Program

Nov 28, 2007

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.

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.

 

KEYWORDS: Children, Preschool, Co-ed, Conduct/Disruptive Disorders, Clinic/Provider-Based, Counseling/Therapy, Parent or Family Component, Family Therapy, Parent Training/Education, Other Behavior Problems, Manual is Available

Program information last updated 11/28/07

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