Program

Apr 23, 2015

OVERVIEW

The Incredible Years Series (IYS) is a prevention and intervention program intended to enhance children’s social and emotional competencies, and ultimately reduce behavior problems. The series consists of three curricula—one each for parents, teachers, and children—that can be used independently or in conjunction with each other.  The training incorporates a range of activities that promote positive parenting and teaching practices, interpersonal skills, academic competence, and general social skills. Overall, the Incredible Years Series has been found to decrease harsh discipline practices, improve pro-active parenting skills and the parent-child relationship, enhance children’s academic and social competence, and decrease aggression.

DESCRIPTION OF PROGRAM

Target population: Families of children ages two through eight at risk for or already exhibiting behavior problems or conduct disorders.

The Incredible Years Series (IYS) originated with BASIC, a core curriculum for parents. Following the success of the BASIC program, curricula have subsequently been developed to address other aspects of parenting skills, teacher and classroom management skills, and children’s social and academic development.  Each of the programs is run by a trained facilitator. The sessions can take place in schools, mental health centers, or other settings.

The core parenting program, BASIC, runs for 12 to 14 weeks. The BASIC curriculum emphasizes parenting skills that include ways to play with your child, help your child learn, monitoring and supervision techniques, and discipline strategies. The BASIC parenting program can be supplemented with two other parenting curricula, ADVANCE and SCHOOL. The ADVANCE curriculum occurs after the BASIC curriculum, and runs for 10 to 12 weeks, emphasizing family interpersonal skills such as communication, anger management, problem-solving, social support, mental health, and coping. The third parenting curriculum, SCHOOL, provides parents with the necessary skills to encourage children’s academic competence. SCHOOL can be implemented in three or four sessions following completion of the BASIC curriculum, or it can be integrated into the core program. SCHOOL involves strategies for parents to help enhance their children’s school readiness and improve their academic skills, as well as ways to help children with homework and relate with teachers. All three curricula revolve around video vignettes which guide group discussions. Sessions also incorporate problem-solving drills, role-playing, and homework activities, which include reading, child observations, and opportunities for parents to practice new skills with their children.

The Incredible Years Teacher Training Program (TEACHER), the second component of the series, can be implemented in six full-day sessions or over the course of 18 to 20 weeks. The teacher training sessions are organized around the same activities as the parent sessions described above. The teacher curriculum emphasizes various classroom management skills that focus on pro-active teaching and discipline strategies. Teachers learn how to manage behavior problems effectively, build teacher-student relationships, foster student social skills, and encourage communication and involvement with parents. Teachers can also receive training in individualized plans and strategies for working with children with diagnosed conduct disorders.

The Dina Dinosaur Social Skills and Problem-Solving Curriculum (CHILD) is the final component of the Incredible Years Series, and represents the child training program.  The curriculum is intended for small groups of children who are exhibiting conduct problems. Sessions run for 18 to 20 weeks and meet for approximately two hours a week. The program employs a wide range of activities, depending on the particular needs and ages of the children involved. Sessions make use of group discussions, videotape vignettes, fantasy play, and instruction, as well as role-playing, puppets, and arts projects. Teachers give children homework assignments to practice skills at home, and constantly provide children with feedback, reinforcement, and praise. The Dina Dinosaur curriculum emphasizes social and emotional competencies, and includes training in communication skills, peer relationships, problem-solving techniques, social skills, conflict resolution, and understanding parent and school supervision and discipline. The ultimate goal of the program is to provide children with alternatives to negative behavior by strengthening their social skills.

As of 2012, the initial cost for group leader training was $290; the cost for materials was $1595 for the BASIC curriculum, and $1995 for BASIC and ADVANCE.  Consultation for group leaders to become accredited was between $600-800.

EVALUATIONS OF PROGRAM

Numerous studies of IYS have been conducted.  The evaluations in Section A below, were conducted by the program developer.  Additional evaluations conducted on independent replications of IYS are in Section B below.

Section A: Studies Conducted by the Program Developer

Study A-1:

Webster-Stratton, C. (1982). Teaching Mothers Through Videotape Modeling to Change Their Children’s Behavior. Journal of Pediatric Psychology, 7(3), 279-294.

Evaluated population: Participants in the study included 35 mothers and their three- to five-year-old children.  On average, the mothers were 33 years old, had 4 years of college education, and had two children.  Socioeconomic status ranged from lower middle to upper middle class.  Study children included 23 boys and 12 girls, with an overall average age of four years.  Seventy-five percent of mothers had taken previous parent-education courses.  Sixty-nine percent were in parent cooperatives.  Over 66 percent of the sample said they were concerned with setting limits and handling misbehavior; 20 percent were concerned with sibling rivalry; eight percent with developmental issues; and six percent with communication ability.

Approach: A videotaped modeling group discussion program was designed to provide parents with a broad base of knowledge and skills for interacting and communicating with their children, and in handling their children’s behavior problems.

Behavioral, attitudinal, social, and demographic data were collected on all mothers and children at the beginning of the study.  On completion of these baseline data, the subjects were assigned at random to two experimental groups: Group A, the early treatment group, and Group B, the waiting-list control group.

After baseline data collection, Group A attended a series of four weekly two-hour videotape modeling discussion sessions which were conducted over four consecutive weeks, while Group B received no treatment.  Immediately after the program was completed, all subjects were retested on all measures.  Two weeks after data collection, Group B attended the same four-week program, while Group A received no further treatment.  All subjects were then retested, to determine immediate post-treatment results for Group B, and six-week follow-up results for Group A.

For the treatment program, both Groups A and B were randomly subdivided into two groups of eight or nine parents.  The videotape vignettes were shown to each group in approximately two-minute segments, following which the mothers discussed their observations.  One graduate student therapist with extensive group-work training conducted all four groups.  The therapist had a prepared script for each vignette, to ensure that the same content was discussed with all the groups, and also to allow for future replication studies.  Parents did not practice directly under supervision what they had observed on the videotapes, but were expected to put into practice what they had learned in their interactions with their children.

Data collection included a combination of parent reports, attitudinal measures, and direct observational data. Behavior observations were obtained by videotaping each mother-child pair for 30 minutes in a playroom via a one-way mirror.

Results: At the end of treatment, results showed a significant decrease in children’s negative affect behaviors and submissive behaviors, and a significant increase in children’s positive affect behaviors when the experimental group of children was compared with the control group.  Also, results showed that mothers in the experimental group reported significantly fewer and less intense behavior problems than the control group mothers.  Two months later, follow-up assessment indicated that the children’s behaviors continued to improve.  The study was subsequently replicated with the control group.  Results suggest that education of groups of parents using a videotape modeling program has powerful secondary effects in changing children’s behaviors.

Study A-2:

Webster-Stratton, C. (1984). Randomized trial of two parent-training programs for families with conduct-disordered children. Journal of Counseling and Clinical Psychology, 52(4), 666-678.

Evaluated population: The study participants consisted of parents of 35 children between the ages of three and eight, with an average age of five years.  Children had no debilitating physical impairments, intellectual deficits, or psychosis, but had screened positively for conduct disorder.

Approach: Children were randomly assigned to an individual therapy or a group videotape therapy condition.  Data were collected at baseline, three months after baseline, and one year after treatment.  For the one-year evaluation, data were collected from 31 of the original 35 families.

This program evaluation of parent-training for parents of children with conduct disorder examined whether IYS videotape-based training was as effective as working with an individual therapist under the IYS model.

Therapist-led programs include individual therapy, which uses direct feedback techniques such as live modeling, role plays, and behavioral rehearsals.  The videotape programs present vignettes of situations with children, and show how parents can resolve them. Both programs use a modified interactional model in the first four weeks, and in the last five weeks teach parents in the use of operant techniques.

The therapist-led program consisted of individualized sessions with a therapist, parent, and child. The therapist modeled parenting skills, and then parents would role-play the scenarios while therapists observed. The therapist-led program covered general scenarios and addressed the child’s specific behavior problems.

The videotape program consisted of groups of eight to10 parents who watched videotapes illustrating parenting skills.  The videos cover 180 possible scenarios, and show how parents resolved the scenarios. The participants watched the videos, and then engaged in discussions of the skills shown. In the videotape program, children did not attend.

Data were collected from multiple sources, including parents, teachers, and through observational measures.  Parents completed daily telephone reports of their child’s behaviors, the Eyberg Child Behavior Inventory, and the Achenbach Child Behavior Checklist.  Home observations were also collected on mother/child interactions following behavioral problems.  For the one year evaluation, teachers completed the Behar Preschool Questionnaire, and parents completed a questionnaire on attitudes towards the interventions.  The Behar Preschool Questionnaire was not used at other collection points because too few children had been in preschool at the other collection points.

Results: Results of the study indicate that there were improvements in both the videotape and individual therapy conditions in the number of behavior problems children experienced. These results were evident at the one-year follow up.  Overall, there were no differences between the videotape and the individual therapy groups, indicating that both conditions were equally effective. When combining the treatment groups, treatment mothers reported significantly fewer behavior problems (p<.001), significantly more prosocial behaviors (p<.05), and significantly less use of spanking (p<.01) than mothers in the control condition.

The researchers stated that the one major difference between the two approaches is that the videotape condition is more cost-effective.

Study A-3:

Webster-Stratton, C., Kolpacoff, M., Hollinsworth, T. (1988). Self-Administered Videotape Therapy for Families With Conduct-Problem Children: Comparison With Two Cost-Effective Treatments and a Control Group. Journal of Consulting and Clinical Psychology, 56(4), 558-566.

Evaluated population: Parents of 114 conduct-problem children who met the following criteria: (a) child aged three to eight years; (b) the child had no debilitating physical impairment, intellectual deficit, or history of psychosis and was not receiving treatment at the time of referral; (c) the primary referral problem was child misconduct (e.g., noncompliance, aggression, oppositional behaviors) occurring for more than six months; and (d) parents rated their children as having a clinically significant number of behavior problems, according to the Eyberg Child Behavior Inventory.

Study children included 79 boys and 35 girls, with a mean age of four years and six months.  Study parents included 104 biological mothers and 70 biological fathers, 10 adoptive mothers, and 10 adoptive or stepfathers.

Approach: The 114 multi-problem families in the study were either self-referred (43 percent) or professionally referred (57 percent).  Parents were randomly assigned to one of four groups: those receiving an individually administered videotape modeling treatment (IVM), a group discussion videotape modeling treatment (GDVM), a group discussion treatment (GD), and a waiting-list control group. The parents were evaluated before the start of the program, and one month after, on their perceptions of children’s adjustment, through biweekly observations and reports of discipline used, on parenting stress level, and through independent observations of parent-child interactions in the home.  Teachers reported on children’s adjustment at school.  During intake, parents were asked to select, from a list,  those negative behaviorsthey felt were major problems, as well as those positive behaviors that would be particularly pleasing to them if performed by their child.  These individually tailored checklists were used as the basis for the phone calls that were conducted biweekly from the time of intake until the post-treatment assessment.

Home observations were conducted by eight extensively trained observers who were blind to the hypotheses and to the group membership of the subjects. When possible, fathers as well as mothers completed the parent report measures, but they were instructed to complete the questionnaires separately.  Due to practical limitations, only the mothers (with the exception of one single father) received the biweekly telephone calls.  For those children in daycare or school (n = 84), forms were sent to teachers to complete.  The teachers were not told that the children had behavior problems, but that their parents were participating in a child development study.

Parents assigned to the GDVM condition came to the clinic weekly for 10-12 two-hour sessions.  Each week, groups of 10-15 parents met with a therapist who showed them one of the 10 videotape programs of modeled parenting skills (approximately 250 vignettes, with 25 minutes of videotape per program).  After each presentation of a two-minute parent-child vignette, the therapist led a focused discussion of the important interactions and elicited parents’ reactions, ideas, and questions about the material.

IVM parents came to the clinic weekly for 10-12 self-administered sessions.   Each week a secretary provided them with a room and one of the 10 videotape programs to watch.  On average, weekly sessions lasted one hour.  IVM parents saw the same videotapes as the GDVM parents, but did not receive the therapist feedback and therapist-led group discussion.  GD parents came to the clinic weekly for 10-12 two-hour sessions.  They met in groups of 10-15 parents with a therapist who led a group discussion of the same topics covered in GDVM.  The only difference between GD and GDVM training was GDVM use of videotapes to illustrate content.

Waiting-list control group parents received no treatment, and had no contact with a therapist.  Parents did receive biweekly telephone calls concerning target child behaviors.  The callers did not offer any direct advice.  After waiting 12 weeks, control subjects were assessed a second time, and were then randomly assigned to one of the treatment conditions.

Each mother-child or father-child interaction was observed in the home for 30 minutes on two evenings during the week.  Whether the mother or father was observed first was randomly determined.

Results: Compared with the control group, all three treatment groups of mothers reported significantly fewer child behavior problems, more prosocial behaviors, and less spanking.  Fathers in the GDVM and IVM conditions, and teachers of children whose parents were in the GDVM and GD conditions, also reported significant reductions in behavior problems compared with control subjects.  Home visit data indicated that all treatment groups of mothers, fathers, and children exhibited significant positive behavioral changes, compared with those in the control group.  There were relatively few differences among treatment groups on most outcome measures, although the differences found consistently favored the GDVM treatment.  The only significant difference was that GDVM mothers reported a lower frequency of children’s behavior problems than did IVM mothers.  Cost effectiveness was the major advantage of the IVM treatment.

Study A-4:

Webster-Stratton, C. (1990). Enhancing the effectiveness of self-administered videotape parent training for families with conduct-problem children. Journal of Abnormal Child Psychology, 18(5), 479-492.

Evaluated population: Parents of 43 conduct-problem children aged three to eight years were studied to find out the impact on child behavior of videotape modeling treatment and therapist consultation.

Approach: Parents were randomly placed into one of three groups.  The individually administered videotape modeling treatment (IVM) group watched one parenting technique video per week.  The IVM plus therapist consultation (IVMC) group watched the same videos as the IVM group, and were told that they could call the therapist at any time over the 10 week video period to discuss any questions or concerns.  These parents were also scheduled for two individual one-hour meetings with the therapist.  Parents could discuss any family or video issues they chose.  The control group received no intervention.  After 12 weeks in the control group, these parents were assigned to one of the treatment groups.

Results: The videotape intervention was associated with improved maternal reports of children’s behavior, reduced maternal stress levels, and reduced use of daily spankings, compared with the control group.  The treatment groups also experienced significant reductions in child’s deviant behaviors.  Results for the fathers showed no significance, but trends paralleled the mothers’.  The IVMC group had significantly fewer no-opportunity commands, i.e., commands that gave the children the opportunity to say no, from the mothers and less deviant behavior from the children, compared with the IVM group.  There were no differences in parent reports of children’s behaviors, or parent satisfaction in the program between the two treatment groups.  The short period of time with the therapist may have limited the results, but it was necessary to keep the program cost-effective.

Study A-5:

Webster-Stratton, C. (1990). Long-term follow-up of families with young conduct problem children: From preschool to grade school. Journal of Clinical Child Psychology, 19(2), 144-149.

Evaluated population: This study examined the long-term impact of parent training programs with 134 parents of preschoolers with conduct problems.

Approach: Parents were randomly assigned to one of three groups.  The individually self-administered videotape modeling (IVM) group had 10-12 weekly meetings in which they individually watched a video about parenting practices.  The group discussion videotape modeling (GDVM) group saw the same videos, along with 10-12 weekly two-hour-long therapist-led group sessions with other parents to discuss the videos.  The group discussion (GD) treatment served as a comparison condition with the video program.  GD parents met weekly for 10-12 weeks in two-hour-long therapist-led group sessions with other parents, but were not shown any videos.  Pre- and post-treatment measures were taken, but this evaluation focused on the long-term (three year) follow-up data.  Parents and children were re-assessed at one year and three year follow-ups. The mean age of the children at the three-year follow-up was eight years.  Parents completed personal and child behavior surveys, along with interviews concerning drug use and mental illness in the family.

Results: All three treatment groups maintained their improvements in reported child behavior problems and prosocial behavior at the three-year follow-up.  Parents in the GDVM group had stable improvement, while GD and IVM groups reported a significant decrease in children’s externalization of problems from baseline to the three-year follow-up.  Parent and teacher reports indicated that maladjusted children were more likely to be from single-parent families.  Families still in need of help at the follow-up had higher rates of alcoholism, drug abuse, and depression in the family.

A notable limitation of this study was its lack of control group, which was not included in the design, because the children who were being treated were at high risk for conduct problems.  The authors cited ethical concerns based on previous evidence to suggest that the program would be effective in helping these children.

Study A-6:

Webster-Stratton, C. (1994). Advancing videotape parent training: A comparison study. Journal of Consulting & Clinical Psychology, 62(3), 583-593.

Evaluated population: This study examined the impact of a parent skills training program and video on 78 families with a child diagnosed as oppositional-defiant or conduct-disordered.

Approach: All parents watched a basic parent skills training video (group discussion videotape modeling: GDVM) in weekly sessions with 10 to 15 other parents.  After the video, a therapist led a discussion about the video and parenting skills.  Thirty-eight families were randomly selected to watch a less detailed video (ADVANCE).  Thirty-nine families were assigned to no additional treatment after the GDVM, and these families served as a control group for the ADVANCE program.  Families were assessed before and after treatment on measures of parent distress, child adjustment, and parent-child interactions.

Results: The ADVANCE group had moderately improved outcomes when compared with the GDVM group.  The ADVANCE group had significant improvements in parents’ problem-solving, communication, collaboration skills, and children’s problem-solving as compared to the GDVM group.  ADVANCE parents had higher satisfaction with their program than the GDVM parents.  At the short-term follow-up, there were no differences between the groups in marital satisfaction, anger, stress levels, or children’s behavior.  ADVANCE mothers had significantly increased marital communication and problem-solving skills, but no improvements in parenting skills or children’s behavior.  The ADVANCE fathers had increases similar to the mothers’ in marital communication and problem-solving skills, but also had improved parenting skills and reported increases in the child’s prosocial behavior.  The ADVANCE program seemed to increase parents’ prosocial knowledge, but not have an impact on the parents’ behavior.  A limitation of this study is that there is no way to determine what specific aspect of ADVANCE accounted for the difference between the groups.

Study A-7:

Webster-Stratton, C. Hammond, M. (1997).  Treating children with early-onset conduct problems: A comparison of child and parent training interventions.  Journal of Consulting and Clinical Psychology, 65(1), 93-109.

Evaluated Population: This study examined the impacts of child training and parent training, alone and in combination, for 97 children, between 4 and 7 years old, with clinically significant behavior problems.

Approach:  Familieswere randomly assigned to 1 of 4 groups: parent training (PT, n=26), a child training (CT, n=27), combined child and parent training (CT + PT, n=22), or a waiting-list control (CON, n=22).  The child training consisted of videotaped vignettes modeling behavior, fantasy play with life-size puppets, and discussion.  Parent training consisted of 17 videotape programs on parenting and interpersonal skills over the course of 22-24 weeks.  Detailed assessments of the interventions included parent reports of child behavior and of their own discipline, independent observations of children’s interactions with peers in the clinic playroom and with parents at home, independent observations of parents’ behaviors at home, assessments of children’s social and problem-solving skills, and consumer satisfaction.

Results:   Posttreatment assessments found significant improvements for all 3 treatment conditions compared with controls.  CT and CT + PT children showed significant improvements in problem solving as well as conflict management skills.  PT and CT + PT parents and children had significantly more positive interactions at home, compared with CT parents and children.  One-year follow-up assessments found that all the significant changes noted immediately posttreatment had been maintained over time.  Moreover, child conduct problems at home had significantly lessened over time.  Analyses of the clinical significance of the results suggested that the combined CT + PT condition produced the most significant improvements in child behavior at the 1-year follow-up.

Study A-8:

Webster-Stratton, C. (1998). Preventing conduct problems in Head Start children: Strengthening parenting competencies. Journal of Consulting & Clinical Psychology, 66(5), 715-730.

Evaluated population: This study examined the impact of a parenting skills training program and videotape with 394 Head Start mothers.

Approach: Nine Head Start centers were randomly chosen to participate in either a program using videotapes to teach parenting skills (PARTNERS), or regular Head Start programming.  Participants in the PARTNERS group were able to discuss the video with group leaders and other parents.  The families were assessed on measures of parenting and child behaviors, based on parent, teacher, and independent observer reports.

Results: All assessments found significant impacts on parenting competence for PARTNERS mothers compared with control-group mothers.  PARTNERS mothers showed significant increases in positive discipline, and decreases in critical parenting, while the control group showed no differences.  Teachers reported greater school involvement with the school from the treatment group, compared with the control group, but the mothers themselves did not report such an increase.  At the one-year follow-up, there was a decrease in parental involvement in kindergarten for both groups, compared with their previous involvement with Head Start.  At post assessment and one-year follow-up, PARTNERS children had significant decreases in researcher-observed negative behaviors, and significant increases in observed positive affect in parent interactions, compared with control children.  However, there were no no significant differences between the groups on maternal reports of child behavior .

Study A-9:

Webster-Stratton, C., Reid, M. J., & Hammond, M. (2001). Preventing conduct problems, promoting social competence: A parent and teacher training partnership in Head Start. Journal of Clinical Child Psychology, 30(3), 283-302.

Evaluated population: Two hundred seventy-two mothers and their four-year-old children from 14 Head Start centers participated in the study.  Fifty-two percent of the mothers were single parents, 84 percent were on a form of welfare, and 63 percent of the children were non-white.

Approach: The 14 Head Start centers were randomly assigned to experimental or control groups. Teachers from the experimental group centers participated in once a month training over the course of six months.  Family service workers completed a three-day training course. Data were collected at baseline, after the 12 week intervention, and one year after the intervention on positive and negative parenting, parent involvement in their child’s education, and child conduct problems at home. Data were also collected at pre-test and post-test, but not one year follow-up on child conduct problems at school and teacher classroom management.

Results: There were positive impacts at post-test on positive and negative parenting, parent involvement in their child’s education, child conduct problems at school, and teacher classroom management. There was a marginal positive impact on child conduct problems at home at post-test. At the one year follow-up, there were marginal positive impacts on positive parenting and child conduct problems at home. There was no impact on negative parenting, and there was a negative impact on parent involvement in their child’s education.

Study A-10:

Webster-Stratton, C., Mihalic, S., Fagan, A., Arnold, D., Taylor, T., Tingley, C. (2001). The Incredible Years: Parent, Teacher and Child Training Series. In D. S. Elliott (Ed.), Blueprints for Violence Prevention (Vol. 11). Boulder, CO: Venture Publishing.

This article/chapter presents and summarizes earlier studies.

Evaluated population: Families with children ages three to eight who are exhibiting or at risk for problem behaviors served as the sample. Sample sizes ranged from 35 to 426 families.

Approach: Evaluations of the IYS series have assessed varying combinations of the curricula. Studies have evaluated the BASIC program alone, the BASIC and ADVANCE programs combined, the BASIC, ADVANCE, SCHOOL, and TEACHER combination, as well as the CHILD program alone and in combination with the other four curricula. The number of conditions in a given study range from two to six, and may include the IYS combinations outlined above, as well as no treatment, individual therapy, a self-administered BASIC curriculum, Head Start services, or a group discussion component of the BASIC program.

The studies incorporate parent and teacher report on a variety of surveys, such as the Parent Attitude Survey, the Eyberg Child Behavior Inventory, and the Child Behavior Checklist. Some studies also include laboratory observations and mothers’ observations of parent and child behaviors. Measures include aspects of parental attitudes, discipline strategies, parent stress, parent-child interactions, child problem-solving skills, peer interactions, child behavior problems, attitudes and social behaviors, as well as social competence, teacher classroom management practices, and the parent-teacher relationship. Most evaluations include assessments at pre-test and upon program completion. Some include a follow-up between one and three years after the program.

Results: Taken together, results of the IYS evaluations have been very positive. Assessments of the parenting programs, BASIC, ADVANCE, and SCHOOL have shown improvements in parents’ constructive discipline strategies, monitoring, communication skills, school bonding, and parent-child interactions. The parenting programs have also been associated with a decrease in the use of harsh discipline, parental depression, and child conduct problems. Finally, the programs have reported increases in children’s compliance and cooperation skills.

The IYS teacher program has been found to decrease harsh discipline techniques, and increase pro-active classroom management skills. The teacher program has also been found to increase children’s cooperation with teachers, and improve school engagement and relations among students. Finally, the IYS teacher program has been shown to encourage bonding with parents and families, and reduce children’s aggressive behaviors toward peers.

The IYS child program has shown increases in children’s cognitive and academic abilities, as well as a significant improvement in social skills. The IYS child program has also been associated with a decrease in child problem behaviors, both at home and at school.

The evaluations outlined above were based on implementation of the IYS programs as they were originally designed (i.e., in entirety and in sequence). Attempts to compress and/or restructure the program components, due to challenges with scheduling, costs, and other logistical considerations, may not produce similar effects.

Study A-11:

Reid, M. J., Webster-Stratton, C., Hammond, M. (2003).  Follow-up of children who received the Incredible Years intervention for oppositional defiant disorder: Maintenance and prediction of 2-year outcome.  Behavior Therapy, 34(4), 471-491.

Evaluated Population: See description from Webster-Stratton, C., Reid, M. J., & Hammond, M. (2004).

Approach: Each family was randomly assigned to one of five different treatment conditions or a waitlist control condition.  Children in the Child Training only (CT) condition attended weekly two-hour group sessions with a therapist for 22 weeks.  In the Parent Training only (PT) condition, parents attended two-hour sessions with a therapist in groups of 10-12, for a period of 22-24 weeks.  In the PT + Teacher Training (TT) condition, the families’ children’s teachers attended four full days of training sessions throughout the school year with professional trainers, and families received the parent treatment.  The CT + TT treatment was a combination of Child Treatment and Teacher Training, and the CT + TT + PT was a combination of all possible treatments.  Measures were taken directly before and after treatment, and at follow-up intervals of one and two years.

Results:  Immediately after the treatment, children in all CT conditions showed more prosocial skills than the control-group children.  Children’s negative behavior with fathers was less in all PT conditions, compared with those in the control group.  Children’s negative behavior with mothers was less in all treatment conditions than in the control group.  Likewise, children in all treatment conditions displayed fewer negative behaviors at school, compared with children in the control group.  Children in the CT and PT + CT + TT conditions displayed more positive behavior with peers, compared with children in the control group.  Except for the school behavior of children in the PT + CT + TT condition, all findings were maintained at the one-year follow-up period.  At the two-year follow-up, all of the findings reported at the one-year follow-up were maintained.  In addition, the researchers performed comparisons between treatment groups.  Children in the PT + TT group displayed fewer behavior problems at home, compared with children in the PT-only group.  There were no differences between treatment groups on measures of conduct problems at school.

Mothers in all of the treatment conditions displayed fewer negative and more positive parenting behaviors than mothers in the control condition at post-treatment.  Fathers in all of the PT conditions displayed fewer negative parenting behaviors than fathers in the control condition.  Fathers in the PT and PT + CT + TT conditions displayed more positive parenting behaviors when compared with those in the control condition.  These changes were all maintained at the one-year follow-up.  Most impacts were maintained at the two-year follow-up as well.  Mothers in the CT and CT +TT conditions were no longer displaying better parenting behaviors when compared with mothers in the control group.  Likewise, fathers in the PT + CT +TT condition were no longer displaying better parenting behaviors when compared with fathers in the control group.

Overall, the strongest effects were found for the Parent Training component of the program, especially for child behavior in the home.  Teacher Training enhanced the treatment effects of both the Parent Training and Child Training programs.  All treatment conditions were found to have positive impacts on at least four of the nine measures.

Study A-12:

Webster-Stratton, C., Reid, M. J., Hammond, M. (2004).  Treating children with early-onset conduct problems: Intervention outcomes for parent, child, and teacher training.  Journal of Clinical Child and Adolescent Psychology, 33(1), 105-124.

Evaluated Population:  One hundred fifty-nine children, ages four to eight, who were diagnosed with Oppositional Defiant Disorder (ODD), were the sample for this study.  To be included in the study, children had to have no debilitating physical impairment or intellectual deficit.  Children also had to have no history of psychosis and be receiving no psychological treatment.  Parents of the children had all reported clinically significant problems with the children on the Eyberg Child Behavior Inventory (ECBI), and the primary referral problem in all cases was child conduct related.  Ninety percent of participants were male, and 79 percent were Caucasian.

Approach: Families were randomly assigned to one of five treatment conditions, or a waitlist control condition. The treatment conditions were Child Training only (CT), Parent Training only (PT), Parent Training and Teacher Training (PT + TT), Child Training and Teacher Training (CT +TT), and Parent Training, Child Training, and Teacher Training (PT + CT + TT). Data were collected through observations in the home and at school, and via parent reports at baseline, post-test, and one-year follow-up on positive and negative parenting, child conduct problems at home and at school, child social competence with peers, and teacher classroom management.

Results:

Parent Training only (PT:) At post-test, PT had positive impacts on mothers’ and fathers’ negative parenting, mothers’ and fathers’ positive parenting, child conduct problems with mothers and with fathers, and child conduct problems at school.

Child Training only (CT): At post-test, CT had positive impacts on mothers’ negative parenting, child conduct problems with mother, child social competence with peers, child conduct problems at school, and teacher negative classroom management.

Parent Training and Teacher Training (PT+TT): At post-test,  PT + TT had positive impacts on mothers’ and fathers’ negative parenting , mothers’ positive parenting, child conduct problems with mother  and with father, child conduct problems at school, and teacher negative classroom management.

Child Training and Teacher Training (CT+TT): At post-test, CT + TT had positive impacts on mother’s negative parenting, child conduct problems with mother, child conduct problems at school, and teacher negative classroom management, and had a marginally positive impact on child conduct problems with father, and child social competence with peers.

Parent Training, Child Training, and Teacher Training (PT+CT+TT): At post-test, PT +CT + TT had positive impacts on mothers’ and fathers’  negative parenting, mothers’ positive parenting, child conduct problems with mother and with father, child social competence with peers, child conduct problems at school, and teacher negative classroom management.

Comparisons between outcomes at post-test, and at one-year follow-up, revealed no differences, indicating maintenance of improvements, except for the outcome of child conduct problems at school, which increased for the PT + CT + TT group.

Study A-13:

Webster-Stratton, C., Reid, M. J., Stoolmiller, M. (2006).  Preventing aggression and improving social, emotional and academic competence: Evaluation of Dina Dinosaur classroom curriculum in high risk schools.  Unpublished manuscript, University of Washington.

Evaluated Population: One hundred twenty Head Start, kindergarten, and first grade classrooms from 14 elementary schools in Seattle were the sample for this study.  The schools served a low-income population ;59 percent of children at the schools participated in free or reduced-price lunch programs.  There were a total of 1,746 students in the study.  Students were 50 percent male .  Students ranged in age from three to eight. Twenty-six percent were Caucasian, 20 percent were Asian, 18 percent were African-American, and 18 percent were Hispanic.

Approach:  Schools were randomly assigned toeither receive the program or to be in the control group.  Children participated in the Incredible Years Dinosaur program, while teachers participated in 28 hours of classroom management training. Control schools were not given any additional services, and continued with their usual Head Start, kindergarten, and first grade curricula.

Results: Teachers in the intervention condition were rated by observers as less critical and more consistent, warm, and nurturing compared with teachers in the control group.  Teachers in the intervention condition also spent more time than teachers in the control condition teaching social and emotional skills.  Teachers in the intervention group reported feeling more bonded with parents than teachers in control classrooms.  Lastly, teachers and parents reported high levels of satisfaction with the program and teachers also reported that the program was easy to implement in the classroom.

Students in the intervention classrooms improved on measures of school readiness, cooperation, concentration, emotional regulation, and social skills compared with students in control classrooms.  The size of the program’s impact was much greater for children with high-risk for negative behavior and children with poor social health.  Children in intervention classrooms displayed fewer negative behaviors and more in engagement in classroom activities when compared with children in the control condition.

Section B: Independent Replications

Study B-1:

Patterson, J., Barlow, J., Mockford, C., Klimes, I., Pyper, C., Stewart-Brown, S. (2002). Improving Mental Health Through Parenting Programmes: Block Randomised Controlled Trial. Archives of Disease in Childhood, 87, 472-477.

Evaluated population: One hundred and sixteen parents of children, aged two to eight years, who scored in the upper 50 percent on a behavior inventory, participated in this study.

Approach: The parents were randomized to a 10-week parenting program delivered by trained health visitors, or no intervention.  Children already receiving treatment for behavior problems, and those with learning difficulties, were excluded.  The main outcome measures were child behavior, general health, parenting stress, and parents’ self esteem and mental health.  These outcomes were measured before and immediately after the intervention, and at six-month follow-up.  The program comprised sessions lasting about two hours each, once a week for 10 weeks.  The activities included video vignettes of parent-child interactions, group discussion, role play, rehearsal of parenting techniques, and home practice.  The techniques covered included play and positive interaction with the child, giving clear commands, limit setting, ignoring undesirable behavior, praising and rewarding desirable behavior, and following through on discipline.  Four of the programs were run at a health center in the evenings.  The other two programs were run at a local community center in the daytime, one in the morning (with childcare available), and the other in the afternoon.  Each group was run by at least one health visitor, with either a second health visitor or a nursery nurse as co-leader, all of whom had received three days of training from the Family Nurturing Network in Oxford.  The group leaders received weekly supervision meetings as a group during the delivery of the programs, to provide support and ongoing training, and ensure equivalence of the six intervention programs and integrity of program delivery compared with the instruction manual.  The control group parents received no treatment.

Results: The program had a greater positive impact on some aspects of the children’s mental health, notably conduct problems, than did the no intervention control condition.  Problem conduct was reduced at the end of the program, and at the six- months follow-up, and the number of behavior problems was reduced at six months.  The intervention also had a short-term impact on social dysfunction among parents.  These benefits were seen among families with children scoring in the clinical range for behavior problems, and also among children scoring in the non-clinical (normal) range.

Study B-2:

Gardner, F., Burton, J., Klimes, I. (2006).  Randomised Controlled Trial of a Parenting Intervention in the Voluntary Sector for Reducing Child Conduct Problems: Outcomes and Mechanisms of Change.  Journal of Child Psychology and Psychiatry, 47(11), 1123-1132.

Evaluated population: Seventy-six British children and their families served as the study sample for this investigation.  All children were between the ages of two and nine, had been referred for help with conduct problems, and scored above the clinical cutoff on the Eyberg problem scale.  A high proportion of subjects were boys living in poverty, with a single parent showing signs of depression.

Approach: Families were randomly assigned to an Incredible Years parenting group in their area, or to a wait-list control group.  Parenting groups took place at nine charity sites across England.  Groups consisted of 10-12 parents and met for two hours every week for 14 weeks.  Parents were encouraged to attend, as were grandparents and parents’ partners.  Children were not present for parenting group sessions.

Assessment sessions took place pre-intervention, immediately following the intervention, and one year after the intervention.  At each session, parent-child interactions were video-recorded, in six structured settings in the home.  Settings involved varying degrees of task demand and parental attention.  Tapes were coded both for parent behavior and child behavior.  Parents also completed measures assessing their parenting skill and their children’s behavior.

Results: Immediately following the intervention, children of parents assigned to the Incredible Years parenting groups had significantly improved their behavior, relative to children of parents assigned to the control group.  Intervention children were observed engaging in negative behavior less frequently, and scored lower on the Eyberg problem and intensity scales.  Intervention children were also observed engaging in independent play more frequently.  Effect-sizes were medium to large.

Parents assigned to Incredible Years groups were less likely to use negative parenting strategies and more likely to use positive strategies immediately following the intervention, relative to parents assigned to the control group.  Especially substantial improvement occurred on measures of reactive, harsh, or coercive parenting.  Intervention parents felt more competent in their role as parents, but did not derive greater satisfaction from being a parent, nor did they feel less depressed.

Comparisons were not made between treatment and control groups at 18-month follow-up, because, at this point, the control group had also participated in the Incredible Years program.  Non-experimental evidence suggests, however, that behavioral and parenting changes observed immediately after the intervention persisted into the next year.  On all measures, no significant changes occurred during the year following the intervention.

Study B-3:

Brotman, L.M., Klein, R.G., Kamboukos, D., Brown, E.J., Coard, S.I, Sosinsky, L.S. (2003). Preventive Intervention for Urban, Low-Income Preschoolers at Familial Risk for Conduct Problems: A Randomized Pilot Study.  Journal of Clinical Child and Adolescent Psychology, 32(2), 246-257.

This study was intended to determine the feasibility of recruiting and engaging in an Incredible Years program urban families with an antisocial family member .

Evaluated population: Thirtychildren between the ages of 2½ and 5 years with an antisocial family member, i.e., with a criminal record, or a diagnosis of either conduct disorder or oppositional defiant disorder. The final sample of 30 preschoolers was two-thirds African American and one-third Hispanic, and 63 percent were male. Twenty-seven percent had a history of residing in a homeless shelter, and 67 percent did not reside with both biological parents at baseline. The mean age was 44 months for children, and 36 years for mothers in the final sample. Of the family members with a history of antisocial behavior, 20 were siblings of the child, five were fathers, and five were either cousins or uncles. Sixteen families were randomly assigned to receive the program, and 14 to the control group, which received no services.

Approach: Families were recruited from three sources: a) family court records of adjudicated-guilty youth, b) a pediatric psychiatry outpatient clinic for disruptive behavior disorders, and c) aftercare services for first-time adult offenders.  Fifty families were identified and deemed eligible for the study. Thirty eligible families (60 percent) provided informed consent and completed the assessment battery.  The goal of the evaluation was to understand whether the intervention improved parenting behaviors and prevented behavior problems among preschool children.  Outcomes were assessed at baseline, at the end of the intervention, and at a six-month follow-up.  Parent behaviors were assessed using videotaped parent-child interaction sessions that were coded using the Global Impressions of Parent-Child Interactions (GIPCI), and the Dyadic Parent-Child Interaction Coding System (DPICS). Child behavior problems were assessed by the parent with the age-appropriate Child Behavior Checklist (CBCL). All of the families receiving the program, and 14 families in the control group (88 percent), were assessed at the end of the program.

Results: The study found adequate levels of attendance at group and home-based sessions, as well as satisfaction with program content and program delivery strategies.  The study found that receiving the program had a moderate impact on externalizing behaviors, with behaviors decreasing over time among children who participated in the intervention, while behaviors increased for children in the control group.  There were no differences in internalizing behaviors over time for either group.  Study parents receiving the program displayed an increase in positive parenting practices, while parents in the control group displayed a decrease.  Parents in both groups displayed an increase in negative parenting behaviors.

Six months after the end of the program, 14 intervention families (88 percent) and six control families (43 percent) participated in a follow-up assessment.  The results of the follow-up were inconclusive, due to the small number of parents from the control group who participated.

Study B-4:

Brotman, L.M., Gouley, K.K., Chesir-Teran, D., Dennis, T., Klein, R.G. (2005). Preventive for preschoolers at high risk for conduct problems: immediate outcomes on parenting practices and child social competence. Journal of Clinical Child & Adolescent Psychology, 34(4), 724-734.

This study is a follow-on to Study B-3 above, with a new sample of preschool-age siblings of antisocial youths.

Evaluated Population:  Ninety-nine preschool-age siblings of adjudicated youths and their families were randomly assigned to an enhanced version of IYS (n=50), or to a no-intervention control group (n=49).  The sample included 92 families.  Of the adjudicated youths, 49 lived at home.  Eighty-three percent of the caregivers were the preschoolers’ biological mothers.  Parents’ average age was 36.3 years; 61 percent were African American and 24 percent were Hispanic.  Preschoolers were on average 3.9 years old, 53 percent were boys, and 43 percent were not enrolled in any out-of-home programs.  Nearly half of the parents had not completed high school, and 59 percent of the families had household incomes under $15,000.

Approach:   This evaluation examined immediate impacts on parenting practices and children’s behavior with peers: (a) harsh disciplinary practices and criticism, (b) praise and reinforcement for prosocial behaviors, (c) cognitive stimulation for learning, and (d) child social competence.  Five cohorts were enrolled over 5 years. Families were randomized to the program and control groups after baseline assessments. At baseline, parents ultimately slated to receive the program were observed to be statistically significantly more negative, and their self-ratings on use of praise were significantly higher than those in the control group.  The baseline assessment involved three visits, and the assessment at the end of the program (8-10 months later) involved two visits.  Parents receiving the program received reimbursement for travel, $100 for completing the baseline assessment, and $50 for completing the end of program assessment.  Parents in the control group received $5 for completing monthly telephone interviews. The prevention program included 22 weekly 2-hour group sessions for parents and preschoolers, ten biweekly home visits, and up to six additional home visits.  Parenting groups used the Parent Program (Basic Preschool Version) from IYS.  Groups for preschoolers incorporated elements from the IY Dinosaur Social Skills and Problem-Solving Curriculum. The immediate outcomes of interest were harsh disciplinary practices and criticism; praise and reinforcement for prosocial behaviors; cognitive stimulation for learning; and child social competence.  Data for parenting practices were collected by observation and self-rating, and child behavior data were collected by observation.

Results:  The evaluation found statistically significant impacts on negative parenting (ES=0.17), parental stimulation for learning (ES=0.09), and child social competence with peers (ES=0.06).

Study B-5:

Brotman, L. M., Gouley, K. K., Huang, K., Rosenfelt, A., O’Neal, C., & Klein, R. G. (2008). Preventive intervention for preschoolers at high risk for antisocial behavior: long-term effects on child physical aggression and parenting practices. Journal of Child & Adolescent Psychology, 37(2), 386-396.

This study is a follow-up to Study B-4 above.

Evaluated Population: Same as in Study 2 immediately above.

Approach: The children were randomly assigned to either the program or to the control condition. The control group and treatment group were not significantly different by race, age, initial parenting style, poverty, or parents’ high school completion.

Children and parents each attended 22 sessions including parenting strategy practice, parent-child interaction, and coaching over six to eight months.  After the initial 22 sessions, they attended 15 hours of “booster sessions.”  The booster sessions were offered to maintain and reinforce skills learned in the original sessions.

Participants were assessed four times, at eight-month increments, over 24 months.  At each time point, the assessments were the same, and interviewing staff were unaware whether the child was in the treatment or control group.  Between times one and two, the intervention took place.  Between times two and three, the booster sessions took place, and no interventions took place between times three and four.

At each time point, the study staff measured observed child physical aggression, parent-rated child physical aggression, and parenting practices.  Raters watched semi-structured parent-child interactions at the home and study center, to obtain a measure of observed child physical aggression.  In both settings, the Dyadic Parent-Child Interaction Coding System-Revised was used to record behaviors.

To rate child physical aggression, parents completed a staff-administered survey.

Parenting practices were measured using three subscales: harsh parenting, responsive parenting, and stimulation for learning. The three scales were based on the ten-minute, parent-child interactions in the home.

Results: The treatment had a significant impact, in the intended directions, on parents’ responsive parenting, harsh parenting, and stimulation for learning. By time four, the program had a significant impact on observed child physical aggression during parent-child interactions. The intervention did not have a significant effect on parent-rated child physical aggression. At time three, there were significant intervention impacts for all three parenting-practice scales (responsive, harsh, stimulation for learning). Stimulation for learning was not measured at time four, but intervention and control groups were significantly different on responsive parenting.

SOURCES FOR MORE INFORMATION

References

A-1 Webster-Stratton, C. (1982). Teaching Mothers Through Videotape Modeling to Change Their Children’s Behavior. Journal of Pediatric Psychology, 7(3), 279-294.

A-2 Webster-Stratton, C. (1984). Randomized trial of two parent-training programs for families with conduct-disordered children. Journal of Counseling and Clinical Psychology, 52(4), 666-678.

A-3 Webster-Stratton, C., Kolpacoff, M., Hollinsworth, T. (1988). Self-Administered Videotape Therapy for Families With Conduct-Problem Children: Comparison With Two Cost-Effective Treatments and a Control Group. Journal of Consulting and Clinical Psychology, 56(4), 558-566.

A-4 Webster-Stratton, C. (1990). Enhancing the effectiveness of self-administered videotape parent training for families with conduct-problem children. Journal of Abnormal Child Psychology, 18(5), 479-492.

A-5 Webster-Stratton, C. (1990). Long-term follow-up of families with young conduct problem children: From preschool to grade school. Journal of Clinical Child Psychology, 19(2), 144-149.

A-6 Webster-Stratton, C. (1994). Advancing videotape parent training: A comparison study. Journal of Consulting & Clinical Psychology, 62(3), 583-593.

A-7 Webster-Stratton, C. Hammond, M. (1997).  Treating children with early-onset conduct problems: A comparison of child and parent training interventions.  Journal of Consulting and Clinical Psychology, 65(1), 93-109.

A-8 Webster-Stratton, C. (1998). Preventing conduct problems in Head Start children: Strengthening parenting competencies. Journal of Consulting and Clinical Psychology, 66(5), 715-730.

A-9 Webster-Stratton, C., Reid, M. J., & Hammond, M. (2001). Preventing conduct problems, promoting social competence: A parent and teacher training partnership in Head Start. Journal of Clinical Child Psychology, 30(3), 283-302.

A-10 Webster-Stratton, C., Mihalic, S., Fagan, A., Arnold, D., Taylor, T., & Tingley, C. (2001). The Incredible Years: Parent, Teacher and Child Training Series. In D. S. Elliott (Ed.), Blueprints for Violence Prevention, 11. Boulder, CO: Venture Publishing.

A-11 Reid, M. J., Webster-Stratton, C., Hammond, M. (2003).  Follow-up of children who received the Incredible Years intervention for oppositional defiant disorder: Maintenance and prediction of 2-year outcome.  Behavior Therapy, 34(4), 471-491.

A-12 Webster-Stratton, C., Reid, M. J., Hammond, M. (2004).  Treating children with early-onset conduct problems: Intervention outcomes for parent, child, and teacher training.  Journal of Clinical Child and Adolescent Psychology, 33(1), 105-124.

A-13 Webster-Stratton, C., Reid, M. J., Stoolmiller, M. (2006).  Preventing aggression and improving social, emotional and academic competence: Evaluation of Dina Dinosaur classroom curriculum in high risk schools.  Unpublished manuscript, University of Washington.

B-1 Patterson, J., Barlow, J., Mockford, C., Klimes, I., Pyper, C., Stewart-Brown, S. (2002). Improving Mental Health Through Parenting Programmes: Block Randomised Controlled Trial. Archives of Disease in Childhood, 87, 472-477.

B-2 Gardner, F., Burton, J., Klimes, I.  (2006).  Randomised Controlled Trial of a Parenting Intervention in the Voluntary Sector for Reducing Child Conduct Problems: Outcomes and Mechanisms of Change.  Journal of Child Psychology and Psychiatry, 47(11), 1123-1132.

B-3 Brotman, L.M., Klein, R.G., Kamboukos, D., Brown, E.J., Coard, S.I, Sosinsky, L.S. (2003). Preventive Intervention for Urban, Low-Income Preschoolers at Familial Risk for Conduct Problems: A Randomized Pilot Study. Journal of Clinical Child and Adolescent Psychology, 32(2), 246-257.

B-4 Brotman, L.M., Gouley, K.K., Chesir-Teran, D.,  Dennis, D.,  Klein, R.G., Shrout, P. (2005).  Prevention for Preschoolers at High Risk for Conduct Problems: Immediate Outcomes on Parenting Practices and Child Social Competence.  Journal of Clinical Child and Adolescent Psychology, 34(4), 724–734.

B-5 Brotman, L.M., Gouley, K.K., Huang, K., Rosenfelt, A., O’Neal, C., Klein, R.G.,  Shrout, P. (2008).  Preventive Intervention for Preschoolers at High Risk for Antisocial Behavior: Long-Term Effects on Child Physical Aggression and Parenting Practices.  Journal of Clinical Child & Adolescent Psychology, 37(2), 386–396.

Website: http://www.incredibleyears.com/

Manual is available

Contact:

Laurie Miller Brotman

NYU Child Study Center

215 Lexington Avenue, 1411

New York, NY 10016

Email: laurie.brotman@nyumc.org

KEYWORDS: Toddlers, Children, Preschool, Males and Females, High-Risk, Black/African American, Hispanic/Latino, Urban, Clinic/Provider-based, Home-based, Home visitation, Parent or Family Component, Parent Training/Education, Skills Training, Conduct/Disruptive Disorders, Social Skills/Life Skills, Parent-Child Relationship

Program information last updated 4/23/15.

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