Parents can play a key role in interventions for their child’s disruptive behavior, according to a new meta-analysis.
While the research did not include causation, co-author Richard A. Epstein, Ph.D., M.P.H., said interactions between parents and children can establish good or bad patterns.
“Involving parents in the interventions has the ability to address not just the child’s behavior but also things in the environment that promote that behavior,” said Dr. Epstein, associate professor of psychiatry at Vanderbilt University School of Medicine.
The analysis is detailed in the report “Psychosocial Interventions for Child Disruptive Behaviors: A Meta-Analysis”(Epstein RA, et al. Pediatrics. Oct. 19, 2015, www.pediatrics.org/cgi/doi/10.1542/peds.2015-2577).
From 2005 to 2011, roughly 3.5% of children ages 3-17 years displayed disruptive behavioral problems, including temper tantrums, aggression and defiance, according to the report.
Researchers reviewed 66 studies on psychosocial interventions for children. The meta-analysis included 28 studies that used at least one of the three most prevalent measures of behavior: Eyberg Child Behavior Inventory (ECBI), Intensity Subscale; ECBI Problem Subscale; and the Child Behavior Checklist, Externalizing (T-score).
Researchers excluded studies of children with attention-deficit/hyperactivity disorder (ADHD) and those in which disruptive behavior was a symptom of another disorder.
The children in the studies demonstrated a significant level of disruptive behavior but did not have to be diagnosed with a disruptive behavior disorder to be included.
The analysis found “moderate strength of evidence” that multicomponent interventions (which all included a parent component) and interventions with only a parent component were more effective than treatment as usual/control conditions. Only two of the studies evaluated a child-only component, which was not enough evidence to support such interventions.
“Information like this could be used by general pediatricians to think about the types of referrals they make and help parents choose between the types of specialty services being offered to them,” Dr. Epstein said.
The meta-analysis did have a handful of limitations. Some of the studies had inadequate blinding, and some were conducted by the developer of the intervention. The interventions typically were provided in academic settings, and the studies did not address psychosocial interventions delivered concurrently with medications.
“The literature base does have a lot of room for improvement, so it is our hope this kind of work will help promote that additional work getting done,” Dr. Epstein said.
The analysis is part of a larger report, which is available at www.effectivehealthcare.ahrq.gov.