Improving Parenting Skills for Families of Young Children in Pediatric Settings A Randomized Clinical Trial
Improving Parenting Skills for Families of Young Children in Pediatric Settings A Randomized Clinical Trial
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DOI：
10.1001/jamapediatrics.2013.2919
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发表时间：
2014-01-01
期刊：
影响因子：
26.1
通讯作者：
Carter, Alice S.
中科院分区：
文献类型：
--
作者：
Perrin, Ellen C.;Sheldrick, R. Christopher;Carter, Alice S.
重要性破坏性行为障碍，如注意力缺陷/多动障碍和对立违抗性障碍，在整个儿童期都很常见且稳定。这些疾病导致长期发病，但受益于早期干预。虽然症状通常在学龄前很明显，但很少有儿童在此期间接受适当的治疗。团体家长培训，如“不可思议的岁月”计划，已被证明是有效的，在改善育儿策略和减少儿童的破坏性行为。因为他们已经监测幼儿的行为和发展，初级保健儿科医生是在一个很好的位置，早期干预时indicated. ObjectiveTo调查的可行性和有效性的家长培训组提供给家长的幼儿在儿科初级保健settings.DESIGN，设置，和参与者这项随机临床试验进行了11个不同的儿科实践在大波士顿地区。共纳入273名2 - 4岁儿童的父母，他们承认在20项检查表上有破坏性行为。干预一个由一名研究临床医生和一名儿科工作人员共同领导的为期10周的不可思议的岁月父母培训小组。结果共150名家长被随机分配到干预组或等待名单组。另外123名父母被分配接受干预，没有随机选择的对照组。与等待名单组相比，两个干预组的改善更大（P <0.05）。随机化和nonrandomized干预groups.Conclusions和相关性自我报告和结构化的观察提供证据的改善，在养育子女的做法和儿童破坏性行为，是由于参与了令人难以置信的年组之间没有显着差异。这项研究证明了在儿科办公室环境中进行的父母培训小组的可行性和有效性，以减少幼儿的破坏性行为。
IMPORTANCE Disruptive behavior disorders, such as attention-deficient/hyperactivity disorder and oppositional defiant disorder, are common and stable throughout childhood. These disorders cause long-term morbidity but benefit from early intervention. While symptoms are often evident before preschool, few children receive appropriate treatment during this period. Group parent training, such as the Incredible Years program, has been shown to be effective in improving parenting strategies and reducing children's disruptive behaviors. Because they already monitor young children's behavior and development, primary care pediatricians are in a good position to intervene early when indicated.OBJECTIVE To investigate the feasibility and effectiveness of parent-training groups delivered to parents of toddlers in pediatric primary care settings.DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial was conducted at 11 diverse pediatric practices in the Greater Boston area. A total of 273 parents of children between 2 and 4 years old who acknowledged disruptive behaviors on a 20-item checklist were included.INTERVENTION A 10-week Incredible Years parent-training group co-led by a research clinician and a pediatric staff member.MAIN OUTCOMES AND MEASURES Self-reports and structured videotaped observations of parent and child behaviors conducted prior to, immediately after, and 12 months after the intervention.RESULTS A total of 150 parents were randomly assigned to the intervention or the waiting-list group. An additional 123 parents were assigned to receive intervention without a randomly selected comparison group. Compared with the waiting-list group, greater improvement was observed in both intervention groups (P < .05). No differences were observed between the randomized and the nonrandomized intervention groups.CONCLUSIONS AND RELEVANCE Self-reports and structured observations provided evidence of improvements in parenting practices and child disruptive behaviors that were attributable to participation in the Incredible Years groups. This study demonstrated the feasibility and effectiveness of parent-training groups conducted in pediatric office settings to reduce disruptive behavior in toddlers.