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  3. Parenting intervention in Sure Start services for children at risk of developing conduct disorder: pragmatic randomised controlled trial
Research

Parenting intervention in Sure Start services for children at risk of developing conduct disorder: pragmatic randomised controlled trial

BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39126.620799.55 (Published 29 March 2007) Cite this as: BMJ 2007;334:678

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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

Competing interests: No competing interests

31 March 2007
Navin Chandra Kunigal Venugopal
Specialist Registrar in Child and Adolescent Psychiatry
London

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

Competing interests: No competing interests

23 March 2007
Saddichha Sahoo
Resident in Psychiatry
Central Institute of Psychiatry, Ranchi,India-834006
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