To assess the behavioural and academic improvement of children who attended a day treatment program during a defined period of time.
Method:
Forty-six children admitted consecutively to the project were assessed on admission and discharge using behavioural and academic measures. They also had intelligence and language assessments. The subjects attended the program for one academic year, on the average. The large majority presented with disruptive behaviour disorders and low academic achievement levels.
Results:
There was a significant improvement reported by the parents in externalizing (P < 0.001) and internalizing (P < 0.05) behaviour. The subjects also gained one academic year, but their levels continued to be low in terms of percentiles. Measures of academic improvement showed significant associations with cognitive measures only (subscales of Wechsler Intelligence Scale for Children-Revised [WISC-R] and Clinical Evaluation of Language Fundamentals-Revised [CELF-R]).
Conclusion:
A day treatment and school program is an effective modality for treatment and remediation of children with severe psychiatric disorders. The academic underachievement may be resistant to remediation within the limited period of attendance in such a program.
ZimetSG. Day treatment in the year two thousand and one. Canadian Child Psychiatry Bulletin1993;2:64–8.
2.
KiserLJCulhaneDPHadleyTR. The current practice of child and adolescent partial hospitalization: Results of a national survey. J Am Acad Child Adolesc Psychiatry1995;34:1336–42.
3.
SayeghLGrizenkoN.Studies of the effectiveness of day treatment programs for children. Can J Psychiatry1991;36:246–53.
4.
BaenenRSStephensMAPGlenwickDS. Outcome in psychoeducational day school programs: A review. Am J Orthopsychiatry1986;56:263–70.
5.
GabelSFinnMAhmadA.Day treatment outcome with severely disturbed children. J Am Acad Child Adolesc Psychiatry1988;27:479–82.
6.
GrizenkoNPapineauDSayeghL.Effectiveness of a multimodal day treatment program for children with disruptive behavior problems. J Am Acad Child Adolesc Psychiatry1993;32:127–34.
7.
RobinsL.Sturdy childhood predictors of adult antisocial behaviour: Replication from longitudinal studies. Psychol Med1978;8:611–22.
8.
LoeberR.Antisocial behavior: More enduring than changeable?J Am Acad Child Adolesc Psychiatry1991;30:393–7.
9.
OffordDBoyleMRacineYFlemingJECadmanDTBlumH. MonroeOutcome, prognosis, and risk in a longitudinal follow-up study. J Am Acad Child Adolesc Psychiatry1992;31:916–23.
10.
WeissGHechtmanLMilroyTPerlmanT.Psychiatric status of hyperactives as adults, a controlled prospective: 15 year follow-up of 63 hyperactive children. J Am Acad Child Psychiatry1985;24211–20.
11.
BarkleyRFischerMEdelbrockCSmallishL.The adolescent outcome of hyperactive children diagnosed by research criteria, I: An 8-year prospective follow-up study. J Am Acad Child Adolesc Psychiatry1990;29:546–57.
12.
MannuzzaSKleinRGBesslerAMalloyPLaPadulaM.Adult outcome of hyperactive boys. Arch Gen Psychiatry1993;50:565–76.
13.
KazdinAE. Treatment of antisocial behavior in children: Current status and future directions. Psychol Bull1987;102:187–203.
14.
ShamsieJHluchyC.Youth with conduct disorder: A challenge to be met. Can J Psychiatry1991;36:405–14.
15.
CohenNJBradleySKolersN.Outcome evaluation of a therapeutic day treatment program for delayed and disturbed preschoolers. J Am Acad Child Adolesc Psychiatry1987;26:687–93.
16.
GrizenkoNSayeghL.Evaluation of the effectiveness of a psychodynamically oriented day treatment program for children with behaviour problems: A pilot study. Can J Psychiatry1990;35:519–25.
17.
NeyPAddamRHantonB.The effectiveness of a child psychiatric unit: A follow-up study. Can J Psychiatry1988;33:793–9.
18.
ZimetSGFarleyGK. Day treatment for children in the United States. J Am Acad Child Psychiatry1985;24:732–8.
19.
DoanRJPettiTA. Patient assessment and treatment planning in child and adolescent partial hospital programs. Community Ment Health J1990;26:297–308.
20.
ZimetSFarleyGSilverJHerbertFBRobbE DuchesneEkanserCSmithD.Behavior and personality changes in emotionally disturbed children enrolled in a psychoeducational day treatment center. J Am Acad Child Psychiatry1980;19:240–56.
21.
GrizenkoNSayeghLPapineauD.Predicting outcome in a multimodal day treatment program for children with severe behaviour problems. Can J Psychiatry1994;39:557–62.
22.
LevineMD. Persistent inattention and unintention in middle childhood. In: LevineMDSatzP, editors. Middle childhood development and dysfunction. Baltimore: University Park Press; 1984. p 183–225.
23.
TramontanaMHooperSCurleyANardolilloEM. Determinants of achievement in children with psychiatric disorders. J Am Acad Child Adolesc Psychiatry1990;29:265–8.
24.
SpreenO.Prognosis of learning disability. J Consult Clin Psychol1988;56:394–7.
25.
BlumH MunroeBoyleMOffordD.Single-parent families: Child psychiatric disorder and school performance. J Am Acad Child Adolesc Psychiatry1988;27:214–9.
26.
MaughamDYuleW.Reading and other learning disabilities. In: RutterMTaylorEHersovL, editors. Child and adolescent psychiatry: Modern approaches. 3rd ed.Oxford: Blackwell Scientific Publications; 1994. p 647–65.
27.
KotsopoulosSWalkerSBeggsKJonesB.Reading and spelling deficits among children attending a psychiatric day treatment program. European Child & Adolescent Psychiatry. 1996;5:83–92.
28.
WechslerD.Wechsler Intelligence Scale for Children-Revised. New York: The Psychological Corporation Harcourt Brace Jovanovich; 1974.
29.
SemelLBWiigEHSecordW.Clinical Evaluation of Language Fundamentals-Revised (CELF-R). New York: The Psychological Corporation Harcourt Brace Jovanovich; 1987.
30.
KaufmanASKaufmanN.Kaufman Test of Educational Achievement. Circle Pines (MN): American Guidance Service; 1985.
31.
BishopD.The underlying nature of specific language impairment. J Child Psychol Psychiatry1992;33:3–66.
32.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed. Revised. Washington (DC): American Psychiatric Association; 1987.
33.
AchenbachTM. The Child Behavior Profile, I: Boys aged 6–11. J Consult Clin Psychol1978;46:478–88.
34.
EdelbrockCAchenbachTM. The teacher version of the Child Behavior Profile, I: Boys aged 6–11. J Consult Clin Psychol1984;52:207–17.
35.
ConnersCK. A teacher rating scale for use in drug studies with children. Am J Psychiatry1969;126:884–8.
36.
AchenbachTMEdelbrockC.The Child Behavior Profile, II: Boys aged 12–16 and girls aged 6–11 and 12–16. J Consult Clin Psychol1979;47:223–33.
37.
KupietzSBialerIWinsbergB.A behavior rating scale for assessing improvement in behaviorally deviant children: A preliminary investigation. Am J Psychiatry1972;128:1432–6.
38.
RacusinGMossN.Psychological assessment of children and adolescents. In: LewisM, editor. Child and adolescent psychiatry. Williams & Wilkins; 1991. p 472–85.
39.
JohnsonSBMelamedBG. The assessment and treatment of children's fears. In: LaheyBBKazdinAE, editors. Advances in clinical child psychology. Volume 2. New York: Plenum Press; 1979. p 107–39.
40.
KleinRG. Parent-child agreement in clinical assessment of anxiety and other psychopathology: A review. Journal of Anxiety Disorders1991;5:187–98.
41.
SaylorCFBaskinCHFureyWKellyMM. Construct validity for measures of childhood depression: Application of multitrait-multimethod methodology. J Consult Clin Psycol1984;Suppl2:977S–985S.
42.
ReynoldsWMAndersonGBartellN.Measuring depression in children: A multimethod assessment investigation. J Abnorm Child Psychol1985;13:513–26.
43.
KotsopoulosSWalkerSCoppingWCôtéAStavrakakiC.Parent rating and self-report measures in the psychiatric assessment of adolescents. Adolescence1994;29:253–63.
44.
AbramowitzAJ. Classroom interventions for disruptive behavior disorders. Child Adolesc Psychiat Clinics North America1994;3:343–59.
HechtmanL.Aims and methodological problems in multimodal treatment studies. Can J Psychiatry1993;38:458–64.
47.
Prentice-DunnSWilsonDRLymanRD. Client factors related to outcome in a residential and day treatment program for children. J Clin Psychol1981;10:188–91.
