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Back You & Your Family Disruptive youth behavior: empowering parents and communities
21 Oct 2012

Disruptive youth behavior: empowering parents and communities


by: ‘Diji Vaughan, MD, FAAP

The title song in this 1966 classic, Follow me, boys! is more than ode to the Boy Scout movement or the last production with Walt Disney’s thumbprints on it. The redemption of the troublesome youth in town and the odyssey of Lemuel “Lem” Siddons intertwine as he earns the respect of the town folk and loyalty of the youth. Disruptive youth behavior with attendant global socioeconomic stressors makes parenting more challenging today and remains a widely prevalent problem. The dim reality that pharmacologic therapy with pills alone will not suffice even in the 21st century and indeed needs a full spectrum of support for success when indicated makes me wonder if Lem’s experience, expertise and approach to solving this problem fictionally would be applicable today.

The town of Hickory and the trouble it faced with it’s troublesome youth in the 1930’s bear some semblance to the disruptive behavioral problems plaguing youth in diverse neighborhoods nationwide today with a view from 30,000 feet. Perhaps, the remarkable gains at the end of the story and community empowerment through the selfless leadership shown by Lem Siddons’ character played by Fred MacMurray and the redemption of Kurt Russell’s character who was the lead prankster certainly appeals as plausible to common sense but it may have found even more traction scientifically in a Randomized Controlled Trial study published in the March 13, 2012 issue of the British Medical Journal.

The team of investigators selected one of the poorer boroughs of London in 2010 and set out to evaluate the effectiveness of a peer led parenting intervention for disruptive behavior problems in children ages 2-11. 116 children and their respective parents were recruited for the study and split into two identical groups at baseline.

Peer mentors from the community were selected, paired and assigned to administer the intervention to small groups of about 7 to 14 parents drawn from the one-half of study participants to be treated. The intervention consisted of a structured manual and using validated methods themed on, social learning, structural, relational, and cognitive behavioral theories and methods for the treatment of disruptive behavior in children. These total of 8 weekly, 2-hr sessions involved sharing of information, group discussion, role play, reflection, and planning/review of homework tasks.

These peer facilitators, the study reports were themselves parents from the local community who had successfully completed an accredited training program that included workshops (totaling 60 hours), submission of a written portfolio, and a period of supervised practice.

The results were promising and showed that this peer led parenting intervention  dubbed “empowering parents, empowering communities”  by the investigators could significantly address child behavior problems and improve parenting competencies, just like Lem Siddons’ bold intervention through the Boy Scout program the town of Hickory decided to spare the program from the blocks eventually redeemed the youth. This approach to care could evolve into a promising method for providing effective and acceptable parenting support to families considered hard to reach otherwise, as their parents try to grapple these issues and others.

The study design had its strengths and flaws but inherently met the well regarded pedigree of a randomized controlled trial although other questions raised as a result of this study merit further evaluation. Formal economic evaluations are yet to be completed by the investigators, the intervention may in the interim offer an economically viable method for increasing provision of evidence based parenting support for families oblivious to the benefits of equipping parents with skill sets to specifically address disruptive behavior problems in their children. I hope we’ll find the will to follow the gains of this study, explore ways of implementation and lead the children away from disruptive behavior, the way Lem Siddons has showed us all for more than a half century. Follow me, Folks!

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‘Diji Vaughan, MD, FAAP

‘Diji Vaughan, MD, FAAP

‘Diji Vaughan, MD, FAAP obtained his primary medical training at the College of Medicine of the University of Lagos. Since graduation, Dr Vaughan has practiced medicine in diverse clinical settings from Family medicine; Ophthalmology to Critical Care/Anesthesiology before residency training in General Pediatrics at Bronx Lebanon Hospital Center/ Children’s Hospital at Montefiore Bronx NY in 2005.

He practiced as a Pediatric Hospitalist in Phoenix AZ after residency training and was adjudged the best General Pediatrician by the Department of Pediatrics at St Joseph’s Hospital & Medical Center, Phoenix AZ for the year 2009 and went to serve on the Pediatric residency training program faculty until 2010. Dr. Vaughan pioneered a successful sole-pediatric hospitalist program afterwards in the east valley, which has now evolved into a full-fledged traditional pediatric practice poised for excellence in primary care. ‘Diji is married with three children and currently lives in Gilbert AZ. He’s a keen historian and soccer fan. His current professional interests include Comparative Effectiveness Research, Tropical Medicine and Developmental/Behavioral Pediatrics.

Website: www.springfieldpeds.com

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