norms and parental expectations. Key risk factors during this period include parental reports of difficult child temperament, noncompliance, aggression, parental irritability and harshness, lack of discipline skills— particularly limit setting—and low parental warmth and playfulness. A substantial number of randomized trials of parent training and support interventions have targeted this constellation of risk factors. The most programmatic and successful work to date has been reported by Carolyn Webster-Stratton and her colleagues (Webster-Stratton, 1989, 1998; Webster-Stratton et al., 1988). Targeted at parents of children demonstrating severe conduct problems, these interventions focused on discipline, supervision, problem solving, praising, and positive interactions. Using both parent reports and direct observation data, they consistently report strong improvements in these skills, as well as improvements in children’s social behavior, lower rates of problems and aggression, and better social skills. The parent training interventions are highly replicable and can be enhanced with videotapes and parenting manuals. Follow-up studies show persistence for up to two years.

An intriguing study by McNeil et al. (1991) demonstrated that improving parenting skills has direct and positive effects on young children’s behavior in preschool classrooms (also see Sheeber and Johnson, 1994). As the next chapter discusses, these strategies can be integrated with school-based programs to produce truly integrated interventions for elementary school students.


Demonstration programs that provide services directly to children to promote their cognitive and behavioral development have a history that stretches back 30 years. The effects of these programs have been reviewed thoroughly, frequently, and recently (Karoly et al., 1998; National Research Council [NRC], 2000a, 2000b; Ramey and Ramey, 1999; Guralnick, 1997; White and Boyce, 1993; Farran, 1990; Haskins, 1989; Karweit, 1989; Carnegie Task Force on Meeting the Needs of Young Children, 1994; Bryant and Maxwell, 1997; Currie, 2000). We do not undertake another review here. Rather, we summarize some of the major lessons from the programs characterized both by the provision of high-quality, intensive services and by the use of rigorous research designs to analyze outcomes (Ramey and Ramey, 1998). High quality refers to the nature of the transactions between caretakers and children, and is supported by the education and training of the caretakers, smaller child/adult ratios, and smaller group size. The findings synthesized below draw from prospective randomized trials targeted to children at risk for developmental delay, mental retardation, poor school achievement, or a combination of the three. A list of

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