Effects of parent enhancement therapy on the treatment outcome and generalization of a parent training program

The purpose of the present study was to examine the effectiveness of parent enhancement training in facilitating treatment and maintenance effects of a parent training program. Seventeen mothers and their clinic-referred noncompliant children were assigned to either a parent training alone group or a parent training plus parent enhancement therapy group. Fifteen mothers and their nonclinic children served as a quasi-control group. All clinic-referred mother-child dyads were treated individually by teaching the mother to reward compliance and other prosocial behavior and to use time-out for noncompliance. In addition, mothers in the parent training plus parent enhancement group also received treatment related to the following areas: parent's perception of their child's behavior, parent's personal adjustment, parent's marital adjustment, and parent's extrafamilial relationships. Assessment consisted of four home observations by independent observers prior to treatment, after treatment, and at a 2-month follow-up. The data indicated that the parent training plus parent enhancement therapy was more effective than parent training alone in changing child deviant behavior at posttreatment and in maintaining child compliance, child deviant behavior, parental rewards and parent contingent attention at follow-up. The control group did not change over the three assessment periods.     

LONG-TERM EFFECTS OF OPPOSITIONAL CHILD TREATMENT WITH MOTHERS AS THERAPISTS AND THERAPIST TRAINERS

The follow-up data reported represent a long-term (3 to 9 years out of treatment) evaluation of 40 children who were clients of the Regional Intervention Program (RIP) from 1969 to 1978. As 3-, 4-, and 5-year olds, these youngsters exhibited severe and prolonged tantrums, continual opposition to adults' requests and commands, and physical aggression toward parents. Each child and mother participated in a standardized intervention package modeled after Wahler's Opposition Child Treatment. Results from school and home-based follow-up showed that: (a) commands, demands, or requests made by parents were likely to be followed by former clients' compliance; (b) former clients' social interactions in the home were overwhelmingly positive and their nonsocial behavior was by and large appropriate; (c) parent behavior in the home was consistent with the child management skills taught many years ago; (d) there were no differences between the compliant, on-task, social interaction and appropriate/inappropriate nonsocial behaviors of former clients and randomly selected class peers; (e) there were no differences in teachers' commands, negative feedback, positive social reinforcement, and repeated commands that were directed toward either former clients or randomly selected class peers; (f) both teachers' and parents' rating of former clients on the modified Walker Problem Behavior Checklist were highly correlated; (g) there were no differences in teachers' rating of former clients and class peers; and (h) of all the studied demographic variables, only age that treatment began and family intactness were related to current levels of behavior.     

Factors associated with parent labeling of children referred for conduct problems

Clinicians have suggested that in some cases normal children have been inappropriately labeled as deviant by their parents and taken to psychological clinics for treatment. Reasons given for such inappropriate labeling have included factors such as the parents' marital distress and intolerance of normal child behavior. This study provided an empirical examination of the appropriateness or inappropriateness of parent labeling of 5–12-year-old children referred by their parents for treatment of conduct problems. The definition of inappropriate labeling derived by the present investigators required that the relationship between the child's actual behavior and the parent's negative label be so imperfect as to raise questions about the justification for the label, and that some identifiable factors other than the child's behavior account for the negative label. Three parent factors evaluated for their contribution to the parent negative label were marital distress, parent negative behavior toward the child, and parent distress about child deviant behavior. The statistical model of hierarchical multiple regression permitted analysis of this definition. The association found between observed child deviant behavior and the parent negative label suggested that parents of this sample perceived their children reasonably accurately. The three parent factors were found to be negligibly related to the parent label. Therefore, the conditions for inappropriate labeling of the children by the parents of this sample were not met.     

Responsive Parenting and Child Socialization: Integrating Two Contexts of Family Life

Developmental and behavioral research traditions differ in their prioritization of certain interpersonal contexts. Developmentalists focus on what might be called the attunement context and investigate how parent responsiveness impacts child symbolic capacities and social behavior. Behaviorists, on the other hand, focus primarily on limit-setting encounters and how reinforcement impacts rates of coercive and cooperative child behavior. The present paper discusses parental attunement from a reinforcement perspective. It illustrates that child behavior is related not only to how parents respond to prior episodes of coercion and cooperation, but to a wide range of child social behaviors.     

Patterns of Parental Adherence and the Association to Child and Parenting Outcomes Following a Multicomponent School-Home Intervention for Youth With ADHD

The goal of the present study was to evaluate the role of parent adherence in the Collaborative Life Skills (CLS) program, a multicomponent school-home intervention, for predicting child and parenting outcomes. A sample of 129 children (63% male; M age = 8.22, SD = 1.10; grades 2–5) with attention-deficit/hyperactivity disorder (ADHD) and their parents participated in CLS, which included 10 weekly behavioral parent training group sessions. Each week, parents provided information on their CLS skill use between sessions (at home) as part of the intervention. Outcome measures included parent and teacher ratings of child behavior and parenting at post-intervention and 6 months follow-up. Growth mixture models examining weekly parent skill use trajectories throughout the intervention significantly predicted parent- and teacher-reported outcomes including parent-rated child behavior, teacher-rated academic competence, and positive parenting behaviors. Fifty-two percent of parents displayed moderate skill use throughout the intervention, whereas the remaining parents had either low (20%) or high (28%) initial levels of use but demonstrated high skill utilization by the middle of the intervention. Results highlight the importance of examining individual differences in parents between session strategy use for behavioral parent training interventions targeting child and parenting outcomes.     

Parents as Social Skills Trainers and Evaluators of Children

This study evaluated the effects of a 4-week group parent training program on parents' conceptual knowledge regarding social skills and perceptions of their children's social competence and psychosocial adjustment. It also examined the concordance prior to parent training between the parent measures and independent sociometric measures of children's acceptance by peers. Participants were 79 normal children enrolled in second grade and 45 parents. A group pretest-posttest design compared experimental and wait-list control parent groups before and after parent training for the experimental group. Parent training produced a significant effect in parents' conceptual knowledge and perceptions of children's social skills over time, and follow-up assessment 6 weeks later suggested maintenance of training effects. Psychosocial adjustment levels were within the normal range before and after treatment. Correlational analyses between parent measures and peer acceptance ratings indicated significant positive relationships between parents' and peers' perceptions on most measures. The findings support the potential value of parents as trainers and evaluators in programs to enhance children's social skills.     

Naturalistic treatment of an autistic child

The present research experimentally evaluated a "naturalistic" treatment program for an autistic child administered by the parents over a 2-yr period. Operant reinforcement techniques previously developed and tested in laboratory settings were initially assessed in a clinic and eventually in the family's home. Experimental manipulations were performed in both settings on rituals, crying and whining, compliance, non-verbal imitation, and verbal imitation. The results clearly indicated that parents can effectively treat autistic behaviors provided that they receive adequate training and supervision in operant reinforcement therapy, and provided that sufficiently potent reinforcers are available to maintain behavior.     

Training parents as behavior modifiers: self-recording of contingent attention

Two mothers of deviant young children were instructed to count their episodes of attention to appropriate child behavior in their homes, using wrist counters. Attention and appropriate child behavior were defined before counting began. Independent observations of parent-child interactions showed that, for each mother-child pair, the percentage of maternal attention given following appropriate child behavior increased, as did the child's appropriate behavior. Removal of the counters did not produce a reversal of the behaviors; instead the increased level stabilized. One mother was then instructed to count her attention to inappropriate child behavior and to decrease it. This instruction had little effect on her attention, and her child's behavior did not change. When both parents were again instructed to count their episodes of attention to appropriate behavior, further improvements in both mothers, and in their children resulted. These results were obtained despite inaccurate parent self-recording. Follow-up observations made over the next five months showed these behavioral gains to be durable. A third parent and his child were unaffected by this training procedure. Thus, there are instances in which self-recording may function as an effective and economical parent-training technique for effecting improvements in child behavior.     

The use of a self-control package to enhance temporal generality of a parent training program

The purpose of the present study was to examine the effectiveness of a self-control package in enhancing temporal generality of a parent training program. Sixteen mothers and their clinic-referred noncompliant children were assigned to either a parent training alone group, or a parent training plus self-control group. All mother-child dyads were treated individually by teaching the mother to reward compliance and other prosocial behavior, and to use time-out for noncompliance. In addition, mothers who also received self-control training learned to self-monitor their use of their new parenting skills and to reinforce themselves for use of the skill during a 2 month follow-up period. Assessment consisted of four home observations by independent observers prior to treatment, after treatment, and at a 2 month follow-up. The data indicated that the children in the parent training plus self-control group were significantly more compliant and less deviant at the 2 month follow-up than the children in the parent training alone group. Parental behavior did not differ between the two groups at the follow-up.     

Effectiveness of a Parent Training Program for Improving Children’s Social Behavior

We tested the efficacy of a social skills training program for the parents of school-aged children experiencing socio-emotional problems. Participating families (N = 42) were randomly assigned to one of three conditions: parent social skills training; parent plus parallel child social skills training; or no-treatment control. The two treatment groups did not differ on any of the outcome measures. Treatment was associated with improvements in parent and child social skills knowledge, parent social problem solving, and child emotional functioning. In follow-up analyses examining mechanisms of change, parental attendance and change in child social skills knowledge predicted response to treatment. Overall, our results highlight the utility of engaging parents as primary participants in the treatment of children’s socio-emotional problems and suggest methods for maximizing the impact of such an intervention.     

Changing the Speech of Autistic Children and Their Parents

The parents of nine autistic preschool children were trained in behavior modification and operant techniques of teaching speech. The study used a multiple baseline design with Group 1 completing behavior modification training while Group 2 remained on the waiting list. Then, Group 1 entered speech training while Group 2 began behavior modification. Finally, Group 2 received speech training. Videotape assessments of parents and child were made pretreatment and after each stage of training. The tapes were coded reliably for the parents' speech oriented and non-speech oriented language and the childrens' speech and non-speech behaviors. There was no change in parental speech oriented language following behavior modification but a substantial rise in such language was noted after speech training. Both mothers and fathers changed after training, although mothers were consistently more active than fathers. Both before and after training, the parents of the more verbal children emitted more speech oriented language than the parents of the mute children. The children showed changes which paralleled those of the parents. There was no significant change in child speech after behavior modification, but a rise in children's speech was obvious when their parents completed the speech training. The verbal children accounted for the changes in the two groups since the mute children showed Iittle evidence of change. The results suggest that parents of nonverbal chiIdren can learn to modify their language behavior and that this parent training can be done in an economical group setting.     

Telehealth parent training for a young child at risk for autism spectrum disorder

The global pandemic has highlighted the importance of telehealth to access behavioral interventions. Face-to-face parent training improves the development and behaviors of young children at risk for autism spectrum disorder (ASD). We evaluated a telehealth parent training intervention for a child at risk for ASD. Two parents identified possible early ASD symptoms in their 30-month-old son (lack of imitation, pointing, and vocal manding). Both parents simultaneously received telehealth behavioral skills training on the Parent Intervention for Children at Risk for Autism program for 1 hour per week over 29 weeks. Multiple baseline designs across parent and child behaviors showed that both parents improved their parent teaching fidelity above 80% and the child improved on all trained behaviors. This study expands the utility of telehealth behavioral parent training to young children at risk for ASD to mitigate early symptoms of ASD.     

Parent and Teacher Ratings in the Assessment and Prediction of Antisocial and Delinquent Behaviors

ABSTRACT Subjects consisted of a sample of two cohorts of approximately 100 boys each whose behaviors were rated by their parents and teachers. Criterion variables included antisocial behavior, based on parent, child, teacher, and interviewer reports, and delinquency, based on parent and child reports in addition to cumulative arrest data taken from juvenile court records. The data suggest that mothers are focused on the daily, irritating behaviors of their sons. Teachers, on the other hand, appear to focus on a relatively small number of items (e.g., child physically attacks others, associates with deviant peers), and thereby provide ratings that are better predictors of delinquency and arrest. When the mothers' ratings were constrained to include only items that were salient for teachers, their predictive validity coefficients approached the magnitude of the teacher coefficients.     

Pathways Triple P‐Positive Parenting Program: Effects on Parent‐Child Relationships and Child Behavior Problems

This study examined the effects of Pathways Triple P (PTP), an early intervention program designed to promote positive parent‐child relationships. Sixty parents met the inclusion criteria of borderline to clinically significant relationship disturbance and child emotional and behavioral problems. They were randomly allocated into PTP or a wait‐list (WL) control group. PTP was delivered in a group format for 9 weeks and consisted of parent skills training and cognitive behavior therapy targeting negative attributions for child behavior. Significant intervention effects were found for improving parent‐child relationships and reducing behavior problems with gains maintained at 3‐month follow‐up. Limitations of the study and implications for future research are discussed.     

Generalization of parent-training results

Two experiments were conducted to assess the generalized effects of several different parent/teacher training programs. In Experiment I it was found that a brief demonstration of how to teach an autistic child new behaviors was sufficient to teach parents how to teach those children those behaviors. However, generalization to new child-target behaviors did not take place. Another parent training program, which did not demonstrate how to teach any one specific child behavior, but was based on teaching the use of general behavior-modification procedures, was effective in teaching the parents how to teach new child-target behaviors. Experiment II then provided analyses of the individual effects of several components of the generalized training program. The results showed that videotape illustrations of the procedures, without the presence of a master teacher, were sufficient to teach the adults. However, sub-parts of the videotapes produced highly specific training results, with each component changing corresponding areas of the adults' behaviors. Viewing of the entire package was necessary before the adults were able to improve the autistic children's behaviors. The study as a whole suggests the importance of obtaining multiple measures of the effects of parent and teacher training programs, including measures of acquisition and generalization of both adult and child behaviors.     

Social reinforcement: A treatment component in verbal self-instructional training

This study investigated the effects of noncontingent social reinforcement on social and academic behaviors in grade school children. Twenty-four children in the second through fifth grades were selected on the basis of teacher ratings of disruptive behavior. Subjects were divided into (a) a high social reinforcement verbal self-instructional (VSI) training group, (b) a low social reinforcement VSI group, and (c) a no-contact control group. Children in VSI groups were removed from their classrooms during four 40-minute periods and given VSI training. Significant between-groups differences on measures of social reinforcement were found indicating its successful manipulation. While none of the dependent measures indicated significant differences between experimental groups, a consistent pattern of difference scores emerged giving limited support to the hypothesis that noncontingent social reinforcement contributed to behavioral gains. Results are discussed in terms of the need for future research on the effects of rapport on treatment outcome.Both authors wish to express their thanks to the Missoula public school administration, principals, psychologists, and teachers. Appreciation is also due to Matthew Firpo and Anita Fisher for their help in this project.     

Training elementary aged peer behavior managers to control small group programmed mathematics

The effects of a training procedure and two maintenance contingencies on consequence-dispensing behavior were investigated. Four peer behavior managers were trained to supervise small groups of subjects (four to six per group) working in programmed math materials and were compared with a teacher skilled in the use of social and point reinforcement and response cost. Manager training was differentially effective in accelerating manager's rates of appropriate social and point dispensing. Having manager reinforcement contingent upon manager consequence-dispensing resulted in moderately higher rates of appropriate social and point dispensing for three of four subjects than did having manager reinforcement contingent upon group study behavior. Two managers exposed to the group performance contingency before the manager performance contingency increased inappropriate social and point-dispensing behaviors to pretraining baseline levels. Subsequent change to the manager performance contingency was effective in reducing the inappropriate dispensing behavior of only one of the two managers.     

EFFECTS OF SELF-MANAGEMENT TRAINING AND REINFORCEMENT ON THE TRANSFER OF IMPROVED CONDUCT IN THE ABSENCE OF SUPERVISION

The instruction, maintenance, and transfer of training of social skills of 3 seriously emotionally disturbed adolescents were accomplished by a self-management training and reinforcement package. During baseline sessions these students, who were covertly filmed in their classroom, averaged over 90% off-task or socially inappropriate behavior while their teacher was out of the room. They showed similar behaviors when walking between classes, unattended by their teacher. Treatment was introduced in the classroom and consisted of social skills and self-management training and reinforcement. Treatment procedures included instruction, modeling, and role playing of social skills, as well as self-assessment, self-recording, and self-reinforcement for correct approximations of these skills. After 5 weeks of training, all subjects demonstrated substantial improvements in the classroom during the teacher's absence and when distracted by other students; however, transfer of social skills did not occur to the between-class setting until students were given explicit instruction to initiate self-managing procedures in this setting.     

Predicting Response to an Internet-Delivered Parenting Program for Anxiety in Early Childhood

Previous research has identified factors related to outcome in child anxiety treatment and parent training programs for child behavior problems. However, it is unclear what factors predict outcomes in interventions delivered online to parents of young children at risk of anxiety. This study investigated predictors of child anxiety outcomes among 433 families with young children (3–6 years) who participated in a randomized controlled trial of Cool Little Kids Online, an eight-module early intervention program for child anxiety based on cognitive-behavioral therapy (CBT). Potential predictors included baseline demographic factors, child and parent mental health factors, and indicators of program use, including number of online modules completed and frequency of homework practice. Results showed that only access to a printer moderated intervention effectiveness. Printer access predicted lower child anxiety in the Cool Little Kids Online group, but had no effect on outcomes in the wait-list group. In both groups, higher levels of child anxiety symptoms, child-inhibited temperament, and poorer parent mental health at baseline predicted higher levels of child anxiety symptoms at 6-month follow-up. The amount of online program use was not related to improvements in child anxiety symptoms. However, parents who reported practicing the program skills more frequently showed greater reductions in child anxiety, and access to a printer was related to frequency of program skills practice. These findings provide empirical support for the important role of skills practice in online CBT interventions, and suggest that practicing program skills may be more important than completing the online modules.