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

7.项目总结/摘要 该应用程序建立在我们以前的干预工作（例如，McIntyre，2008 a，2008 b，2013; McIntyre & Neece，2016; Neece，2014），并提出了一项对230名学龄前儿童（年龄 3-5发育迟缓（DD）。行为问题和共同发生的父母压力是常见的 DD儿童及其家庭的问题。父母压力大， 对DD儿童的行为干预的反应;然而，养育压力几乎从未直接 在这些治疗中得到解决（McIntyre & Neece，2016）。拟议的研究将测试以下方面的益处： 在提供行为父母培训（BPT）之前解决父母压力，以便更有效地 减少儿童行为问题，一旦干预交付，以及调查的机制 干预结果的发生。研究设计将采用跨中心随机对照试验 (RCT)标准行为父母培训与心理教育（BPT-E）相比， 训练加正念减压（BPT-M）。样本将从莱恩县抽取， 俄勒冈州和南加州的内陆帝国。所有家庭将参加家庭和实验室 基线评估和治疗后即刻以及6个月和12个月时的家庭评估 治疗后3个月。措施包括标准化和验证的自我报告和教师报告 问卷调查，黄金标准的心理评估，和观察措施。主要结局 是儿童行为问题将使用标准正态理论回归进行分析， 结构方程建模技术，特别关注潜在增长建模。主要意图- 将在一组序贯中介中指定比较BPT-E与BPT-M的治疗有效性假设 分析。拟定研究是一项跨中心RCT，每个中心有一名PI。McIntyre博士（MPI，University of 俄勒冈州）有超过15年的经验，与儿童和他们的家庭DD。她的研究 专注于行为问题的早期干预和预防。麦金太尔博士将最佳可行疗法 本研究中使用的干预措施，并已完成两项评估该干预措施疗效的RCT（R 03 HD 047711和R 01 HD 059838）。Neece博士（MPI，洛马琳达大学）拥有十多年的 与DD儿童的工作经验，并在过去5年中研究了可行性和有效性， MBSR为不同样本的学龄前儿童的父母与DD。麦金太尔医生和妮斯医生 在合作研究超过10年，并共同撰写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.