Early intervention for parents at risk of child abuse and neglect: A preliminary investigation.

An early intervention program for young parents and children who have been identified as being at risk of child maltreatment was evaluated. Thirty mother–child dyads were randomly assigned to one of two conditions: (a) an information group offered by the child protection agency (which served as a control condition) or (b) a special program of behavioral parent training in addition to the agency group. Self-report measures indicated that significant improvements in parenting risk and child behavior problems at posttest and at 3-month follow-up were evident only for mothers who received parent training in addition to information groups. Home observation data were inconclusive, possibly due to the limited opportunities to observe behaviors of interest. Both groups showed improvements in their child-rearing environments and in their children's adaptive behaviors at follow-up. Caseworker ratings of clients' risks of maltreatment and abilities to manage their families at 1-year follow-up significantly favored the families who received parent training in addition to information. Methodological and treatment issues arising from this preliminary investigation of early intervention with diverse population of high-risk parents and children are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support and treatment outcome in behavioral family therapy for child conduct problems.

Assessed the role of social support in the outcome of child management training (CMT) for single parents of conduct problem children and assessed the impact of adjunctive ally support training (AST) on treatment outcome. 22 single parents with a child diagnosed as oppositional or conduct-disordered received CMT or CMT plus AST. Each group received the same 6-wk parent training program and the AST group received an extra social support intervention. Measures of parent behavior, child deviance, social support (SS), and parental depression were obtained at pre- and posttreatment and at 6-mo follow-up. Both groups improved, and changes maintained at follow-up. AST produced no extra gains. Responders from either group were more likely than nonresponders to report high levels of SS from friends. Results emphasize the importance of SS and the difficulty of incorporating changes in SS into treatment programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child and parent weight loss in family-based behavior modification programs.

Overweight preadolescents and parents from 76 families were assigned to 1 of 3 behavioral treatment groups: parent/child target, child target, or nonspecific target. Percent overweight changes at the end of the 8-mo treatment and 13-mo follow-up were equivalent for children in the 3 treatment groups, but parents in the parent/child group lost more weight during treatment. Weight changes for parents and children increased through the 8-mo treatment. Patterns of maintenance showed that 40% of the children were within 20% of their ideal weight by the end of treatment, achieving nonobese status. 100% of the newly nonobese children in the parent/child group maintained nonobesity during follow-up, whereas only 30% in the child-alone group and 33% in the nonspecific group maintained nonobesity. In addition, weight losses for parents and children in the same family correlated positively at the end of treatment but not at follow-up. Results suggest that parental modeling may be important during treatment, but long-term results probably are due to parental reinforcement of child self-regulation. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An evaluation of parental problem-solving training in the behavioral treatment of childhood obesity.

The current investigation evaluated the efficacy of including parental problem-solving training in a behavioral weight-reduction program for obese children. Children and their parents were randomly assigned to a problem-solving, behavioral, or instruction-only weight-loss group. Children in the problem-solving group lost significantly more weight and decreased their percent overweight and body-mass indices significantly more during the 8-week treatment program than either behavioral or instruction-only subjects. These differences were maintained at the 3- and 6-month follow-up sessions. Only those parents in the problem-solving group significantly increased their problem-solving skills during the program. Child weight loss was significantly correlated with increases in parental problem-solving ability from pretreatment to posttreatment and from posttreatment to the 6-month follow-up. This evidence supports the conclusion that problem-solving training is a desirable addition to a behavioral weight-loss program for children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acquisition and transfer of empathy by the parents of early adolescents through structured learning training.

Measured the effectiveness of A. P. Goldstein's (1973) structured learning training (modeling, role playing, and social reinforcement) in teaching parents of adolescents to respond empathically to their children; also measured was the extent to which transfer of training occurs when adolescents participate in training with their parents. 37 mothers of 6th-8th graders volunteered to attend a minicourse on communication. The mothers were divided into 4 groups, including the control group. All groups except the control group received structured learning training in empathy; in 1 group the children did not participate, in a 2nd group the children participated separately, and in the 3rd group they participated with their parents. After 3 wks (6 hrs) of training, the treatment groups showed significantly more empathy. The closeness of the mean empathy scores on the behavioral measure to the scores on the written measure suggested that all 3 treatment groups transferred the skill they had learned. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An early intervention model for pediatric settings.

Four groups of preschool children are likely to present to pediatricians in private or hospital practice: those with (a) developmental disabilities identifiable at a young age, (b) illnesses or handicaps, (c) temperamental traits predisposing to parent–child interaction problems, and (d) behavior problems. Parents view pediatricians as experts in child development and thus seek their guidance. Yet, many of these children will require treatment beyond the pediatrician's office. The Early Intervention Program (EIP) for Preschoolers and Parents is intended for such children. Organized into modules that focus on specific needs of the child and/or the parent–child interaction, EIP emphasizes parent training and skills development through applying behavioral–social learning principles. The modules include individual tutoring in speech and self-help skills, toddler management for behavioral compliance, and classrooms for developing school readiness skills and cooperative peer relationships. EIP is consistent with the treatment orientation of pediatricians and can serve as a useful training resource for pediatric residents. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treating children with early-onset conduct problems: A comparison of child and parent training interventions.

Families of 97 children with early-onset conduct problems, 4–8 yrs old, were randomly assigned to 1 of 4 conditions: a parent training treatment group (PT), a child training group (CT), a combined child and parent training group (CT?+?PT), or a waiting-list control group (CON). Posttreatment assessments indicated that all 3 conditions had resulted in significant improvements in comparison with controls. Comparisons of the 3 treatment conditions indicated that CT and CT?+?PT children showed significant improvements in problem solving as well as conflict management skills, as measured by observations of their interactions with a best friend; differences among treatments on these measures consistently favored the CT over the PT condition. As for parent and child behavior at home, PT and CT?+?PT parents and children had significantly more positive interactions, compared with CT parents and children. One-yr follow-up assessments indicated that all the significant changes noted immediately posttreatment had been maintained over time. Moreover, child conduct problems at home had lessened over time. Analyses of the clinical significance of the results suggested that the combined CT?+?PT condition produced the most significant improvements in child behavior at 1-yr follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Child and Parent Weight Loss in Family-Based Behavior Modification Programs": Correction to Epstein et al.

Reports an error in the original article by Leonard H. Epstein, Rena R. Wing, Randi Koeske, Frank Andrasik, and Deborah J. Ossip (Journal of Consulting and Clinical Psychology, 1981, 49, 674-685). There are several errors in Table 3. The corrected table is provided. (The following abstract of this article originally appeared in record 1982-01694-001.) Overweight preadolescents and parents from 76 families were assigned to 1 of 3 behavioral treatment groups: parent/child target, child target, or nonspecific target. Percent overweight changes at the end of the 8-mo treatment and 13-mo follow-up were equivalent for children in the 3 treatment groups, but parents in the parent/child group lost more weight during treatment. Weight changes for parents and children increased through the 8-mo treatment. Patterns of maintenance showed that 40% of the children were within 20% of their ideal weight by the end of treatment, achieving nonobese status. 100% of the newly nonobese children in the parent/child group maintained nonobesity during follow-up, whereas only 30% in the child-alone group and 33% in the nonspecific group maintained nonobesity. In addition, weight losses for parents and children in the same family correlated positively at the end of treatment but not at follow-up. Results suggest that parental modeling may be important during treatment, but long-term results probably are due to parental reinforcement of child self-regulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital discord and treatment outcome in behavioral treatment of child conduct disorders.

Research assessing the role of marital variables in the treatment of childhood conduct disorders is scarce. The aim of this study was (a) to assess the role of marital discord in the overall outcome of a program training parents in behavioral techniques (behavioral parent training) and (b) to assess the effects of an adjunctive treatment (partner support training [PST]) on outcome. The latter treatment focused on marital conflict, communication, and problem solving. Twenty-four families with a child diagnosed as oppositional or conduct disordered were assigned to either a marital-discord group (n?=?12) or a no-marital-discord group (n?=?12). Families within each group were then randomly assigned to either child management training (CMT) alone or CMT with PST. Measures of child deviance, parenting behavior, and marital satisfaction were collected at pre- and posttraining and at a 6-month follow-up. Results indicated a significant interaction between marital discord and treatment type on most measures at follow-up but not at posttraining. Although PST added little to the maintenance of change for the nondiscordant group, it produced significant gains over those who received CMT only for the discordant group. Further results highlighting the interaction of marital and treatment variables are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A controlled evaluation of behavior modification with conduct problem children.

Evaluated a behavioral intervention program for conduct problem children with both behavioral and academic difficulties in elementary school. 16 Ss were each assigned to either a treatment or a "no-contact" control group. A standardized 20-hr treatment program involving the child, parents, and the teacher was provided by clinical psychologists. Both observational recordings and teacher ratings of social and academic behavior demonstrated that significantly greater behavioral improvement had occurred for treated than for control children. However, at a 9-mo follow-up, the control group had improved sufficiently that these differences were no longer significant. Although no differences existed between treated and untreated children in achievement test performance (California Achievement Test) or grades at termination, follow-up revealed that the treated Ss had significantly better achievement scores and grades 9 mo after termination. Ratings of therapists by teachers and parents were uniformly positive, and there were no dropouts during the 3-4 mo course of treatment. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impacts d'un programme d'interventions multidimensionnel con?u pour les parents et leur enfant ayant un TDAH sur le stress parental et la relation parent–enfant.

The behaviours that characterize ADHD (Attention-Deficit/Hyperactivity Disorder) often lead to impairments in the parent–child relationship and contribute to increased stress amongst parents of children with the disorder. The main objective of this research is to evaluate the impact of a multimodal intervention program (Multi-Propulsions) on parental stress and on parent–child relationship as perceived by parents. The program combines: (1) a cognitive-behavioural program for ADHD children including physical activities in an adapted gymnasium; (2) a cognitive-behavioural parent training program; (3) joint activities with children and parents under the supervision of professionals. Sample contents 23 families with ADHD children aged between 6 and 12 years old from the ADHD clinic of the Rivière-des-Prairies Hospital in Montreal. Participants were randomly assigned to treatment or waiting group. Results highlight the efficiency of Multi-Propulsions program for diminishing parental stress, particularly stress associated with child's characteristics, and these therapeutic gains were maintained four months after the treatment. Furthermore, the results show an improvement in the quality of parent–child relationship. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Toward generic principles of treating parents and children: Integrating psychotherapy with the school-aged child and early family intervention.

Generic principles governing the outcome and process of the treatment of children and their families can be generated from both research on the psychotherapy of school-aged children and early family intervention. Evidence indicates that the amenability of the child or parent to treatment and the comprehensiveness, duration, and intensity of the helping process are significant parameters. Definition of significant early family intervention roles allows linkage to various therapeutic roles with school-aged children and forces the recognition that most treatment situations involve more roles than are officially recognized. This articulation of the profile of intervention roles among poverty level, 1st-time parents at risk for neglecting their infant drew on several bodies of theory: psychoanalytic, cognitive, behavioral, social cognitive, and positive reinforcement principles, and advocacy and direct assistance as used in clinical social casework. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Residential behavior therapy for children with conduct disorders

Children with conduct disorders are often referred to residential treatment centers (RTCs). RTCs shorten the length of treatment and thus feel they need to reconceptualize the purpose and process of treatment. Two intervention strategies have been found to affect conduct disorder in outpatient settings: parent training programs that are based on operant learning principles and cognitive-behavioral programs that focus on the relation between cognition and behavior. These strategies should not be transferred to the RTC but adapted to the characteristics of residentially treated conduct disordered children and their parents. These methods should be used together to integrate and strengthen the various learning processes that residential treatment can foster. An outline is given of a comprehensive and integrated residential treatment program based on behavioral methods that have been proven to affect conduct disorder.     

Long-term effects of family-based treatment of childhood obesity.

This study was a 5-year follow-up of obese children who participated in a family-based behavioral weight-control program targeting and reinforcing children and parents for weight loss (Epstein, Wing, Koeske, Andrasik, & Ossip, 1981). Children in the parent-plus-child group showed significantly greater weight reductions after 5 years (–22.7% overweight) than did children in a child-alone target group or in a no-target control group (4.3% and 8.2% overweight, respectively). One third of children in the parent-plus-child group were within 20% of normal weight in comparison with 5% of the children in the no-target control group. Height percentile decreased from the 72nd to the 60th percentile; these changes were negatively related to weight change. These children remained taller than the average child after weight loss, and children of short and medium-height parents were still relatively taller than their parents after 5 years. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Problem solving in the treatment of childhood obesity.

This study randomized obese children from 67 families to groups that received a 6-month family-based behavioral weight-control program plus parent and child problem solving, child problem solving, or standard treatment with no additional problem solving. The standard group showed larger body mass index (BMI) decreases than the parent?+?child group through 2 years, with significant differences in the percentage of children who showed large BMI changes. Significant statistical and clinical improvements were observed over time in child behavior problems and parental distress. Parent problem solving increased in the parent?+?child condition relative to the other conditions, whereas child problem solving increased equally in all conditions. The bulk of evidence suggests that problem solving did not add to treatment effectiveness beyond the standard family-based treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The generalization effects of parent training across stimulus settings

Five parents of nonverbal children were trained in two home settings to modify antecedents and consequences to their children's vocalizations. Generalization effects of the parent training on both the parent's and children's behaviors under different stimulus conditions were investigated using multiple-baseline designs. Increases in parent prompting and reinforcing their children's vocalizations generalized only minimally to a new setting in the home where parent training had not occurred. Child increases in vocalizations produced by the parents in the training settings did generalize to this new setting in the home. There was minimal generalization of child vocalizations to a free-play setting at school. In a formal speech session conducted by a behavior specialist at school, only one child showed definite increases in acquisition rate as a function of the parents starting to train the sound at home.     

The prevention of depressive symptoms in rural school children: A randomized controlled trial.

A controlled trial was conducted to evaluate a prevention program aimed at reducing depressive and anxious symptoms in rural school children. Seventh-grade children with elevated depression were selected. Nine primary schools (n=90) were randomly assigned to receive the program, and 9 control schools (n=99) received their usual health education classes. Children completed questionnaires on depression, anxiety, explanatory style, and social skills. Parents completed the Child Behavior Checklist (T. M. Achenbach, 1991). No intervention effects were found for depression. Intervention group children reported less anxiety than the control group after the program and at 6-month follow-up and more optimistic explanations at postintervention. Intervention group parents reported fewer child internalizing and externalizing symptoms at postintervention only. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of a child-care training program for parents at-risk for child neglect.

Evaluated a home-based parent training program aimed at teaching crucial childcare skills (e.g., diapering, bathing, feeding, safety) to 22 low-IQ mothers of children (aged 1–23 mo) considered at-risk for child neglect. Ss were randomly assigned to a training or control group. Posttests showed that the mean percent correct score (88%) of the training group was then similar to that of 12 nonhandicapped comparison mothers, with both significantly greater than the mean (61%) of the control group. The training group maintained improvements up to 76 wks following training, and the control group, when subsequently trained, had a mean score of 92%. Finally, where it could be observed, the health of children improved concomitant with the parents learning proper childcare. Parent training in childcare may help reduce the likelihood of child neglect due to parental incompetency. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The interaction of parent and child gender in physical child maltreatment.

Assessed cross-generational patterns of physical child maltreatment taking the gender of both parents and child into consideration, and the experience of shame regarding one's own physically abusive behaviors. 1536 parents (mean age 47 yrs) and their 983 children (mean age 18 yrs) were administered the Conflict Tactics Scale (M. A. Straus, 1989) along with other questionnaires to gather information on aggressive behavior, shame experienced in abusing their children and demographic data. The parents were categorized as physically abusive or nonabusive if both parent and child ratings of the parents' behavior were in agreement. Results show that parents received more physical child maltreatment from their own same gender parent than from opposite gender parents. Among the abusive parents, the more maltreatment they received as children by the same gender parent, the less shame they felt for using such punishment on their own children. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family education to enhance the moral atmosphere of the family and the moral development of adolescents.

Examined the effects of a course for families in democratic conflict resolution on (a) the family's collective decision-making abilities, and (b) the moral reasoning of adolescent participants. 16 couples and their adolescent children were divided into 3 groups: parents and their adolescents, parents only, and a control group. Both experimental groups met for 10 weekly 2.5-hr sessions and received training in conflict resolution and the use of family meetings. Assessment was based on the Parental Attitude Research Instrument, 2 self-report inventories, a behavioral role-play test, the Kohlberg Moral Judgment Interview, and an analysis of tape recordings of the family meetings. A 1-yr follow-up assessment of the Kohlberg measure was also used. Parents in both experimental groups significantly increased their equalitarian attitudes toward family decision making. Furthermore, families in both groups significantly improved their effectiveness in collective decision making; the parent–adolescent group showed greater improvement than the parent group on most of the variables measured. Finally, the results suggest that adolescents who participated in the training significantly improved their scores in moral reasoning. This gain was maintained at follow-up. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)