An RCT of Parent Training for Preschoolers with Delays

针对学龄前儿童延迟家长培训的随机对照试验

• 批准号: 8097210
• 负责人: LAURA LEE MCINTYRE
• 金额: $ 59.68万
• 依托单位: UNIVERSITY OF OREGON
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-01 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8097210
• 关键词: 3 year old; Adaptive Behaviors; Adolescent; Adult; Age; American; Area; Behavior; Behavior Disorders; Behavioral; Brestan; Caregivers; Child; Child Behavior; Childhood; Clinical Trials Design; Cognitive; Competence; Cost Effectiveness Analysis; Cost-Benefit Analysis; Costs and Cost Analysis; Data; Data Analyses; Development; Developmental Disabilities; Early treatment; Economics; Environmental Risk Factor; Epidemiologic Studies; Family; Family member; Fathers; Frequencies; Funding; Future; Gills; Grant; Growth; Health education; High Prevalence; Home environment; Hour; Individual; Informal Social Control; Intellectual functioning disability; Intervention; Language Disorders; Left; Measures; Mental Depression; Mental Health; Mental disorders; Modeling; Modification; Mothers; Nursery Schools; Outcome; Parent-Child Relations; Parenting behavior; Parents; Pathway interactions; Play; Preschool Child; Preventive; Problem behavior; Psychopathology; Psychosocial Assessment and Care; Randomized Controlled Trials; Relative (related person); Reporting; Research; Rewards; Risk; Sampling; Schools; Secondary Prevention; Self Efficacy; Series; Services; Social Behavior; Social isolation; Stress; System; Testing; Time; Training; Training Programs; United States; Videotape; Work; base; behavior change; boys; care giving burden; community setting; cost; dual diagnosis; efficacy testing; experience; follow-up; girls; informant; kindergarten; longitudinal design; maternal depression; social; statistics; successful intervention; teacher; treatment as usual; uptake

DESCRIPTION (provided by applicant): The revised application proposes a 5-year study examining the effects of a group-based parent training program as early intervention (secondary prevention) with 200 parents with preschool children who have mild/moderate developmental disabilities. The efficacy of the Incredible Years Parent Training series (IYPT; Webster-Stratton, 1984, 1994) with developmental disabilities modifications (IYPT-DD; McIntyre, 2008a, 2008b) will be compared with treatment as usual. The IYPT-DD is an intensive 12-week group-based intervention (2.5 hours per week) that uses group discussion and videotape vignettes to target 5 curricular areas: child play, praise, rewards, effective limit setting, and handling challenging behavior. The treatment as usual condition will include individual child and family services afforded to children with developmental disabilities in preschool and community settings. The IYPT series has been demonstrated to be efficacious for decreasing behavior problems in typically developing children (Webster-Stratton, 1984, 1994); however, this approach has not been fully investigated with families of young children with developmental disabilities, who are also at risk for significant problem behavior. The PI has successfully pilot tested this intervention with DD modifications with parents who have preschool-age children with developmental disabilities. Preliminary evidence from a funded R03 grant suggests feasibility, acceptability, and efficacy in terms of reducing child behavior problems and negative parent-child interactions (McIntyre, 2008a, 2008b; McIntyre & Phaneuf, 2007; Phaneuf & McIntyre, 2007). This proposed study will build on the initial pilot work and use a longitudinal design and randomized controlled trial to test the efficacy of IYPT-DD for (a) reducing child maladaptive behavior and increasing child adaptive behavior immediately posttreatment and at 6-month, 12-month, and 18-month follow- up assessments; (b) reducing inappropriate/negative parent-child interactions, increasing positive parenting practices, and increasing parental competence and self-efficacy immediately posttreatment and at 6-month, 12-month, and 18-month follow-up assessments; (c) increasing adaptation to school as measured by teacher assessments of children's early sociobehavioral adjustment in kindergarten; (d) determining if changes in child maladaptive and adaptive behavior are a function of changes in parenting behavior; and (e) determining if contextual influences, such as parenting stress, maternal depression, and partner support/relationship quality, moderate child outcomes. Advancements in multivariate data analysis, such as general growth mixture modeling, will be used to study the environmental factors associated with the formation of adaptive and maladaptive developmental trajectories, as well as to determine the efficacy of the parent intervention relevant to altering those trajectories. Economic analyses, including cost analysis, benefit-cost analysis, and cost- effectiveness analysis, will be used to determine the impact of the intervention relative to cost burden and determine the feasibility of uptake in community settings. PUBLIC HEALTH RELEVANCE: This study examines the hypothesis that a 12-week, group-based parent training program, Incredible Years Parent Training with Developmental Disabilities modifications (IYPT-DD; McIntyre, 2008a, 2008b) can be used with parents of preschool children with developmental disabilities and can reduce child maladaptive behavior, increase adaptive behavior, promote positive parenting practices, and promote early adjustment in school. The intervention, if successful, could be cost-effectively implemented across the United States within early education and health delivery systems. The study will also significantly contribute to our understanding of the emergence of childhood behavior disorders and mental health problems in both boys and girls with developmental disabilities.

描述（由申请人提供）：修订后的申请提出了一项为期5年的研究，以200名患有轻度/中度发育障碍的学龄前儿童的父母为对象，研究基于小组的父母培训计划作为早期干预（二级预防）的效果。将比较Incredible Years Parent Training系列（IYPT; Webster-Stratton，1984，1994）与发育障碍改良（IYPT-DD; McIntyre，2008 a，2008 b）的疗效与常规治疗。IYPT-DD是一项为期12周的强化小组干预（每周2.5小时），使用小组讨论和录像带小插曲来针对5个课程领域：儿童游戏，表扬，奖励，有效限制设置和处理挑战性行为。常规治疗将包括在学前和社区环境中向发育残疾儿童提供的个别儿童和家庭服务。IYPT系列已被证明可有效减少典型发育儿童的行为问题（Webster-Stratton，1984，1994）;然而，这种方法尚未在发育障碍幼儿的家庭中进行充分研究，这些幼儿也有发生严重问题行为的风险。PI已经成功地对这种干预措施进行了试点测试，并对患有发育障碍的学龄前儿童的父母进行了DD修改。来自R 03基金的初步证据表明，在减少儿童行为问题和消极的亲子互动方面，这种方法是可行的、可接受的和有效的（McIntyre，2008 a，2008 b; McIntyre & McIntyeuf，2007; McIntyeuf & McIntyre，2007）。这项拟议的研究将建立在初步试点工作的基础上，并使用纵向设计和随机对照试验来测试IYPT-DD在以下方面的功效：（a）在治疗后立即以及在6个月、12个月和18个月的随访评估中减少儿童适应不良行为和增加儿童适应行为;（B）在治疗后即刻和6个月、12个月时，减少不适当/消极的亲子互动，增加积极的育儿实践，并增加父母的能力和自我效能，（c）透过教师评估幼儿园儿童的早期社会行为适应情况，以衡量他们对学校的适应程度;（d）确定儿童适应不良和适应行为的改变是否与父母行为的改变有关;以及（e）确定是否存在环境影响，例如养育压力、母亲抑郁和伴侣支持/关系质量，中度儿童结局。多变量数据分析的进展，如一般的生长混合模型，将用于研究与适应性和适应不良的发展轨迹的形成相关的环境因素，以及确定与改变这些轨迹相关的父母干预的功效。经济分析，包括成本分析、效益-成本分析和成本效益分析，将用于确定干预措施相对于成本负担的影响，并确定在社区环境中采用的可行性。 公共卫生关系：本研究检验了一个假设，即一个为期12周的，以小组为基础的父母培训计划，难以置信的岁月父母培训与发育障碍的修改（IYPT-DD;麦金太尔，2008年a，2008年b）可以用于学龄前发育障碍儿童的父母，可以减少儿童适应不良行为，增加适应行为，促进积极的父母行为，并促进早期调整在学校。如果成功的话，这种干预措施可以在美国各地的早期教育和保健系统中以具有成本效益的方式实施。这项研究也将大大有助于我们了解儿童行为障碍和心理健康问题的出现在男孩和女孩的发育障碍。