Innovations in Practice: Brief behavioral parent training for children with impairing ADHD characteristics – a pilot study

IF 6.8 3区医学 Q1 PEDIATRICS Child and Adolescent Mental Health Pub Date : 2024-12-07 DOI:10.1111/camh.12743

Marijn Nijboer, Roos van Doornik, Annabeth P. Groenman, Saskia van der Oord, Rianne Hornstra, Barbara van den Hoofdakker, Tycho J. Dekkers

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Abstract

Background

Behavioral parent training (BPT) is a well-established intervention for children with attention-deficit/hyperactivity disorder (ADHD), but most programs are long, which may limit their accessibility. This could be improved by making programs shorter. Here, we studied (1) the feasibility of a new brief BPT program and its procedures, and (2) pre–post changes in daily rated problem behaviors (primary outcome), children's disruptive behaviors, ADHD/ODD characteristics, impairment, and parents' sense of parenting competence (secondary outcomes).

Methods

We conducted a nonrandomized pilot study including parents of 28 children (4–12 years) with impaired ADHD characteristics. We examined treatment dropout, parent and therapist satisfaction, recruitment rates, study drop-out, measurement response and completion rates, acceptability of measurements according to parents, and treatment fidelity. Pre–post changes in the treatment group were compared to those in a historical control group using mixed model analysis, except for those outcomes that were not assessed in the control group. Within-group differences were analyzed for all outcomes.

Results

Feasibility of the program and study procedures were good. Treatment dropout was 14.2%, parents and therapists were satisfied with the new program. We recruited 1.5 participants per month, study dropout was 10.7%, response/completion rates ranged from 82% to 100%, measurements were acceptable for parents, and treatment fidelity was 96%. We found substantial within-group changes (d's = .68–.77) and medium-sized between-group changes (d's = .46–.48) on daily rated problem behaviors. We observed no changes on most of the secondary outcomes, except for disruptive behaviors and impairment.

Conclusion

Our newly developed brief BPT program was feasible and we observed improvements in children's daily-rated problem behaviors. These results suggest that brief BPT might be beneficial for clinical practice if the findings are confirmed in large-scale randomized controlled trials.

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实践中的创新：对有缺陷多动症特征的儿童进行简短的父母行为训练——一项试点研究。

背景：行为父母训练（BPT）是一种行之有效的儿童注意力缺陷/多动障碍（ADHD）的干预措施，但大多数项目都很长，这可能限制了他们的可及性。这可以通过缩短节目来改善。在这里，我们研究了(1)一个新的简短的BPT项目及其程序的可行性，以及(2)日常评定的问题行为（主要结果）、儿童的破坏性行为、ADHD/ODD特征、损害和父母的养育能力感（次要结果）的前后变化。方法：我们进行了一项非随机试点研究，包括28名（4-12岁）ADHD特征受损儿童的父母。我们检查了治疗退出、家长和治疗师满意度、招募率、研究退出、测量反应和完成率、家长对测量的可接受性和治疗保真度。除对照组未评估的结果外，使用混合模型分析将治疗组的前后变化与历史对照组的变化进行比较。对所有结果进行组内差异分析。结果：本研究方案和研究步骤具有较好的可行性。治疗退出率为14.2%，家长和治疗师对新项目感到满意。我们每月招募1.5名参与者，研究退出率为10.7%，响应/完成率为82%至100%，测量结果为家长可接受，治疗保真度为96%。我们发现在日常评定的问题行为上，组内变化很大（d = 0.68 - 0.77），组间变化中等（d = 0.46 - 0.48）。除了破坏性行为和损伤外，我们观察到大多数次要结果没有变化。结论：我们新开发的简短BPT项目是可行的，我们观察到儿童日常评定的问题行为有所改善。这些结果表明，如果研究结果在大规模随机对照试验中得到证实，简短的BPT可能对临床实践有益。

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来源期刊

Child and Adolescent Mental Health PEDIATRICS-PSYCHIATRY

CiteScore

8.30

自引率

3.30%

发文量

审稿时长

>12 weeks

期刊介绍： Child and Adolescent Mental Health (CAMH) publishes high quality, peer-reviewed child and adolescent mental health services research of relevance to academics, clinicians and commissioners internationally. The journal''s principal aim is to foster evidence-based clinical practice and clinically orientated research among clinicians and health services researchers working with children and adolescents, parents and their families in relation to or with a particular interest in mental health. CAMH publishes reviews, original articles, and pilot reports of innovative approaches, interventions, clinical methods and service developments. The journal has regular sections on Measurement Issues, Innovations in Practice, Global Child Mental Health and Humanities. All published papers should be of direct relevance to mental health practitioners and clearly draw out clinical implications for the field.