Testing the Efficacy of Mindfulness-Based Stress Reduction Combined with Behavioral Parent Training in Families with Preschoolers with Developmental Delay

7.项目摘要/摘要 此应用程序建立在我们之前的干预工作(例如，McIntyre，2008a、2008b、2013；McIntyre& Neess，2016；Neess，2014)，并提议对230名学龄前儿童(年龄)进行纵向干预研究 3-5岁)，发育迟缓(DD)。行为问题和共同发生的育儿压力是常见的 发育迟缓儿童及其家庭中的问题。父母的压力越大，压力越小 对发育迟缓儿童的行为干预反应；然而，父母的压力几乎从来没有直接 在这些治疗中解决(McIntyre&Neess，2016)。这项拟议的研究将测试 在提供行为父母培训(BPT)之前解决父母压力，以便更有效地 在实施干预后减少儿童行为问题，并调查其机制 通过它来实现干预结果。该研究设计将采用跨站点随机对照试验 标准行为父母心理教育训练(BPT-E)与行为父母的比较 训练加上基于正念的减压(BPT-M)。样本将从莱恩县抽取， 俄勒冈州和南加州的内陆帝国。所有家庭都将参加家庭和实验室 基线评估和家庭评估在治疗后立即以及在6个月和12个月进行 治疗后几个月。措施包括标准化和有效的自我报告和教师报告 问卷、黄金标准的心理评估和观察性测量。主要结果是 令人感兴趣的是儿童行为问题。分析将使用标准正态理论回归和 结构方程建模技术，特别关注潜在增长建模。主要意图-- 比较BPT-E和BPT-M的疗效假设将在一组顺序调解中明确 分析。拟议的研究是一项跨地点随机对照试验，每个地点有一个PI。McIntyre博士(MPI，加州大学 俄勒冈州)有超过15年的工作经验，与患有痴呆症的儿童及其家人合作。她的研究 注重对行为问题的早期干预和预防。麦金太尔博士改编了BPT 本研究中使用的干预措施，并已完成两项评估该干预措施效果的随机对照试验(R03 HD047711和R01 HD059838)。尼斯博士(洛马琳达大学MPI)有十多年的 在过去的5年里，我在与患有痴呆症的儿童一起工作的经验中，研究了 MBSR适用于不同样本的患有DD的学龄前儿童的父母。麦金太尔博士和尼斯订婚了 在合作研究方面有10多年的经验，并与人合著了专注于家庭因素的出版物 预测发育障碍儿童的行为结果。

7. Project Summary/Abstract This application builds on our previous intervention work (e.g., McIntyre, 2008a, 2008b, 2013; McIntyre & Neece, 2016; Neece, 2014) and proposes a longitudinal intervention study of 230 preschool-age children (ages 3–5 years) with developmental delays (DD). Behavior problems and co-occurring parenting stress are common problems in children with DD and their families. High levels of parental stress are associated with reduced response to behavioral interventions for children with DD; yet, parenting stress is almost never directly addressed in these treatments (McIntyre & Neece, 2016). The proposed study will test the benefit of addressing parental stress prior to delivering behavioral parent training (BPT) in order to more effectively reduce child behavior problems once the intervention is delivered, as well as investigate the mechanisms through which intervention outcomes occur. The study design will use a cross-site randomized, controlled trial (RCT) of standard behavioral parent training with psychoeducation (BPT-E) compared with behavioral parent training plus mindfulness-based stress reduction (BPT-M). The sample will be drawn from Lane County, Oregon, and the Inland Empire in Southern California. All families will participate in home and laboratory assessments at baseline and home assessments immediately posttreatment, as well as at 6 months and 12 months posttreatment. Measures include standardized and validated self-report and teacher-report questionnaires, gold-standard psychological assessments, and observational measures. The primary outcome of interest is child behavior problems. Analyses will be conducted using standard normal theory regression and structural equation modeling techniques, with a particular focus on latent growth modeling. Primary intent-to- treat efficacy hypotheses comparing the BPT-E with BPT-M will be specified within a set of sequential mediation analyses. The proposed study is a cross-site RCT with a PI at each site. Dr. McIntyre (MPI, University of Oregon) has more than 15 years of experience working with children with DD and their families. Her research has focused on early intervention and prevention of behavior problems. Dr. McIntyre adapted the BPT intervention used in this study and has completed two RCTs assessing the efficacy of this intervention (R03 HD047711 and R01 HD059838). Dr. Neece (MPI, Loma Linda University) has more than a decade of experience working with children with DD, and during the past 5 years has studied the feasibility and efficacy of MBSR for a diverse sample of parents of preschool children with DD. Drs. McIntyre and Neece have engaged in collaborative research for more than 10 years and have coauthored publications focused on family factors predictive of behavioral outcomes in children with developmental disabilities.