| Description |
A meta-analysis examining the effectiveness of treatments for noncompliant behavior in children and adolescents was conducted. Studies published in English between 1965 and 2009 were included. A total of 258 articles were included in the study; 179 single-subject studies and 79 mixed and between group design studies. The total number of participants included in the study was 6,249; 459 subjects in the singlesubject component of the study with a total of 12,728 data points and 5,790 subjects in the group design component with 2,606 being part of the control group and 3,184 being part of the treatment group. All studies were examined using Hierarchical Linear Model (HLM). The overall treatment effect size for studies using HLM was -2.95 for singlesubject design studies; it was 1.54 for group design studies. Both can be considered large treatment effects. Three intervention types were examined, which included manipulation of antecedents, manipulation of consequences, and training (parent, teacher, and child). All treatment types are effective in reducing noncompliant behavior, but there was no statistically significant difference between the intervention types. Moderator variables were examined and included diagnosis, type of noncompliance, treatment type, age, gender, treatment setting, treatment implementer, functional behavior assessment or analysis, and source of article (journal or dissertation/theses). A significant effect was found for those diagnosed with mood disorder in single-subject studies and those diagnosed with adjustment disorder with disorder of conduct in group design studies. Both results need to be interpreted with caution due to small numbers included in the analysis. For single-subject studies both behavior momentum as a treatment type and teacher as an implementer were clinically significant. Extinction was also significant in group design studies, but must be interpreted with caution because only 1 group design study that used extinction was included in the analysis. Age was also significant in single-subject studies. It was found that every month that age increases, the treatment effect increases by 0.008 standard deviations. A discussion of the results is provided, as well as implications for practice and research. |
