomes

Victimization - Child abuse/neglect/maltreatment

Early Family/Parent Training Programs

This practice includes programs that seek to provide families and parents with training and skills to help promote their children’s physical, mental, and social skills. The practice is rated Effective for reducing child problem behaviors for children whose families participated in early family/parent training programs, compared with control group children whose families did not participate in programming.

Evidence Ratings for Outcomes

Juvenile Problem & At-Risk Behaviors - Multiple juvenile problem/at-risk behaviors

Social Skills Training for Preventing Antisocial Behavior of Youth

This practice involves the promotion of social and social-cognitive competencies to prevent future antisocial behavior. The practice is rated Effective for preventing overall antisocial behavior, aggression, delinquency, oppositional and disruptive behaviors, and general antisocial behavior.

Evidence Ratings for Outcomes

	Juvenile Problem & At-Risk Behaviors - Overall antisocial behavior
	Juvenile Problem & At-Risk Behaviors - Aggression
	Crime & Delinquency - Multiple crime/offense types
	Juvenile Problem & At-Risk Behaviors - Oppositional/disruptive behaviors
	Juvenile Problem & At-Risk Behaviors - General antisocial behaviors

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?