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Parent training programs have high potential to promote positive parent-child relationships as well as reach and engage parents to participate. Digitally delivered programs may overcome the barriers associated with face-to-face interventions, such as stigma, logistic challenges and limited resources.
Objectives
To assess the effectiveness and feasibility of digital universal parent training program for families with 3 years-old children, focusing on parenting skills and child´s behavior.
Methods
A non-blinded randomized controlled trial (RCT) with two groups: (I) the intervention group, in which participants receive the parent training and (II) the waiting list group, in which participants are placed on a waiting list to receive the parent training intervention after the first follow-up measurement have been completed. Participants must meet the following inclusion criteria: a) guardians having a child age 3 years, b) participating to annual health checkup in child health clinic, c) at least one of the guardian is able to understand the languages that intervention is provided.
Results
Pilot study with feasibility assessment finished at early 2021. Recruitment of the wider RCT study is currently ongoing. The results from the pilot study and more detailed description about the intervention will be presented.
Conclusions
This study with good national geographical coverage is a unique possibility to evaluate universal parenting program on promoting parenting behaviors associated with the promotion of optimal child emotional development. This study also provides population level information about parenting skills and child´s behavior.
It is widely known that pretend play and creativity are essential developmental processes for typically developing children, but there has been little collective examination of the role of creative play in children with developmental disabilities. In this chapter, we review the importance of creativity for children with various developmental disabilities, with a specific focus on pretend play. Research over the past decade in disorders such as autism spectrum disorder (ASD), Down Syndrome (DS), cerebral palsy (CP), Prader-Willi Syndrome (PWS), and Williams Syndrome (WS) indicates that pretend play is a development skill area where many of these children show deficits, and these deficits may be impactful on their ability to develop appropriate social, emotional, cognitive, and behavioral skills associated with pretend play. Recent research also suggests that pretend play can be used as a means of intervention to improve the play skills and associated skills of socioemotional and cognitive-behavioral functioning in children with developmental disabilities. Future study should examine the use of increasingly accessible means of pretend play intervention, such as telehealth, and focus on how parent-training interventions can be utilized to effectively implement pretend play for children with developmental disabilities at an early age.
Non-violent resistance (NVR) is an approach for parents and other caregivers that helps to increase presence and overcome impulsive and dangerous behaviors, while reducing conflict and escalation. The practical, evidence-based advice accompanies a detailed list of all the new applications of NVR and an overview of the supporting literature. A step-by-step presentation of the treatment is laid out alongside a useful model on escalation and its prevention. The approach achieves high parent engagement and cooperation, with over twenty controlled studies showing that NVR effectively reduces parental helplessness, parental impulsiveness, parent–child conflicts, and family discord.
Friedrich Lösel was born in Germany in 1945. He is Emeritus Professor at Cambridge University (UK), as well as Erlangen University and Berlin Psychological University in Germany. He received the Stockholm Prize in Criminology, the Sellin-Glueck Award from the American Society of Criminology, and the Joan McCord Award from the Academy of Experimental Criminology. He created the Erlangen–Nuremberg Development and Prevention Study (ENDPS), which combined a prospective longitudinal and experimental design and investigated more than 600 children and their families from kindergarten to adolescence. The ENDPS showed that accumulated individual and social risk factors at preschool age predicted behavior problems in youth, but there was also developmental flexibility. The prevention part of the ENDPS implemented a universal training of child social skills, a parent training on positive parenting, and a combination of both. There were substantial short-term effects and promising outcomes after 10 years. The ENDPS team trained about 2,000 facilitators for a nationwide dissemination of the program. He also carried out an important longitudinal study on school bullying showing that intensive bullying perpetration was not only a school phenomenon but correlated with violence in other contexts and with criminal behavior in adulthood.
Up to today, there are experimental evidences pointing out the usefulness of cognitive-behavioral interventions for the treatment of children with Attention Deficit / Hyperactivity Disorder (ADHD), including the Parent Training, classified as’empirically validated treatment’ and mainly suitable to build specific parenting skills (Pelham, Wheeler e Chronis, 1998; SINPIA, 2006).
Objectives:
This study examines a process of Parent Training carried out with a group of parents of children with ADHD.
Aims:
Improving the parenting knowledge and skills in the strategies of management of children's problematic behaviors; encouraging the expression of emotions and managing parental stress.
Methods:
The training takes place in 12 meetings, the group is formed by 4 couples of parents of children diagnosed with ADHD.
Evaluation of the effectiveness of the treatment: subjective criterion, concerning the degree of satisfaction expressed by parents in using the educational intervention techniques, learned and experienced in the group work, and objective criterion through the use of standardized pre-and post-treatment assessment tools: Parent Stress Index (PSI -RR Abidin, 2008) and Alabama Parent Questionnaire (APQ - Frick, 1991).
Results:
Acquisition of a specific knowledge of the Attention Deficit Disorder / Hyperactivity, of the strategies to manage the child's behavior, development of a parental attitude oriented toward problem-solving, becoming thus positive models of behavior, in order to promote family relationships.
Conclusions:
This intervention adds to the management of the problems related to ADHD, the support and the management of the emotional aspects related to parental competence.
Building on prior work using Tom Dishion's Family Check-Up, the current article examined intervention effects on dysregulated irritability in early childhood. Dysregulated irritability, defined as reactive and intense response to frustration, and prolonged angry mood, is an ideal marker of neurodevelopmental vulnerability to later psychopathology because it is a transdiagnostic indicator of decrements in self-regulation that are measurable in the first years of life that have lifelong implications for health and disease. This study is perhaps the first randomized trial to examine the direct effects of an evidence- and family-based intervention, the Family Check-Up (FCU), on irritability in early childhood and the effects of reductions in irritability on later risk of child internalizing and externalizing symptomatology. Data from the geographically and sociodemographically diverse multisite Early Steps randomized prevention trial were used. Path modeling revealed intervention effects on irritability at age 4, which predicted lower externalizing and internalizing symptoms at age 10.5. Results indicate that family-based programs initiated in early childhood can reduce early childhood irritability and later risk for psychopathology. This holds promise for earlier identification and prevention approaches that target transdiagnostic pathways. Implications for future basic and prevention research are discussed.
Parent–child interaction is critical for early language and literacy development. Parent training programs have proliferated to support early interactions. However, many environmental and psychosocial factors can impact the quality of parent–child language and literacy interactions as well as training program outcomes. This preliminary randomized controlled trial examined maternal perceived self-efficacy and locus of control during a language and literacy parent training program. Thirty mother–child dyads (mother age 21–40; children 2;6–4;0) were assigned in parallel to the training or control group. The training was efficacious for mothers and children – training-group dyads made significantly greater gains in maternal strategy use, responsivity, and child print awareness than the control group. Gains were maintained one month post-training. Children whose mothers had more external baseline control perceptions identified significantly fewer print targets at baseline and made greater gains than those with more internal control perceptions. Future directions and implications are discussed.
Many children with autism spectrum disorder (ASD) exhibit difficulties with negative affect. Cognitive behavioural therapy (CBT) has been successfully adapted for individuals with ASD to treat these difficulties. In a wait-list control study, for example, group analyses showed promising results for young children with ASD using a developmentally adapted group CBT approach. This report examined response to group CBT in terms of individual-level change in young children with ASD. Eighteen children with ASD, aged 5–7 years, and their respective parents participated in treatment. Parents completed pre- and post-treatment measures of negative affect and related behaviours. Treatment responders and non-responders were grouped based on significant treatment outcomes as assessed by statistically significant change for lability/negativity and 20% decrease in intensity, duration or frequency of emotional outbursts. Results indicated that 67% of children met criteria as a treatment responder, showing meaningful improvement in at least two outcome measures. No significant group differences emerged for initial characteristics before treatment. Wilcoxon signed rank tests determined pre-/post-treatment change in parental confidence for each treatment responder group. Results indicated statistically significant increase for the treatment responder group in parent-reported confidence in their own ability and in their child's ability to manage the child's anger and anxiety, but these results were not significant for the treatment non-responder group. Results provide additional evidence that CBT can significantly decrease expressions of anger/anxiety in children with ASD as young as 5 years, yet also suggest need for further improvement.
It has recently been asserted that a paradigm shift is emerging in the delivery of parenting programs. Specifically, it has been suggested that interventions from the field of interpersonal neurobiology represent sophisticated alternatives to positive parenting interventions based on social learning models and behavioural principles, and better reflect how contemporary practitioners consider parenting. We examine this assertion, dispel a number of myths, and conclude that characterisations of positive parenting programs are frequently misleading and do not adequately reflect contemporary models of practice. There is little justification to support the claim that the field should abandon this ‘paradigm’. Indeed, there has been a considerable expansion in the evidence base supporting positive parenting programs and the emergence of a public health framework that blends universal and indicated interventions that can greatly increase the reach and lower the costs of delivering parenting interventions.
Background: Little is known about the effect of case-formulation based cognitive behaviour therapy (CBT) for anxious children. Aim: The present study explores the feasibility of case-formulation driven CBT for anxious children. Parents were involved in treatment as either co-facilitators (involved only as the child's assistants, treatment being primarily directed at the child), or as co-clients (parents received therapy targeting theoretically established maintaining mechanisms; children received half of the sessions, parents the other half). Method: Feasibility of the case-formulation driven CBT was established by comparing the completion rate and the percentage of children free of anxiety after treatment, with manualized treatments reported in existing meta-analyses. Children aged 7–12 years and their parents participated (n = 54). Families were assessed at pre- and posttreatment and at 6-month follow-up. Results: All families completed treatment and the percentage of recovery in the case-formulation driven approach was comparable to results obtained in manualized treatments. Conclusion: The findings from this stage I study supports the notion that a case-formulation driven approach to CBT may be a feasible option when selecting treatment for anxious children; however, further studies must be conducted before firm conclusions can be drawn.
Background: Previous research has indicated that parent cognition, including anxious beliefs and expectations, are associated with both parent and child anxiety symptoms and may be transferred from parent to child. However, the content and frequency of parent worry in relation to their children has yet to be examined as a potential form of anxious parent cognition, and little is known about normative parent worry. Aims: The purpose of the current study is to extend the research on parent cognition and child anxiety by focusing on parent worry (i.e. parent worry in relation to their children) as a potential predictor of child anxiety. Method: A comprehensive self-report measure of parent worry was developed and administered to a community-based sample of parents. Results: An exploratory factor analysis yielded a single factor solution. Parent worry was found to be a more robust predictor of child anxiety than parent anxiety symptoms, and parent worry mediated the association between parent anxiety symptoms and child anxiety. Most common worries reported by parents fell within the domains of life success and physical well-being. Conclusion: Overall, this study adds to the literature on parent cognitive biases and has the potential to inform parent-based interventions for the treatment of child anxiety. Further, this study provides initial data on normative parent worry.
Background: Children of parents with bipolar disorder are at increased risk of disturbance. Aims: This study examined relationships between parental mood, parenting, household organization and child emotional and behavioural adjustment in families with a parent with bipolar disorder to determine areas of specific need for parenting support. Method: 48 parents were recruited through advertisements via self-help organizations. The study was conducted online. Parental mood and activity was assessed by self-report questionnaires (CES-D, ISS, MDQ and SRM); parenting was assessed using the Parenting Scale (PS). The SDQ was used to assess the parent's view of their child's emotional and behavioural difficulties. The Confusion, Hubbub and Order Scale (CHAOS) assessed household organization. Results: Parents reported high levels of difficulties across all measures and scores were above clinical cut-offs on most scales. Children were reported as showing high levels of disturbance on the SDQ, including all sub-scales. Parenting and depression scores were significantly positively correlated, as were depression, parenting and CHAOS score. Regression analyses indicated that CHAOS was the strongest predictor of Total Difficulties and Emotional Symptoms on the SDQ. Conclusions: Families are likely to benefit from interventions tailored to meet their parenting needs.
Anxiety is the most pervasive childhood mental health disorder today. This study examined the parent component of a school-based universal prevention and early intervention program. Participating parents (N = 122) completed four measures on anxiety, the Anxiety Sensitivity Index, the Center for Epidemiological Studies-Depression, the Penn State Worry Questionnaire, and the Screen for Child Anxiety Related Emotional Disorders, before and after the parent program. The effectiveness of the program was investigated by analysing mean scores of the parent self-reported anxiety symptoms and parent reports of child anxiety symptoms. The main analyses conducted were 2 × 2 between-within ANOVAs for each measure. The hypothesis that parents who participated in the program (n = 20) would report reduced anxiety symptoms for themselves and for their children when compared to parents who did not attend (n = 120) was not confirmed. The parent's satisfaction level with the program was also studied, with high acceptability ratings providing strong social validity for this program. Implications of the findings, strengths, limitations and suggestions for further research are discussed.
The effectiveness of The Incredible Years parent-training program with a small sample of four high risk solo mothers in a public clinic setting was assessed. All families had a number of risk factors for early drop-out and poor outcomes. Mindful of resource limitations in the public setting, economical strategies were used to enhance attendance rates and engagement. For the outcome evaluation, a multiple baseline across participants design was used. Participants attended a 2-hour group treatment session weekly for twenty weeks, with booster sessions at 2 months and 4 months following treatment. Participants had sons aged between 6 years and 9 years diagnosed with ADHD. Family functioning was assessed from a pretreatment interview schedule, measures of child behaviour and parent and family functioning. Participants also completed program satisfaction and program evaluation measures. Results showed: (a) all mothers engaged with and finished the program, (b) improvement in family functioning, (c) improvements in some teacher and parent reports of child behaviour, (d) increased parenting confidence, (e) reduced stress and depression levels for most parent participants, and (f) reports of better parent–child relationships. Additionally, participants all reported being highly satisfied with the program. Findings overall support the use of easy to do engagement strategies and the use of the Incredible Years parent-training program as an effective, low cost and early step intervention for families at higher risk in a day-to-day practice setting. The use of this intervention in an overall stepped care approach is considered and discussed.
A self-directed variant of the Positive Parenting Program (Triple P) was evaluated using 63 preschool-age children at-risk of developing conduct problems. Families were randomly assigned to either Self-directed Triple P (SD), a self-administered behavioural family intervention program, or a waitlist group (WL). The 10-unit SD program teaches parents 17 parenting skills to increase pro-social child behaviours and decrease problem behaviours in home and community settings. Using mothers' reports of child behaviour and parenting practices, mothers in the SD group reported significantly less child behaviour problems, less use of dysfunctional discipline strategies, and greater parenting competence than mothers in the WL group. On measures of parental adjustment, there was no significant difference in conditions at post-intervention based on mothers' reports of depression, anxiety, stress and conflict with partners over parenting issues. Mothers' reports at 6-month follow-up indicated that gains in child behaviour and parenting practices achieved at post-intervention were maintained.
A 4-year follow-up compared the long-term effects of two treatments for severely conduct disorder children referred to a Child and Adolescent Mental Health Service (CAMHS). Forty-two families received either the standard CAMHS treatment or a more intensive intervention. The intensive treatment involved a unit-based component for parents to practise new child management strategies. At the 6-month follow-up the intensive treatment group showed significant improvements on all measures of child behaviour and maternal mental health and improvements remained significant at the 4-year follow-up. By contrast, initial improvements for the standard treatment group, which were significant on only two measures, were not significant at the 4-year follow-up. The results suggest that the intensive treatment was advantageous in bringing about long-term improvements for these families. They also add to the growing evidence that interventions involving the rehearsal of child management strategies have better outcomes than those using more didactic methods of parent training.
Thirty-seven (37) couples experiencing child behavior problems and concurrent marital conflict were randomly assigned to one of two variants of a group parent training program, either Standard Group Triple P (SGTP; n=19) or Enhanced Group Triple P (EGTP; n=18). SGTP incorporated 8 sessions (4 group sessions and 4 telephone consultations) and taught parents to identify the causes of child behaviour problems, promote children's development, manage misbehavior and plan ahead to prevent child behavior problems in “high risk” parenting situations. Families in the EGTP condition received SGTP plus 2 additional group sessions of parent support training that taught partners to support one another to parent as a team. These additional sessions included information and active skills training in communication skills; giving and receiving constructive feedback; holding casual conversations; supporting each other when problems occur; holding problem solving discussions; and improving relationship happiness. There were significant improvements from pre- to post-intervention for both conditions, on measures of disruptive child behavior, dysfunctional parenting style, conflict over parenting, relationship satisfaction and communication. No differences, however, were found between the two conditions, with both the EGTP and the SGTP programs resulting in similar outcomes. In the main, initial treatment effects for both mothers and fathers were maintained at 3-month follow-up.
Parent training is one of the most effective interventions for behaviour problems in young children. Most models of parent training are largely behavioural in content and have been developed from social learning theory. As with developments in treatments for adult disorders, it is proposed that parent training implementation and parental engagement may be improved by the introduction of a cognitive component. In particular, the use of the “thoughts, feelings, behaviour cycle” throughout parent training is proposed as a tool for challenging parental beliefs and attributions regarding children's behaviour and increasing parental uptake of the behavioural strategies that are taught. Preliminary findings are discussed with reference to clinical implications and future research.
There is a substantial literature reporting the co-occurrence of maternal depression and child behaviour problems. Behavioural interventions have proven efficacy in the treatment of conduct problems, and a number of studies have reported gains in parental mental health following parent training. The mechanisms by which this is achieved are not clear, but it is likely that interventions that include parent training in observation skills and exposure to success will impact on both the child's conduct problems and maternal depression. This paper reports on the outcomes of two treatments for children with severely disruptive behaviour, the standard treatment offered by a Child and Adolescent Mental Health Service, and an intensive parent training intervention. It was predicted that the more specific skills training in the intensive treatment would make improvements in maternal health and child behaviour more likely. Significant overall improvements were found in measures of child behaviour, parental practices and maternal mental health. A correlation emerged between the improved child behaviour and the improved parenting strategies. Significant improvements for the intensive treatment group were seen on every measure. Significant improvement in the measure of maternal mental health contrasted with little change for the standard treatment group.