Dr. David Grodberg
Jul 27, 2021
A toddler who refuses to go to bed. A child that won’t take “no” for an answer. A teen that stays out past their curfew. As a parent myself, I know our children don’t always behave the way we hope they would and that their occasional difficult behaviors are really just a healthy part of growing up.
Sometimes, though, these disruptive behaviors become the norm for a child or adolescent and increase in frequency and severity. A child’s behavior may reach the point where it interferes with day-to-day functioning. This often has a profound effect not only on the child’s wellbeing but also on the personal and professional lives of working parents and caregivers. These individuals can suffer from lost work productivity and, in some cases, make the difficult choice to leave their employer so they have more time to focus on their children’s needs.
Today, I’m happy to share some very promising trends from our ongoing work with parents and caregivers of kids and teens with disruptive behaviors. We looked at 10 families with children who met the diagnostic criteria for a disruptive behavior disorder who then completed Brightline’s 12-session parent behavior training. We found that 100% of kids whose parent or caregiver completed this training experienced clinical improvement from disruptive behavior disorder.
But first, let me give you some background.
What is disruptive behavior?
Disruptive behavior refers to a full range of pediatric behaviors, some completely normal, others extreme or aggressive enough to require professional intervention. When disruptive behavior reaches a level that is severe and intense, the child or adolescent may be diagnosed with a disruptive behavior disorder (DBD). According to the Centers for Disease Control and Prevention, an estimated 7.4% of American children have a diagnosable behavior problem, with more than half of these also meeting criteria for attention deficit hyperactivity disorder (ADHD).
Disruptive behavior can take a big toll on parents and caregivers, who in turn become less effective at their jobs and sometimes develop mental health issues of their own. The good news is we already have proven methods for managing disruptive behavior. The American Academy of Pediatrics recommends behavioral parent training as a first line intervention. This approach is not only science-based but also extremely scalable using Brightline’s technology, leading to a highly effective intervention for kids’ and teens’ disruptive behavior.
How Brightline cares for disruptive behavior
At Brightline, we know that pediatric behavioral health concerns affect the whole family and that the most effective interventions involve the whole family.
That’s why our comprehensive, evidence-based program for children and adolescents with behavioral health needs provides family-focused support. Brightline’s highly specialized pediatric behavioral health clinical services are blended with self-guided and coach-supported skills based training for parents and caregivers, all delivered virtually and powered by a measurement-based system of care.
To explore how effective Brightline’s program is for children and adolescents with disruptive behavior, we looked at 10 families with children who met the diagnostic criteria for a disruptive behavior disorder and who completed Brightline’s 12-session parent behavior training.
As part of Brightline’s measurement-based system of care, we collect a number of surveys before and after the behavioral parent training. The first of these is the Patient Reported Outcomes Measurement Information System (PROMIS), developed by the National Institute of Health (NIH), which allows us to gather parents and caregivers’ reports of their children’s disruptive behaviors. We also measure the Clinical Global Impression - Improvement scale (CGI-I), which allows the clinician to assess whether and by how much the patient’s illness has improved or worsened.
The results: Children get better
We’re happy to share that Brightline’s content and clinical care solutions help families. Here’s what we found:
100% of children showed reliable clinical improvement from disruptive behavior disorder based on the Clinical Global Improvement (CGI-I) scale.
80% of parents and caregivers reported their children’s disruptive behavior improved significantly based on the Patient Reported Outcomes Measurement Information System (PROMIS) developed by the National Institute of Health (NIH).
For more details, download our summary: Brightline program is highly effective in reducing children’s disruptive behavior.
Looking forward: Giving working families the support they need
We know how challenging and time consuming it can be for working parents and caregivers to manage children with extreme disruptive behaviors. Disruptive behaviors can be costly too. Families often have to go out of network for the help they need while employers lose out on employee productivity and talent retention. Additionally, health plans pay for the expensive downstream costs of untreated or undertreated behavioral health conditions.
More employers today are choosing to offer comprehensive pediatric behavioral health benefits to their teams to better support the needs of today’s working parents and caregivers. We hope offering these benefits will soon become the norm for employers and health plans, so we can get help to every single family that needs it.
David Grodberg, MD, MS, is Brightline’s chief psychiatric officer. Board certified in both adult psychiatry and child and adolescent psychiatry, David is currently a faculty member at the Yale School of Medicine and served as medical director of the Yale Child Study Center Outpatient Clinic.