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162 ACQ Volume 11, Number 3 2009 ACQuiring knowledge in speech, language and hearing
Future directions
Four new early intervention and prevention programs have
now been established, at the Austin, Royal Children’s
Hospital, Bendigo and North Eastern CAMHS. Collectively,
these programs are now known by the acronym CASEA
(CAMHS and Schools Early Action), the name reflecting
collaboration between the Mental Health and Education
services. Although all CASEA programs have the same
model and over-riding philosophy, they have evolved as
separate programs, with slightly different emphases, staffing
and execution of the program.
KKPP is a program constantly developing program and
is committed to evaluating its outcomes. Future directions
include further research and university partnerships, more
links with community agencies, and extending the work
to the preschool population. The work to date has been
exciting and stimulating with positive outcomes overall,
showing that a collaborative and early intervention approach
to behavioural problems does make a difference for
teachers, parents and the children themselves by getting
them on a more positive life trajectory.
References
AACAP. (2007). Practice parameter for the assessment and
treatment of children and adolescents with oppositional
defiant disorder. American Academy of Child and Adolescent
Psychiatry, 46(1), 126–140.
AACAP. (2009). Oppositional defiant disorder: A guide for
families by the American Academy of Child and Adolescent
Psychiatry. Retrieved 24 March 2009 from http://www.
Brann, P, Corboy, D., Costin, J., McDonald, J., Hayes, L.,
& Turner, M. (2007). An evaluation of an early intervention
approach to disruptive behaviours in primary school children:
Kool Kids, Positive Parents (KKPP) and CAMHS and Schools
Together (CAST). Melbourne: Eastern Health. Unpublished
report for the Mental Health Branch Victoria.
Goodman, R. (2001). The Strengths and Difficulties
Questionnaire. Retrieved 7 Nov. 2005 from http://www.
Gresham, F. M., & Elliott, S. N. (1990). The social skills
rating system. Circle Pines, MN: American Guidance Services.
Partridge, A. (2009). Evaluation of an early intervention
program for childhood conduct problems. Unpublished
doctoral dissertation, Deakin University, Melbourne, Australia.
Webster-Stratton, C., & Reid, M. J. (2003). Treating
conduct problems and strengthening social and emotional
competence in young children: The Dina Dinosaur Treatment
program. Journal of Emotional and Behavioural Disorders,
11(3), 130–143.
Table 3. KKPP parent group
Session Topic/area
1 Understanding child behaviour
Quality time
2 Giving effective commands, behaviour management (use
of praise and ignoring)
3 Active listening – tuning into your child
4 Incentive planning – how do we promote more positive
behaviour?
5 Managing misbehaviour
6 Helping children to manage their emotions
7 Helping children develop social skills
8 Building positive school/home relationships
Suzanne Lim has worked in CAMHS for around 20 years as well as
in private practice, education settings and overseas. She is currently
the team manager of the Kool Kids Positive Parents program, a CAMHS
in Schools Early Action (CASEA) program, which provides early
intervention and prevention for children with behavioural difficulties.
Correspondence to:
Suzanne Lim
Team Manager, Kool Kids Positive Parents
Senior Clinician Speech Pathologist
Eastern Health Child and Adolescent Mental Health (CAMHS)
C/- 19 Grey Street, East Ringwood, Victoria, 3135
email:
behaviour, an individualised focus might include further parent or
teacher interviews, pupil support group meeting to discuss
specific issues, referrals for additional assessments or the
setting up of a positive behaviour plan. Representatives from
all schools are invited to training in functional behavioural
assessments and development of a positive behaviour plan
for children with particularly challenging behaviour.
KKPP has time-limited involvement with each school. All
parents who are involved with the targeted component receive
written and verbal feedback with recommendations. To aid
sustainability, schools are provided with the training and materials
to implement the programs for a second time without KKPP
clinical staff (who are available on a consultant basis).
Outcomes
Both qualitative and quantitative evaluation of KKPP was
completed on data collected from the 32 schools concerning
220 children and their parents who were involved at the
targeted level of intervention, from mid 2004 to the end of
2006. The children were mainly boys from grades 1 and 2,
who had high levels of conduct problems compared to their
peers, with teachers rating more than 70% of these children
as being in the clinical range.
Analysis of parent and teacher SDQ data found significant
decreases in children’s problems following the group
interventions, with improvements on all scales, i.e., children’s
overall difficulties, emotional problems, conduct problems,
hyperactivity, peer problems and prosocial behaviours. The
percentage of children who were in the clinical range on the
SDQ fell from 75% to 53% according to teachers. Analysis
of the Social Skills Rating Scale Gresham & Elliott, 1990)
found statically significant improvements in social skills and
academic competence as well as significant reductions in
problem behaviour according to both teacher and parent
reports (Brann et al, 2007). Results also indicated that
parents had a greater sense of competency and satisfaction
following the program and had become less verbose, lax
and over-reactive (Brann et al., 2007). Long-term follow up
showed that these improvements in parents and children
were sustained up to 6 to 18 months post program delivery
(Partridge, 2009).
Analysis of feedback questionnaires from education
staff, parents, children and co-facilitators indicated that
satisfaction with the programs was high and the strategies
introduced were valued. The group activities were popular
with the small Kool Kids group as well as the whole class
and the use of puppets made an enormous difference in
engaging the children. “Sam” – a large boy puppet – rapidly
became the KKPP mascot!