The Implementation of the Fast Track Program: An Example of a Large-Scale Prevention Science Efficacy Trial

In 1990, the Fast Track Project was initiated to evaluate the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders in four demographically diverse American communities (Conduct Problems Prevention Research Group [CPPRG], 1992). Representing a prevention science approach toward community-based preventive intervention, the Fast Track intervention design was based upon the available data base elucidating the epidemiology of risk for conduct disorder and suggesting key causal developmental influences (R. P. Weissberg & M. T. Greenberg, 1998). Critical questions about this approach to prevention center around the extent to which such a science-based program can be effective at (1) engaging community members and stakeholders, (2) maintaining intervention fidelity while responding appropriately to the local norms and needs of communities that vary widely in their demographic and cultural/ethnic composition, and (3) maintaining community engagement in the long-term to support effective and sustainable intervention dissemination. This paper discusses these issues, providing examples from the Fast Track project to illustrate the process of program implementation and the evidence available regarding the success of this science-based program at engaging communities in sustainable and effective ways as partners in prevention programming.     

Preventing Serious Conduct Problems in School-Age Youth: The Fast Track Program

Children with early-starting conduct problems have a very poor prognosis and exact a high cost to society. The Fast Track project is a multisite, collaborative research project investigating the efficacy of a comprehensive, long-term, multicomponent intervention designed to prevent the development of serious conduct problems in high-risk children. In this article, we (a) provide an overview of the developmental model that serves as the conceptual foundation for the Fast Track intervention and describe its integration into the intervention model; (b) outline the research design and intervention model, with an emphasis on the elementary school phase of the intervention; and (c) summarize findings to date concerning intervention outcomes. We then provide a case illustration, and conclude with a discussion of guidelines for practitioners who work with children with conduct problems.     

Predictor Variables Associated with Positive Fast Track Outcomes at the End of Third Grade

Progress has been made in understanding the outcome effects of preventive interventions and treatments designed to reduce children's conduct problems. However, limited research has explored the factors that may affect the degree to which an intervention is likely to benefit particular individuals. This study examines selected child, family, and community baseline characteristics that may predict proximal outcomes from the Fast Track intervention. The primary goal of this study was to examine predictors of outcomes after 3 years of intervention participation, at the end of 3rd grade. Three types of proximal outcomes were examined: parent-rated aggression, teacher-rated oppositional–aggressive behavior, and special education involvement. The relation between 11 risk factors and these 3 outcomes was examined, with separate regression analyses for the intervention and control groups. Moderate evidence of prediction of outcome effects was found, although none of the baseline variables were found to predict all 3 outcomes, and different patterns of prediction emerged for home versus school outcomes.     

Commentary: The Fast Track Project: A Seminal Intervention Efficacy Trial

The Fast Track Project is a seminal intervention efficacy trial with several hallmark features, including theoretically driven intervention components, rigorous implementation, and integrity in how results are characterized. Critical issues are discussed in relation to sustainability, a controversy over what really constitutes prevention, and replicability.     

Commentary on Meehl

The classic article by Meehl (1978) raises fundamental issues regarding the viability of theorizing in the “soft” psychological sciences and the weakness of statistical significance testing in appraising the validity of the field’s theories. These concerns are as valid today as they were a quarter of a century ago. Despite the lack of clear progress that has been made in terms of theory building, I raise several examples from developmental psychopathology research that reveal progress in the field’s conceptual and methodologic rigor, including the testing of genotype by environment interactions, the statistical advances driving longitudinal research, and the use of intervention and prevention trials to address questions of etiology and mechanisms related to psychopathology.     

An Ecological Approach to Behavioral Development: Insights From Comparative Psychology

In this article, I review recent work from comparative psychology, highlighting several conceptual and methodological insights drawn from comparative research and exploring their value to an ecological approach to behavioral development. In particular, I consider examples of a major focus of comparative psychology, the search for developmental mechanisms and processes underlying the expression of species-typical behavior. This focus has provided several insights regarding behavioral development that have supported an ecological approach and provided a richness and depth of perspective on behavior complementary to that found in ecological psychology. Specifically, I review the related notions of probabilism, equifinality, nonlinearity, and distributed control and discuss their applicability to and support of ecological theory.     

Applying cognitive training to target executive functions during early development

Developmental psychopathology is increasingly recognizing the importance of distinguishing causal processes (i.e., the mechanisms that cause a disease) from developmental outcomes (i.e., the symptoms of the disorder as it is eventually diagnosed). Targeting causal processes early in disordered development may be more effective than waiting until outcomes are established and then trying to reverse the pathogenic process. In this review, I evaluate evidence suggesting that neural and behavioral plasticity may be greatest at very early stages of development. I also describe correlational evidence suggesting that, across a number of conditions, early emerging individual differences in attentional control and working memory may play a role in mediating later-developing differences in academic and other forms of learning. I review the currently small number of studies that applied direct and indirect cognitive training targeted at young individuals and discuss methodological challenges associated with targeting this age group. I also discuss a number of ways in which early, targeted cognitive training may be used to help us understand the developmental mechanisms subserving typical and atypical cognitive development.     

Multidimensionality of Youth Psychopathic Traits: Validation and Future Directions

The seven articles featured in this Special Section on “Child Psychopathic Traits for Specifying Conduct Disorder” collectively prosecute an important tension in the field: despite evidence that psychopathic traits in children, adolescent, and adults are multidimensional, callous-unemotional (CU) traits have evolved to nearly eclipse the construct of youth psychopathic traits. That is, does inclusion of grandiosity and impulsivity, and related psychopathic constructs improve predictive models? Employing a rich array of methods, these studies converged to suggest that using the entire constellation of psychopathic traits significantly improved predictions of key criteria. Crucially, predictions were consistent across development, multiple external criteria, and diversely recruited samples (e.g., community, incarcerated). From a developmental psychopathology framework (Cicchetti 2008), I synthesize the theoretical and empirical implications of these studies and offer perspectives on future directions. In particular, there is an urgent need to elucidate mechanisms from psychopathic traits to important clinical, public health, and functional outcomes; identification of potential causal processes is necessary to establish the validity of psychopathic traits and to ultimately innovate intervention and prevention efforts.     

Commentary: causal processes leading to antisocial behavior

Conceptual, and empirical, questions are raised regarding the notion that physical aggression is the main individual risk factor for antisocial behavior, that language impairment also constitutes a risk factor, the meaning of the male preponderance for antisocial behavior, the findings on environmentally mediated risk; the role of biosocial interplay; social context effects; the construct of antisocial behavior, developmental trends; processing of experiences; and transactional effects. The main blocks to using research to develop policy are the lack of evidence on (a) the mediators of the causal processes, (b) what is needed to bring about change, (c) ways to ensure that individuals who need interventions actually receive them, and (d) differences in levels of antisocial behavior.     

Developmental Psychopathology: Reactions, Reflections, Projections

In this paper, I describe the field of developmental psychopathology, discuss its major tenets, and delineate its boundaries with other disciplines with an eye toward the future. I articulate how I envision those aspects of developmental psychopathology that I view as central to the discipline affecting the field and evolving over time. The current status and suggested directions for a number of issues are discussed, including: the interface between normal and abnormal development; developmental mechanisms and processes across the life span; the need for an interdisciplinary approach; prevention and intervention; and training. I believe that a continued and expanded interface between the study of normal and atypical development will span the dualisms that exist between the clinical study of and research into disorders of childhood and adulthood, between basic and applied research, and between psychology and biology. If fostered, I envision an exciting new era of theoretical and empirical work in the developmental sciences.     

Change and processes of change within interventions to promote adjustment to multiple sclerosis: Learning from patient experiences

This qualitative study was nested within a trial of cognitive behaviour therapy (CBT) and supportive listening for patients with multiple sclerosis (MS). It aimed to enrich understanding of the changes made during therapy and to explore processes of change. In-depth interviews with 30 participants from the treatment trial were analysed inductively and five main themes were developed. The benefits that participants described experiencing as a result of the interventions were highly variable, idiosyncratic and often departed from outcomes measured within the trial. Tuning into and sharing one’s thoughts and feelings and learning specific strategies for living with MS appeared to be important processes for change, and participants identified the latter as particularly important for sustaining long-term benefits from therapy. Whether participants fully engaged with the interventions appeared to be related to their perceptions of being the right sort of candidate for the intervention, their expectations and motivations, the therapeutic relationship, adequate tailoring of the intervention, and practical issues. This study builds on previous research on factors and processes involved in adjustment to MS, the benefits of CBT for this population and highlights important issues to consider when developing psychosocial interventions for people with MS.     

Understanding the Links Between Social Support and Physical Health: A Life-Span Perspective With Emphasis on the Separability of Perceived and Received Support

ABSTRACT— Social support has been reliably related to physical health outcomes. However, the conceptual basis of such links needs greater development. In this article, I argue for a life-span perspective on social support and health that takes into account distinct antecedent processes and mechanisms that are related to measures of support over time. Such a view highlights the need to distinguish measures of perceived and received support and its links to more specific diseases (e.g., chronic, acute) and stages of disease development (e.g., incidence). I discuss both the novel implications of these theoretical arguments for research on social support and physical health, as well as the potential intervention approaches that are apparent from this perspective.     

The growth of developmental thought: Implications for a new evolutionary psychology

Evolution has come to be increasingly discussed in terms of changes in developmental processes rather than simply in terms of changes in gene frequencies. This shift is based in large part on the recognition that since all phenotypic traits arise during ontogeny as products of individual development, a primary basis for evolutionary change must be variations in the patterns and processes of development. Further, the products of development are epigenetic, not just genetic, and this is the case even when considering the evolutionary process. These insights have led investigators to reconsider the established notion of genes as the primary cause of development, opening the door to research programs focused on identifying how genetic and non-genetic factors coact to guide and constrain the process of development and its outcomes. I explore this growth of developmental thought and its implications for the achievement of a unified theory of heredity, development, and evolution and consider its implications for the realization of a new, developmentally based evolutionary psychology.     

If It's Offered,Will They Come? Influences on Parents' Participation in a Community-Based Conduct Problems Prevention Program

This study examined influences on the rate and quality of parent participation in the Fast Track Program, a multi-system, longitudinal preventive intervention for children who are at risk for conduct problems. A theoretical model of the relations among family coordinator characteristics, parent characteristics, the therapeutic engagement between family coordinator and parent, and rate and quality of parent participation was the basis for this study. Family coordinators are the Fast Track program personnel who conduct group-based parent-training sessions and home visits. Participants in this study included 12 family coordinators (42% were African American, 58% European American) and 87parents (55% were African American, 45% European American). The level of therapeutic engagement between the parent and the family coordinator was positively associated with the rate of parent attendance at group training sessions. The extent of family coordinator-parent racial and socioeconomic similarity and the extent of the family coordinator's relevant life experiences were highly associated with the level of therapeutic engagement. The quality, but not the rate, of participation was lower for African American parents. Implications of these findings for preventive intervention with this population are discussed.     

Evaluation of the First 3 Years of the Fast Track Prevention Trial with Children at High Risk for Adolescent Conduct Problems

Fast Track is a conduct-problem prevention trial that derives its intervention from longitudinal research on how serious and chronic adolescent problem behaviors develop. Over 9,000 kindergarten children at 4 sites in 3 cohorts were screened, and 891 were identified as high risk and then randomly assigned to intervention or control groups. Beginning in Grade 1, high-risk children and their parents were asked to participate in a combination of social skills and anger-control training, academic tutoring, parent training, and home visiting. A multiyear universal classroom program was delivered to the core schools attended by these high-risk children. By the end of third grade, 37% of the intervention group was determined to be free of serious conduct-problem dysfunction, in contrast with 27% of the control group. Teacher ratings of conduct problems and official records of use of special education resources gave modest effect-size evidence that the intervention was preventing conduct problem behavior at school. Parent ratings provided additional support for prevention of conduct problems at home. Parenting behavior and children's social cognitive skills that had previously emerged as proximal outcomes at the end of the 1st year of intervention continued to show positive effects of the intervention at the end of third grade.     

Testing hypotheses on specific environmental causal effects on behavior

There have been strong critiques of the notion that environmental influences can have an important effect on psychological functioning. The substance of these criticisms is considered in order to infer the methodological challenges that have to be met. Concepts of cause and of the testing of causal effects are discussed with a particular focus on the need to consider sample selection and the value (and limitations) of longitudinal data. The designs that may be used to test hypotheses on specific environmental risk mechanisms for psychopathology are discussed in relation to a range of adoption strategies, twin designs, various types of "natural experiments," migration designs, the study of secular change, and intervention designs. In each case, consideration is given to the need for samples that "pull-apart" variables that ordinarily go together, specific hypotheses on possible causal processes, and the specification and testing of key assumptions. It is concluded that environmental risk hypotheses can be (and have been) put to the test but that it is usually necessary to use a combination of research strategies.     

Prevention science and neighborhood influences on low-income children's development: theoretical and methodological issues

Despite the rapid growth of research on neighborhood influences on children, little of this research may be useful to prevention scientists. Most studies have ignored processes by which neighborhood conditions influence individual outcomes. To encourage neighborhood research that can better guide the development of preventive interventions, we propose a model that focuses attention on mediating and moderating processes, is appropriate for studies interested in individual differences in outcomes, acknowledges the transactions between residents and neighborhoods, and is sensitive to how neighborhood influences may differ for children at different developmental stages. Furthermore, we argue that greater attention to several methodological issues also can make neighborhood research more useful for the next generation of prevention programs to help low-income urban families and children cope successfully with the challenges posed by their neighborhoods.     

Opening the black box: Presenting a model for evaluating organizational-level interventions

Organizational-level occupational health interventions are often recommended when improvements in working conditions, employee health, and well-being are sought within organizations. Research has revealed that these interventions result in inconsistent effects despite being based on theoretical frameworks. This inconsistency indicates that intervention studies need to be designed to examine directly how and why such interventions bring about change and why they sometimes fail. We argue that intervention studies should include a process evaluation that includes a close examination of the psychological and organizational mechanisms that hinder and facilitate desired intervention outcomes. By drawing on existing intervention literature we present an evidence-based model containing three levels of elements that appear to be crucial in process evaluation. We describe how this model may be applied and developed in future research to identify better the mechanisms that link intervention processes to intervention outcomes.     

Participatory Action Research (PAR) in Middle School: Opportunities, Constraints, and Key Processes

Late childhood and early adolescence represent a critical transition in the developmental and academic trajectory of youth, a time in which there is an upsurge in academic disengagement and psychopathology. PAR projects that can promote youth's sense of meaningful engagement in school and a sense of efficacy and mattering can be particularly powerful given the challenges of this developmental stage. In the present study, we draw on data from our own collaborative implementation of PAR projects in secondary schools to consider two central questions: (1) How do features of middle school settings and the developmental characteristics of the youth promote or inhibit the processes, outcomes, and sustainability of the PAR endeavor? and (2) How can the broad principles and concepts of PAR be effectively translated into specific intervention activities in schools, both within and outside of the classroom? In particular, we discuss a participatory research project conducted with 6th and 7th graders at an urban middle school as a means of highlighting the opportunities, constraints, and lessons learned in our efforts to contribute to the high‐quality implementation and evaluation of PAR in diverse urban public schools.     

Processes and pathways in development via digital media: Examples from word learning

Word learning unfolds over multiple, cascading pathways which support in-the-moment processing and learning. The process is refined with each exposure to a word, and exposures to new words occur across a variety of forms and contexts. However, as children are exposed to more and more digital media, the ways in which children encounter, learn, and build on their vocabulary is also shifting. These shifts represent changes in context, content, and at the level of the child that can lead to negative outcomes. Less work, however, has discussed what these differences mean for how things change in the underlying developmental cascade and learning processes. Here, we suggest that the increasing presence of digital media may shift the developmental pathways for learning (the chain of events that support future learning) but not necessarily the developmental processes (the mechanisms underlying learning). Moreover, the interaction of the two may lead to different behavior and outcomes for learning in a digital era. We argue it is imperative for researchers to not only study how digital media differs from everyday learning, but directly measure if the well-worn pathways, processes, and variables found with decades of research with real items translate to a digital media era.