(PS4-70) School-based Targeted Prevention for Children with Mild Intellectual Disabilities and Behavior Problems: A Pilot Implementation Study

Objective: Children with mild intellectual disabilities or borderline intellectual functioning (MID-BIF) display more behavior problems (e.g., aggressive and oppositional defiant behavior) than typically developing children. However, research into psychosocial interventions for children with MID-BIF is sparse. The first aim of this pilot study was thus to evaluate the implementation process of Keeping Control of Anger, a school-based targeted prevention program addressing behavior problems that was specifically adapted for children with MID-BIF. Our second aim was to conduct a preliminary test of the intervention’s effectiveness to reduce behavior problems in children with MID-BIF. Our study took place in a routine school mental health care, allowing us to evaluate the implementation process and behavior problem changes as they naturally occur.

Methodology: Thirteen children (M_age = 12.1, SD_age = 1.6, 76.9% male, M_IQ = 75.5, SD_IQ = 6.4) who met all eligibility criteria (i.e., age between nine and fourteen years old, IQ between 65-85, and elevated behavior problems) were included. Children received one individual session, ten group sessions, and one group booster session. We assessed child- and teacher-reported behaviour problems before and after the intervention. We evaluated intervention effects both at the group level and at the individual level.

Results: Regarding intervention reach, we found that mental health professionals in the naturalistic setting did not exclusively include children of the target population: 41.7% of the children they initially selected to take part in the intervention did not meet all inclusion criteria. To the children who met all eligibility criteria, all intervention sessions were delivered and children attended on average 85% of the sessions, indicating acceptable dosage. Children and trainers reported acceptable responsiveness, satisfaction, and comprehension. Group-level behavior problem decreases (i.e., Cohen’s d) were small. Individual-level behavior problem changes (i.e., Reliable Change Indices) showed large heterogeneity and little reliable change.  

Conclusion: The results provide initial evidence that the intervention has potential for successful implementation in schools. To further optimize the program and better estimate the intervention’s effectiveness to reduce behavior problems in children with mild intellectual disabilities or borderline intellectual functioning, minor adjustments to the program and follow-up research with a control group are needed.