Managing extreme behaviour

While most young children go through periods of challenging behaviour, according to University New South Wales, around 6 per cent of Australian children have genuine disruptive behaviour disorders which put them at risk of future school failure and dropout, family violence, mental illness, and crime.

A new resource to support parents and educators trying to manage these children is now being trialled in Sydney and could lead to broader changes. UNSW has partnered with several public primary schools and preschools in south-western Sydney to establish one of the world's first school-based therapy clinics providing evidence-based early intervention to young children with severe disruptive behaviour.

Free intervention support for kids and families

Program director and clinical psychologist from the School of Psychology at UNSW Science, Associate Professor Eva Kimonis, officially launched the outreach clinic at Ingleburn Public School in June with many children and their families already set to benefit from its programs.

In its first year of operation the clinic will assess more than 1000 children and offer a form of intervention called Parent-Child Interaction Therapy (PCIT) free of charge to children who have been identified as being at risk – as well as their parents and teachers.

While the clinic will be conducted from Ingleburn Public School, it will operate across a wider area and include students from other primary schools and preschools.

Ingleburn Public School principal, Graeme Green, is also hopeful that the clinic model will be so successful that it will spread into schools in the greater Sydney metro area.

"Nothing like this has been done before in a school setting. We are empowering our students to become collaborative, innovative global citizens, and this program will help them get there," said Mr Green.

About the Parent-Child Intervention Therapy program

The PCIT program is an evidence-based treatment for children between the ages of two and seven who display disruptive behaviour problems. Students will be invited to participate in the program if identified as being at-risk – either via a school-wide screening or by a teacher referral. Children struggling to transition from preschool to kindergarten may also be eligible to take part.

"This is a really important step in bridging the gap between clinical research and practice," said Associate Professor Kimonis. "We have excellent evidence-based treatments that many families are never able to access."

As with most developmental or behavioural issues, early intervention she believes is the key.

"These children tend to have early-starting conduct problems that negatively affect their home and school environments. There are a whole host of negative things that are likely to eventuate downstream for these children, their families, peers and teachers if we don't address those problems early enough," said Kimonis.

"By preschool age we can reliably identify when a child's disruptive behaviours are at a level that require intervention."

A foundation in ground-breaking research

In 2013, Associate Professor Kimonis founded the Parent-Child Research Clinic at UNSW Psychology. In 2016 she published a groundbreaking study showing that indications of callous-unemotional traits which describe children low in empathy and remorse can be reliably observed in children as young as age three. Following this she developed an enhanced PCIT treatment to target the unique needs of children with callous-unemotional traits because of their poor response to existing evidence-based treatments. She plans to deliver both standard and targeted versions of PCIT at the Ingleburn clinic.

According to UNSW, research has shown that PCIT reduces children's disruptive behaviours, improves parenting skills and overall family functioning, reduces parental stress levels, and has lower dropout rates than other parenting interventions.

Standard PCIT has two phases delivered via real-time coaching of parents using a wireless headset from behind a one-way mirror by a therapist. The intervention typically involves between 14 and 21 weekly one-hour sessions.

"We will also be implementing other interventions in partnering schools, including a general parenting program and online teacher training that we will be rolling out to help educators learn skills to manage disruptive behaviours," said Kimonis.

Helping a community in need

The south-western Sydney area where the project will run has vulnerable communities with pockets of significant disadvantage with some families, groups and communities characterised by financial instability and unemployment; poorer mental and physical health; and lower use of preventative services compared to the rest of NSW.

"Although there is some support for vulnerable families, some serious barriers can prevent them from accessing mental health services including lack of knowledge and understanding of the availability and cost of treatment, lack of child care, and long waiting lists. It is our goal to overcome many of these barriers by delivering PCIT directly in local schools," said Associate Professor Kimonis.

"This community is fortunate to have such forward-thinking leadership at the seven participating schools. Our hope is that this world-first, grassroots initiative will achieve national recognition and serve as a model for schools across Australia."

We look forward to bringing you more developments regarding the UNSW Parent-Child Research Clinic and the PCIT program as they unfold.

If you are an early childhood educator who is concerned about the behaviour of a child in your care, the clinic has various resources available on their website. For more details on UNSW Parent-Child Research Clinic, their research and support programs, please visit Conduct Problems.