Academic journal article Journal of Early Childhood and Infant Psychology

Evaluating Outcomes of a Behavioral Parent Training Program for Caregivers of Young Children: Waitlist Control vs. Immediate Treatment

Academic journal article Journal of Early Childhood and Infant Psychology

Evaluating Outcomes of a Behavioral Parent Training Program for Caregivers of Young Children: Waitlist Control vs. Immediate Treatment

Article excerpt

Rates of early emerging challenging behavior in young children (ages 18 months to 7 years) continue to increase each year. Current estimates suggest that nearly 25% of otherwise healthy and typically developing young children have mild to moderate levels of chronic behavior problems (Knapp, Ammen, Arstein-Kerslake, Poulson, & Mastergeorge, 2007; Raaijmakers, Posthumius, van Hout, van Engeland, & Matthys, 2011). The most commonly cited challenging behavior in young children include sleeping difficulties, mealtime and feeding issues, toilet training, temper tantrums, aggression, sibling rivalry and noncompliance (Campbell, 1995; Hale, Berger, LeBourgeois, & Brooks-Gunn, 2011; Lavigne et al., 1996). Higher rates of chronic behavior problems (25-35%) have been identified for children with risk factors, such as minority racial or ethnic group membership (Choi & Jackson, 2011; Copage, Bennett, & McNeil, 2001) or low-socioeconomic status (Gross et al., 2003; Webster-Stratton, 1998; Zhai, Brooks-Gunn, & Waldfogel, 2011).

The impact of challenging behavior in young children has been well-documented and in general, the earlier the age of onset, the more stable and intense the associated outcomes will be (Dishion, French, & Patterson, 1995; McCrae, 2009; Meisch & Wesbrook, 2011). Behavior problems which emerge in the toddler or preschool years have been shown to predict childhood academic failure, social isolation, adolescent delinquency and gang membership, and adult incarceration (Dishion, French, & Patterson). As the prevalence rates of challenging behavior among young children continue to rise, professionals across disciplines have developed a variety of interventions to help prevent and treat these behaviors. Group-delivered behavioral parent training has emerged as an economical and effective intervention that empowers parents to prevent and address challenging behavior in young children (Lundahl, Risser, & Lovejoy, 2006; Maughan, Christiansen, Jenson, Olympia, & Clark, 2005; Nelson, 1995; Sandall & Ostrosky, 1999; Smith & Fox, 2003). Helping Our Toddlers, Developing Our Children's Skills (HOT DOCS; Armstrong, Lilly, & Curtiss, 2006a, 2006b) is a group-delivered behavioral parent training program, which has recently been shown to result in positive outcomes for participants (Armstrong, Hornbeck, Beam, Mack, & Popkave, 2006; Salinas, Smith, & Armstrong, 2011; Williams, 2007, 2009; Williams, Armstrong, Agazzi, & Bradley-Klug, 2010).

Despite early findings supporting the positive outcomes of the HOT DOCS program, previous evaluations of this curriculum have lacked the rigorous methodology of a controlled trial necessary to consider the program as an evidence-based intervention. The current research project is a pilot study evaluation using a waitlist-control design to evaluate the effectiveness of the HOT DOCS program. The specific aims of the study were to evaluate the effectiveness of the HOT DOCS parent training program in:

1. Reducing caregivers' perceptions of the severity of children's problem behaviors;

2. Increasing participants' knowledge of child development and behavioral principles; and

3. Decreasing participants' stress associated with providing care to young children.


Intervention Program

HOT DOCS, or Helping Our Toddlers Developing Our Children's Skills (Armstrong, Lilly, & Curtiss, 2006a) is a behavioral parent training program that incorporates both behavioral and ecological perspectives in its theoretical framework. HOT DOCS was designed to teach caregivers a problem-solving process based upon the foundation of behavioral principles (e.g., antecedents, consequences, and function of behavior) delivered in parent-friendly language. Unlike other parent training programs that focus on teaching parents to eliminate specific behavior problems, HOT DOCS empowers caregivers to use a step-by-step method to identify features of the environment and interpersonal interactions that may contribute to the reinforcement or maintenance of current and future problem behaviors. …

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