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

基本信息

批准号：
8640359
负责人：
LAURA LEE MCINTYRE
金额：
$ 4.86万
依托单位：
UNIVERSITY OF OREGON
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-06-01 至 2016-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8640359
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 Intervention 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

项目摘要

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.

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，研究基于小组的父母培训计划作为早期干预（二级预防）的影响，有200名患有轻度/中度发育障碍的学龄前儿童。令人难以置信的年份父母培训系列的功效（IYPT； Webster-Stratton，1984，1994）随发展障碍的修改（IYPT-DD; McIntyre，2008a，2008b）的功效与往常一样。 IYPT-DD是一项基于12周的集团干预措施（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，赞美，奖励，有效的限制设置和处理具有挑战性的行为。像往常一样，治疗将包括为学龄前和社区环境中发育障碍儿童提供的个人儿童和家庭服务。 IYPT系列已被证明可以有效地减少典型发展的儿童的行为问题（Webster-Stratton，1984，1994）。但是，这种方法尚未与患有发育障碍的幼儿家庭进行充分研究，他们也面临着重大问题行为的风险。 PI已成功试行DD修改与患有发育障碍儿童的父母进行了DD修改。资助的R03赠款的初步证据表明，在减少儿童行为问题和负面的亲子互动方面，可行性，可接受性和功效（McIntyre，2008a，2008b; McIntyre＆Phaneuf，2007; Phaneuf＆McIntyre，2007年）。这项拟议的研究将基于最初的试验工作，并使用纵向设计和随机对照试验来测试IYPT-DD对（a）减少儿童适应不适的行为的功效，并在治疗后立即以及在6个月，12个月和18个月的后续评估中立即增加儿童适应性行为；（b）减少不适当/负面的亲子互动，增加积极的育儿习惯，并在处理后立即增加父母的能力和自我效能感，并在6个月，12个月和18个月的随访评估中；（c）通过对幼儿园儿童早期社会行为调整的教师评估来衡量对学校的适应；（d）确定儿童适应不良和适应性行为的变化是否是育儿行为变化的函数；（e）确定上下文影响，例如育儿压力，孕产妇抑郁和伴侣支持/关系质量，适度的儿童结果。多变量数据分析（例如一般生长混合物建模）的进步将用于研究与形成适应性和适应不良的发育轨迹相关的环境因素，并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，收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吸收的可行性。