Development of a Resident Education Curriculum:  Assessment and Treatment of Aggression in Children with Disruptive Behaviour Disorders

Investigators: Daniel Gorman, M.D., Tamara Pringsheim, M.D., & Brendan F. Andrade, Ph.D.

Introduction: As early intervention may lead to prevention of poor outcomes, physicians treating children and youth are in an optimal position to positively impact children's health through the implementation of evidence-based care. Proper training of resident physicians during their formative years can have a profound impact on the provision of care as these physicians receive their qualifications and go on to educate the next generation of physicians.

Objectives: To create a national educational curriculum to promote the implementation of evidence-based guidelines among physicians to improve the quality of care and health outcomes of youth with disruptive and aggressive behaviours.

Project Stage:  Implementation stage.

Health and Clinical Relevance:  This project will contribute to greater awareness and knowledge of evidence-based healthcare among physicians.

Funding Source: RBC-Sick Kids Knowledge Translation Fund


Assessment and Management of Oppositional and Aggressive Behaviour in Children and Youth 

Investigators: Tamara Pringsheim, M.D., Brendan Andrade, Ph.D., Roxanne Goldade, M.D., Daphne Handanos, M.D., Roger Thomas, M.D., Laurie Ross, M.D.

Introduction: Oppositional and aggressive behaviours are common in school-age children, while adolescents may also test limits, argue with adults, and break rules. Such behaviours are usually developmentally appropriate, but when they are severe and persistent, they may represent psychopathologies, such as Oppositional Defiant Disorder or Conduct Disorder, which are often comorbid with Attention Deficit Hyperactivity Disorder5. Children and adolescents with severe disruptive and aggressive behaviour can pose safety risks, disturb family functioning, and experience considerable impairment in their emotional, social, and academic development10, 11. Therefore, it is critical that they and their families receive comprehensive assessment, evidence-based treatment, and continued support and monitoring.

Objectives: There are four main objectives for this research. Firstly, to describe a biopsychosocial model for understanding disruptive/aggressive behaviours in youth. Second, to explain a conceptual approach to formulation and care planning for psychosocial interventions. Third, to review the evidence base for the pharmacological management of disruptive/aggressive behaviour in youth with ADHD, ODD or CD. Lastly, to explain how to appropriately monitor antipsychotic drug safety in this age group

Project Stage:  Completed.

Health and Clinical Relevance:  This project will contribute to more understanding about child-level mental processes, family dynamics, peer relationships and community influences when asessing aggressive and oppositional behaviours.

Funding Source: ??????

Canadian Guidelines on Pharmacotherapy for Oppositional Behaviour, Conduct Problems, and Aggression in Children and Adolescents with Disruptive Behaviour Disorders: Creation of a Patient Decision Aid

Investigators: Tamara Pringsheim, M.D., Daniel Gorman, M.D. & Brendan F. Andrade, Ph.D.

Introduction: This one day workshop and project includes stakeholders to collect information to inform the development of a patient decision aid to support intervention for children and youth with disruptive behaviour disorders.

Objectives: Given that Attention Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder and Conduct Disorder are the most common mental health disorders among Canadian boys, the authors will collect information to support development of a patient aid for families with children in this population to educate them regarding treatment options and to help improve decision making.

Health and Clinical Relevance:  This project will contribute to processes to better include parents and children in shared decision making processes.

Project Stage: Meeting completed and recommendations being compiled.

Funding Source: CIHR Institute of Human Development, Child and Youth Health