Effectiveness of the Stepping Stones Triple P group parenting program in reducing comorbid behavioral problems in children with autism

Children with autism spectrum disorders often exhibit comorbid behavioral problems. These problems have an impact on the severity of the core symptoms, the progression of the disorder as well as on the families’ quality of life. We evaluated the effectiveness of the Stepping Stones Triple P group parent training program as a supplementary intervention in the treatment of children with autism spectrum disorder. Therefore, we employed a single group repeated measures design and assessed child variables via parents’ and teachers’ judgments at four successive time points. The participants were parents of 24 children with autism spectrum disorder aged between 3.6 and 12 years. We found a significant reduction of comorbid behavioral problems in the children, primarily in the parents’ judgment at follow-up. Furthermore, a reduction of the autism spectrum disorder core symptoms emerged. The teachers’ judgment particularly revealed an improvement in children’s social relationships. Effect sizes were large ( ƞ2 ranging from 0.14 to 0.23). The findings demonstrate the effectiveness of the Stepping Stones Triple P as a supplementary intervention for reducing comorbid behavioral problems in the treatment of children with autism spectrum disorder. Higher parental self-efficacy and parental attributions, including parents’ ability to influence child problem behaviors, are discussed as important factors for the effectiveness of Stepping Stones Triple P.

A randomised controlled trial of the Group Stepping Stones Triple P training programme for parents of children with developmental disabilities

The central aim of this study was to examine the effectiveness of Group Stepping Stones Triple P (GSSTP) in an Irish context for families of children with both developmental disabilities and internalising and externalising behavioural problems. Parents of 84 children (mean age = 5.73; SD = 2.06) with developmental disabilities and co-occurring behaviour problems attending Irish public health services were randomly assigned to a 9-week GSSTP group or a waiting list control (WLC) group. All parents completed self-report measures before (Time 1) and after (Time 2) the programme and parents in the GSSTP group were assessed at 3- to 5-month follow-up (Time 3). At Time 2, clinical improvement and reliable change rates on the primary dependent variables (summary scales of the Developmental Behaviour Checklist and Strengths and Difficulties Questionnaire) were significantly higher in the GSSTP group than in the WLC group. At Time 2, mean scores of the GSSTP group showed significant, small to medium improvements relative to the WLC group on parent-reported child behaviour problems, parenting skills and confidence, and parental adjustment. Most of these improvements were maintained at 3- to 5-month follow-up. These results indicate that GSSTP is a promising intervention for improving child behaviour and parenting outcomes in a mixed-disability group in an Irish context.

A qualitative study of parents’ and facilitators’ experiences of Group Stepping Stones Triple P for parents of children with disabilities

In this qualitative study, we evaluated parents’ and facilitators’ experiences of the Group Stepping Stones Triple P (GSSTP) programme for parents of children with disabilities. The study was embedded in a randomized controlled trial (RCT) of GSSTP and carried out in the Irish public health service. Eight parents and three psychologists participated in the study. We used a semi-structured interview schedule to collect data and conducted a thematic content analysis of interview transcripts to identify particularly useful and less helpful aspects of the programme and ways that its future delivery may be improved. We conducted separate analyses on parent and psychologist data. The main findings were that parents considered the GSSTP to have helped them develop better self-regulation and behaviour management skills, which contributed to improved family relations. Negative aspects of the programme included the use of dated videos, the volume of programme content, the attrition rate and the shortcomings of the programme in meeting the complex needs of vulnerable families. Improvement suggestions included increasing flexibility of manualised content, providing follow-up support to vulnerable parents, incentivizing parents to attend and updating videos.