***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives : 1 ) To investigate the comorbidity of verbal and nonverbal learning disability subtypes with several domains of behavior problems among 8-year-old children . 2 ) To determine whether receipt of an early intervention modified the association between childhood behavior problems and learning disabilities ( LD ) . Methods : This is a secondary data analysis of the Infant Health and Development Program ( IHDP ) , a r and omized clinical trial of an early intervention provided between ages 0 and 3 involving 985 children born low birthweight and premature . The findings are based on a prospect i ve follow-up of these children at 8 years of age . Results : Compared to children without verbal LD ( VLD ) , those with VLD were twice as likely to exhibit clinical levels of total behavior problems and 89 % more likely to exhibit externalizing behavior problems . Analysis of specific subscales of behavior revealed significant associations with anxious/depressed and withdrawn behaviors , as well as an increased likelihood of attention problems among children with VLD . No significant association was found between nonverbal LD ( NVLD ) and any type of behavior problem . Furthermore , there was a significant interaction between VLD and the intervention , in which the odds of internalizing behavior problems were greater among children with VLD . No interaction effect of the intervention occurred for any type of behavior problem among children with NVLD . Conclusions : These findings provide evidence that distinct differences exist for different learning disability subtypes with regards to behavioral outcomes and the effects of early intervention services among 8-year-old children A population -based , r and omized universal classroom intervention trial for the prevention of disruptive behavior ( i.e. , attention-deficit/hyperactivity problems , oppositional defiant problems , and conduct problems ) is described . Impact on developmental trajectories in young elementary schoolchildren was studied . Three trajectories were identified in children with high , intermediate , or low levels of problems on all 3 disruptive behaviors  at baseline . The intervention had a positive impact on the development of all disruptive behavior problems in children with intermediate levels of these problems at baseline . Effect sizes of mean difference at outcome were medium or small . In children with the highest levels of disruptive behavior at baseline , a positive impact of the intervention was found for conduct problems A population -based r and omized intervention trial for the prevention of conduct problems ( i.e. , oppositional defiant disorder and conduct disorder ) is described . The LIFT ( Linking the Interests of Families and Teachers ) intervention was design ed for all first- and fifth- grade elementary school boys and girls and their families living in at-risk neighborhoods characterized by high rates of juvenile delinquency . The 10-week intervention strategy was carefully targeted at proximal and malleable antecedents in three social domains that were identified by a developmental model of conduct problems . From 12 elementary schools , 671 first and fifth grade rs and their families participated either in the theory-based universal preventive intervention or in a control condition . The intervention consisted of parent training , a classroom-based social skills program , a playground behavioral program , and systematic communication between teachers and parents . A multiple measure assessment strategy was used to evaluate participant satisfaction and participation , fidelity of implementation , and the immediate impacts of the program on targeted antecedents OBJECTIVE . To examine the extent to which the Early Start program of home visitation had beneficial consequences in the areas of maternal health , family functioning , family economic circumstances , and exposure to stress and adversity . METHODS . The study used a r and omized , controlled trial design in which 220 families receiving the Early Start program were contrasted with a control series of 223 families not receiving the program . Families were enrolled in the program after population screening conducted by community health nurses . Families were enrolled in the program for up to 36 months . Outcomes were assessed at 6 , 12 , 24 , and 36 months after trial entry . RESULTS . There was a consistent lack of association between maternal and family outcomes and group membership . There were no significant differences between the Early Start and control series in any comparisons . CONCLUSIONS . This evaluation suggested that the Early Start program failed to lead to parent- and family-related benefits . This absence of benefit for parent/family outcomes is contrasted with the benefits found previously for child-related outcomes , including child health , preschool education , child abuse and neglect , parenting , and behavioral adjustment . This comparison suggests that home visitation programs may provide benefits for child-related outcomes in the absence of parent- or family-related outcomes The outcomes of a r and omized clinical trial of a new behavioral family intervention , Stepping Stones Triple P , for preschoolers with developmental and behavior problems are presented . Forty-eight children with developmental disabilities participated , 27 r and omly allocated to an intervention group and 20 to a wait-list control group .  Parents completed measures of parenting style and stress  , and independent observers assessed parent-child interactions . The intervention was associated with fewer child behavior problems reported by mothers and independent observers , improved maternal and paternal parenting style , and decreased maternal stress . All effects were maintained at 6-month follow-up Aims : To assess the effectiveness of a parenting programme , delivered by health visitors in primary care , in improving the mental health of children and their parents  among a representative general practice population . Methods : Parents of children aged 2–8 years who scored in the upper 50 % on a behaviour inventory were r and omised to the Webster-Stratton 10 week parenting programme delivered by trained health visitors , or no intervention . Main outcome measures were the Eyberg Child Behaviour Inventory and the Goodman Strengths and Difficulties Question naire to measure child behaviour , and the General Health Question naire , Abidin ’s Parenting Stress Index , and Rosenberg ’s Self Esteem Scale to measure parents ’ mental health . These outcomes were measured before and immediately after the intervention , and at six months follow up . Results : The intervention was more effective at improving some aspects of the children ’s mental health , notably conduct problems , than the no intervention control condition . The Goodman conduct problem score was reduced at immediate and six month follow up , and the Eyberg Child Behaviour Inventory was reduced at six months . The intervention also had a short term impact on social dysfunction among parents . These benefits were seen among families with children scoring in the clinical range for behaviour problems and also among children scoring in the non- clinical ( normal ) range . Conclusion : This intervention could make a useful contribution to the prevention of child behaviour problems and to mental health promotion in primary care This report describes the 3 year outcomes of three different variants of the  Triple P-Positive Parenting Program , a behavioural family intervention .  Families were r and omly assigned to one of three intervention conditions or to a waitlist condition . At 1 year follow-up there were similar improvements on observational and self-report measures of preschooler disruptive behaviour for Enhanced , St and ard and Self Directed variants of Triple P. At 3 year follow-up ( completed by 139 families ) , each condition showed a similar level of maintenance of intervention effects . Approximately 2/3 of preschoolers who were clinical ly elevated on  measures of disruptive behaviour  at pre-intervention moved from the clinical to the non- clinical range . Across conditions , there was a comparable preventive effect for each intervention for these high risk children . The implication s of the findings for the development of brief , cost effective  parenting interventions within a public health framework are discussed OBJECTIVE Despite recognition of the need for parenting interventions to prevent childhood behavioral problems , few community programs have been evaluated . This report describes the r and omized controlled evaluation of a four-session psychoeducational group for parents of preschoolers with behavior problems , delivered in community agencies . METHOD In 1998 , 222 primary caregivers , recruited through community ads , filled out question naires on parenting practice s and child behavior . Parents were r and omly assigned to immediate intervention or a wait-list control . The intervention comprised three weekly group sessions and a 1-month booster , the focus being to support effective discipline ( using the video 1 - 2 - 3 Magic ) and to reduce parent-child conflict . RESULTS Using an intent-to-treat analysis , repeated- measures analyses of variance indicated that the parents who received the intervention reported significantly greater improvement in parenting practice s and a significantly greater reduction in child problem behavior than the control group . The gains in positive parenting behaviors were maintained at 1-year follow-up in a subset of the experimental group . CONCLUSIONS This brief intervention program may be a useful first intervention for parents of young children with behavior problems , as it seems both acceptable and reasonably effective OBJECTIVE To determine if a home-based nurse intervention ( INT ) , focusing on parenting education/skills and caregiver emotional support , reduces child behavioral problems and parenting stress in caregivers of in utero drug-exposed children . DESIGN R and omized clinical trial of a home-based INT . SETTING S Two urban hospital newborn nurseries ; homes of infants ( the term infant is used interchangeably in this study with the term child to denote those from birth to the age of 36 months ) ; and a research clinic in Baltimore , Md. PARTICIPANTS In utero drug-exposed children and their caregivers ( N = 100 ) were examined when the child was between the ages of 2 and 3 years . Two groups were studied : st and ard care ( SC ) ( n = 51 ) and INT ( n = 49 ) . INTERVENTION A home nurse INT consisting of 16 home visits from birth to the age of 18 months to provide caregivers with emotional support and parenting education and to provide health monitoring for the infant . MAIN OUTCOME MEASURES Scores on the Child Behavior Checklist and the Parenting Stress Index . RESULTS Significantly more drug-exposed children in the SC group earned t scores indicative of significant emotional or behavioral problems than did children in the INT group on the Child Behavior Checklist Total ( 16 [ 31 % ] vs 7 [ 14 % ] ; P = .04 ) , Externalizing ( 19 [ 37 % ] vs 8 [ 16 % ] ; P = .02 ) , and Internalizing ( 14 [ 27 % ] vs. 6 [ 12 % ] ; P = .05 ) scales and on the anxiety-depression subscale ( 16 [ 31 % ] vs. 5 [ 10 % ] ; P = .009 ) . There was a trend ( P = .06 ) in more caregivers of children in the SC group reporting higher parenting distress than caregivers of children in the INT group . CONCLUSIONS In utero drug-exposed children receiving a home-based nurse INT had significantly fewer behavioral problems than did in utero drug-exposed children receiving SC ( P = .04 ) . Furthermore , those caregivers receiving the home-based INT reported a trend toward lower total parenting distress compared with caregivers of children who received SC with no home visits This article describes a 20-year program of research on the Nurse Home Visitation Program , a model in which  nurses visit mothers beginning during pregnancy and continuing through their children 's second birthdays to improve pregnancy outcomes , to promote children 's health and development , and to strengthen families ' economic self-sufficiency . The results of two r and omized trials ( one in Elmira , New York , and the second in Memphis , Tennessee ) are summarized , and an ongoing trial in Denver , Colorado , is briefly described . Results of the Elmira and Memphis trials suggest the following : The program benefits the neediest families ( low-income unmarried women ) but provides little benefit for the broader population . Among low-income unmarried women , the program helps reduce rates of childhood injuries and ingestions that may be associated with child abuse and neglect , and helps mothers defer subsequent pregnancies and move into the workforce . Long-term follow-up of families in Elmira indicates that nurse-visited mothers were less likely to abuse or neglect their children or to have rapid successive pregnancies . Having fewer children enabled women to find work , become economically self-sufficient , and eventually avoid substance abuse and criminal behavior . Their children benefitted too . By the time the children were 15 years of age , they had had fewer arrests and convictions , smoked and drank less , and had had fewer sexual partners . The program produced few effects on children 's development or on birth outcomes , except for children born to women who smoked cigarettes when they registered during pregnancy . The positive effects of the program on child abuse and injuries to children were most pronounced among mothers who , at registration , had the lowest psychological re sources ( defined as high levels of mental health symptoms , limited intellectual functioning , and little belief in their control of their lives ) . Generally , effects in Elmira were of greater magnitude and covered a broader range of outcomes than in Memphis , perhaps because of differences between the population s studied , community context s , or a higher rate of turnover among home visitors in Memphis than in Elmira . The article concludes that the use of nurses as home visitors is key ; that services should be targeted to the neediest population s , rather than being offered on a universal basis ; that clinical ly tested methods of changing health and behavioral risks should be incorporated into program protocol s ; and that services must be implemented with fidelity to the model tested if program benefits found in scientifically controlled studies are to be reproduced as the program is replicated in new communities Aims : To test the effectiveness at one year of the Webster Stratton Parents and Children Series group parenting programme in a population sample of parents . Methods : In a multicentre block r and omised controlled trial , parents of children aged 2–8 years in 116 families who scored in the upper 50 % on a vali date d behaviour inventory , took part in Webster-Stratton ’s 10 week parenting programme led by trained and supervised health visitors . The following outcome measures were used : Eyberg Child Behaviour Inventory , Goodman Strengths and Difficulties Question naire , General Health Question naire , Parenting Stress Index , Rosenberg Self Esteem Scale . Results : The intervention significantly reduced child behaviour problems and improved mental health at immediate and 6 month follow ups . One year differences between control and intervention groups were not significant . Qualitative results suggest that these findings might be attributable in part to either Hawthorne effects or contamination of control group . At interview parents described ways in which the programme had improved their mental health . They reported g 
    Output:
    
Effective preventive interventions exist primarily for behaviour and , to a lesser extent , emotional problems , and could be disseminated from research to mainstream in Australia , ensuring fidelity to original programmes .