Program Profile: Prevention Program for Externalizing Problem Behavior (PEP)

The program is a preventative, group-based training intervention for parents and kindergarten teachers of young children with externalizing problem behaviors. The program seeks to reduce problem behaviors and ultimately prevent delinquency later in life. The program is rated Promising. Treatment group mothers and teachers reported statistically significantly fewer child problem behaviors, compared with the control group. However, there was no effect of observer-rated problem behaviors.

A Promising rating implies that implementing the program may result in the intended outcome(s).

A Promising rating implies that implementing the program may result in the intended outcome(s).

Program Goals

The Prevention Program for Externalizing Problem Behavior (PEP) is a preventative behavioral-training program for parents and kindergarten teachers of children, between the ages of 3 and 6, who exhibit externalizing problem behavior. PEP is a 10-week intervention consisting of weekly sessions of about 90–120 minutes in duration. Sessions are facilitated by an experienced child psychologist and are held in kindergarten classrooms for groups of about 5–6 participants. Each group receives training separately, with teachers and parents in different training groups. Ultimately, the program aims to decrease child problem behavior by improving parenting skills and parent–child interactions. The program targets families of children with early onset of externalizing problem behaviors, as these children are more at risk for delinquency later in life.

Target Population

The PEP intervention targets families with kindergarten children between the ages of 3–6 with externalizing problem behaviors (i.e., at risk for delinquency).

Program Activities

PEP is a 10-week intervention based on a program developed to treat oppositional and hyperkinetic disorders among school-age children. A PEP-trained child psychologist administers weekly sessions in kindergarten classrooms with groups of parents and teachers. The sessions are each about 90–120 minutes in duration and include

• Defining individual problem situations and basic strategies for dealing with them
• Teaching caregivers behavior modification strategies
• Reiterating parenting strategies for common situations

The topics are thoroughly tailored to focus on each child individually, in an effort to provide the parent or teacher a chance to apply the skills with a specific situation/child in mind. Caregivers are taught how to better handle child problem behavior using stress-reduction techniques, with the primary focus on encouraging and praising instances of compliance. In an effort to maintain behavioral changes, caregivers are trained to monitor their own behavior and that of their children.

Program Theory

PEP was developed to treat grade-school children with oppositional and hyperkinetic disorders, with the idea that adolescent drug use and delinquency are frequently associated with early onset of disruptive behavior problems (Moffitt 1993). Developmental models of disruptive child behavior indicate that ineffective parenting, coercive and punitive discipline, and lack of monitoring are correlated with early child-behavior problems (Patterson, DeGarmo, and Forgatch 2004). When the child problem behavior is of particularly early onset, it is recommended that prevention programs specifically target caregivers as an avenue to improve behavior.

Study

Hanisch and colleagues (2010) conducted a randomized controlled trial using a study sample from Cologne, Germany, which included children between the ages of 3 and 6 with externalizing problem behavior (PEP treatment group, n = 91; control group, n = 64). An instrument derived from the Child Behavioral Checklist (CBCL) was used to screen children for behavior problems. Parents and teachers of children with identified externalizing problem behaviors were eligible for the study (with the primary unit of analysis being the child). Kindergartens were strategically selected to represent low, middle, and high socioeconomic status. Specifically, 91 children from 32 kindergartens were randomly assigned to the intervention group, and 64 children from 22 kindergartens were randomly assigned to the control group. The control group was statistically similar to the PEP intervention group in terms of average age, gender, and symptom severity. The control group was untreated and received no intervention.

Teachers and parents completed various rating scales and questionnaires that measured child behavior, parenting skills, and perceptions of child symptoms. Researchers conducted 3-hour home visits in which they administered structured interviews, academic tests, and child behavior rating scales. The family interviews were used to collect baseline data regarding socioeconomic and family characteristics. Approximately 8 weeks postintervention, a 3-hour follow-up home assessment was conducted. Analyses included t-tests and multivariate analyses of covariance to examine baseline and outcome differences between groups. No subgroup analyses were conducted.

A parent–teacher screening should be conducted prior to the intervention to ensure that the most at-risk children are being targeted. Child psychologists are trained by the senior author using Prevention Program for Externalizing Problem Behavior (PEP) standardized material and procedures.

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

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

Moffitt, Terrie E. 1993. "Adolescence-Limited and Life-Course-Persistent Antisocial Behavior: A Developmental Taxonomy." Psychological Review 100(4):674–701.

Patterson, Gerald R., David DeGarmo, and Marion S. Forgatch. 2004. "Systematic changes in families following prevention trials." Journal of Abnormal Child Psychology 32(6): 621–633.

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

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

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