Table 3KQ1. RCTs of parenting interventions

Mean Age (SD) %
Interventions comparedResults
Child behaviorParent competence
Bagner, D 200728GoodN = 30
Mean age: 54m
Male: 77%
PCIT vs. WLCDevelopmentally delayed children showed significantly improved compliance compared to nontreated controlsSignificant improvement in positive communication
ITT, F (1,29) = 5.79, p = 0.023, d = 0.67
Bor, W 200219GoodN = 87
Mean age: 41m
Male: 68%
Triple P vs. EBFI vs. WLCBehavior improved under both enhanced and standard Triple P interventionsNo change in negative parenting style, both enhanced and standard program effected change to an equally significant degree; neither intervention reduced inattentive behavior from post to followup
ECBI-Ip <0.01PSp <0.001
ECBI-Pp <0.001PSOCp <0.001
Child behavior improvement F (8,82) = 3.17, p = 0.004
Bywater, T 200926GoodN = 116
Mean age: 53m
Male: 58%
IYPP vs. WLCSignificant reduction in antisocial and hyperactive behavior and increased self controlImproved measures of perceived parenting stress and positive communication
ITT effect size of intervention 0.95 (95% CI, 0.82 to 1.37)
Only 18% of children in intervention group above behavior cut-off did not show some improvement at 3 months post
ECBI-Ip <0.001
ECBI-Pp <0.001
Connersp <0.001
Connell, S 199717FairN = 24
Mean age: 49m
Male: 43%
Triple P self directed vs. WLCReduction in disruptive behavior F (1,22) = 30.67; p = 0.0005Self-directed Triple P with telephone contact effectively reduced disruptive behavior
ECBI-Pp <0.00
ECBI-Ip <0.00
Cummings, JG 2008132GoodN = 54
Mean age: NR
Male: 61%
IYPP vs. SET-PCBoth interventions show significantly improved cooperation and enthusiasmSET-PC essentially equivalent in outcome to IYPP and IYPP is more cost-effective and does not require same intensity of intervention leader training
ECBI-Ip <0.070
Reduction shown in BSI F (1, 26) = 8.14, p = 0.008
Cunningham, CE 1995133GoodN = 150
Mean age: 54m
Male: 51%
CBPTSignificant improvements in child behaviorSignificant group improvement over clinic/individual, post and followup points; Sense of Competence more improved in clinic/individuals than in group intervention; immigrant, ESL, and parents of severely behavior disordered children more likely to enroll in community groups; Community Tx groups more than 6 times more cost-effective than clinic and individual groups
CBCL-Ep <0.001
Decrease in negative child behaviors F (92,192) = 8.91, p <0.001
Dadds, M 199222FairN = 22
Mean age: 55m
Male: 68%
CMT vs. CMT with support person (ally) (pre-Triple P)Children showed improved behavior under both conditions: CMT, F (4,16) = 96.13, p <0.001 and CMT with Ally, F (4,16) = 50.63, p <0.001Mothers’ perceived support system best predictor of response to treatment conditions
Eyberg, SM 199534
Primary study related to Shuhmann (1998)35 Hood, (2003)29
FairN = 50
Mean age: 64m
Male: 80%
PCIT vs. WLCECBI-Ip <0. 01Initial data on short-term effect on parenting locus of control
ECBI-Pp <0.00
Disruptive behavior reduced
Post-Tx classroom observations do not differ between referred children and classroom peers
PLOCp <0.02
Funderburk, BW 199833GoodN = 84
Mean age: 54m
Male: 100%
PCIT vs. WLCSignificant improvement in social competence between post-treatment and followup (maturational); Strong generalization of PCIT at 12m; 18m,
ECBI-I, F (3,5) = 6.66, p = 0.03
ECBI-P, F (3,4) = 11.81, p = 0.02
Home behavior stays within normal limits at 18m, so slide in classroom likely due to classroom demands
Hood, K 200329GoodN = 64
Mean age: 59.5m
Male: 81%
PCIT vs. WLCECBI-I, F (2, 44) = 35.69, p <0.0001
ECBI-P, F (2, 44) = 38.68, p <0.0001
Improved behavior in reported by parents and observed in classroom
Parent report more positive interaction with children; less parent stress; increased locus of control; parents were more tolerant of child’s behavior immediately postintervention than at 3 to 6 years postintervention
Hutchings, J 200725
See Table 4: 200724, Bywater T, 200926, Jones K, 2008139
GoodN = 116
Mean age: 53m
Male: 58%
IYPP vs. WLCSignificant reduction in antisocial and hyperactive behavior and increased self controlImproved measures of perceived parenting stress and positive communication
Behavioral effect size 0.63 (95% CI, 2.0 to 6.9)
ECBI-Ip <0.001
ECBI-Pp <0.001
Connersp <0.001
Jones, K 200724
See Hutchings, 200725
GoodN = 79
Mean age: 46m
Male: 68%
IYPP vs. WLCUsing clinical cutoff criteria, 58% of Tx group compared with 33% of WLC had followup scores below the level of clinical concernmean difference of 9.6 (3.7 to 15.5, p <0.002) between groups at follow-up for positive parenting behaviors; effect size of 0.57
Connorsp <0.013
DPICS-CDp >0.004
Lavigne, JV 200823GoodN = 117
Mean age: 54m
Male: 53%
IYPP vs. MITSignificant behavior improvement with intervention across all 3 conditions including bibliotherapy (MIT) over time F (2, 305.94) = 25.52, p = 0.001Dose effect – little effect of therapist led intervention over bibliotherapy unless parents attended significant proportion of sessions
ECBI-Ip <0.002PSIp <0.01
ECBI-Pp <0.001PLOCp <0.02
Markie-Dadds, C 2006a18FairN = 63
Mean age: 43m
Male: 63%
Triple P vs. SD vs. WTCBoth SD and EBFIImproved at posttreatment but some evidence of relapse effect in parenting at followup.

At followup, mothers report decline in perceived self efficacy
ECBI-Ip <0.01
ECBI-Pp <0.01PSOC-Sp <0.001
Children showed lower levels of disruptive behavior F (4,34) = 3.39, p = 0.019PSOC-Ep <0.05
Markie-Dadds, C 2006b16GoodN = 41
Mean age: 47m
Male: 76%
ESD vs. SD vs. WLCECBI-Ip <0.001ESDSD
ECBI-Pp <0.001PDR-Tp <0.01NS
Children in Enhanced Triple P showed significantly lower levels of disruptive behavior than standard program, although both interventions demonstrated significant improvement over WLC, F (4,30) = 10.41, p = 0.0001Mothers in Enhanced Triple-P report higher levels of perceived parenting efficacy than mothers in standard Triple P condition
Matos, M 200930FairN = 32
Mean age: NR
Male: NR
PCIT vs. WLCHighly significant reduction in ADHD and oppositional behaviors F = 32.73; p <0.000PPIp <0.000
ECBI-Ip <0.000Increased use of positive parenting practices
ECBI-Pp <0.000
Nixon, RD 200131GoodN = 34
Mean age: 47m
Male: 82%
PCIT vs. WLCReduced hyperactivity and improved behavioral flexibility;
by 6m, intervention group comparable to normal social validation controls;
ADHD symptom severity reduced F (1, 30) = 5.42, p <0.05
Results from PSI NR
Nixon, RD 200332

Related to Nixon 2004140 see Table 4
FairN = 54
Mean age: 47m
Male: 70%
PCIT vs. ABB PCITInitially standard PCIT intervention superior but at 6m followup the result of the Standard and the Abbreviated programs become similarShorter PCIT intervention works as well as standard intervention;
Mother report significantly less stress in the abbreviated program; blinded observations of parenting interaction show increased in positive communication
ECBI-I-MRp <0.001p <0.001PSINSp <0.05
CBCL-ENSNSPSOCp <0.05p <0.05
Independent observations of reduced child non-compliant behavior F (5,39) = 7.25; p <0.001PLOCp <0.001p <0.01
P−p <0.01NS
P +p <0.001p <0.001
Pisterman, S 1989135GoodN = 50
Mean age: 49m
Male: 81%
PBT vs. WLCPositive Tx effect on child compliance p <0.001Positive Tx effect on parental style of interaction and management skills; effects maintained at 3m followup
Pisterman, S 1992137FairN = 57
Mean age: 47m
Male: 91%
PBT vs. WLCSignificantly increased child compliance F (2,86) = 11.05, p <0.05Parents observed to have increased quality and frequency of positive parenting communication; improved parental compliance-management skills
Pisterman, S 1992136GoodN = 91
Mean age: 50m
Male: 86%
PBT vs. WLCLack of concordance between measures of observed vs. reported child behavior, however PBT showed impact on child behavior and compliance F (6,168) = 3.90, p <0.01Group PBT had positive impact on parenting stress and parental sense of competence, independent of actual improvements in observed child and parent behavior
Sanders, MR 200721GoodN = 139
Mean age: 85m
Male: 68%
Triple P vs. EBFI vs. SD vs. WLCECBI-Fp <0.01PSOCp <0.05
Enhanced, Standard and Self-directed all showed maintenance of Txd gains; Changes in disruptive behavior maintained or further improved
Sustained improvement at 1 and 3yr followup; (F= 2.72, p = 0.01)
Schumann, EM 199835
Related to Eyberg (1995)34 and Hood, (2003)29
GoodN = 64
Mean age: 60m
Male: 81%
PCIT vs. WLCECBI-Ip <0.01Allocation by family so both available parents could participate
Parent report more positive interaction with children; less parent stress; increased locus of control; maternal perception of child behavior more positive than paternal perception
ECBI-Pp <0.01
Improved behavior both reported by parents and observed in classroom F (1,38) = 36.18, p <0.01
Sonuga-Barke, EJ 200136GoodN = 78
Mean age: 36m
Male: 62.9%
PBT (preNFPP) vs. PCS vs. WLCPBT effect size usually found in range associated with stimulant medications F (2,74) = 11.64; p <0.0001;
Clinically significant improvement in child behavior under PBT condition; little or no effect with PCS
PBT had more effect on measures of parent satisfaction than PCS
Sonuga-Barke, EJ 200238GoodN = 83
Mean age: 36m
Male: NR
PBT (preNFPP) vs. WLCIntervention related to high levels of improvement in child behavior unless mother also has ADHD,
F (2,80) = 8.32, p <0.005
High levels of maternal ADHD limit behavioral improvement in child
Sonuga-Barke, EJ 200437GoodN = 89
Mean age: 36m
Male: NR
PBT vs. WLCPBT did not significantly improve ADHD symptoms when delivered by specialist vs. non-specialist visitors
F = 0.26 (95% CI, −0.24 to −0.68)
Maternal well-being decreased in PBT and WLC conditions; Change between groups 0.22 (95% CI, −0.23 to 0.67); difference may be due to specialist vs. non-specialist health visitors
Thompson, MJJ 200939GoodN = 41
Mean age: 52m
Male: 100%
NFPP vs. TAULarge effect size ( >1) of intervention of ADHD symptoms on the PACS Chi-squared (1) = 7.025; p = 0.008
Impact of intervention on ODD is less pronounced
Calculated on small N
No significant improvement in measures of maternal mental health
Williford, AP 200827GoodN = 96
Mean age: 53m
Male: 72%
IYPP vs. NTIntervention decreased child disruptive behavior in the classroom
Chi-square (1, N = 76) = 7.04, p = 0.008
Positive impact on parenting behavior, but no difference in caregiver report of perceived changes of child behavior between intervention and control groups; teachers in consultation model and parents in intervention model report significantly improved behavior (at least 1SD decrease in at least one measure of disruptive behavior)

Note: table reports effect size for studies included in quality assessment of data

Abbreviations: ABB = Abbreviated PCIT delivery; ADHD = Attention Deficit Hyperactivity Disorder; BSI = Brief Symptom Inventory; CBCL-A = child behavior checklist-attention; CBCL-E = child behavior checklist-externalizing; CBPT = community-based parent behavior training; CI = confidence interval; CMT = Child Management Training; DPICS = Dyadic Parent-Child Interaction Coding Scheme – Child Deviance; EBFI = enhanced behavioral family intervention; ECBI-I = Eyberg Child Behavior Inventory; ECBI-F = Eyberg Child Behavior Inventory - function; ECBI-I = Eyberg Child Behavior Inventory - Intensity; ECBI-I-MR = Eyberg Child Behavior Inventory – Intensity-Mother Report; ECBI-P = Eyberg Child Behavior Inventory - Problem; ESD = enhanced self directed Triple P; ESL = English as a second language; HEAR = Helping Encourage Affect Regulation; ITT = Intention to Treat analysis; IYPP = Incredible Years Parenting Program; m = months; MIT = minimal intervention therapy; N = sample size; NFPP = New Forest Parenting Program; NR = not reported; NS = not significant; ODD = oppositional defiant disorder; PBT = parent behavior training; PCIT = Parent-Child Integration Therapy; PCS = Parent counseling and support; PS = parent stress; PS-T = parenting style, Total; PSI = parent stress index; PLOC = parental locus of control; PSOC = parenting sense of competence; PSOC-E = parenting sense of competence-satisfaction; PSOC-E = parenting sense of competence-efficacy; PPI = Parenting Practices Inventory; SD = standard deviation; SET-PC = Supportive Expressive Therapy-Parent Child; ST = standard; TAU = treatment as usual; Tx = treatment; WLC = Wait List Control; y = year

From: Results

Cover of Attention Deficit Hyperactivity Disorder
Attention Deficit Hyperactivity Disorder: Effectiveness of Treatment in At-Risk Preschoolers; Long-Term Effectiveness in All Ages; and Variability in Prevalence, Diagnosis, and Treatment [Internet].
Comparative Effectiveness Reviews, No. 44.
Charach A, Dashti B, Carson P, et al.

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