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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. aacap.org/galleries/eAACAP.ResourceCenters/ODD_guide.pdf 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 Unpublished report for the Mental Health Branch Victoria.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. youthinmind.net/Aus/ 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 Unpublished doctoral dissertation, Deakin University, Melbourne, Australia.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. 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.

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

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!

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: Suzanne.Lim@easternhealth.org.au

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ACQ Volume 11, Number 3 2009

ACQ uiring knowledge in speech, language and hearing