Prevention of behavior problems in a selected population: Stepping stones triple P for parents of young children with disabilities

Res Dev Disabil. 2014 Nov;35(11):2958-75. doi: 10.1016/j.ridd.2014.07.036. Epub 2014 Aug 12.

Abstract

Because young children with disabilities are at elevated risk for development of challenging behaviors, and caregivers of these children typically lack access to evidence-based parenting interventions, two randomized trials were conducted to examine the impact of an evidence-based parenting intervention, Stepping Stones Triple P (SSTP), as a selective preventive intervention. Both studies targeted parents of children under two with a variety of disabilities who were enrolled in the IDEA Part C Early Intervention (EI) system in one state. SSTP was delivered in family homes. In Study One, 49 families were randomly assigned to EI services as usual, with or without SSTP; a 52% attrition rate from treatment was seen. No significant between-group differences were seen aside from a trend toward reduced symptoms of parental depression at follow-up. Intervention group children demonstrated significant decline in behavior problems from post treatment to follow-up, and there was a trend toward improved parenting style in the intervention group during this same time frame. Study Two incorporated a separate workforce intervention for EI service coordinators; 40 families on their caseloads were then randomly assigned to receive EI services as usual with or without SSTP. Attrition from treatment was limited to 20%. No differential impact was seen on child behavior; a trend was noted post-treatment on parent symptoms of depression and on the observed parent-child relationship. At 12-month follow-up, there was a trend favoring improvement in the intervention group in parenting style; statistically significant impact was also seen on the observed quality of the parent-child relationship. SSTP shows promise as a selective preventive intervention for an early intervention population. Reasons for the differential findings between the two studies are explored and suggestions for future research are provided.

Keywords: Children; Disabilities; Evidence-based parenting intervention; Home-based intervention; Parenting; Randomized design.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Caregivers / education
  • Caregivers / psychology
  • Child Behavior Disorders / prevention & control*
  • Child Behavior Disorders / psychology
  • Depression / prevention & control
  • Depression / psychology
  • Developmental Disabilities / nursing
  • Developmental Disabilities / psychology
  • Developmental Disabilities / rehabilitation*
  • Disabled Children / psychology
  • Disabled Children / rehabilitation*
  • Down Syndrome / nursing
  • Down Syndrome / psychology
  • Down Syndrome / rehabilitation
  • Evidence-Based Practice
  • Female
  • Home Care Services
  • Humans
  • Infant
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Male
  • Parent-Child Relations
  • Parenting*
  • Parents / education*
  • Parents / psychology
  • Young Adult