Early Risk Identification and Intervention Group (ERIIG)

Established: April 2007; first meeting convened for 27th April 2007.

Convenor (Chair): Dr Margaret Thompson, Reader/Consultant in Child and Adolescent Psychiatry, University of Southampton; contact mt1@soton.ac.uk

Members:
Professor Edmund Sonuga-Barke, Professor of Developmental Psychology, Director of the Development Brain Behaviour-Unit, University of Southampton, with a particular interest in the neuropsychology of preschool AD/HD modelling pathways of risk and also parenting trials

Joanne Barton: Consultant Child and Adolescent Psychiatrist North Staffordshire Combined Healthcare NHS Trust : Assessment, Expressed Emotion, parenting trials

Cathy Laver-Bradbury, Nurse Consultant in AD/HD, Nurse Tutor in University of Southampton, parenting trials for children with AD/HD

Frances Gardner: Reader in Child and Family Psychology, Director of Centre for Evidence Based Intervention, Oxford University, parenting and conduct disorder, parenting trials, observational assessment.

Alain Gregoire, Honorary Senior Lecturer, Division of Neurosciences, University of Southampton, Consultant in Perinatal Medicine, Hampshire Partnership Trust, Southampton. Convenor of the group on Post- natal psychosis, rural psychiatry, mother-child relationships following post-natal psychosis

Carmilla Von Keyserlingk, Health Economist, University of Southampton

Lynn Murray: Professor of Developmental Psychology 18, co-Director Winnicot Research Unit, University of Reading, research into postnatal depression, influence of temperament on early childhood behaviour

Kapal Sayal: Senior Lecturer in CAP, University of Nottingham (screening in primary care, pathways to referral

Stephen Scott: Reader in Child and Adolescent Psychiatry) (CAP), Kings College, parenting trials. Interventions with children with externalising disorders

Alan Stein: Professor of Child Psychiatry at Oxford, attachment, assessment of parent-child relationships

David Turner: Health Economicst, University of Southampton

Ian Wong: Professor/Reader and Director of the Centre for Paediatric Pharmacy Research at the London School of Pharmacy, Institute of Child Health and Great Ormond Street Hospital: medication trials, Cessation of medication in ADHD

Howard Abikoff, Professor of Child and Adolescent Psychiatry at New York University School of Medicine and Director of the Institute for Attention Deficit Hyperactivity and Behavior Disorders at the NYU Child Study Center: Pre-school children, parenting trials, pharmacology. He will be a consultant to the group.

Devolved nation members:
David Coghill: Senior Lecturer, Dundee: ADHD, pharmacology, Neuro-psychology

David Daley: Lecture in Psychology North Wales Clinical Psychology Programme, University of Wales Bangor, self-directed intervention, Webster- Stratton Incredible Years, expressed emotion

Christine Puckering: Consultant Clinical Psychologist, Royal Hospital for Sick Children, Yorkhill, Glasgow; Research Fellow, Royal Hospital for Sick Children, Yorkhill:
Honorary Senior Research Fellow, Psychological Medicine, Division of Community Based Sciences, University of Glasgow: assessment of difficult parent-child relationship and treatment trials (Mellow Parenting).

Service user involvement: The Southampton Child and Adolescent ADHD service have regular meetings with user groups and obtain feedback from then. The group will be also in regular contact with Andrea Bilbow at ADDIS which is a national charity which supports parents with ADHD.

Remit and Aims:
Early identification of risk for common childhood mental disorders and the development of effective intervention to reduce risk for later disorder are widely recognised as a major public health goal. The rates of childhood mental health problems continue to increase. Interventions later on in childhood appear limited in effectiveness for many conditions. Early risk factors have been successfully identified. Interventions that target nascent forms of disorder by reducing risk appear to offer the best opportunity to alter trajectories to negative outcome before negative coercive cycles have been established for both externalising and internalising disorders.

This group will develop large-scale trials to establish the effectiveness and cost-effectiveness of early identification and intervention strategies in pre-school groups (up to 6 years) at risk for common and debilitating disorders of childhood. Targeted problems will include externalising problems such as attention deficit/ hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) and internalising problems such as anxiety and social phobias and depression. There will be a special focus on risk factors relating to temperamental features within the pre-school child (e.g., shyness, emotionality, restlessness etc), family and parental functioning and social disadvantage and exclusion. Choice of interventions for large-scale trials within the MHRN will be evidenced based, identified on the basis of existing published data.

Current Status & Future Plans:
The group has had several informal discussions with members of the group, and the first formal meeting of the group was on 3rd July 2007, at the University of Southampton.

Two sub-groups have been formed:
· a group to look at Internalising disorders: to address research areas of  post natal depression, and mother child relationships  and attachment
· Next steps: The internalising disorder group convened in Oxford in November 07 by Paul Ramchandani and Sara Halligan.  Members are: Alan Stein, Lynne Murray, Alan Gregoire, and Christine Puckering

· a group to look at externalising disorders: to address research areas of  ADHD and conduct disorder

· Next steps: The Externalising disorder group convened in Southampton in December by David Daley and Margaret Thompson.  Members are Edmund Sonuga-Barke, Frances Gardner, Stephen Scott, Wai Chen, Joanne Barton, Kapil Sayal, and David Coghill.

· We are considering three possibilities for further consideration: a trial of the self help manual for parents of preschool children with ADHD within a broad dimension of social classes including Sure Start communities; a trial of group parenting for children with ADHD in reception classes alongside teacher training; possibly a head to head trail for children with ADHD, the NFPP and Webster-Stratton a parenting programme for children with conduct disorder.

· The next meeting of the whole group has been arranged for January 10th 08 at Southampton in Ashurst Hospital and will have a video link. The plan for this meeting is for the two groups to discuss work in progress, and plan which protocols we will develop in order to seek grant funding.