Parents' Explanatory Models for Severe Disruptive Behavior of Preschool Children

Year Awarded: 2002
Project Leaders:
Marsha Rappley, MD, MSU Department of Pediatrics and Human Development, Barry Kaufman, Ph.D., Children's Services Community Mental Health, Judy Pugh, Ph.D., MSU Department of Anthropology, M. Fran Jozefowicz, Ph.D., Children's Services, Community Mental Health

Project Description:
Children at risk or "expelled" represent 6% of children in day care or preschool in the Greater Lansing area, and another 8% are identified with severe behavior problems. In addition, the number of preschoolers who receive psychotropic medication for behavior management is increasing and the current prevalence is greater than 1%. Little is published from the point of view of the parent, on their understanding of why their child has disruptive behavior, what might help them to deal with this problem, and where they believe they should seek help.

The goal is to determine the role of the parent's explanatory model for severe, disruptive behavior of preschoolers. Hypotheses are: 1) parents of preschoolers with severe disruptive behavior seek help from both professional and lay sources and weigh these as equally valid sources of information and help. 2) A medical model is associated with: the level of severity of the behavior, the parent's experience with another child's favorable response to pharmacological management of behavior, and greater attribution of problems to the child rather than to the family or the social context in which they live. 3) A parent's decision to give a preschooler psychotropic medication is strongly associated with a sense of helplessness about solving problem behavior. 4) These families have a greater burden of health problems, mental health problems, and social distress than families whose preschoolers are not identified as having severe, disruptive behavior.

A structured interview will be administered to 20 parents of children facing expulsion from daycare, and 20 parents of matched controls recruited from the day care of preschool setting of the study subjects. the results will inform service and delivery models, as well as the debate about pharmacologic behavior management of preschoolers, as disseminated in publications and oral presentations. Discussion is underway with NIMH, section on integration of behavioral sciences, project officer Emeline Otey, with a goal of increase in the diversity of families and including teachers and physicians in future work.

Recent Developments:

Parenting preschoolers is a demanding job. When those preschoolers exhibit disruptive behaviors, parenting becomes even more of a challenge. While 8% of children in day care or preschool in the greater Lansing area are identified as having severe behavior problems, another 6% are at risk or have already been "expelled." In addition, these young children are increasingly receiving psychotropic medication.

To understand how parents and families respond to and cope with such behavioral problems researchers will collect first hand data about parental behavior. They will interview parents of children facing expulsion from day care, as well as parents of matched controls recruited from the same day care or preschool setting.

"This study will help us to understand the problems faced by these families from their point of view and how service and support agencies, including medical settings, might best be of help," said Marsha Rappley, project co-leader and associate professor in the Department of Pediatrics and Human Development.

Researchers hypothesize that parents seek and take advice from medical and non-medical persons, often resorting to medication out of a sense of helplessness. Collaborators hope the results will tailor service and delivery models to better meet the needs of parents, as well as expand the knowledge base in the debate about pharmacological behavior management of preschoolers.