Testing the goodness-of-fit of a multifaceted preventive intervention for children at risk for conduct disorder

George M. Realmuto, Gerald J. August, Elizabeth A. Egan

Research output: Contribution to journalArticlepeer-review


Objective: To determine the importance of parents' global adaptive functioning as a predictor of participation rate and subsequent child social competence outcome in 3 program components of an evidence-based, multifaceted, preventive intervention for at-risk children. Method: Families of program children (n = 124, mean age 6.6 years at recruitment) were offered 3 program components that continued for 3 years: a 6-week summer program, a biweekly family program that included concurrent parent and child education and skills training groups, and a flexibly tailored home visitation family support program. We used structural equation modelling to test hypotheses about the effects of parental characteristics on program attendance in each of the program components over 3 years, as well as their relation to children's social competence. Results: Predictors of attendance included child IQ, socioeconomic status (SES), and single-parent status for some components but not others, depending on parents' global adaptive functioning. Predictors of child social competence outcome were mediated by attendance in specific program components and were dependent on parent global adaptive functioning. Some components contributed decisively to social competence outcomes, and others did not, despite subjects' participation. Conclusions: Common family characteristics (that is, child IQ, SES, and single-parent status) predict program attendance differently, depending on parents' global adaptive functioning. Parents' global adaptive functioning determined whether attendance in specific program components mediated children's social competence. In this preventive intervention, as in clinical practice, only knowledge of the goodness-of-fit between participant characteristics and program attributes can ensure optimum benefit.

Original languageEnglish (US)
Pages (from-to)743-752
Number of pages10
JournalCanadian Journal of Psychiatry
Issue number11
StatePublished - Nov 2004


  • Aggressive children
  • At-risk children
  • Conduct disorder
  • Disruptive children
  • Outcome
  • Parent functioning
  • Participation
  • Prevention


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