A prevention trial was conducted to evaluate a temperament-based intervention (INSIGHTS into Children's Temperament) as compared to a Read Aloud attention control condition in reducing behavior problems among inner city children. The participants were 148 inner-city first and second grade children, their parents, and their 46 teachers who were from six schools in a Northeastern city. Parents were interviewed on the Parent Daily Report at baseline and every two weeks until the completion of the intervention phase to assess the extent of child problem behaviors in the home. The parents also were interviewed at baseline with the Disruptive Module of the Diagnostic Interview for Children and completed the Brief Symptom Index to assess parental depression.
A repeated measures multivariate analysis of covariance with parental depression as a covariate was conducted to examine the children's behavior over the course of the intervention. In order to test the impact of INSIGHTS for the overall sample and to determine whether the intervention was differentially effective for children diagnosed with a disruptive disorder versus those who did not receive a diagnosis, two and three-way interactions were examined and found to be significant. The INSIGHTS intervention was more effective than Read Aloud in reducing children's problem behaviors at home across both the diagnosed and non-diagnosed groups, but demonstrated a significantly greater efficacy among children who were at diagnostic levels compared to those who were within normal levels.
Editors' Strategic Implications: The authors describe the promising practice of instructing parents and teachers on how to adapt their behavior management strategies to fit each child's temperament. Replication with a longitudinal follow-up will be necessary to determine whether program effects persist.
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This manuscript was primarily supported by funding from the National Institute of Nursing Research (R01NR4781)
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Appendices
Appendix A
INSIGHTS: Curriculum Outline for Parents and Teachers
Part 1: The 3 R‘s of Child Management: Recognize, Reframe, and Respond
Session One: Recognizing Child Temperament
The program begins with a welcome from the facilitator and the opportunity for the participants to introduce themselves and explain why they have chosen to take part in the program. The facilitator then presents an overview of the program and discusses the need for consistent attendance and the importance of keeping session discussions confidential in order to maintain trust among the participants. The content of the session includes a discussion of the major concepts of temperament: its biological basis, resistance to modification, manifestation in situations involving stress and change, and relationship to goodness of fit. Vignettes demonstrating the four dimensions of school-age temperament are shown. Participants are asked to observe the children during the week for expressions of temperament.
Session Two: Reframing Child Temperament
The participants are given a computer generated temperament profile of the children that is based on the information that they provided at baseline. They then discuss how the temperament profile does or does not match their intuitive impressions. Strengths and concerns regarding particular child temperaments are discussed. For example, a child who is high in approach is eager to meet new people and try new activities. His/her parents and teachers, however, might be concerned about the safety of such a child. The participants are asked to observe the children's behavior and their own response to a situation that occurs during the week.
Session Three: Parent and Teacher Responses
Vignettes in this session demonstrate how parent and teacher responses lead to different adult/child interactions. The participants learn to identify their responses as optimal, adequate, or counter-productive. The importance of the manner in which messages are spoken or delivered is also discussed.
Part 2: Gaining Compliance
Session Four: Gaining Control
The session focuses on how parents and teachers can gain compliance through effective child management techniques. Individual contracts for dealing with identified behavior problems are designed. Homework includes implementing the contract and reporting results in subsequent sessions.
Session Five: Giving Recognition
The importance of recognition is stressed in this session. Examples of reinforcements are discussed, demonstrated in the vignettes, and role-played in modeling exercises.
Session Six: Disciplining School-Age Children
General principles of discipline are discussed in this session. Vignettes display some of the common behavior problems that school-age children often exhibit. Guidelines for using time-out are presented. Strategies for dealing with children who are high or low on the temperament dimensions are emphasized. The parents and teachers develop a discipline plan for isolated incidents which they are encouraged to implement consistently.
Session Seven: Parents and Teachers Are People Too
Gaining compliance is still emphasized in this session, but adult needs are also discussed. Strategies to implement time-out for participants are explored.
Part 3: Giving Control–Sessions Eight Through Ten
Session Eight: Fostering Independence
The developmental need of school-age children for independence is explored in this session. Vignettes demonstrate age-appropriate activities and child management strategies to foster responsibility and Positive life-style habits.
Session Nine: Reviewing the Three R‘s
Content from session one through three is reviewed. The participants are engaged in identifying the 3R‘s in vignettes depicting more complex disciplinary situations.
Session Ten: Putting it All Together
The content of sessions four through seven is reinforced. Vignettes demonstrating more complex behavioral problems are shown. Parents and teachers are given the opportunity to model their responses. Completion certificates are given to the participants.
Appendix B
Parent Daily Report Items (Chamberlain & Reid, 1987)
Aggressiveness | Lying |
Arguing | Negativism |
Bedwetting | Pants wetting |
Competitiveness | Pouting |
Complaining | Running around |
Crying | Running away (wandering) |
Defiance | Sadness/unhappiness |
Destructiveness | Soiling |
Fearfulness (unreasonable) | Stealing |
Fighting with sibs (physical only) | Talking back to parent |
Fire-setting | Teasing |
Hitting others | Temper tantrums |
Hyperactive | Whining |
Irritableness | Yelling |
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McClowry, S.G., Snow, D.L. & Tamis-LeMonda, C.S. An Evaluation of the Effects of INSIGHTS on the Behavior of Inner City Primary School Children. J Primary Prevent 26, 567–584 (2005). https://doi.org/10.1007/s10935-005-0015-7
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DOI: https://doi.org/10.1007/s10935-005-0015-7