A Feasibility Trial of a Group, Online Behavior Parent Training Program Implemented by School Practitioners for Caregivers of Elementary School Students

Engaging Fathers in Behavioral Parent Training: Listening to Fathers' Voices

Parent Training Interventions to Reduce Challenging Behavior in Children with Intellectual and Developmental Disabilities

Parent training is one of the most commonly used treatments for children with Attention deficit-Hyperactivity Disorder; however, there are few studies that empirically examine the effectiveness of Barkley's widely used parent training program. Thirty-one families with ADHD children in preschool through fifth grade were randomly assigned to a seven week immediate parent training program or to one of two delayed treatment groups. The sessions were co-facilitated by two individuals using Barkley's Defiant Children Clinician's Manual for Parent Training. Treatment outcome was evaluated through observation, parent ratings, and teacher ratings numerous times before and after treatment in a multiple baseline design. The major findings were: a) Parent training resulted in significant changes in parents' behavior (including use of approving statements and reduced need to repeat commands to obtain compliance): b) Parent training resulted in changes in children's behavior in the home setting (including increased compliance, decreased hyperactive behavior and decreased problematic behavior in general); c) Parent training resulted in changes in parents' and children's behavior that were maintained over time; and d) Parent training did not result in significant changes in the children's behavior in the school setting. Recommendations are provided for adding an additional session to Barkley's program, and for working with teachers to better meet children's needs in the school setting.

Current treatment of Attention Deficit/Hyperactivity Disorder (ADHD) and other disorders affecting central nervous system functioning leading to disruptive behaviors in children and adolescents seldom include an adjunctive psychosocial intervention. Objective: The purpose of this quality improvement study was to implement Behavioral Parent Training (BPT) in an outpatient private practice setting to improve outcomes in home, school, and social settings for children and adolescents. Method: Parent(s)/guardian(s) of ten (n=10) children ages seven through 12. The study utilized the Vanderbilt ADHD Diagnostic Parent Rating Scale, Home Situations Questionnaire, and Disruptive Behavior Disorder Rating Scale – Parent Form as well as Teacher Rating Scale and School Questionnaires for measurement of behaviours prior to BPT. The standardized ADHD parent and teacher rating scales along with the questionnaires for both were again completed at the conclusion of the BPT sessions for comparison. Results: Findings indicated significant improvements in disruptive behaviour. Conclusion: Psychosocial interventions such as BPT can be a powerful adjunct to pharmacotherapy in ADHD and behavior disorders for this population. Providing such intervention in a routine practice setting offers the potential for improved outcomes in the child/adolescent’s home, school, and social setting.

Background: Externalizing behavior in deaf children causes many psychological problems for their parents. Aggression and rulebreaking behaviors in children with severe hearing loss may cause psychological problems in parents and in managing children's behavior.Consequently, the present study aimed at investigating the effect of parental behavioral training of mothers on reducing theexternalized behaviors (aggression and rule breaking behavior) of their 9- to 10- year old children with severe hearing loss.Methods: This was an experimental study with pretest, posttest, and a control group. The research population included all studentswith severe hearing loss and their mothers. Thus, 30 mothers whose children had the most severe hearing loss were selected as ourmain sample among 80 mothers who had completed the Child Behavior Checklist. Then, they were placed into the experimental(n=15) and control groups (n=15) after being matched based on age, educational level, and socioeconomic status. The research toolwas Child Behavior Checklist-Persian Version. The parental behavior training was provided for the experimental group in nine 90-minute sessions.Results: The results of the present study indicated the effectiveness of experimental treatment on decreasing the aggressive behaviorsof children of mothers in the experimental group compared to mothers of the control group (p=0.001). Moreover, the results revealeda decrease in rule breaking behaviors (p= 0.007) in children of mothers of the experimental group compared to mothers of thecontrol group.Conclusion: Parents’ behavioral training is important in decreasing the aggressive and offensive behaviors in children with severehearing loss who are at risk of behavioral problems. Furthermore, some research has highlighted the necessity of such trainings forparents of these children. Thus, the present study, emphasizing the importance of childhood problems, found that mothers’ behavioraltraining could prevent behavioral problems of school-aged children with hearing loss and reduce the recurrence of such problems.

Using the Prevent-Teach-Reinforce model to reduce challenging behaviors in children with autism spectrum disorder in home settings: A feasibility study

PurposeThis study aims to examine the concurrent influence of parental stress, executive functions and communication skills on challenging behaviors in children with Autism Spectrum Disorder (ASD). These behaviors are frequently exhibited by children with ASD and can be attributed to a variety of factors, including the child’s environment and their own level of development.Design/methodology/approachThe current investigation was cross-sectional. Based on the inclusion criteria, 74 children with ASD were chosen, including those aged 4–7 years and 11 months, those with a moderate level of ASD and those without medical conditions or accompanying issues. Convenience sampling was implemented.FindingsIn children with ASD, challenging behaviors were observed to be significantly correlated with all three factors of parental stress, executive functions and communication skills (p < 0.05). Additionally, the executive functions were the most effective predictor of the frequency of challenging behaviors in these children. Furthermore, parental stress was the most effective predictor of the severity of challenging behaviors.Originality/valueIn previous research, the examination of the concurrent impact of factors that influence challenging behaviors demonstrated by children with ASD was restricted to the child’s level (executive functions and communication skills), whereas environmental factors such as parental stress were disregarded. To the best of the authors’ knowledge, this is the first research to look at the concurrent influence of three crucial factors: parental stress, executive functioning and communication abilities on challenging behaviors in children with ASD. The findings suggest that interventions targeting challenging behaviors in children with ASD may benefit from addressing the child’s executive function difficulties and parental stress.

Temperament predicts challenging behavior in children with autism spectrum disorder at age 5

Parent training (PT) has emerged as a promising treatment for disruptive behavior in children with autism spectrum disorder (ASD). This review summarizes the essential elements of PT for disruptive behavior in children with ASD and evaluates the available evidence for PT using both descriptive and meta-analytic procedures. We searched Medline, PsycINFO, and PubMed databases (1980-2016) in peer-reviewed journals for randomized controlled trials (RCTs) of PT for disruptive behavior in children with ASD. The systematic search of 2023 publications yielded eight RCTs involving a total of 653 participants. We calculated effect sizes using either raw post-treatment means and standard deviations for each treatment group (PT and control) or group mean differences with associated 95% confidence intervals (CIs). Differences in post-treatment means were converted to a standardized difference in means (SMD) for each primary outcome. Results support the efficacy of PT for disruptive behavior in children with ASD, with a SMD of -0.59 [95% CI (-0.88, -0.30); p<0.001]. Across these eight studies, there was significant heterogeneity in the effect of PT on disruptive behavior. This variability is likely due to differences in sample size, number of treatment sessions, study duration, and control condition employed. Current findings provide solid support for the efficacy of PT for disruptive behavior in children with ASD. Future studies should focus on effectiveness trials to promote wider implementation of PT in clinical settings.

Background: Several parent training programmes and behavioural teacher training programmes built on learning theory have been developed for problem prevention and treatment of attention-deficit/hyperactivity disorder (ADHD) and/or oppositional defiant disorder (ODD) during the last few decades. Group format has often been used for parent training but single-subject designs are more common in teacher training. More studies have focussed on pre-school children than on older children, and a minority have been conducted in public mental health settings. Aim: This study aimed to evaluate a combined parent and teacher manual-based group training programme for children with ADHD conducted by the staff at a child and adolescent psychiatric clinic in Sweden. Method: The intervention was a modified version of Barkley's programme. Children were randomized to an Intervention or a Control group. Sixty-one parents and 68 teachers answered questions about ADHD and ODD symptoms, and about behavioural problems when the study started and at a 3-month follow-up. Results: Results showed that the intervention resulted in a reduction of the number of children who met DSM-IV criteria for ADHD and/or ODD. Effects were more pronounced in the home setting than in the school setting, and were further accentuated when both parents and teachers of the same child took part in the intervention. Teachers with more problematic classroom situations benefited most from the intervention. Conclusion: The programme, “Strategies in Everyday Life”, has, in a regular clinical setting, demonstrated promising effects on children's disruptive behaviour, and a clinical implication was to recommend involving both parents and teachers in the programme.

What can Implementation Science tell us about scaling interventions in school settings? A scoping review

Food environment interventions targeting children and adolescents: A scoping review

Cognitive–behavioural treatment (CBT) in children and adolescents includes: (1) psychoeducation of the patient and their parents/teachers; (2) family-based psychosocial interventions, in particular behavioural parent training; (3) psychosocial interventions in school settings (e.g. classroom interventions and teacher training; academic interventions); (4) cognitive behaviour therapy of the child/adolescent (e.g. social skills training, organizational skills training). A multimodal psychosocial treatment approach, utilizing a combination of several of the CBT interventions, is described. ADHD aims at reducing the ADHD symptoms, psychosocial impairments associated with ADHD, and the related behavioural and emotional problems. Overall, most of these interventions are empirically based interventions that have been shown to be effective in several trials.

Many clinicians find it challenging to obtain training in evidence-based interventions, including behavioral parent training, which is considered the front-line treatment for children with disruptive behaviors (Chacko et al., 2017). Workshops, ongoing consultation, and feedback provided in person are effective, yet are rarely feasible for clinicians in the field (Fixsen, Blase, Duda, Naoom, & Van Dyke, 2010). The purpose of the present study was to conduct a preliminary assessment of an online tutorial combined with live remote coaching for training mental health professionals in behavioral parent training. Participants in this pretest-posttest open trial were 22 clinicians and graduate students (73% female) from around the United States. The web platform operated successfully, and clinicians found the training to be highly satisfactory. Compared to pre-training, participants demonstrated large improvements in knowledge about disruptive behavior and behavioral parent training and performed significantly better on demonstrations of skill in administering behavioral parent-training components. An online course combined with live remote coaching is a promising methodology for significantly increasing the number of clinicians trained in evidence-based interventions for disruptive behavior in children. Next steps for evaluation and expansion of this training model are discussed.

This multiple baseline study evaluated the efficacy of behavioral parent training (BPT) for 12 parents (M age = 39.17 years; 91% mothers) and their children (ages 6-12; 83% boys) both with Attention-Deficit/Hyperactivity Disorder (ADHD), and also explored the acute effect of stimulant medication for parents before and after BPT. Parents rated their own and their children's symptoms and impairment and were stabilized on optimally dosed medication. Then, parents discontinued medication and were randomly assigned to a 3, 4, or 5 week baseline (BL), during which they provided twice-weekly ratings of their impairment, parenting, and their child's behavior. Following BL, parents and their children completed two laboratory tasks, once on their optimally dosed medication and once on a placebo to assess observable effects of medication on parent-child behavior, and they completed additional assessments of family functioning. Parents then completed eight BPT sessions, during which they were unmedicated. Twice-weekly ratings of parent and child behavior were collected during BPT and additional ratings were collected upon completing BPT. Two more parent-child tasks with and without parent medication were conducted upon BPT completion to assess the observable effects of BPT and BPT plus medication. Ten (83.33%) parents completed the trial. Improvements in parent and child behavior were observed, and parents reported improved child behavior with BPT. Few benefits of BPT emerged through parent reports of parent functioning, with the exception of inconsistent discipline, and no medication or interaction effects emerged. These results, although preliminary, suggest that some parents with ADHD benefit from BPT. While pharmacological treatment is the most common intervention for adults with ADHD, further examination of psychosocial treatments for adults is needed.