Parents Plus Research Articles

The healthy habits questionnaire (HHQ): Validation of a measure designed to assess problematic influential behaviours amongst families of children living with obesity or a risk of developing obesity.

The 48-item Healthy Habits Questionnaire (HHQ-48) was developed to (1) monitor positive changes in family lifestyles following engagement in the Parents Plus Healthy Families (PP-HF) parent training programme and (2) be utilised as a standalone measure in clinical settings to identify and track problematic influential behaviours amongst families of children in weight-management services. This study aimed to develop and validate a brief version of the HHQ-48. The scale was administered to a cross-sectional community sample (n = 480), and on two occasions to a control sample (n = 50) and an experimental sample (n = 40) from a randomised controlled trial (RCT) of the PP-HF programme to assess test-retest reliability and sensitivity to change respectively. Exploratory and confirmatory factor analysis showed that a 23-item, 4-factor version of the HHQ (i.e., the HHQ-23) best fit the data. The scale and factor subscales had good internal consistency and test-retest reliability. They also had good concurrent and construct validity shown by significant correlations with another scale that assessed lifestyle issues, and scales that assessed parenting satisfaction, family functioning, and children's strengths and difficulties. The HHQ-23 was sensitive to change following parents completing the PP-HF programme. The HHQ-23 may, therefore, be used to monitor positive changes in family lifestyles following engagement in the PP-HF parent training programme. The HHQ-23 also shows promising potential as a standalone screening measure or as part of a larger battery of screening assessments in paediatric weight-management services.

Developing Parents Plus

In this article, we describe the development and investigation of the social validity of Parents Plus, a parent-implemented intervention for preschool children with developmental language disorder. Parents Plus is a fully online intervention that is delivered through three components: (a) training delivered through an app that educates parents on how to use focused stimulation (FS), a language facilitation strategy; (b) parent implementation of FS during naturally occurring routines; and (c) remote practice-based coaching provided by a coach via Zoom. Parents Plus was developed in three steps: (a) initial content development with input from parents and professional advisory board members, (b) brief field test with five parent–child dyads, and (c) full-length field test with seven parent–child dyads. Throughout the development process, we collected social validity data on the intervention's goals, procedures, content and outcomes. Each step was followed by revisions to Parents Plus. Findings suggest that Parents Plus has strong social validity. Recommendations for early intervention practice are provided based on lessons learned, such as different methods to scaffold learning experiences for parents.

The Effect of Parenting Programme on the Symptoms and the Family Functioning of Children with Attention Deficit and Hyperactivity Disorder Who Have Residual Symptoms Despite Medical Treatment

AbstractThis study aims to determine the effects of the Parents Plus Children's Programme (PPCP) on children's symptoms of attention deficit and hyperactivity disorder (ADHD) and on family functionality and parenting stress. The children in the study were aged 6–11 years, and they had been diagnosed with ADHD and had residual symptoms despite effective dosage and timing of their medication. Forty-six couples, who with their children met the eligibility criteria, were enrolled and randomly allocated to the PPCP or the control group. The intervention involved a 9-week, 2 h a week, parenting group exercise. Those in the PPCP group improved significantly more over time on Conners’ Parent Rating Scale-Revised, Family Assessment Device, and Parent Stress Index than those in the control condition. The trial is the first clinical study involving the parents of children with ADHD that addresses residual symptoms and functional impairments that remain despite the administration of the maximum effective dose of pharmacological treatment.

The Parents Plus Children’s Programme—a qualitative study exploring parents’ experiences of participation and cognitive factors mediating outcome

ABSTRACTThis article presents the findings of a qualitative study of parents’ perceptions of a video-modelling assisted group-based parent training programme, the Parents Plus Children’s Programme (PPCP). PPCP was developed in Ireland and is culturally sensitive to the Irish context. PPCP aims to reduce emotional and behavioural difficulties in children aged 6–11 years. Twenty-one caregivers of children attending a child and adolescent mental health service in Dublin with significant behavioural problems were interviewed five months following completion of PPCP. Thematic analysis was used to explore caregivers’ perceptions of changes in their children, benefits of participation and effective programme strategies, with a view to identifying cognitive factors mediating outcome. Improvements observed included children being calmer, being better able to communicate feelings and needs, and having better emotional regulation. “Tuning in” to children, engaging in play, explaining rules, communicating calmly and planned sanctions were identified as effective programme strategies. Group support emerged as the main benefit of participation. Perceived parental control, ability to reframe children’s misbehaviour, consistency with discipline and hopefulness differentiated participants who observed improvements and those who did not. The findings were interpreted within a social-cognitive theoretical framework with reference to self-efficacy beliefs. Implications for clinical practice are also discussed.

A first-level evaluation of a school-based family programme for adolescent social, emotional and behavioural difficulties.

This study is a first-level evaluation of an intervention targeted at adolescents with social, emotional and behavioural difficulties in Irish post-primary schools. It is a combined implementation of the Working Things Out adolescent programme and the Parents Plus Adolescent Programme (WTOPPAP). Overall, 47 parents and their children (mean age: 13.81 years) took part in the study. The study used a repeated measures design to assess change at pre- and post-intervention and 5-month follow-up using the Strengths and Difficulties Questionnaire, McMaster General Functioning Scale, Goal Attainment (parent- and adolescent-rated), Parent Stress Scale and Kansas Parenting Satisfaction Scale (parent-rated) as assessment measures. This study found that parent-rated child total difficulties and adolescent-rated emotional difficulties significantly improved from pre-test to 5-month follow-up. Parent- and adolescent-rated goals, and parent-rated child conduct difficulties, parental stress and satisfaction with parenting also significantly improved from pre- to post-test. These gains were largely maintained at 5-month follow-up. These findings indicate that the WTOPPAP may be an effective intervention for adolescents with emotional and behavioural difficulties and their parents. It was demonstrated that a manualised family intervention could be effectively rolled out at a number of school locations, with delivery and evaluation being conducted by school staff. Further implications are also discussed.

Parents Plus Systemic, Solution-Focused Parent Training Programs: Description, Review of the Evidence Base, and Meta-Analysis.

Parents Plus (PP) programs are systemic, solution-focused, group-based interventions. They are designed for delivery in clinical and community settings as treatment programs for families with child-focused problems, such as behavioral difficulties, disruptive behavior disorders, and emotional disorders in young people with and without developmental disabilities. PP programs have been developed for families of preschoolers, preadolescent children, and teenagers, as well as for separated or divorced families. Seventeen evaluation studies involving over 1,000 families have shown that PP programs have a significant impact on child behavior problems, goal attainment, and parental satisfaction and stress. The effect size of 0.57 (p<.001) from a meta-analysis of 10 controlled studies for child behavior problems compares favorably with those of meta-analyses of other well-established parent training programs with large evidence bases. In controlled studies, PP programs yielded significant (p<.001) effect sizes for goal attainment (d=1.51), parental satisfaction (d=0.78), and parental stress reduction (d=0.54). PP programs may be facilitated by trained front-line mental health and educational professionals.

A first-level evaluation of a family intervention for adolescent social, emotional and behavioural difficulties in Child and Adolescent Mental Health Services

This study is a first-level evaluation of a family intervention targeted at adolescents with social, emotional and behavioural difficulties (SEBD) attending Child and Adolescent Mental Health Services (CAMHS) in Ireland. It is a combined implementation of the Working Things Out adolescent programme and the Parents Plus Adolescent Programme (WTOPPAP).Method: A total of 93 adolescents aged 11–17 years (M = 14.64, SD = 1.31; 39% male) and their parents took part in the study. The study used a quasi-experimental One-Group Pretest-Posttest design to assess change from pre- to post-intervention using the Strengths and Difficulties Questionnaire, the McMaster General Functioning Scale, Goal Attainment, Parent Stress Scale and the Kansas Parenting Satisfaction Scale. Both parent- and adolescent-rated goal attainment and general family functioning improved from pre- to post-intervention. Parents also rated their satisfaction with parenting as having significantly improved. Adolescent-rated emotional difficulties significantly improved for the overall sample and parent-rated child total difficulties for female adolescents significantly improved from pre-test to post-test. Parents of female adolescents also reported a significant drop in parental stress. These findings indicate that the WTOPPAP may be an effective intervention for adolescents with SEBD, particularly females, and their parents. Further implications are discussed.

Positive parenting: a randomised controlled trial evaluation of the Parents Plus Adolescent Programme in schools.

BackgroundThe aim of this study was to evaluate the Parents Plus Adolescents Programme (PPAP)—a parent training course specifically targeting parents of young adolescents (aged 11–16 years)—when delivered as a preventative programme in community school settings.MethodsA sample of 126 parents (mean age of children = 12.34 years; range = 10–16 years) were randomly assigned to either a treatment (PPAP; n = 82) or a waiting-list control condition (WC; n = 44). Analyses are based on a study-completer sample post-treatment (n = 109 parents: PPAP n = 70; WC n = 39) and sample at 6 month follow up (n = 42 parents).ResultsBoth post-treatment (between groups) and 6-month follow-up comparisons of study completers (within PPAP group) revealed significant positive effects of the parenting intervention with respect to adolescent behaviour problems and parenting stress. The post treatment comparisons demonstrated large effect sizes on global measures of child difficulties (partial eta squared = 0.15) and self-reported parent stress (partial eta squared = 0.22); there was a moderate effect size on the self-reported parent satisfaction (partial eta squared = 0.13).ConclusionsThis study provides preliminary evidence that PPAP may be an effective model of parent-training implemented in a community-based setting. The strengths and limitations of the study are discussed.

An evaluation of the Parents Plus-Parenting When Separated programme.

This study evaluated the Parents Plus-Parenting when Separated Programme, an intervention specifically designed to address the needs of separated parents in an Irish context. In a randomized control trial, 82 separated parents with young children were assigned to the Parents Plus-Parenting when Separated Programme treatment group and 79 to a waiting-list control group. They were assessed on measures of client goals, parenting satisfaction, child and parental adjustment and interparental conflict at baseline (Time 1) and 6 weeks later (Time 2), after the treatment group completed the Parents Plus-Parenting when Separated Programme. From Time 1 to 2, significant goal attainment, increases in parenting satisfaction and decreases in child behaviour problems, parental adjustment problems and interparental conflict occurred in the Parents Plus-Parenting when Separated Programme group, but not in the control group. These results supported the effectiveness of Parents Plus-Parenting when Separated Programme, which should be made more widely available to separated parents.

A community led approach to delivery of the Parents Plus Children's Programme for the parents of children aged 6–11

Childhood internalising and externalising disorders tend to persist when left untreated and place affected individuals at higher risk of compromised outcomes. The social costs include school dropout, unemployment, family breakdown and substance abuse. Effective preventive interventions require a public health approach. The aim of this experimental study was to evaluate the effectiveness of the Parents Plus Children's Programme (PPCP) delivered in community and school contexts by frontline professionals from diverse backgrounds. Participating parents with children aged 6 to 11 were randomly assigned to a Treatment Group (n=44) or a no treatment Control Group (n=31). The efficacy of training was assessed using self-report questionnaires completed by participants in both Treatment and Control groups. Significant post treatment improvements were recorded on measures of parenting-related stress, child problem behaviour and parent satisfaction with medium to large effect sizes. Treatment group results were maintained at six-month follow-up. These results support the efficacy of the PPCP as a community led intervention with potential to prevent and interrupt child behaviour problems through supported parenting practice, before problems become critical and entrenched.

A controlled clinical evaluation of the Parents Plus Children’s Programme for parents of children aged 6–12 with mild intellectual disability in a school setting

The aim of this study was to evaluate the effectiveness of the parent training, Parents Plus Children's Programme (PPCP) as an intervention for parents of children with mild intellectual disabilities. Participants were parents of children, aged six to 12, attending a special school for children with mild general learning disability (n = 29). Minor programme adaptations were made. Pre and post-assessment included the Strengths and Difficulties Questionnaire, the Parenting Stress Index, the Kansas Parent Satisfaction Scale and parent identified personal and child-related goals. A significant reduction in clinical range scores for treatment group participants (n = 16) was observed. Conversely, clinical range scores for control group participants (n = 13) increased, or remained elevated. These preliminary results suggest that PPCP may be successfully delivered as a routine community-based intervention and aid to prevent and reduce behavioural problems, reduce parent stress and increase parent confidence and satisfaction. Further investigation of programme effectiveness for parents of children with developmental disability is warranted.

A Pilot Study on the Impact of a Home-based Parenting Intervention: Parents Plus

This article reports on a pilot study undertaken in order to explore the impact of a home-based parenting intervention (Parents Plus), on parents and families. Parents Plus is part of a Welsh Early Years strategy called Flying Start and aims to promote positive parent–child interactions. This article explores the medium-term to long-term impact of the intervention. One hundred and ninety-seven families who received the intervention between 2000 and 2007 were sent letters advising they would be telephoned to take part in a survey about their perceptions of Parents Plus, and were given the choice to opt out of the research. A total of 21 mothers participated in a short telephone survey, and six mothers participated in in-depth interviews that explored changes in family life in more detail. Interviews were transcribed and analysed using thematic content analysis. The results showed that the intervention had a dual impact: practical tips and techniques to help manage behaviour, and emotional support for mothers. The article presents in diagrammatic form mothers' reported changing experiences and attitudes towards their need for help and their esteem as parents through the intervention period.

A Controlled Clinical Evaluation of the Parents Plus Children’s Programme: A Video-based Programme for Parents of Children Aged 6 to 11 with Behavioural and Developmental Problems

This article describes the development and the clinic-based evaluation of the Parents Plus Children's Programme (PPCP), a group-based video-modelling-assisted programme for parents of children aged 6 to 11 referred to a Child Mental Health Service with significant behavioural problems both with and without associated developmental difficulties. In evaluating the programme, a sequential block design was used to assign 74 parents of children referred to the service to the PPCP group (n = 42) or the Treatment as Usual (TAU) Comparison Group (n = 32). Assessment took place before and immediately following the 8-week intervention for both groups and at 5-month follow-up for the PPCP Group. Compared to the TAU Group postprogramme, the PPCP Group displayed significant reductions in total difficulties and conduct problems as measured by the Strengths and Difficulties Questionnaire, decreased parental stress, increased parental confidence and significant improvements in parent-defined problems and goals. These positive changes were maintained at 5-month follow-up for the PPCP group, in addition to further significant improvements in peer problems and prosocial behaviour. The analysis also suggests that the programme is more effective for parents of children with behavioural problems only, than for those with associated developmental difficulties. The strengths and limitations of the study are discussed, as well as the difficulties of conducting practice-based research.

Parents Plus Programme 1: Evaluation of Its Effectiveness for Pre‐School Children with Developmental Disabilities and Behavioural Problems

Background This study aimed to evaluate the effectiveness of the Parents Plus programme with families of pre‐school children with developmental disabilities and significant behavioural problems in the Irish health service. The Parents Plus programme is a group‐based parent training package involving video modelling, which was designed to be effective for children with conduct problems, but without developmental disabilities.Materials and methods Pre‐ and post‐treatment assessments were conducted with 22 treated cases and 19 waiting‐list controls with a protocol that included the Strengths and Difficulties Questionnaire, the Child Behaviour Checklist, the General Health Questionnaire‐12, the Kansas Parental Satisfaction Scale, the Family Assessment Device, the Perceived Social Support Scale, the Family Inventory of Life Events and Changes, the Parenting Stress Index and the Questionnaire on Resources and Stress.Results Following the treatment, a comparison of treatment and control group means showed that the treated group showed better adjustment on the total difficulties scale of the Strengths and Difficulties Questionnaire. These gains were maintained at 10‐month follow‐up. Fifty per cent of treated cases showed clinically significant improvement and 14% showed reliable change on the Strengths and Difficulties Questionnaire. The treatment group reported a high level of satisfaction with the Parents Plus programme and showed significant goal attainment after treatment and at follow‐up.Conclusions For some families of pre‐school children with developmental disabilities and significant behavioural problems, the Parents Plus programme is an effective intervention and may be incorporated into routine early intervention clinics in the Irish health service.

An Evaluation of the Parents Plus Programme for pre-School Children with Conduct Problems: A Comparison of those with and without Developmental Disabilities

Abstract This study examined the effectiveness of the Parents Plus Programme for families of pre-school children with significant behavioural problems, comparing those with and without developmental disabilities. Twenty-two parents of children with developmental disabilities and conduct problems (the disability group), and 17 parents of children with conduct problems, but without developmental disabilities (the conduct problems group), were assessed before and after participating in the Parents Plus Programme, and at 10 months follow-up. More than 70% of cases in both the disability and conduct problems groups showed clinically significant improvement on the Total Difficulties scale of the Strengths and Difficulties Questionnaire. During the follow-up period, parents in the disability group showed a deterioration in psychological adjustment (on the General Health Questionnaire-12), while parents in the conduct problems group showed an improvement. Parents in the disability group reported a higher level of...

Parents Plus – Right from the Start

Parents Plus – Right from the Start