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Aggressive and unruly children: how to prevent behavioral disorders

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Aggression, challenge, rejection of the rules, whims as a response to everything and its opposite. They could be the early signs of a behavior disorder, a condition that affects 5 to 10% of children and that if it persists over time, it risks compromising education, sociality, health, in a word, the future of those affected. But parents can make a real difference by taking action before these symptoms get worse. They can do it, as long as you give them the tools they need to do it. Because even in this case, as with everything, prevention might be better than cure.

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And indeed it is. As demonstrated by a single-blind randomized trial conducted on children aged 12 to 36 months and published in Jama Pediatrics. The study is part of Healthy Start, Happy Start a larger project from the University of Cambridge and Imperial College London and is one of the first public health trials on the prevention of difficult behaviors in very young children.

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Researchers have selected 300 families of boys and girls from one to three years old who had already shown the first signs of behavior management difficulties, obtaining a score of 20% higher on the SDQ, the Strengths and Difficulties Questionnaire. The SDQ is one behavioral screening for developmental age. On half of the 300 families the authors tested the effectiveness of VIPP-SD, an intervention that uses the video-feedback technique (the acronym stands for Video-Feedback Intervention to promote Positive Parenting and Sensitive Discipline) on the other half did not. . However, all families benefited from support for difficult children (an intervention evidently foreseen in the United Kingdom, which the authors define as minimal and which consists roughly of advice from health professionals or GPs, referrals to mental health services, parental support).

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The program VIPP-SD is developing in six sessions lasting about 90 minutes each that take place in children’s homes. Where a health worker films parents and children interacting in everyday situations (play, lunch…). At a later stage, the content of the clips is carefully analyzed and reviewed together with the adults, highlighting the moments of parent-child harmony or the most problematic ones, to understand what works and what doesn’t. Reviewing and analyzing oneself, and at the same time being able to take advantage of the expertise of an expert helps parents to identify the signals of their children, and to respond accordingly with positive and effective attitudes.

The results: more than two points of difference

The children of families who in addition to routine support had also benefited from video-feedback support scored significantly lower on the screening tests than the others: the average difference between the scores of the two groups was 2.03 points. What do two points mean in terms of tantrums or aggression or broken toys? To give an idea, 2 points roughly correspond to the difference between having tantrums every day and having them once or twice a week, or between regularly throwing or breaking toys and other objects and almost not doing it again, as stated in a released note. from the University of Cambridge. 95% of the children have completed the project, which for now is experimental.

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From research to the real world

“Often when a program like this becomes a real health service we expect a decline in effectiveness compared to the research conditions. Instead we have seen a clear and surprising change in children’s behavior,” he said. Christine O’Farrelly, of the Center for Play in Education, Development and Learning of the University of Cambridge, first author of the paper. “The fact that this program has been effective with babies as young as one or two years old represents a real opportunity to intervene early and protect them from persistent mental health problems,” he added. Beth Barker, also a Cambridge researcher and co-author of the trial.

Well placed resources

“Providing this program within health services would require investment, but realistically we think it can be delivered as part of routine care,” he said. Paul Ramchandani, one of the authors of the study, also in force at Cambridge University. “Which – reflects Ramchandani – would benefit a group of children who risk future education, behavior, well-being and mental health problems. We have the ability to invest early and alleviate those difficulties now by preventing potential long-term problems that are much worse than the current ones. “

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