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RESEARCH: Judy Hutchings, Tracey Bywater, Dave Daley, Frances Gardner, Chris Whitaker, Karen Jones, Catrin Eames, and Rhiannon T Edwards Parenting intervention in Sure Start services for children at risk of developing conduct disorder: pragmatic randomised controlled trial BMJ 2007; 334: 678 [Abstract] [Full text]

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Good parenting best bet against bad conduct

Saddichha Sahoo   (23 March 2007)

Effective use of sure start is benficial to the society

Navin Chandra Kunigal Venugopal   (31 March 2007)

Good parenting best bet against bad conduct 23 March 2007
Saddichha Sahoo, Resident in Psychiatry Central Institute of Psychiatry, Ranchi,India-834006 Send response to journal: Re: Good parenting best bet against bad conduct	It is heartening to note that the randomised controlled trial of parenting intervention in Sure Start services proved effective in reducing the problems of conduct disorder.It has been noted from a long time that good parenting is the best bet to develop a well-behaved child, but now we have evidence to back this up. However I would like to draw attention to certain facts that may have influenced the findings. It is noted that more people dropped out from the intervention group(17.3%) as compared to controls(4%)although, there were fewer conduct problems (on the Eyberg child behaviour inventory)reported in the intervention group [15.7 (SD-5.1)] compared to controls [28 (SD- 4.2)]. There is also a skewed distribution of the sample in both groups as SDs are more than means as seen in Table 2.Could these have influenced the findings in any way? Competing interests: None declared
Effective use of sure start is benficial to the society 31 March 2007
Navin Chandra Kunigal Venugopal, Specialist Registrar in Child and Adolescent Psychiatry London Send response to journal: Re: Effective use of sure start is benficial to the society	It is very heartening to see a study that has effectively shown that the sure start programs are beneficial to the parents coming from disadvantaged backgrounds and to the society in general as well. Following the report by Meadows and Belsky et.al(2006) reporting that there was no evidence to suggest that sure start reduced conduct problems. There was wide publication in the media of the lack of evidence that sure start programmes were helpful or benficial. There was also a suggestion that the government had probably wasted valuable money on an untested programme. This probably resulted in the subsequent reduction of funds as well. Now that there is a study that has shown that using the programme in an effective way actually helps reduce conduct problems not only in subjects, but also in their siblings and the consequent reduction of stress on parents. I hope that there is a similar attention given to this study in the wider media as it may help in generating much needed funds to help children and parents who could benefit from the programme. It has been shown in previous studies that by the age of 28, the cost for individuals with conduct disorder could be 10 times that of individuals without conduct problems (Scott et.al, 2001). As the eventual cost is paid by the taxpayer anyway, surely continuing and encouraging such programmes would be more effective use of the taxpayers money rather than withdarwal of funding as is currently happening. Reference: Stephen Scott,Martin Knapp,Juliet Henderson,Barbara Maughan. Financial cost of social exclusion: follow up study of antisocial children into adulthood, BMJ 2001; 323:191. Meadows P. Cost effectiveness of implementing SSLPs: an interim report, research report. London: Department for Education and Skills, 2006 Belsky J, Melhuish E, Barnes J, Leyland AH, Romaniuk H. Effects of Sure Start local programmes on children and families: early findings from a quasi-experimental, cross sectional study. BMJ 2006;332:1476-8. Competing interests: None declared