Parenting Interventions for Parents of Adolescents with Intellectual Disabilities

智力残疾（ID）出现在儿童生命的发育阶段，其定义为对发展产生持久影响的认知和适应缺陷（卫生部，2001年；Carulla等人，2011年）。对于父母来说，有一个患有ID的孩子通常会带来额外的压力（Amaral， Dawson和Geschwind, 2011； Peer和Hillman， 2014）。此外，青春期是发育的重要时期，身体、社会、情感和认知都会发生变化，所有这些都可能导致青少年更容易出现情绪和行为问题。此外，心理健康问题的发病和流行在青春期和成年早期达到高峰（Kessler et al., 2007）。因此，青春期给患有本征性人格的父母带来了进一步的挑战。与正常发育的同龄人相比，患有本我的青少年更有可能表现出情绪、行为和心理健康问题（Ageranioti-Belanger等人，2012；Baker等人，2002）。行为问题的增加与父母幸福感的下降有关（Baker, 2005； Cohen等人，2016；Giallo等人，2015）。越来越多的证据表明，育儿干预在改善育儿、青少年行为和情绪问题、家庭关系以及ID儿童父母的心理健康和福祉方面是有效的（breereton, Tonge, and Kiomall, 2009; Mazzucchelli, Jenkins and Sofronoff, 2018; Ward, Theule， and张，2016;Webster-Stratton and Reid, 2017）。然而，缺乏关注父母干预青少年ID的研究。与赫里福德郡和伍斯特郡卫生与保健（HWHC） NHS信托基金和3p国际合作，该博士学位旨在评估ID青少年的父母干预措施，并为这一被忽视领域的证据基础做出贡献。研究1的目的是通过完成对ID青少年及其父母和家庭的现有育儿计划和结果的系统回顾，综合现有的ID青少年父母干预措施的证据。研究二的目的是检讨建设桥梁3p计划。我们将举办一系列咨询讲习班，与有身份证的青少年的父母、有身份证的青少年以及为这些家庭工作的专业人员进行磋商。收集的资料将利用专题分析加以综合，并由一个专家小组加以审查。研究3旨在全面评估所有利益相关者对“建桥3p”干预的可行性和可接受性。这项研究将是一项两组可行性研究，参与者随机分配到研究2中开发的干预措施中。与利益相关者的访谈将被收集，以便从研究参与者的角度探索可行性研究问题，并阐明关键的过程问题。本研究的首要目标是帮助为青少年的父母提供适当的支持，以改善这些家庭的结果。在学术上，这个项目将提供一个深入了解父母干预的青少年有身份证的父母，一个研究领域以前被忽视。拟议的研究也将为未来的“建设桥梁3p计划”研究提供信息。同样，这项研究将为我们的合作伙伴提供宝贵的见解，随后使3p和HWHC NHS信托能够有效地为家庭提供支持。

Intellectual disability (ID) emerges during the developmental stage of a child's life and is defined by cognitive and adaptive deficits which have a lasting impact on development (Department of Health, 2001; Carulla et al., 2011). Having a child with ID is often associated with additional stressors for parents (Amaral, Dawson and Geschwind, 2011; Peer and Hillman, 2014). Further, adolescence is a significant time in development, with physical, social, emotional and cognitive changes, all of which can contribute to increased vulnerability of emotional and behavioural problems for adolescents. In addition, the onset and prevalence of mental health problems peaks during adolescence and early adulthood (Kessler et al., 2007). Therefore, the period of adolescence adds further challenges for parents of individuals with ID. Compared to their typically developing peers, adolescents with ID are more likely to exhibit emotional, behavioural and mental health problems (Ageranioti-Belanger et al., 2012; Baker et al., 2002). Increases in behavioural problems have been associated with decreases in parental well-being (Baker, 2005; Cohen et al., 2016; Giallo et al., 2015). There is a growing evidence-base to suggest that parenting interventions are effective in improving parenting, adolescent behavioural and emotional problems, family relationships and mental health and wellbeing of parents of children with ID (Brereton, Tonge, and Kiomall, 2009; Mazzucchelli, Jenkins and Sofronoff, 2018; Ward, Theule, and Cheung, 2016; Webster-Stratton and Reid, 2017). However, there is a lack of research focusing on parenting interventions for adolescents with ID. In collaboration with Herefordshire and Worcestershire Health and Care (HWHC) NHS Trust and Triple P International, this PhD aims to evaluate parenting interventions for adolescents with ID and to contribute to the evidence base in this neglected area. The aim of Study 1 is to synthesise the existing evidence on the use of parent-based interventions for adolescents with ID, by completing a systematic review of existing parenting programmes and outcomes for adolescents with ID and their parents and families. Study 2 aims to review the Building Bridges Triple P programme. We will undertake a series of consultation workshops with parents of adolescents with ID, adolescents with ID, and professionals who work with these families. Information collected will be synthesised using thematic analysis and reviewed by an expert panel. Study 3 aims to comprehensively evaluate the feasibility and acceptability of the Building Bridges Triple P intervention for all stakeholders. This study will be a two-arm, feasibility study, with participants randomised to the intervention developed in Study 2. Interviews with stakeholders will be gathered to enable exploration of the feasibility research questions from the perspectives of the participants in the study and elucidate key process issues.The overarching goal of this research is to help provide parents of adolescents with ID with appropriate support in order to improve outcomes for these families. Academically, this project will offer an in-depth understanding of parental interventions for parents of adolescents with ID, an area of research previously overlooked. The proposed research will also inform future research into the Building Bridges Triple P programme. Equally, this research will offer a valuable insight for our collaborative partners, subsequently enabling Triple P and HWHC NHS Trust to effectively tailor the support it provides to families.