Improvements In Child Behavior Research Articles

Parent Interventions Improve Behavior After Pediatric Traumatic Brain Injury: A Systematic Review and Meta-analysis.

To examine child behavior change scores from randomized controlled trials (RCTs) of parent interventions for pediatric traumatic brain injury (TBI). MEDLINE, EMBASE, PsycINFO, and CINAHL were searched to identify studies that examined parent interventions for pediatric TBI. Inclusion criteria included (i) a parent intervention for children with TBI; (ii) an RCT study design; (iii) statistical data for child behavior outcome(s); and (iv) studies that were published in English. Seven studies met inclusion criteria. All interventions reported improved child behavior after pediatric TBI; however, child and parent factors contributed to behavior change scores in some interventions. Factors found to contribute to the level of benefit included age of child, baseline behavior levels, sociodemographics (eg, parent income, parent education), and parent mental health. Improved child behavior outcomes resulting from parent interventions for pediatric TBI are well supported by the evidence in the peer-reviewed literature. Clinicians are encouraged to consider child and parent factors as they relate to child behavior outcomes.

Mindful Parent Training for Parents of Children Aged 3-12 Years with Behavioral Problems: a Scoping Review.

ObjectivesWhile mindfulness-based parenting programs (MPPs) are increasingly popular for reducing child behavior problems, the evidence for the advantages of MPP over existing behavioral parent training is unclear. Existing systematic reviews have largely excluded the breadth of MPP protocols, including those that integrate behavioral skills components. Therefore, a scoping review was conducted to map the nature and extent of research on MPPs for parents of children aged 3 to 12 years with behavioral problems.MethodsPRISMA-ScR guidelines were used to conduct an encompassing peer literature review of cross-disciplinary databases. Studies were included if they reported mindfulness interventions for parents of children aged between 3 and 12 years with externalizing behavior problems and had an outcome measure of child behavioral problems that could be represented as an effect size. Randomized controlled trials as well as quasi-experimental, pre-post studies and unpublished dissertations were included.ResultsSixteen studies met the inclusion criteria (N = 1362). The majority of MPPs delivered mindfulness adapted to parenting based on the Bögels’ protocol within clinical settings. There was a dearth of fully integrated mindfulness and behavioral programs. MPPs generally produced pre-to-post-intervention improvements with small effect sizes across child behavior and parent style, stress, and mindfulness measures. Examining longer follow-up periods compared to pre-intervention, effects reached a moderate size across most outcome measures.ConclusionsMPPs continue to show promise in improving child behavior and parental mindfulness, well-being, and style. Further research is needed to determine how to best leverage the advantages of mindfulness in augmenting the well-established effectiveness of behavioral programs.

Applications of operant demand to treatment selection I: Characterizing demand for evidence-based practices.

Various treatment approaches have been determined efficacious for improving child behavior outcomes. Despite a variety of evidence-based options, consumers often disregard empirically supported treatments to pursue alternatives that lack empirical support, such as 'fad' therapies. The choice to pursue therapies lacking empirical support has been considered a 'gamble' on therapeutic outcomes and this form of risky choice has historically been explained using various cognitive heuristics and biases. This report translates quantitative analyses from the Operant Demand Framework to characterize how caregivers of children with behavioral issues consume treatment services. The Operant Demand Framework is presented, its utility for characterizing patterns of treatment consumption is discussed, and a preliminary application of cross-price analyses of demand is performed to illustrate how various factors jointly influence treatment-related choice. Results indicated that caregivers endorsing interest in receiving behavioral parent training regularly pursued pseudoscientific alternatives as a functional substitute for an established therapy, despite explicit language stating a lack of evidence. These findings question the presumption of rationality in models of treatment choice and degree to which scientific evidence influences the consumption of therapies. This report concludes with a discussion of Consumer Behavior Analysis and how quantitative analyses of behavior can be used to better understand factors that enhance or detract from the dissemination of evidence-based practices.

Parent-child interaction therapy (PCIT) with families of children with autism spectrum disorder.

Parent-child interaction therapy (PCIT) is an evidence-based behavioral parent training program designed for preschool-age children that emphasizes supporting parent-child interaction patterns to improve child behavior and enhance the quality of parent-child relationships. PCIT has been deemed efficacious in treating children with disruptive behavior disorders, and recent studies have shown promising results utilizing aspects of PCIT with children with autism spectrum disorder (ASD), but none of these studies applied the entire PCIT intervention per manual protocol. The present study is the first to test the efficacy of PCIT, without modification, with families of preschool-age children with ASD without comorbid behavioral difficulties. This study employed a single-subject multiple-probe design to evaluate the efficacy of PCIT with four families with children with ASD between the ages of 2 and 4 years old (M = 40 months) over a 4-month period. PCIT was effective in increasing positive parenting behavior, decreasing negative parenting behavior, and increasing child compliance to parental commands. Parents reported greater confidence in parenting abilities post-treatment and significant improvement in the core areas of autism symptomatology. Parents endorsed significant improvement in aspects of the parent-child relationship, such as attachment and involvement. Parents of children with ASD demonstrated more positive and effective parenting behavior and reported enhancements in the parent-child relationship after participating in PCIT. Children were more compliant to parental commands and exhibited improvements in social and behavioral functioning. Increases in positive parenting behaviors and child compliance to parental requests were maintained 1 month after treatment and outside the clinic setting during generalization sessions. Parents of children with ASD reported a high degree of satisfaction with PCIT. The present study provides initial evidence of the efficacy of utilizing PCIT with families of preschool-age children with ASD and supports the continued investigation of the efficacy of PCIT with this population.

Lower Maternal Chronic Physiological Stress and Better Child Behavior at 18 Months: Follow-Up of a Cluster Randomized Trial of Neonatal Intensive Care Unit Family Integrated Care

To assess whether Family Integrated Care (FICare) in the neonatal intensive care unit improves maternal chronic physiological stress and child behavior at 18months of corrected age for infants born preterm. Follow-up of a multicenter, prospective cluster-randomized controlled trial comparing FICare and standard care of children born at <33weeks of gestation and parents, stratified by tertiary neonatal intensive care units, across Canada. Primary outcomes at 18months of corrected age were maternal stress hormones (cortisol, ie, hair cumulative cortisol [HCC], dehydroepiandrosterone [DHEA]) assayed from hair samples. Secondary outcomes included maternal reports of parenting stress, child behaviors (Internalizing, Externalizing, Dysregulation), and observer-rated caregiving behaviors. Outcomes were analyzed using multilevel modeling. We included 126 mother-child dyads from 12 sites (6 FICare sites, n=83; 6 standard care sites, n=43). FICare intervention significantly lowered maternal physiological stress as indicated by HCC (B=-0.22 [-0.41, -0.04]) and cortisol/DHEA ratio (B=-0.25 [-0.48, -0.02]), but not DHEA (B=0.01 [-0.11, 0.14]). Enrollment in FICare led to lower child Internalizing (B=-0.93 [-2.33, 0.02]) and Externalizing behavior T scores (B=-0.91 [-2.25, -0.01]) via improvements to maternal HCC (mediation). FICare buffered the negative effects of high maternal HCC on child Dysregulation T scores (B=-11.40 [-23.01, 0.21]; moderation). For mothers reporting high parenting stress at 18months, FICare was related to lower Dysregulation T scores via maternal HCC; moderated mediation=-0.17 (-0.41, -0.01). FICare has long-term beneficial effects for mother and child, attenuating maternal chronic physiological stress, and improving child behavior in toddlerhood. NCT01852695.

Sensing technologies and child–computer interaction: Opportunities, challenges and ethical considerations

This study presents the outcomes of a systematic literature review of empirical evidence on the capabilities of sensing technologies for child–computer interaction (CCI). This paper provides an overview of what and how sensing technologies have been used to explain, understand, and predict children’s experiences with interactive devices and technologies and in what contexts. A search resulted in 44 papers that were included in the analysis. The results of the review depict the capabilities of sensing technologies for gauging children’s performance, engagement, and experiences (while interacting with technology) and the ongoing advances and implications that emerge from the employment of sensors to capture and improve child behavior. In particular, we identified the four main objectives (i.e., engagement of children, recognition/prediction of special needs/behavior, explaining/understanding the behavior/attitude, and learning performance/experiences) that the CCI research has been focusing on with sensor data. We also summarize the implications derived from the reviewed articles and frame them within four thematic areas. Finally, this review stresses that future research should consider developing a framework that would enable sensor data capacities to be aligned with the ethical, social, and generalizability guidelines. These sensor capacities could also be utilized to advance theory and practice. Our findings set a baseline for supporting the adoption and democratization of sensor data within future interactive technology research and development for children.

35.4 LAY-COUNSELOR DELIVERED TRAUMA-FOCUSED CBT (TF-CBT) FOR BEREAVED AFRICAN CHILDREN: OUTCOMES AND ACCEPTABILITY

The majority of the world’s children reside in low- and middle-income countries, yet few treatments have been tested in these settings. We present data from an NIMH-funded randomized controlled trial testing the effectiveness and acceptability of lay-counselor–delivered trauma-focused CBT (TF-CBT) in a sample of 640 youth who experienced death of 1 or both parents in Tanzania and Kenya. Child clinical outcomes were assessed at the end of treatment and at 12 months posttreatment. Acceptability was assessed via qualitative interviews 1 year after treatment with children and guardians, with 160 interviews randomly selected for qualitative coding, following a grounded theory approach. In the completed randomized controlled trial, at posttreatment, TF-CBT was more effective than usual care (UC) in reducing posttraumatic stress (PTS) among children who experienced parental death in 3 of 4 sites: rural Kenya (Cohen d = 1.04), urban Kenya (d = 0.56), and urban Tanzania (d = 0.45). At the 12-month follow-up, TF-CBT was more effective in reducing PTS only among children in rural (d = 0.86) and urban (d = 0.99) Kenya. At the 12-month follow-up in Tanzania, children who received TF-CBT and UC had comparable rates of improvement. The intervention was highly acceptable. Child-level benefits were mentioned by almost all guardians (149/160), including improvements in child behavior, mood, feelings, and/or thinking. Children also frequently cited improvements (128/160), including fewer loss-related bad memories, thoughts, and/or feelings, and general improvements in mood or feelings. Few guardians or children mentioned challenges or dislikes, other than the program being viewed as too short. Tanzanian guardians were more likely to mention community-level benefits from sharing knowledge in their communities. Other qualitative coding work, focused on counselor session notes, also suggests that Tanzanian guardians were more likely to share learned skills and lessons from TF-CBT in their communities. TF-CBT demonstrated the greatest effectiveness in Kenya and high acceptability in both Kenya and Tanzania. The qualitative results provide some context for treatment outcomes and inform next directions.

Utilization of telemedicine to support caregivers of young children with ASD and their Part C service providers: a comparison of intervention outcomes across three models of service delivery

BackgroundFamilies of young children with autism spectrum disorder (ASD) frequently experience barriers to accessing evidence-based early intervention services. Telemedicine presents an opportunity to increase access to these services, particularly for families in rural and under-resourced areas. The present article describes a brief behavioral intervention and support model for families of young children with concerns for ASD. In the context of the COVID-19 pandemic, this service model shifted to telemedicine-only service delivery, resulting in an opportunity to analyze intervention outcomes from services delivered either via traditional in-person visits, telemedicine-only sessions, or a hybrid model including both in-person and telemedicine sessions.MethodsData are presented for 115 families with toddlers 16-33 months of age who participated in a six-session behavioral intervention and support service model either in-person, through telemedicine, or through a hybrid service model. This intervention was available for families referred for ASD evaluation through the state Part C early intervention program. Intervention feasibility, fidelity of implementation, child outcomes, and stakeholder satisfaction are compared across service delivery models.ResultsCaregivers, behavioral consultants, and Part C early intervention providers reported satisfaction with services, regardless of service delivery model. Caregivers and consultants also reported positive child outcomes. Statistically significant differences emerged for caregiver- and consultant-reported child outcomes in some domains, with stakeholders in the telemedicine-only group reporting slightly less improvement, compared to stakeholders in the in-person-only group. Caregivers and consultants in the telemedicine-only group also provided qualitative feedback on benefits and challenges related to telemedicine services.ConclusionsBoth caregivers and behavioral consultants reported positive outcomes following a brief behavioral intervention and support model targeted at families of young children with concern for ASD. Stakeholders reported improvement in child behavior and satisfaction with services across in-person, telemedicine-only, and hybrid models of service delivery. These results suggest that telemedicine presents a promising opportunity for increasing service access. Additional research is needed to continue optimizing the experience of telemedicine-based service delivery for both families and intervention providers.

Comprehensive Meta-Analysis of Attention-Deficit/Hyperactivity Disorder Psychosocial Treatments Investigated Within Between Group Studies

Interventions for attention-deficit/hyperactivity disorder (ADHD) include positive behavior supports (e.g., parent training, school-based contingency management, behavioral peer interventions), training interventions (e.g., organizational skills training, social skills training, etc.), and other interventions (e.g., academic accommodations/modifications, self-monitoring). There is a need to conduct a comprehensive meta-analysis of psychosocial treatments for ADHD given discrepancies between meta-analyses. The present meta-analysis reports the results of between-group studies that compared a psychosocial treatment to a control condition from 1968 to 2016. In total, 226 studies were identified that met inclusion criteria. Results of the meta-analysis were organized by treatment type, rater, and domain of outcome assessed. Results indicated considerable variability across these parameters, with the strongest effects for proximal outcomes of behavioral parent training (improvements in parenting behaviors yielded a standardized mean difference of 0.70) and improvements in child behavior following implementation of behavioral school intervention (standardized mean difference of 0.66 and 0.72 for teacher ratings of ADHD symptoms and impairment, respectively). Other interventions were not extensively studied as stand-alone approaches. Results are discussed in light of current support for the use of psychosocial interventions for individuals with ADHD.

Cultural Adaptation of Group Parenting Programs: Review of the Literature and Recommendations for Best Practices.

Group parenting programs based on cognitive-behavioral and social learning principles are effective in improving child behavior problems and positive parenting. However, most programs target non-Hispanic, White, English-speaking families and are largely inaccessible to a growing Hispanic and non-White population in the United States. We sought to examine the extent to which researchers have culturally adapted group parenting programs by conducting a systematic review of the literature. We identified 41 articles on 23 distinct culturally adapted programs. Most cultural adaptations focused on language translation and staffing, with less focus on modification of concepts and methods, and on optimizing the fit between the target cultural group and the program goals. Only one of the adapted programs engaged a framework to systematically record and publish the adaptation process. Fewer than half of the culturally adapted programs were rigorously evaluated. Additional investment in cultural adaptation and subsequent evaluation of parenting programs is critical to meet the needs of all US families.

The Effects of a Parenting Program on Maternal Well-Being: Evidence from a Randomized Controlled Trial

AbstractThis paper evaluates how a light-touch parenting program for parents of children below school entry age affects maternal family well-being. We analyze data from a randomized controlled trial focusing on non-disadvantaged parents. Overall, results show no short-term effects but a relatively large positive effect of the intervention on maternal family well-being in the medium term. With a 20- to 30-percent standard deviation, the effects appearing three years after treatment are relatively large. Mechanisms such as improvements in child behavior are further explored.

Evaluation of a Brief Family-Centered Service Provision Model for Treating Children's Severe Behavior: A Retrospective Consecutive Case Series Analysis.

This article serves as an initial program evaluation of a service provision model for providing applied behavior analysis services to families with severe behavior needs. A retrospective consecutive case series design was used to evaluate the effectiveness, feasibility, and cost of the model. We analyzed records for all families served through the model from summer 2017 to fall 2018. A total of 55 families received services, with 87% of children having autism and 63% having an intellectual disability. Within-participant single-case experimental designs were used to evaluate the clinic's assessment procedures, and caregiver interviews were used to evaluate the feasibility and effectiveness of developed and implemented treatments. Conclusive assessment results were obtained for approximately 69% of children. For families that received treatment, 92% reported improved child behavior. Intent-to-treat analyses that included families that withdrew from services prior to receiving treatment indicated that 61% of families experienced improved child behavior. Assessment and treatment outcomes for families that attended all appointments are commensurate with those of other similar clinics reported in the literature; however, the percentage of families that withdrew from services is substantially higher. For families adhering to the clinic's services, children's challenging behavior may be effectively assessed and treated through brief outpatient contacts utilizing services based on applied behavior analysis.

An Evaluation of an Integrated Stuttering and Parent-Administered Self-Regulation Program for Early Developmental Stuttering Disorders.

Purpose This study reports findings from a clinical trial that implemented an early stuttering treatment program integrated with evidence-based parenting support (EBPS) to children who stutter (CWS) with concomitant self-regulation challenges manifested in elevated attention-deficit/hyperactivity disorder (eADHD) symptoms and compared those outcomes to CWS receiving stuttering treatment without EBPS. Method Participants were 76 preschool CWS and their parent(s). Thirty-six of these children presented with eADHD and were quasirandomized into two groups: stuttering treatment only (eADHDstandard) or stuttering treatment integrated with EBPS (eADHDintegrated). The remaining children did not meet criteria for eADHD symptoms and received stuttering treatment only (No-eADHDstandard). Pre, post, and 3-month follow-up measures of stuttering treatment outcomes as well as treatment effects on measures of child behavior difficulties and parenting practices were examined. Results Significant reduction in stuttering was found for all groups. However, the eADHDintegrated group showed a greater reduction in stuttering frequency than the eADHDstandard group, and at follow-up, stuttering frequencies in the eADHDintegrated group matched those of children in the No-eADHDstandard group, while stuttering in the eADHDstandard group remained significantly higher. Children with eADHD symptoms who received the integrated program also required significantly less stuttering intervention time than those children with eADHD symptoms who received stuttering treatment only. Families in the eADHDintegrated group reported large and significant improvements in child behavior and parenting practices. Conclusion This study provides support for an early treatment program for CWS. The integrated stuttering and self-regulation management program for CWS with eADHD symptoms proved successful for fluency and behavioral improvements, which were sustained at follow-up.

Parenting, mental health and economic pathways to prevention of violence against children in South Africa.

Parenting programs based on social learning theory have increasing empirical evidence for reducing violence against children. Trials are primarily from high-income countries and with young children. Globally, we know little about how parenting programs work to reduce violence, with no known studies in low or middle-income countries (LMICs). This study examines mechanisms of change of a non-commercialized parenting program, Parenting for Lifelong Health for Teens, designed with the World Health Organization and UNICEF. A cluster randomized trial showed main effects on parenting and other secondary outcomes. We conducted secondary analysis of trial data to investigate five potential mediators of reduced violence against children: improved parenting, adolescent behaviour, caregiver mental health, alcohol/drug avoidance, and family economic strengthening. The trial was implemented in rural South Africa with 40 sites, n=552 family dyads (including adolescents aged 10-18 and primary caregivers). Intervention sites (n=20) received the 14-session parenting program delivered by local community members, including modules on family budgeting and savings. Control sites (n=20) received a brief informational workshop. Emotional and physical violence against children/adolescents and each potential mediator were reported by adolescents and caregivers at baseline and 9-13 months post-randomisation. Structural equation modelling was used to test simultaneous hypothesized pathways to violence reduction. Improvements in four pathways mediated reduced violence against children: 1) improved parenting practices, 2) improved caregiver mental health (reduced depression), 3) increased caregiver alcohol/drug avoidance and 4) improved family economic welfare. Improved child behaviour was not a mediator, although it was associated with less violence. Simultaneously bolstering a set of family processes can reduce violence. Supporting self-care and positive coping for caregivers may be essential in challenging contexts. In countries with minimal or no economic safety nets, linking social learning parenting programs with economic strengthening skills may bring us closer to ending violence against children.

Educating Parents About Corporal Punishment and Effective Discipline: Pediatricians' Preparedness, Motivation, and Barriers.

To assess US pediatricians' preparedness, motivation, and barriers related to educating parents about corporal punishment (CP) and effective child discipline. A random sample of 1500 pediatricians was drawn from a nationwide database in the United States. A self-administered questionnaire was sent via mail in 2016. The response rate (53%; n=787) was maximized via repeated survey mailings and use of cash incentives. The majority of respondents were White (69%), female (59%) and were members of the American Academy of Pediatrics (85%). Most pediatricians felt somewhat prepared to advise parents about child discipline, particularly CP, and perceived their colleagues to be slightly less prepared than themselves. Although most (72%) respondents believed it was "extremely/very" likely that parents valued their advice about child discipline, only 36% believed parents were "extremely/very" likely to follow their advice. Most respondents were highly motivated to participate in activities designed to change norms regarding CP. The most common strategy pediatricians identified for improving child behavior was being consistent with rules (71%). Perceived barriers to providing child discipline advice to parents included lack of time (90%), lack of insurance reimbursement (48%), and lack of training and educational resources (47%). Pediatricians are a key source of professional advice for parents about how to discipline children safely. Given this, along with strong approval and use of CP in the United States and its harm for children, the current findings suggest a strong need for pediatricians to receive additional training on how to advise parents about child discipline along with removal of barriers to providing such advice.

Strong families: a new family skills training programme for challenged and humanitarian settings: a single-arm intervention tested in Afghanistan

BackgroundChildren living in challenged humanitarian settings (including those in rural/underserved areas, the displaced, refugees, in conflict/post conflict situations) are at greater risk of mental health difficulties or behavioural problems, with caregivers acting as their main protective factors. While many family skills programmes exist, very few were developed for, or piloted in, low resource settings (settings with limited infrastructure, typical of humanitarian settings). We therefore designed a brief and light programme; the Strong Families (SF) programme, consisting of 5 h contact time over 3 weeks. We conducted a pilot study with the aim to test the feasibility of implementation, and a preliminary look at the effectiveness of SF, in improving child behaviour and family functioning in families living in Afghanistan.MethodsWe recruited female caregivers and children aged 8–12 years through schools and drug treatment centres in Afghanistan and enrolled them in the SF programme. Demographic data, emotional and behavioural difficulties of children and parental skills and family adjustment measures were collected from caregivers before, 2 and 6 weeks after the intervention. Outcome was assessed through the SDQ (Strengths and Difficulties Questionnaire), assessing children’s behavioural, emotional, and social issues, and PAFAS (Parenting and Family Adjustment Scales), measuring parenting practices and family functioning.ResultsWe enrolled 72 families in the programme with a 93.1% retention rate (n = 67) for data collection 6 weeks post intervention. Mean age of caregivers was 36.1 years, they had 3.8 children on average and 91.7% of them had experienced war/armed conflict in their past. The average total difficulty score of the SDQ (ranging from 0 to 40, with scores above 16 being indicative of high problems) of the 72 children reduced significantly, from 17.8 at pre-test to 12.9 at post-test and 10.6 at second follow-up, with no difference in gender and most noticeably amongst those with the highest scores at baseline. Likewise, PAFAS scores decreased significantly after the programme, again with caregivers with the highest scores at baseline improving most.ConclusionsThe implementation of a brief family skills programme was seemingly effective and feasible in a resource-limited setting and positively improved child mental health and parenting practices and family adjustment skills. These results suggest the value of such a programme and call for further validation through other methods of impact assessment and outcome evaluation.Trial registrationISRCTN76509384. Retrospectively registered on March 9, 2020.

Interventions Supporting Mental Health and Positive Behavior in Children Ages Birth-5 Yr: A Systematic Review.

It is critical for providers to use evidence-based interventions to address mental health and behavioral barriers to occupational performance during early childhood. To identify evidence-based interventions within the scope of occupational therapy practice to improve mental health and positive behavior for children ages 0-5 yr and their families. PsycINFO, Cochrane, ERIC, MEDLINE, and OTseeker databases were searched for publications from 2010 through March 2017. This review was completed in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Risk of bias was assessed for each article using either A Measurement Tool to Assess Systematic Reviews (AMSTAR) or the Cochrane method. Articles meeting inclusion criteria were critically appraised. Forty-six articles met inclusion criteria and were organized into three themes: touch-based interventions (n = 9), parent-child interaction therapy (PCIT; n = 4), and instruction-based interventions (n = 33). Statistically significant findings and overall risk of bias supported the use of touch-based interventions, PCIT, and parent training. The evidence indicates that touch-based interventions can improve infant self-regulation (strong), social behavior, and attachment (moderate) and reduce maternal stress, anxiety, and depression (low). Moderate-strength evidence supports PCIT to improve child behavior. The evidence indicates that parent training can improve parent behavior, maternal-infant attachment (strong), and parent mental health (moderate). Teacher training can improve mental health and behavior (moderate). Group-based parent training and sleep training have insufficient support (low). Occupational therapy professionals working with children younger than age 5 yr can use the results of this systematic review to guide clinical decision making related to mental health and behavioral outcomes.

Modeling Treatment-Related Decision-Making Using Applied Behavioral Economics: Caregiver Perspectives in Temporally-Extended Behavioral Treatments.

Evidence-based behavioral therapies for children with disruptive and challenging behavior rarely yield immediate improvements in behavior. For caregivers participating in behavioral therapies, the benefits from these efforts are seldom visible until after substantial time commitments. Delays associated with relief from challenging behavior (i.e., improved behavior) can influence how caregivers decide to respond to instances of problem behavior, and in turn, their continued commitment (i.e., integrity, adherence) to treatments that require long-term implementation to produce improvements in child behavior. This study applied delay discounting methods to evaluate how delays affected caregiver preferences related to options for managing their child's behavior. Specifically, methods were designed to evaluate the degree to which caregiver preferences for a more efficacious, recommended approach was affected by delays (i.e., numbers of weeks in treatment). That is, methods evaluated at which point caregivers opted to disregard the optimal, delayed strategy and instead elected to pursue suboptimal, immediate strategies. Results indicated that caregivers regularly discounted the value of the more efficacious treatment, electing to pursue suboptimal approaches when delays associated with the optimal approach grew larger. Caregivers demonstrated similar patterns of suboptimal choice across both clinical (i.e., intervention) and non-clinical (i.e., monetary) types of decisions. These findings are consistent with research that has highlighted temporal preferences as an individual factor that may be relevant to caregiver adherence to long-term evidence-based treatments and encourage the incorporation of behavioral economic methods to better understand caregiver decision-making.

Improving Parent Emotion Socialization Practices: Piloting Tuning in to Kids in Iran for Children With Disruptive Behavior Problems

ObjectiveTo evaluate Tuning in to Kids (TIK), an emotion‐focused parenting program for mothers and preschool children with disruptive behavior problems in Iran.BackgroundDisruptive behaviors occur in approximately 23% of Iranian children and are associated with poorer emotional competence. The TIK parenting program was used to improve children's emotion competence and behavior by focusing on parent emotion socialization practices and emotion‐coaching skills.MethodFifty‐four children (3–6 years of age) were screened for behavior problems and randomly assigned to intervention or waitlist control conditions. Mothers in the intervention condition attended a six‐session version of the TIK program with two booster sessions at 2‐month intervals. Mothers completed questionnaires assessing children's behavior and emotional competence as well as parents' emotional socialization and emotion regulation at preintervention, postintervention, and 3‐month follow‐up.ResultsCompared with those in the control condition, mothers in the intervention condition reported statistically lower emotion dismissive parenting, child behavior problems, and emotion lability, as well as more emotion coaching.ConclusionTIK shows promise as a way of enhancing parent emotion socialization resulting in improved child behavior and emotional competence in children with disruptive behavior problems.ImplicationsThe findings suggest the program is a useful addition to existing parenting programs used in Iran.

Jandu Yani U ‘For All Families’ Triple P—positive parenting program in remote Australian Aboriginal communities: a study protocol for a community intervention trial

IntroductionThe population-based (Lililwan) study of fetal alcohol spectrum disorder (FASD) revealed a high prevalence of FASD in the remote communities of the Fitzroy Valley, Western Australia (WA) and confirmed anecdotal...