Parent Training, Dual Diagnosis, and Children with MR

描述（由申请人提供）：患有智力迟钝/发育障碍（MR/DD）的个体出现行为问题或精神健康障碍（BP/MH）的可能性是正常发育个体的3-4倍，使他们面临许多负面结果的风险（例如，社会孤立、职业困难）。一些证据表明，这些行为问题始于童年早期，并对父母产生负面影响。如果不及时治疗，儿童就有可能患上行为障碍或精神疾病，这给照顾者带来了沉重的负担，并增加了家庭外安置或昂贵治疗的可能性。拟议的研究将利用父母培训作为早期干预（二级预防）技术，对40名有轻度/中度发育迟缓的幼儿（2-4岁）的父母进行研究。提出了一种随机、治疗/对照设计。我们将使用《不可思议的岁月》（Incredible Years）基础父母培训幼儿系列（IYBPT; Webster-Stratton, 1984,1994）作为干预手段。这种为期12周的密集干预利用小组讨论（每组8-12名家长）和录像片段来针对四个课程领域：儿童游戏，表扬，奖励和有效的限制设置。IYBPT系列已被证明在减少典型发育儿童的行为问题方面是有效的。此外，首席研究员已经成功地在有发育迟缓幼儿的父母身上试验了这种干预方法。来自试点数据（N=13）的初步证据表明，在减少消极的亲子互动和减少父母报告的压力方面，初步的可行性、可接受性和有效性。这项建议的研究将以初步试验工作为基础，并采用前、后处理/对照设计：(1)将IYBPT -幼儿系列应用于有发育迟缓幼儿（2-4岁）的照顾者，(2)测试IYBPT在减少儿童行为问题和减少不适当/消极亲子互动方面的功效，(3)探索父母培训在减少父母压力、日常争吵和照顾者抑郁方面的潜力，这些通常与儿童精神病理学的发展有关。(4)通过提高父母教养能力来降低这一群体未来行为问题的风险。

DESCRIPTION (provided by applicant): Individuals with mental retardation/developmental disabilities (MR/DD) are 3-4 times more likely to develop a behavior problem or mental health disorder (BP/MH) than typically developing individuals, placing them at risk for a number of negative outcomes (e.g., social isolation, vocational difficulties). Some evidence suggests that these behavior problems begin in early childhood and negatively impact parents. Left untreated, children are at risk for developing a behavior disorder or mental illness, which places significant burden on caregivers and increases the likelihood of out-of-home placement or costly treatment. The proposed study will utilize parent training as an early intervention (secondary prevention) technique with forty parents with young children (2-4 years) with mild/moderate developmental delay. A randomized, treatment / control design is proposed. The Incredible Years Basic Parent Training Early Childhood series (IYBPT; Webster-Stratton, 1984, 1994) will be used as the intervention. This intensive 12- week intervention utilizes group discussion (8-12 parents per group) and videotape vignettes to target four curricular areas: child play, praise, rewards, and effective limit setting. The IYBPT series has been demonstrated to be efficacious in decreasing behavior problems in typically developing children. Furthermore, the Principal Investigator has successfully pilot tested this intervention approach with parents who have young children with developmental delay. Preliminary evidence from pilot data (N=13) suggest initial feasibility, acceptability, and efficacy in terms of reducing negative parent-child interactions and decreasing parent-reported stress. This proposed study will build on the initial pilot work and use a pre-, post treatment/ control design to: (1) utilize the IYBPT - Early Childhood series with caregivers who have young children (2-4 years) with developmental delay, (2) test the efficacy of the IYBPT in reducing child behavior problems and decreasing inappropriate/negative parent-child interactions, (3) explore the potential for parent training to reduce parent stress, daily hassles, and caregiver depression, often implicated in the development of psychopathology in children, and (4) decrease the risk of future behavior problems in this group by focusing on increasing parenting competence.