"PCIT-techniques” for preschool "PCIT-techniques” for preschool teachersteachers

Preventing disruptive behavior in young children: an intervention program in

kindergartens

Cand.psychol. Inger Marie Kvarum Cand.psychol. Inger Marie Kvarum Hospital of Nordland, Norway Hospital of Nordland, Norway

Norwegian University of Science and Technology (NTNU)Norwegian University of Science and Technology (NTNU)

Anne Kristine Wormdal & Turid-Suzanne Berg-NielsenAnne Kristine Wormdal & Turid-Suzanne Berg-NielsenNorwegian University of Science and Technology (NTNU)Norwegian University of Science and Technology (NTNU)

The kingdom of Norway, The kingdom of Norway, some factssome facts

Constitutional Constitutional monarchymonarchy

Area: 385 155 kmArea: 385 155 km²² Population: 4.600.000Population: 4.600.000 Most of the schools and Most of the schools and

kindergartens are publickindergartens are publicwww.ssb.nowww.ssb.no

www.norge.nowww.norge.no

The The locallocal area where this study area where this study was conductedwas conducted Indre Salten, a rural area in North- Norway Indre Salten, a rural area in North- Norway

(north of the artic circle)(north of the artic circle) Consist of 5 Consist of 5 kommunerkommuner (counties) (counties) Area, in total: 7314 kmArea, in total: 7314 km²² Total population in Indre Salten: 20500Total population in Indre Salten: 20500

www.salten.nowww.salten.no 4000 children4000 children

5, 25 % of the referred children to BUPIS in 2004 5, 25 % of the referred children to BUPIS in 2004 had behavioral problems (ODD, CD)had behavioral problems (ODD, CD)Bup-dataBup-data

BackgroundBackground

2-17 % of the population under 6 years 2-17 % of the population under 6 years have behavioral problemshave behavioral problems Filcheck, McNeil, Greco & Bernard, Filcheck, McNeil, Greco & Bernard,

20042004

The group is increasing The group is increasing (Zeiner, Backe-Hansen, Eskeland, Ogden, Rypdal & (Zeiner, Backe-Hansen, Eskeland, Ogden, Rypdal &

Sommerschild, Sommerschild,

High stability throughout yearsHigh stability throughout years Campbell, 1995Campbell, 1995

Their social competencies are low Their social competencies are low Ogden, 2001, Lamer, Ogden, 2001, Lamer,

19971997

Risk of developing more serious problems Risk of developing more serious problems later in life (e.g. depression, ODD, CD) later in life (e.g. depression, ODD, CD) Ogden, Ogden,

2001, Lamer, 19972001, Lamer, 1997

Continue: backgroundContinue: background

Official recommendations from 1997: Official recommendations from 1997: Prevention and early interventions are Prevention and early interventions are needed, possibilities in kindergartens needed, possibilities in kindergartens

(Zeiner, Backe-Hansen, Eskeland, Ogden, Rypdal & Sommerschild, (Zeiner, Backe-Hansen, Eskeland, Ogden, Rypdal & Sommerschild,

1997)1997)

PMT-O, MST and "The incredible years” by PMT-O, MST and "The incredible years” by Webster-Stratton were put into use and Webster-Stratton were put into use and evaluated in Norwayevaluated in Norway

However, few studies have conducted and However, few studies have conducted and evaluated prevention programs in evaluated prevention programs in kindergartenskindergartens (Sørlie, 2000)(Sørlie, 2000)

The aim of this studyThe aim of this study

Develop, carry out and evaluate an Develop, carry out and evaluate an intervention program based on PCIT in intervention program based on PCIT in Norwegian kindergartensNorwegian kindergartens

Goals:Goals:- make the employees more aware of - make the employees more aware of

own own communication- and playing skills communication- and playing skills- give the employees a tool to use if - give the employees a tool to use if

neededneeded- evaluate the perceived usefulness of - evaluate the perceived usefulness of

this this intervention program intervention program

Main purposesMain purposes

Is it possible to observe changes in the Is it possible to observe changes in the employees communication- and playing skills employees communication- and playing skills by using PCIT- techniques?by using PCIT- techniques?

-More -More ""do skills” and less do skills” and less ""don’t skills”don’t skills”

Would the employees feel that they have Would the employees feel that they have changed in their way of communicating and changed in their way of communicating and playing with all children in kindergartens? playing with all children in kindergartens?

Continue: main purposesContinue: main purposes

Do the employees perceive the Do the employees perceive the intervention program as useful?intervention program as useful?

Is there any correlation between perceived Is there any correlation between perceived usefulness of the program and personal usefulness of the program and personal variables as variables as educationeducation years of experience in kindergartensyears of experience in kindergartens personal experience with disruptive childrenpersonal experience with disruptive children

SubjectsSubjects

4 departments from two different public 4 departments from two different public kindergartens in Indre Salten kindergartens in Indre Salten (The communes of Fauske and Saltdal)(The communes of Fauske and Saltdal)

12 (13) employees12 (13) employeesall females, mean age: 40.2 years, years of experience all females, mean age: 40.2 years, years of experience in kindergartens: 12.1 years (mean)in kindergartens: 12.1 years (mean)

12 (13) children from these departments12 (13) children from these departmentsGirls: boys = 8:4, mean age: 4.8 yearsGirls: boys = 8:4, mean age: 4.8 years

Informed consent from the employees and Informed consent from the employees and the parentsthe parents

ProcedureProcedure

Present the project, ”ice-breaking” Present the project, ”ice-breaking” (Des. & Jan.2004/2005)(Des. & Jan.2004/2005)

Pre- measurement of the subjects in play Pre- measurement of the subjects in play with children : videotaped (Jan.2005)with children : videotaped (Jan.2005)

Evening training course (Febr. 2005)Evening training course (Febr. 2005) Coaching (Feb. & Mars 2005)Coaching (Feb. & Mars 2005) Post-measurement: videotaped, DPICS, Post-measurement: videotaped, DPICS,

self-report questionnaire for evaluation self-report questionnaire for evaluation (Mars-April-05) (Mars-April-05)

131311

The situation, an example from The situation, an example from the video-clipsthe video-clips

ResultsResults

Significant changes in most of the “do Significant changes in most of the “do – skills” and “don’t – skills” – skills” and “don’t – skills” (Table 1)(Table 1) More “do-” and less “don’t skills”More “do-” and less “don’t skills”But: But: less “information descriptions”less “information descriptions” No significant changes in “reflective” and No significant changes in “reflective” and

“critical statements” and in “indirect “critical statements” and in “indirect commands”commands”

Table 1: DPICS, before and Table 1: DPICS, before and after the projectafter the project

Do - skillsDo - skills NN M M (before)(before)

MM(after)(after)

SDSD TT DfDf SignificanceSignificance(2-taled)(2-taled)

Labeled praiseLabeled praise 1212 1,251,25 9,009,00 4,394,39 -6,112-6,112 1111 ,000***,000***

Behavioral descriptionsBehavioral descriptions 1212 0,580,58 9,179,17 5,505,50 -5,405-5,405 1111 ,000***,000***

Information Information descriptionsdescriptions

1212 29,5829,58 19,9219,92 6,296,29 5,3275,327 1111 ,000***,000***

Unlabeled praiseUnlabeled praise 1212 1,001,00 3,423,42 2,352,35 -3,557-3,557 1111 ,004**,004**

Reflective statementsReflective statements 1212 8,758,75 10,6710,67 7,007,00 -,949-,949 1111 ,363,363

Don’t – skillsDon’t – skills

QuestionsQuestions 1212 23,5823,58 6,006,00 7,627,62 7,9927,992 1111 ,000***,000***

Direct commandsDirect commands 1212 3,583,58 0,830,83 2,262,26 4,2134,213 1111 ,001**,001**

Indirect commandsIndirect commands 1212 3,423,42 2,832,83 3,153,15 ,642,642 1111 ,534,534

Critical statementsCritical statements 1212 0,250,25 0,250,25 0,730,73 ,000,000 1111 1,001,00

Continue: resultsContinue: results

The participants reported that they had The participants reported that they had changed their “do- skills” and “don’t – skills”changed their “do- skills” and “don’t – skills” (Table 3)(Table 3) : : “ “descriptions”descriptions” “ “avoiding questions”avoiding questions” ““praising appropriate behavior”,praising appropriate behavior”, ““reflections”reflections”

They evaluated selective ignoring as importantThey evaluated selective ignoring as important

Continue: ResultsContinue: Results

The intervention program was evaluated The intervention program was evaluated highly positive by the participantshighly positive by the participants (Table 2)(Table 2)

Table 2: The perceived Table 2: The perceived usefulness of the projectusefulness of the project

Benefit of participatingBenefit of participating NN M (SD)M (SD)

My personal benefit of the course My personal benefit of the course

My personal benefit of the coaching My personal benefit of the coaching

The benefit for the kindergartenThe benefit for the kindergarten

The benefit for kindergartens in The benefit for kindergartens in generalgeneral

1111

1111

1111

1111

6,10 (0,70)6,10 (0,70)

6,40 (0,67)6,40 (0,67)

5,82 (0,87)5,82 (0,87)

6,20 (0,60)6,20 (0,60)

Continue: ResultsContinue: Results

No connection between the participant’s No connection between the participant’s evaluation of the program and their evaluation of the program and their educational background, years of educational background, years of experience or personal experience with experience or personal experience with disruptive children disruptive children

Table 3: Perceived changesTable 3: Perceived changes

Perceived personal changes Perceived personal changes NN M (SD)M (SD)

Behavioral descriptionsBehavioral descriptionsAvoid questionAvoid questionPraise appropriate behaviorPraise appropriate behaviorReflective statementsReflective statementsIgnore inappropriate behaviorIgnore inappropriate behaviorAvoid commandsAvoid commandsImitatingImitatingParticipating in playingParticipating in playing

10101111111111111111111111111111

5,70 (0,68)5,70 (0,68)5,36 (0,67)5,36 (0,67)5,27 (0,91)5,27 (0,91)5,27 (1,11)5,27 (1,11)4,55 (0,69)4,55 (0,69)4,18 (1,33)4,18 (1,33)3,82 (1,25)3,82 (1,25)3,45 (1,57)3,45 (1,57)

DiscussionDiscussion

The actual changes in the participants “do- The actual changes in the participants “do- and don’t – skills” were a result of the and don’t – skills” were a result of the chosen focus in my coaching chosen focus in my coaching

Positively evaluation of the project, does Positively evaluation of the project, does it: it: reflects a need for this kind of knowledgereflects a need for this kind of knowledge a result of the selection of participants (highly a result of the selection of participants (highly

motivated) motivated) Small group of participants (N= 12 (13) )Small group of participants (N= 12 (13) ) Practical issuesPractical issues

Future directionsFuture directions

How has this intervention affected the How has this intervention affected the children who participated?children who participated? Changes in behavior?Changes in behavior? Generalized at home?Generalized at home? Longitudinal effect Longitudinal effect

The effectiveness of this kind of The effectiveness of this kind of intervention compared to othersintervention compared to others

ReferencesReferences Campbell, S.B. (1995): Behaviour Problems in Preschool Campbell, S.B. (1995): Behaviour Problems in Preschool

Children: A Review of Recent Research, in Children: A Review of Recent Research, in Journal of Child Journal of Child Psychology and Psychiatry, Psychology and Psychiatry, Vol. 36 (1), s. 113-149Vol. 36 (1), s. 113-149

Filcheck, H.A., McNeil, C.B., Greco, L.A. & Bernard, R.S. Filcheck, H.A., McNeil, C.B., Greco, L.A. & Bernard, R.S. (2004): Using a whole-class token economy and coaching of (2004): Using a whole-class token economy and coaching of teacher skills in a preschool classroom to manage teacher skills in a preschool classroom to manage disruptive behaviour, disruptive behaviour, Psychology in the SchoolsPsychology in the Schools, Vol. 41 (3), , Vol. 41 (3), s.351-361.s.351-361.

Lamer, K. (1997), Du og jeg og vi to! Om å fremme sosial Lamer, K. (1997), Du og jeg og vi to! Om å fremme sosial kompetanse, teoriboka. kompetanse, teoriboka. Oslo, Universitetsforlaget ASOslo, Universitetsforlaget AS

Ogden, T. (2001): Ogden, T. (2001): Sosial kompetanse og problematferd I Sosial kompetanse og problematferd I skolen; kompetanseutviklende og problemløsende arbeid i skolen; kompetanseutviklende og problemløsende arbeid i skolenskolen, Oslo; Gyldendal Akademisk. , Oslo; Gyldendal Akademisk.

Continue: referencesContinue: references

Sørlie, M. (2000): Sentrale kunnskapskilder og klassifikasjon Sørlie, M. (2000): Sentrale kunnskapskilder og klassifikasjon av tiltak, In Sørlie, M. av tiltak, In Sørlie, M. Alvorlige atferdsproblemer og lovende Alvorlige atferdsproblemer og lovende tiltak i skolen,tiltak i skolen, Oslo: Praxis forlag, s. 27-34. Oslo: Praxis forlag, s. 27-34.

Zeiner, P., Backe-Hansen, E., Eskeland, S., Ogden, T., Zeiner, P., Backe-Hansen, E., Eskeland, S., Ogden, T., Rypdal, P. & Sommerschild, E.H., Norges Forskningsråd Rypdal, P. & Sommerschild, E.H., Norges Forskningsråd (2004/1997): (2004/1997): Barn og unge med alvorlige atferdsvansker: Barn og unge med alvorlige atferdsvansker: Hva kan nyere viten fortelle oss? Hva slags hjelp trenger Hva kan nyere viten fortelle oss? Hva slags hjelp trenger de? de? ; Ekspertuttalelse etter konferansen 18.-19.september ; Ekspertuttalelse etter konferansen 18.-19.september 1997 om tilbud til barn og unge som er spesielt vanskelige 1997 om tilbud til barn og unge som er spesielt vanskelige eller utagerende, Oslo: Norges Forskningsråd. eller utagerende, Oslo: Norges Forskningsråd.