Comparing styles of parent-child conversation: The influence on children's conduct problems and emotion knowledge

<p>This preliminary study conducted across Canberra and Wellington was the first to compare the effectiveness of two styles of maternal-reminiscing as an adjunct to Parent Management Training (PMT) for mothers of children ranging from four to eight-years-old (M = 63.1, SD = 14.4 months) with conduct problems. This was a manualised six session intervention. Parents in both conditions received PMT. Parents were asked to reminisce with their child about shared events using their allocated style of maternal reminiscing. The W-D-E condition drew on research by Van Bergen, Salmon, Dadds, and Allen (2009) which encouraged mothers to use 'wh' questions and detailed descriptive information about the even. The R-U-S style extended on the research by Ensor and Hughes (2008) in which mothers were encouraged to be responsive and allow their child to lead the conversation. Both conditions placed a direct focus on discussing emotion, including labels, behaviours, causes and consequences of emotion. As expected, both condition showed a significant decrease in conduct problem severity and a significant increase in aspects of children‟s emotion knowledge between pre- and immediately post-intervention. However, there were no significant differences between conditions with respect to children‟s conduct problems severity and emotion knowledge. Given that the literature supports a link between deficits in emotion knowledge and children‟s conduct problems, and that parental discussion of emotion supports children‟s developing socioemotional development, the current preliminary study extends on the work by Salmon, Dadds, Allen, and Hawes (2009) in which efforts are being made to integrate emotion components with PMT.</p>

Comparing styles of parent-child conversation: The influence on children's conduct problems and emotion knowledge

<p>This preliminary study conducted across Canberra and Wellington was the first to compare the effectiveness of two styles of maternal-reminiscing as an adjunct to Parent Management Training (PMT) for mothers of children ranging from four to eight-years-old (M = 63.1, SD = 14.4 months) with conduct problems. This was a manualised six session intervention. Parents in both conditions received PMT. Parents were asked to reminisce with their child about shared events using their allocated style of maternal reminiscing. The W-D-E condition drew on research by Van Bergen, Salmon, Dadds, and Allen (2009) which encouraged mothers to use 'wh' questions and detailed descriptive information about the even. The R-U-S style extended on the research by Ensor and Hughes (2008) in which mothers were encouraged to be responsive and allow their child to lead the conversation. Both conditions placed a direct focus on discussing emotion, including labels, behaviours, causes and consequences of emotion. As expected, both condition showed a significant decrease in conduct problem severity and a significant increase in aspects of children‟s emotion knowledge between pre- and immediately post-intervention. However, there were no significant differences between conditions with respect to children‟s conduct problems severity and emotion knowledge. Given that the literature supports a link between deficits in emotion knowledge and children‟s conduct problems, and that parental discussion of emotion supports children‟s developing socioemotional development, the current preliminary study extends on the work by Salmon, Dadds, Allen, and Hawes (2009) in which efforts are being made to integrate emotion components with PMT.</p>

A randomized controlled trial of a new intervention in early symptomatic syndromes eliciting neurodevelopmental clinical examinations: PR-ESSENCE

The need for effective intervention programs for youth with neurodevelopmental problems (ESSENCE) and challenging behaviour is great. This study examines Problem Resolution in ESSENCE (PR-ESSENCE), a newly developed model in which children and parents develop mutual problem resolution strategies. Ten-week randomized controlled trial of PR-ESSENCE for children and adolescents aged 5–18 years, compared to treatment as usual. Outcomes were assessed at baseline and randomized period endpoint. Primary outcome was the Clinical Global Impression—Improvement scale (CGI-I) rated by blinded assessors. Secondary outcomes were rated by parents—SNAP-IV, Eyberg Child Behavior Inventory (ECBI), Relationship Problems Questionnaire, Family Burden of Illness Module, and children—Beck Youth Inventories (BYI). ClinicalTrials.gov identifier: NCT03780413. The study enrolled 108 participants (active n = 72; controls n = 36, randomized 2:1), of whom 95 completed the randomized period. No clinically significant group differences were found in baseline characteristics. More than half had autism and 80% had ADD or ADHD. Large treatment effects were seen on CGI-I (ITT analysis, Effect Size 1.48). Treatment responders, much/very much improved on CGI-I, were 51.4% in active group and 5.6% of controls. Effect sizes were medium to large in parent ratings on SNAP-IV (ODD and ADHD symptoms), ECBI (behaviour problems), and in BYI child self-ratings of disruptive behaviour. PR-ESSENCE treatment improved global symptoms and functioning (CGI-I), behaviour problems, ADHD and ODD symptoms, and disruptive behaviour. Treatment effects were at least equivalent to those in previous studies of well-established Parent Management Training and Collaborative Problem Solving programs.

Cluster Analysis of Child Externalizing and Prosocial Behaviors in a Randomized Effectiveness Trial of the Family-Check Up and Internet-Delivered Parent Training (iComet)

Objective: To explore whether children with various externalizing/prosocial behavior profiles benefit differently from face-to-face training than from an internet-based parent management training (PMT) programme. Methods: A total of 231 families with children (aged 10 to 13 years) with externalizing behavior problems (EBP) were randomized to receive either the Family Check-Up, delivered by therapists in the community, or the internet-based PMT program (iComet). Person-oriented analysis was used for subtyping the children according to combinations of prosocial behavior and EBP. Results: The person-oriented analysis resulted in five significantly different clusters. There were no significant differences between the five clusters in relation to the total difficulties score of the Strengths and Difficulties Questionnaire, family warmth or family conflict, but the within-group effect sizes for the main outcome (total difficulties score) from baseline to post-treatment varied from Cohen’s d of 0.52 to 2.56. There were no significant interaction effects between the clusters and type of intervention. However, for children high on symptoms of attention deficit hyperactivity disorder and moderate to high on oppositional defiant disorder, and low to relatively high on prosocial behaviors (Cluster 3 respectively 5), substantial residual EBP-symptomatology remained at post-treatment, although both interventions resulted in significant effects. The other three clusters were within the non-clinical EBP-range at post-intervention, irrespective of treatment condition. There were no significant differences between the clusters regarding treatment completion rate (ranging from 47.2% to 67.4%). This study illustrates the value of distinguishing between different profiles of children in the context of PMT for parents of children with EBP.

Promoting Resilience in Children Exposed to War and Political Violence by Strengthening Parenting

A key factor associated with children’s resilience in the face of adversity is access to an effective parent or caregiver. Decades of research have shown that parenting practices are malleable and that improvements in parenting predict improvements in children’s development. However, the application of parenting interventions to the population of children and families affected by war and political violence is relatively new. This chapter briefly reviews the theoretical and conceptual rationale for parenting interventions in the context of political violence and war and provides data from passive and intervention studies to demonstrate the potential for parenting interventions to strengthen children’s resilience following political adversity. The chapter reviews observational parenting studies, parenting interventions for war and political violence that are based on the parenting interventions known as Generation PMTO (the Parent Management Training–Oregon model), as well as data from feasibility and randomized controlled trials.

Adding the Coping Power Programme to parent management training: the cost-effectiveness of stacking interventions for children with disruptive behaviour disorders

Parent management training (PMT) programmes and child cognitive behavioural therapy are recommended approaches for treatment of oppositional defiant disorder in children, and combining these may be effective. However, little is known regarding the economic efficiency of this additive effect. A within-trial cost-effectiveness analysis was carried out in Sweden including 120 children aged 8–12 who screened positive for disruptive behaviour disorders, within a psychiatric care setting, and their parents. They were randomly assigned to either the Swedish group-based PMT Comet, or to an enhanced version, where an additional child component was provided, the Coping Power Programme (CPP). Child behaviour problems as well as healthcare and educational resource use were measured at baseline, post-test and at two-year follow-up. A net benefit regression framework was used to estimate differences in costs and health outcomes between the two intervention arms during the two-year period. Comet with CPP cost on average 820 EURO more per family than Comet only. At the 2-year follow-up, there were 37% recovered cases of ODD in Comet with CPP, in comparison to 26% in the Comet only arm. At a willingness-to-pay of approximately 62,300 EURO per recovered case of ODD, Comet with CPP yielded positive net benefits, in comparison to Comet only. Offering children the CPP simultaneously as their parents receive PMT, in comparison to only providing PMT, yields clinically relevant gains. Despite the relatively small cost for CPP, investment in combining PMT and CPP should be guided by resource prioritisation. Trial registration number: ISRCTN10834473, date of registration: 23/12/2015