Quality statement 1: Early intervention

Quality statement

Children aged 3 to 7 years attending school classes where a high proportion of children are identified as at risk of developing a conduct disorder take part in a classroom-based emotional learning and problem-solving programme.

Rationale

A number of social factors increase the risk of a child developing a conduct disorder. Evidence suggests that early intervention can reduce this risk; classroom-based interventions for populations with a high proportion of children who are at risk of developing a conduct disorder have been shown to be effective in reducing antisocial behaviour in children. Given the variety of programmes available, it is important to deliver an evidence-based programme to ensure that this intervention is delivered effectively and appropriately.

Quality measures

Structure

a) Evidence of locally agreed protocols for the identification of school classes where a high proportion of children are at risk of developing a conduct disorder, by individuals or groups with relevant expertise in antisocial behaviour and conduct disorders in children.

b) Evidence of local arrangements for health and social care practitioners, managers and commissioners to work with colleagues in the education sector to design local pathways that include provision of classroom-based interventions for children at risk of developing a conduct disorder.

c) Evidence of local arrangements to ensure that children aged 3 to 7 years in classroom populations that have a high proportion of children identified to be at risk of developing a conduct disorder are offered a classroom-based emotional learning and problem-solving programme.

Data source: Local data collection.

Process

Proportion of school classes (for children aged 3 to 7 years) where a high proportion of children are identified to be at risk of developing a conduct disorder that receive a classroom-based emotional learning and problem-solving programme.

Numerator – the number of school classes in the denominator that receive a classroom-based emotional learning and problem-solving programme.

Denominator – the number of school classes (for children aged 3 to 7 years) that have a high proportion of children identified as at risk of developing a conduct disorder.

Data source: Local data collection.

Outcome

Rates of antisocial behaviour within a classroom population.

Data source: Local data collection

What the quality statement means for service providers, health and social care and education practitioners, and commissioners

Service providers ensure that they work with partner organisations, including schools, to identify classroom populations where a high proportion of children are at risk of developing a conduct disorder, and deliver classroom-based, evidence-based emotional learning and problem-solving programmes.

Health, social care and education practitioners work in collaboration to identify classroom populations where a high proportion of children are at risk of developing a conduct disorder, and deliver a classroom-based, evidence-based emotional learning and problem-solving programme.

Commissioners ensure that they work with partner organisations, including schools, to design local pathways that include identification of classroom populations where a high proportion of children are at risk of developing a conduct disorder, and deliver classroom-based, evidence-based emotional learning and problem-solving programmes.

What the quality statement means for patients, service users and carers

Children in school classes that have a lot of children who are at risk of developing antisocial or aggressive behaviour are offered a programme of activities as part of the class that helps them to learn about managing their emotions and solving problems.

Source guidance

Definitions of terms used in this quality statement

Children identified as at risk of developing a conduct disorder

The following factors have been associated with an increased risk of a child or young person developing a conduct disorder:

Classroom-based emotional learning and problem-solving programmes

These programmes should consist of interventions intended to:

  • increase children's awareness of their own and others' emotions

  • teach self-control of arousal and behaviour

  • promote a positive self-concept and good peer relations

  • develop children's problem-solving skills.

Typically the programmes should consist of up to 30 classroom-based sessions over the course of 1 school year. [Adapted from Antisocial behaviour and conduct disorders in children and young people (NICE clinical guideline 158), recommendation 1.2.2]

High proportion of children identified as being at risk of developing a conduct disorder

This should be defined locally by individuals and/or groups with relevant expertise in antisocial behaviour and conduct disorders in children, and knowledge of the risk factors associated with an increased risk of a child developing a conduct disorder. These individuals and groups may include:

  • special educational needs coordinators (SENCO)

  • teachers

  • educational psychologists

  • local education authority departments.

  • Child and Adolescent Mental Health Services (CAMHS) departments

  • community paediatric departments. [Developed from expert consensus]

Equality and diversity considerations

It is important that schools have local protocols in place to ensure that parents and carers are made aware that their child will take part in a classroom-based emotional learning and problem-solving programme.

The workforce across agencies should, as far as possible, reflect the local community. Practitioners should have training to ensure that they have a good understanding of the culture of families with whom they are working. Interpreters should be provided if no practitioner is available who speaks a language in which the family members can converse fluently. Consideration should be given to the settings in which assessments are conducted to reflect cultural diversity.