Guide to Effective Programs
for Children and Youth

Parent-Mediated Treatment Program

OVERVIEW

The Parent-Mediated Treatment program is a modified replication of the Helping the Noncompliant Child program. The Parent-Mediated Treatment program is designed for preschool-aged children who have been diagnosed with Attention Deficit/Hyperactivity Disorder (AD/HD). The program seeks to give parents knowledge about AD/HD and also teach them positive parenting behaviors to deal with their children. A randomized, wait list design experimental evaluation of the program found that it was effective in increasing child compliance, reducing negative parenting behavior, and increasing positive parenting behavior at post-test and three months later. The program had no impact on children’s noncompliant behavior.

DESCRIPTION OF PROGRAM

Target population: Preschool-aged children who have been diagnosed with AD/HD

The Parent-Mediated Treatment program was initially developed by Forehand and McMahon (1981) and Barkley (1981) and modified for this application. The program consists of a series of 12 weekly sessions. Ten of these sessions are conducted in parent-only groups and 2 of them are individual sessions for both parent and child with a therapist. In the first three group sessions, leaders present information about parent-child interactions, behavior management, AD/HD, and practical safety issues and realistic expectations of their child. The rest of the sessions include role-playing, modeling, rehearsal, and other interactive activities and also additional didactic instruction. The last session is a review of previous instruction and guidelines for handling problems in the future.

EVALUATION(S) OF PROGRAM

Pisterman, S., McGrath, P., Firestone, P., Goodman, J. T., Webster, I., & Mallory, R. (1989). Outcome of parent-mediated treatment of preschoolers with attention deficit disorder with hyperactivity. Journal of Consulting and Clinical Psychology, 57(5), 628-635.

Evaluated population: 46 parents with children ages 3-6 who were not yet attending the first grade. Parent-child pairs were referred to an hospital in Ontario, Canada for treatment of Attention Deficit Disorder with Hyperactivity (ADDH) (now referred to as Attention Deficit/Hyperactivity Disorder (AD/HD)). Children averaged 50 months old, and 77 percent were male.

Approach: To be eligible for the study, children had to meet a set of criteria. In short, they had to have the DSM criteria for ADDH (now AD/HD), score above peers on a hyperkinesis index, have lower than average compliance with parents, score lower than average on Peabody Picture Vocabulary test, be between the age of 3 and 6 and not be attending the first grade, and have a constant medication status for hyperactivity throughout the intervention. After meeting these criteria, parents were randomly assigned to the treatment program or a wait-list control group. Groups were balanced in terms of sex, family composition, education level of the parent, and medication status of the child.

Parent-child pairs in the intervention condition attended 10 weekly group sessions and also 2 individual sessions with their child. Parents and children in the control group attended some sessions but these were only for data collection purposes and feedback was not given to the parent. Data were collected using a behavioral assessment where parents were instructed to interact with their child on a compliance task. During this time, parent-child interactions were monitored and recorded. Other measures included the amount of cooperation between the parent and child, the frequency of inappropriate behaviors, on task time, parent rated hyperkinesis, parent reinforced child compliance, and parent style of interaction.

Results: At pre-test, there were no differences between parents and children in the intervention group and those in the control group. At both post-test and follow-up, children in the intervention condition were rated higher on the two measures of child compliance compared with children in the control condition. The program had only a modest effect on the frequency of noncompliance. At follow-up, parents in the intervention condition gave a higher percentage of appropriate commands and reinforcement for compliance than parents in the control condition, due to a decline in inappropriate commands. At post-test and follow-up, parents in the treatment condition had a lower level of directive behavior and greater positive behavior. There was no difference between parents in the treatment and control group with respect to percentage of negative parenting behavior.

SOURCES FOR MORE INFORMATION

Program manual available for purchase at many locations including: http://www.amazon.com/Helping-Noncompliant-Child-Clinicians-Training/dp/0898626110

References

Barkley, R. A. (1981). Hyperactive children: A handbook for diagnosis and treatment. New York: Guilford.

Forehand, R. L. & McMahon, R. J. (1981). Helping the noncompliant child: A clinician’s guide to parent training. New York: Guilford.

Program categorized in this guide according to the following:

Evaluated participant ages: 3-6 years / Program age ranges in the Guide: early childhood

Program components: clinic-based, provider-based, or miscellaneous; counseling/therapy; parent or family component

Measured outcomes: social and emotional health and development; behavioral problems

Program information last updated 11/28/07