Program For Parents Of Children Research Articles

Functions of a group-based parenting program for parents of children with mental health issues-some observations from a tertiary care center

Child and adolescent mental health issues have a wide prevalence and cause serious burden and stress to the psychosocial health of parents and caregivers. Psychosocial interventions have proved to be useful adjuncts to pharmacological treatment in childhood psychiatric conditions because of their long standing nature and psychosocial implications. The present paper aims to identify and enlist the benefits of one such group-based parenting program practiced in a mental health services inpatient setting. The paper borrows from the experiences and observations of a psychiatric social worker who has considerable experience in conducting such group sessions. The material recorded here helps in understanding that parents and caregivers perceive benefits of significant magnitude from regular group session inputs, which help them to deal with the mental health issues of their children, and which also turn out to be a source of support.

Internet-based information and support program for parents of children with burns: A randomized controlled trial

BackgroundThe aim of the study was to evaluate the feasibility and effects of an internet-based information and self-help program with therapist contact for parents of children and adolescents with burns. The program aimed to reduce parents’ symptoms of general and posttraumatic stress. MethodsParticipants were parents of children treated for burns between 2009–2013 at either of the two specialized Swedish Burn centers. Sixty-two parents were included in a two-armed, randomized controlled trial with a six-week intervention group and a wait-list control group, including a pre and post-assessment, as well as a 3 and 12-month follow-up. The intervention contained psychoeducation, exercises and homework assignments, and the intervention group received weekly written feedback from a therapist. The main outcome was stress (post-traumatic stress, general stress and parental stress). ResultsThe program had a beneficial effect on posttraumatic stress in the short term, but did not affect general stress or parental stress. The parents rated the program as being informative and meaningful, but some of them thought it was time-consuming. ConclusionThe program has the potential to support parents of children with burns. The intervention is easily accessible, cost-effective and could be implemented in burn care rehabilitation.

Social Validity of a Training and Coaching Program for Parents of Children With Autism Spectrum Disorder on a Waiting List for Early Behavioral Intervention

Due to limited public resources, many children with autism spectrum disorder and their families must wait several months, if not years, to access early behavioral intervention (EBI) services. Service providers must thus develop alternative support models to assist families placed on waiting lists. The present study assessed the social validity of one such initiative, a training and coaching program for parents whose children had been put on a waiting list for EBI services. This program consisted of group training sessions on strategies to cope with their child’s disorder based on applied behavioral analysis and on one-hour, weekly follow-up meetings to support parents’ interventions with their child over the course of 12 months. Social validity was assessed through parental satisfaction with this program and their perception of its effects on themselves, the family, the child, and parental stress. The 94 participants were generally satisfied with the program overall, although they wished for more frequent and intensive interventions. They reported that the program had positive effects on their psychological well-being, their family’s quality of life, and their child’s behavior. However, parenting stress levels were found to have increased over the 12-month period. These results demonstrate that training and individually supporting parents can be beneficial for families of children with ASD who cannot have access to early behavioral intervention immediately upon receiving a diagnosis. Importantly, however, these lower-cost, parent-focused programs cannot be considered a substitute for more intensive and children-driven services.

Delivering solid treatments on shaky ground: Feasibility study of an online therapy for child anxiety in the aftermath of a natural disaster

Objective: To assess feasibility of online cognitive behaviour therapy (CBT) for children and adolescents with anxiety in the aftermath of a natural disaster. Method: 42 children and adolescents with clinical anxiety referred from primary care were invited to complete an internet CBT program (BRAVE-ONLINE). Outcome measures and assessment timelines were chosen to allow a comparison of the results with the program developers’ randomised controlled trials. Results: At 6-month post intervention, more than half (55%) of the 33 participants assessed, no longer met criteria for their primary anxiety disorder. The mean number of anxiety diagnoses dropped from 2.76 (SD = 0.85) at baseline to 1.06 (SD = 1.25) at follow-up (z = −4.51, p < .001). Participants’ anxiety and mood symptoms reduced and health-related quality of life improved significantly by follow-up. Satisfaction ratings were moderate to high. On average, by 6-month follow-up, children and adolescents had completed 6 of 10 sessions and parents had completed 5/6 (child parent program) and 3/5 sessions (adolescent parent program). Conclusions: Following a natural disaster (the Canterbury earthquakes), children and adolescents showed clinically significant improvement in anxiety and mood when they used BRAVE-ONLINE. This approach was both feasible and acceptable to families and offered a solution when mental health services were under pressure.

Developing “Family Integrated Treatment” for Autistic Disorders and Comparing its Efficacy on Decreasing Parenting Stress of Parents of Autistic Children with “Little Bird” Method

Introduction: Autism is one of the most famous neuro-developmental disorders and increases parental stresses. On the other hand, decrease of parental stress has positive effect on child response to treatment. So, the main goal of this study was to develop a family education program for parents of children with autism, which is effective on decreasing their parental stress. Materials and Methods: The first part of the study was a qualitative research of three categories of information resulted from deep interviews with 11 specialists, semi-structured interviews with 30 parents and review of 101 articles. The second part was an experimental research on two intervention, and one control groups, with three examination stages: before, after and one-month fallow-up. To fulfill this goal, 42 parents were selected from the parents of autistic children who received services in Tehran Autism Center, Iran, during the study period, and then, were divided randomly to tree groups. The material used for this section of study was Parental Stress Index (PSI). The results were analyzed using covariate analysis and analysis of variance techniques via SPSS 20 software. Results: Our family integrated treatment method for autistic disorders was more efficient on decreasing reinforcing (P = 0.032), mood (P = 0.010), acceptability (P = 0.013), and adaptability (P = 0.004), and total score of child stress (P = 0.004). In addition, it showed significant effect on competence (P = 0.002), depression (P = 0.001), social isolation (P = 0.002), attachment (P < 0.001), role restriction (P =0.001), parental health (P = 0.003), and total score of parental stress (P < 0.001), and also on PSI-total score (P < 0.001), in comparison with 2 other groups. Conclusion: In comparison with previous parental training programs like little bird program which mostly focuses on stress of child domain, family integrated treatment method pays attention to special needs of every single family and its comprehensiveness; and is effective on decreasing parental domain of stress as well.

Behavioral and Nondirective Guided Self-Help for Parents of Children with Externalizing Behavior: Mediating Mechanisms in a Head-To-Head Comparison.

Parent training (PT) delivered as a guided self-help intervention may be a cost- and time-effective intervention in the treatment of children with externalizing disorders. In face-to-face PT, parenting strategies have repeatedly been identified as mediating mechanisms for the decrease of children's problem behavior. Few studies have examined possible mediating effects in guided self-help interventions for parents. The present study aimed to investigate possible mediating variables of a behaviorally oriented guided self-help program for parents of children with externalizing problems compared to a nondirective intervention in a clinical sample. A sample of 110 parents of children with externalizing disorders (80% boys) were randomized to either a behaviorally oriented or a nondirective guided self-help program. Four putative mediating variables were examined simultaneously in a multiple mediation model using structural equation modelling. The outcomes were child symptoms of ADHD and ODD as well as child externalizing problems, assessed at posttreatment. Analyses showed a significant indirect effect for dysfunctional parental attributions in favor of the group receiving the behavioral program, and significant effects of the behavioral program on positive and negative parenting and parental self-efficacy, compared to the nondirective intervention. Our results indicate that a decrease of dysfunctional parental attributions leads to a decrease of child externalizing problems when parents take part in a behaviorally oriented guided self-help program. However, none of the putative mediating variables could explain the decrease in child externalizing behavior problems in the nondirective group. A change in dysfunctional parental attributions should be considered as a possible mediator in the context of PT.

Aportaciones de la Terapia de Aceptación y Compromiso al Trabajo con Madres y Padres de Niñas y Niños Atendidos en Salud Mental: Experiencias de la Intervención Grupal.

En la literatura científica se pueden encontrar distintas propuestas de grupos destinados al entrenamiento de madres y padres de niños y niñas con problemas comportamentales, predominando aquéllas que se basan en la Terapia de Conducta. El desarrollo de las Terapias Contextuales ha supuesto un cambio poniendo la meta del tratamiento no en la reducción/eliminación de síntomas, sino en que la persona logre una vida con más significado, usando para ello estrategias de aceptación. En particular, la Terapia de Aceptación y Compromiso (ACT) ha aportado una teoría sobre la cognición y el lenguaje, destacando su influencia en la regulación del comportamiento, integrando los valores en el tratamiento y desarrollando estrategias terapéuticas para enfrentarse de forma diferente a las emociones y pensamientos aversivos que funcionan como barreras para el cambio. El presente artículo describe la propuesta de un programa de diez sesiones basado en la ACT así como los resultados que se obtuvieron al aplicarlo en un Centro de Salud entre los años 2012 y 2015, a un total de 69 familias.

Effects of a Feeding Guide Education Program for Parents of Children with Cerebral Palsy

ë°°ê²½ 및 ëª©ì : 본 연구는 섭식에 ì–´ë ¤ì›€ì´ 있는 2-3세 뇌성마비 아동의 주 양육자 7쌍을 대상으로 섭식에 영향을 줄 수 있는 섭식 환경, 구강 민감도, 구강기능운동성, 섭식 기능과 ê´€ë ¨ëœ 내용을 교육한 뒤 주 양육자가 뇌성마비 아동에게 ì§ì ‘ 중재하였을 때 나타나는 효과를 ì•Œì•„ë³´ê³ ìž 하였다. 방법: 부모교육 시작 ì „ ì‚¬ì „ê²€ì‚¬ë¥¼ 1회 ì‹¤ì‹œí•˜ê³ 5회기의 부모교육을 실시하였다. 부모교육이 ëë‚˜ê³ 2주 뒤에 사후평가 1회를 실시하였다. 섭식 환경, 구강 민감도 및 섭식 기능은 5ì  척도로 í‰ê°€í•˜ê³ êµ¬ê°•ê¸°ëŠ¥ìš´ë™ì„±ì€ 6ì  척도로 평가한 뒤 교육 ì „ê³¼ 교육 후의 ì ìˆ˜ 차이를 살펴보았다. ê²°ê³¼: 섭식 지도에 관한 부모교육 이후 주 양육자가 뇌성마비 아동에게 ì§ì ‘ 중재를 실시한 ê²°ê³¼, 뇌성마비 아동의 네 가지 변인 ì ìˆ˜ê°€ 모두 높아졌다. 연구에 참여한 뇌성마비 아동들의 섭식 환경은 ê°œì„ ë˜ì—ˆê³ , 구강 민감도는 낮아졌으며, 구강기능운동성과 섭식 기능이 향상되면서 섭식에 도움이 되었다. ë ¼ì˜ 및 ê²°ë¡ : 임상에서 중증뇌성마비 아동의 섭식 중재 시 이를 ì ìš©í•œë‹¤ë©´ 구강기능운동성과 섭식 기능 향상에 도움을 줄 수 ìžˆê³ ì¹˜ë£Œì‹¤ë¿ 아니라 ê°€ì •ì—ì„œë„ 섭식 치료가 연계되어 치료의 효과를 더 높일 수 있을 것이다. Keywords: 뇌성마비, 부모교육, 섭식 환경, 구강 민감도, 구강기능운동성, 섭식 기능

Digital Parent Training for Children with Disruptive Behaviors: Systematic Review and Meta-Analysis of Randomized Trials.

Digital-based parent training (DPT) programs for parents of children with disruptive behaviors have been developed and tested in randomized trials. The aim of this study was to quantitatively assess the efficacy of these programs versus a control condition. We conducted a systematic review and random effects meta-analysis of peer-reviewed randomized studies comparing DPT targeting children with disruptive behaviors versus a control group (wait list or no treatment). Altogether, seven studies (n = 718) were meta-analyzed. Compared to the control groups, DPT resulted in significantly greater improvement in child behavior (effect size [ES] = 0.44, 95% confidence interval [CI] = 0.21-0.66, studies = 7), parent behavior (ES = 0.41, 95% CI = 0.25-0.57, studies = 6), and parental confidence (ES = 0.36, 95% CI = 0.12-0.59, studies = 4). The improvement in child behavior was moderated by age group and severity of clinical presentation, which overlapped 100%. While DPT was superior to control conditions in studies of young children (mean age <7 years) with a clinical range of disruptive behaviors (ES = 0.61, 95% CI = 0.40-0.82, studies = 4), results were nonsignificant in studies of older children (mean age >11 years) with a nonclinical range of symptoms (ES = 0.21, 95% CI = -0.01 to 0.42, studies = 3). Analyses yielded similar results of higher ESs favoring studies of young children with clinical range disruptive behaviors for parent behavior and parental confidence, but the differences were not significant. Results further suggested that in studies of younger children, interactive programs (e.g., computerized programs) were more effective in improving child behavior compared to noninteractive programs (e.g., watching video clips) (p < 0.05). Although additional studies are needed, DPT holds promise as a potentially scalable evidence-based treatment of children with disruptive behaviors that can save human resources.

Effectiveness and cost-effectiveness of a brief school-based group programme for parents of children at risk of ADHD: a cluster randomised controlled trial.

National Institute for Health and Care Excellence guidelines recommend a stepped care approach for the identification and management of children with, or at risk of, attention-deficit/hyperactivity disorder (ADHD). We investigated the effectiveness, cost-effectiveness and acceptability of a group parenting intervention programme (+/- a teacher session) for children at risk of ADHD. In a three-arm cluster randomised controlled trial, 12 primary schools were randomly assigned to control, parent-only and combined (parent + teacher) intervention arms. Eligible children had high levels of parent-rated hyperactivity/inattention (n = 199). At 6 month follow-up, the primary outcome measure was the parent-completed Conners' Rating Scale - Revised (ADHD index). Secondary outcomes included the Conners' sub-scales (hyperactivity, cognitive problems/inattention and oppositional behaviour), the teacher-completed Conners' Rating Scale - Revised, child health-related quality of life, parental burden and parental mental health. The cost-effectiveness analyses reflected a health and personal social services perspective. ISRCTN87634685. Follow-up data were obtained from 76 parents and 169 teachers. There was no effect of the parent-only (mean difference = -1.1, 95% CI -5.1,2.9; p = 0.57) or combined interventions (mean difference = -2.1, 95% CI -6.4,2.1; p = 0.31) on the ADHD index. The combined intervention was associated with reduced parent-reported hyperactivity symptoms (mean difference = -5.3; 95% CI -10.5,-0.01; p = 0.05) and the parent-only intervention with improved parental mental health (mean difference = -1.9; 95% CI -3.2,-0.5; p = 0.009). The incremental costs of the parent-only and the combined interventions were £73 and £123, respectively. Above a willingness-to-pay of £31 per one-point improvement in the ADHD index, the parent-only programme had the highest probability of cost-effectiveness. Participants found the interventions acceptable. For children at risk of ADHD, this school-based parenting programme was not associated with improvement in core ADHD symptoms. Secondary analyses suggested a possible reduction in parent-reported hyperactivity and parental mental health problems. Future research should compare targeted interventions against watchful waiting and specialist referral.

A Randomized Controlled Trial Testing the Efficacy of the Creating Opportunities for Parent Empowerment Program for Parents of Children With Epilepsy and Other Chronic Neurological Conditions.

Parents of children with epilepsy and other neurological conditions live with a feeling of constant uncertainty. The uncertainty associated with caring for a child with a neurological condition produces stress, which leads to decreased parental belief in caregiving skills, anxiety, and depression, ultimately altering parental functioning resulting in an increase in child behavioral problems. The stress associated with caring for children with neurological conditions is unlike caring for children with other chronic conditions. Neurological conditions are unpredictable, and there are often no warning signs before an acute event. This unpredictability accompanied with stigma results in social isolation and impacts family functioning. In addition, children with neurological conditions have a higher rate of psychological comorbidities and behavior problems when compared with children with other chronic conditions. This produces an additional burden on the parents and family. This randomized controlled trial tested the efficacy of the Creating Opportunities for Parent Empowerment intervention for parents of children with epilepsy and other neurological conditions. This intervention was administered at three intervals: (a) during hospital admission, (b) 3 days after hospital discharge by telephone, and (c) 4-6 weeks after hospital discharge. Forty-six parents of children admitted to the inpatient neuroscience unit at Boston Children's Hospital participated in the study. Several study limitations resulted in an inadequate sample size to obtain the power necessary to reach statistically significant results for most of the research questions. A one-between, one-within multivariate analysis of variance revealed that the main effect of time was significant for differences in state anxiety for both the usual care group and the intervention group, F(1, 20) = 9.86, p = .005, indicating that state anxiety for both groups combined was more pronounced during the hospitalization. A one-between, one-within multivariate analysis of variance showed that the effect of the interaction between time and group was significant for internalized behavior assessment system score only (p = .037) because the usual care group reported a significant decrease in internalizing behavior scores in their children over time. Findings from this study have significant implications for clinical practice and future research. Parents of children with neurological conditions often struggle to manage a constant feeling of uncertainty in their daily lives. Nurses possess the knowledge and expertise necessary to identify the psychosocial needs of these parents and provide education and support as needed. Future research should focus on designing interventions to meet the needs of these families and develop strategies to help improve the quality of life for both the parent and child living with a neurological condition.

Bracing in Ponseti Clubfoot Treatment: Improving Parental Adherence Through an Innovative Health Education Intervention.

Clubfoot is the most common musculoskeletal birth defect, characterized by abnormal tendon and muscle development, leading to abnormal bone alignment of the feet. The Ponseti method is considered the gold standard in clubfoot treatment, and consists of a series of plaster castings, followed by 4 years of brace use. The most common cause of clubfoot relapse is nonadherence with the bracing protocol by the child's caretakers. The purpose of this study was to design, implement, and evaluate an educational bracing program for parents of children with clubfoot in an effort to improve bracing adherence. The educational bracing program for parents of children with clubfoot was designed with incorporation of findings from previous research, adult teaching methodology, and parental feedback. An educational brochure and a practice doll were created for use in educational sessions with parents during routine treatment visits. Two educational sessions were conducted with a health educator, employing identical questionnaires to assess changes in parental knowledge and skills upon completion of the program. Thirty parents completed the educational bracing program, and the majority reported increased knowledge and self-efficacy regarding the bracing protocol of the Ponseti method. In addition, the health practitioners who conducted the educational sessions witnessed an improved ability of all parents to apply the brace as directed, and to recognize and correct improper fit. Completion of the educational program by the parents resulted in immediate improvements in knowledge and skills related to clubfoot bracing. Given that noncompliance to the bracing protocol is the most common cause of clubfoot relapse, these immediate effects of the educational program are promising not only because they encourage proper brace use, but because these immediate improvements have the potential to reduce future rates of clubfoot relapse.

Effectiveness of a group-based program for parents of children with dyslexia

Parents of children with dyslexia experience more parenting stress and depressive symptoms than other parents. The purpose of this study was to evaluate the effects of a cognitive-behavioral group-based program for parents of dyslexic children on parenting stress levels, parent–child homework interactions and parental competencies. 39 children with dyslexia and their mothers were randomly assigned either to a cognitive-behavioral-therapy group or a waiting-list control group. The intervention lasted for 3 months. Mothers filled in the Parenting Stress Index and a paper–pencil questionnaire assessing dyslexia specific stress, conflicts in homework situations and competencies in dealing with dyslexia. Assessment took place before, immediately after, and 3 months following intervention. A multivariate analysis of variance revealed overall effectiveness of the program (partial η2 = .091), which can be mainly attributed to the reduction of parenting stress and dyslexia specific stress as well as an enhancement of parental competencies. Planned contrasts showed that effects could not be approved directly after the training but 3 months later, indicating a delayed effect. Future studies should examine program effects on mothers and fathers on the basis of a larger representative sample.

Online Support Program for Parents of Children With a Chronic Kidney Disease Using Intervention Mapping: A Development and Evaluation Protocol.

BackgroundThe care for children with a chronic kidney disease (CKD) is complex. Parents of these children may experience high levels of stress in managing their child’s disease, potentially leading to negative effects on their child’s health outcomes. Although the experienced problems are well known, adequate (online) support for these parents is lacking.ObjectiveThe objective of the study is to describe the systematic development of an online support program for parents of children with CKD, and how this program will be evaluated.MethodsIntervention Mapping (IM) was used for the development of the program. After conducting a needs assessment, defining program objectives, searching for theories, and selecting practical applications, the online program e-Powered Parents was developed. e-Powered Parents consist of three parts: (1) an informative part with information about CKD and treatments, (2) an interactive part where parents can communicate with other parents and health care professionals by chat, private messages, and a forum, and (3) a training platform consisting of four modules: Managing stress, Setting limits, Communication, and Coping with emotions. In a feasibility study, the potential effectiveness and effect size of e-Powered Parents will be evaluated using an explorative randomized controlled trial with parents of 120 families. The outcomes will be the child’s quality of life, parental stress and fatigue, self-efficacy in the communication with health care professionals, and family management. A process evaluation will provide insight in parents’ experiences, including their experienced level of support.ResultsStudy results are expected to be published in the summer of 2016.ConclusionsAlthough the development of e-Powered Parents using IM was time-consuming, IM has been a useful protocol. IM provided us with a systematic framework for structuring the development process. The participatory planning group was valuable as well; knowledge, experiences, and visions were shared, ensuring us that parents and health care professionals support the program.Trial RegistrationDutch Trial Registration: NTR4808; www.trialregister.nl (Archived by WebCite at http://www.webcitation.org/6cfAYHcYb)

An evaluation of the Cygnet parenting support programme for parents of children with autism spectrum conditions

Parents of children on the autistic spectrum often struggle to understand the condition and, related to this, manage their child’s behaviour. Cygnet is a parenting intervention which aims to help parents address these difficulties, consequently improving parenting confidence. It is widely used in the United Kingdom (UK). Despite this, there have been few evaluations. This paper reports a small-scale pragmatic evaluation of Cygnet as it was routinely delivered in two English cities. A non-randomised controlled study of outcomes for parents (and their children) was conducted. Data regarding intervention fidelity and delivery costs were also collected. Parents either attending, or waiting to attend, Cygnet were recruited (intervention group: IG, n=35; comparator group: CG, n=32). Parents completed standardised measures of child behaviour and parenting sense of competence pre- and post-intervention, and at three-month follow-up (matched time points for CG). Longer-term outcomes were measured for the IG. IG parents also set specific child behaviour goals. Typically, the programme was delivered as specified by the manual. Attending Cygnet was associated with significant improvements in parenting satisfaction and the specific child behaviour goals. Findings regarding other outcomes were equivocal and further evaluation is required. We conclude that Cygnet is a promising intervention for parents of children with autism in terms of, at least, some outcomes.

'Our story': Support program for parents of children with disabilities: Example of good practice in preschool institutions

Raising a child with a developmental disability can be a serious challenge for parents, which leads to increased parenting stress and has multiple impacts on family well-being. Even though there is a well recognized need for support for parents of children with disabilities, our country lacks the systematized support programs and their evaluations. Program 'Our Story' aims to educate parents about the key processes that lead to accepting the child's condition and recognizing an appropriate care model for a child with disabilities. The program is based on attachment theory and the importance of resolution to diagnosis- emotional and cognitive acceptance of the child's health condition and its implications. It is a structured program, consisting of six thematic meetings with a group of parents. The group counseling is led by two professionals who have previously undergone a 32-hour program for the implementation of training. This paper presents the experiences from two preschool institutions, in which the program was implemented and evaluated. Also it discusses the importance and possibilities of implementing a support program for parents of children with disability in the context of early education system.

How are families taught to look after their children on peritoneal dialysis?

For patients to be started on peritoneal dialysis (PD), they need to be trained on how to perform dialysis at home. Understanding how to carry out dialysis is difficult for adults, but perhaps even more challenging for parents of children. This study was performed to examine the PD teaching programs for parents of children with end-stage renal disease (ESRD) and to explore the issues related to educating parents of children with ESRD. A survey method was used to carry out the research through the distribution of self-completed questionnaires to pediatric dialysis units (ten units) in Saudi Arabia in both governmental and non-governmental hospitals. The questionnaire content was identified using information gained from other research performed in the field of home PD training. The questionnaire was piloted with experienced renal nurses. Questionnaires were distributed to 87 specialized nurses within the ten PD units. Descriptive statistical analysis SPSS (19.00) was used to analyze the data. Statistical tests were used to distinguish the relationship and the significant effects between variables. The response rate was 72% (n=63). Peritonitis rates varied in each hospital, and ranged from zero to three episodes per patient-year (median 1.17 episodes per patient-year). There was a significant association between home visits and peritonitis rates (P<0.01). This study has provided an initial overview of pediatric PD training programs in Saudi Arabia and has provided valuable data in this regard.

Teen Mother and Child Experiences in a Parent-Child Music Program

In this paper, we outline the rationale and growing research base for parent-child music programs as a means to strengthen caregiver-child bonding, with particular interest in positively impacting the lives of adolescent mothers and their infants. Secondary schools that offer daycare and parenting classes are ideal sites for delivering parent-child music programs, and music educators are well situated to become involved in such initiatives. To illustrate, the findings of a pilot program implemented in a mid-size Canadian Prairie city are presented. Working with a local parent-child music instructor, Cree Elder and Metis singer-songwriter, an 8-week culturally responsive music program based on Kindermusik (2010) was designed and delivered to 13 young women and their infants. Data were collected using participant-observations; focus group interviews with the mothers and individual interviews with the parent-child music instructor, an Elder, and school staff; informal check-in interviews with most adolescent mothers; and video footage and photographs taken during the parent-child music program. The Listening Guide (Gilligan, Spencer, Weinberg, & Bertsch, 2003) was used to analyze focus group interviews and thematic analysis (Braun & Clarke, 2006) was utilized to elucidate the other data. Findings suggest that practical music-based interactions, which model and reinforce parenting skills through welcoming, informal, positive and culturally responsive activities, strengthened mother-infant connections, enhanced maternal wellbeing, and developed children’s social skills.

The significance of structured parental educational intervention on childhood atopic dermatitis: a randomized controlled trial.

Parental education is important in managing childhood chronic diseases. The aim of the study was to evaluate the effects of a short-term structured educational programme for parents of children with moderate to severe atopic dermatitis ( AD), aged 3 months to 7 years, on the clinical course of AD, parental stress, anxiety and the quality of family life. One hundred thirty-four parents with AD children were recruited in a randomized controlled clinical trial at the Outpatient Unit of Pediatric Dermatology, Children's Hospital in Zagreb. The primary outcome was change in the severity of eczema measured using SCORing AD (SCORAD) and Patient Oriented (PO) SCORAD index, changes of symptom scores for pruritus and sleep disturbance. Secondary outcomes included change in stress level according to the Perceived Stress Scale (PSS); change in anxiety level according to State Trait Anxiety Inventory (STAI) and change in the quality of family life according to the Croatian version of the Family Dermatology Life Quality Index (FDLQI). Participants in the intervention group had a significantly lower SCORAD (P = 0.000), PO SCORAD (P = 0.000) index, pruritus (P = 0.000), sleep disturbance (P = 0.001), level of perceived stress (P = 0.024) and anxiety as a state (P = 0.42) than those in the control group at the second visit. After the educational programme, participants in the intervention group had a significantly lower impact of AD on the total quality of family life (P = 0.006). We found a statistically significant difference between the two groups with respect to additional education received between the visits. The control group had acquired significantly more additional education (P = 0.007). There was no significant difference between groups in the amount of corticosteroid used. Our structured educational programme had a positive effect on AD severity, quality of family life, parental stress and anxiety.

Effectiveness of a focused, brief psychoeducation program for parents of ADHD children: improvement of medication adherence and symptoms.

ObjectiveTo evaluate the efficacy of a psychoeducation program for parents of children with ADHD in enhancing adherence to pharmacological treatment and improving clinical symptoms.MethodsWe developed a psychoeducation program based on the theory of planned behavior (TPB). Eighty-nine children with ADHD were cluster randomly assigned for their families to receive 3 months of well-structured psychoeducation (intervention group, n=44) or only general clinical counseling (control group, n=45). Parents in the intervention group were given an expert lecture (with slides and a parent manual), attended two expert-guided parent group sessions, and were invited to join a professional-guided online community. Measurement of parents’ knowledge about ADHD, components of the TPB model, and child ADHD symptoms were taken before and after intervention. Medication adherence was assessed thoroughly at the end of the first and third months. Satisfaction with the psychoeducation program was assessed only in the intervention group. Two-independent-samples t-test, ANOVA, and chi-square test were employed to compare differences between groups.ResultsCompared to the control group, medication adherence in the intervention group was significantly higher after 1 and 3 months (97.7% intervention vs 75.6% control, P=0.002, and 86.4% intervention vs 53.3% control, P=0.001, respectively). Accordingly, the ADHD rating scale scores were lower in the intervention group than the control group after intervention (33.7±5.4 vs 45.1±7.9, P=0.008). Greater improvements in parents’ knowledge about ADHD and many components of the TPB model were observed in the intervention group, especially increased intention to adhere to medication, compared to the control group (P<0.001).ConclusionThis psychoeducation program had a positive impact on both medication adherence and clinical symptoms of ADHD children. It could be considered as a potential beneficial supplement to clinical practice.