Becoming Partners: A School-Based Group Intervention for Families of Young Children Who Are Disruptive

Abstract A multiple family discussion group program was implemented and evaluated by school counselors working with families of young children referred by their teachers for aggression and attention problems. The logic guiding construction of the program and the program's unique aspects are described. Outcome data revealed that the program was effective in reducing the children's hyperactive, defiant, and aggressive behavior and improving the parents' management skills. The advantages of school counselors conducting this program are discussed. School counselors often find themselves working with young children like Tim who demonstrate disruptive behavior and attention difficulties in school. These children are often overactive, inattentive, and demonstrate noncompliance, impulsivity, limited self-control, and an impaired ability to interact appropriately with adults and peers. These behaviors often result in academic difficulties, increased risk for rejection by their peers, and stigmatization as problem children by school staff Research on the causes of noncompliance and aggression in children reveal that in addition to differences in temperament that may contribute to their noncompliance, 4 children who are aggressive and disruptive at school often experience harsh inconsistent parenting at home (Brannigan, Gemmell, Pevalin, & Wade, 2002). Moreover, a number of studies report how the challenge of raising a difficult child (e.g. who is unpredictable, irritable, and unresponsive) often elicits a series of increasingly harsh parenting-child interactions that not only increase the levels of parental stress and guilt and diminish a sense of parenting competence, but also create a mutually coercive cycle of interaction (Johnson & Reader, 2002). Without appropriate, consistent parenting for these temperamentally difficult children, early behavior problems escalate to more severe problems and age-appropriate social competencies fail to emerge (Miller, 1998). Our program targets parents/families of primary grade children (e.g. first and second grade) whose child has been identified as demonstrating classroom conduct/behavior problems by their classroom teacher. There are several reasons for targeting this age range. First, teachers complain of problems in these children of noncompliance, limited self-control, and poor relations with peers. Second, these children are at increased risk for rejection by their peers. Third, a significant number of children who become chronically antisocial and delinquent first exhibit conduct problems during the preschool and early school years. We hoped that intervention with the families of disruptive primary school age children could help these parents teach their 7 children to behave appropriately before the child's behaviors resulted in peer rejection, well-established negative reputations, school problems, and academic failure

Becoming Partners: A School-Based Group Intervention for Families of Young Children Who Are Disruptive

A multiple family discussion group program was implemented and evaluated by school counselors working with families of young children referred by their teachers for aggression and attention problems. The logic guiding construction of the program and the program’s unique aspects are described. Outcome data revealed that the program was effective in reducing the children’s hyperactive, defiant, and aggressive behavior and improving the parents’ management skills. The advantages of school counselors conducting this program are discussed

Risk of COVID-19 after natural infection or vaccinationResearch in context

Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health

Risk of COVID-19 after natural infection or vaccinationResearch in context

Summary: Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health