Preventing Behavioral Disorders via Supporting Social and Emotional Competence at Preschool Age.

Background: 13-18% of all preschool children have severe behavioral problems at least transiently, sometimes with long-term adverse consequences. In this study, the social training program "Lubo aus dem All! - Vorschulalter" (Lubo from Outer Space, Preschool Version) was evaluated in a kindergarten setting.

Methods: 15 kindergartens were randomly assigned to either an intervention group or a control group, in a 2:1 ratio. The intervention was designed to strengthen emotional knowledge and regulation, the ability to take another person's point of view, communication skills, and social problem solving. The control group continued with conventional kindergarten activities. The primary endpoint was improvement in social-cognitive problem solving strategies, as assessed with the Wally Social Skills and Problem Solving Game (Wally). Secondary endpoints were improvement in prosocial behavior and reduction in problematic behavior, as assessed with the Preschool Social Behavior Questionnaire (PSBQ) and the Caregiver-Teacher Report Form (C-TRF). Data were collected before and after the intervention and also 5 months later. Mixed models were calculated with random effects to take account of the cluster design and for adjustment for confounding variables.

Results: 221 children in kindergarten, aged 5-6 years, were included in the study. Randomization was unsuccessful: the children in the intervention group performed markedly worse on the tests carried out before the intervention. Five months after the end of the intervention, the social-cognitive problem solving strategies of the children in the intervention group had improved more than those of the children in the control group: the intergroup difference in improvement was 0.79 standard deviations of the Wally test (95% confidence interval [CI] 0.13-1.46). This effect was just as marked 5 months later (0.63, 95% CI 0.03-1.23). Prosocial behavior, as measured by the PSBQ, also improved more in the intervention group, with an intergroup difference of 0.37 standard deviations (95% CI 0.05-0.71).

Conclusion: An age-appropriate program to prevent behavioral disorders among kindergarten children improved both the children's knowledge of prosocial problem solving strategies and their prosocial behavior.