Day treatment literature programs have been a mainstay of psychiatric intervention among preschoolers since the mid-20th century. Also referred to as partial hospitalization, these programs supply intensive treatment in a assembly setting for several hours every week, usually with informative and recreational components. In the Canadian province of Quebec, more than 200 preschoolers are treated in Day remedy publications programsat any one time, and most of these children are mentioned for treatment of behavioral problems (1). However, this mode of intervention has seldom emerged in the literature.
The effectiveness of day treatment for preadolescent children with disruptive demeanour disorders (that is, oppositional defiant disorder or perform disorder) has been described (2), but few studies have been published specific to the preschool age group.(Stiller,2004) Developmental and framework differences (for demonstration, language skills and learned demands) restrict the applicability of evidence on programs for older young children to programs for preschoolers. Also, day remedy studies have described preschoolers as having behavior problems but have not used DSM-IV criteria for diagnosing disruptive demeanour disorder, afresh limiting comparisons with studies of preadolescent children. One of the couple of available studies of preschool day remedy did not find positive treatment effects (3). More clues are apparently required in this area.
General Features
The "containing" function of a therapeutic milieu has been widely recognized as a mediator of change in psychiatry. The milieu allows for a prolonged assessment of a child's difficulties and of complex family systems. A day treatment center may be the only place where disruptive children and their families find acceptance, because these children are often rejected by peers, schools, and other caregivers because of their behavior . Cottrell and colleagues ascertained that children whom psychiatrists assign to day treatment have more psychopathology, clinician-rated impairment, and parental mental health and substance abuse issues than children assigned to other treatments.(Cottrell,2005) Many children are referred to day treatment centers because their needs could not be met with community or outpatient resources .
Most Day treatment literature programsare multimodal, addressing multiple areas of difficulty for a child or within the family with a combination of treatment modalities. Smolla and Lebel suggested that the specific mandate of day treatment is to provide integrated care from multiple specialists targeting not only behavioral problems but also emotional issues, developmental delays, and contributory medical problems. A high correlation between behavioral problems and developmental and language delays has been found , and two-thirds of children in day treatment may have such delays. It is possible that Day treatment literature programsserve preschoolers with both behavior problems and developmental delays in a uniquely efficient manner, but little research supports this notion. Not all Day treatment literature programsare able to include speech therapists, occupational therapists, and physiotherapists on their treatment teams.
Children in day treatment are a captive audience for intensive intervention, particularly in programs requiring attendance on multiple days per week. The actual interventions offered differ from center to center and from country to ...