title: Prevention of behavior problems in a selected population: Stepping stones triple P for parents of young children with disabilities.
abstract: Because young children with disabilities are at elevated risk for development of challenging behaviors, and caregivers of these children typically lack access to evidence-based parenting interventions, two randomized trials were conducted to examine the impact of an evidence-based parenting intervention, Stepping Stones Triple P (SSTP), as a selective preventive intervention. Both studies targeted parents of children under two with a variety of disabilities who were enrolled in the IDEA Part C Early Intervention (EI) system in one state. SSTP was delivered in family homes. In Study One, 49 families were randomly assigned to EI services as usual, with or without SSTP; a 52% attrition rate from treatment was seen. No significant between-group differences were seen aside from a trend toward reduced symptoms of parental depression at follow-up. Intervention group children demonstrated significant decline in behavior problems from post treatment to follow-up, and there was a trend toward improved parenting style in the intervention group during this same time frame. Study Two incorporated a separate workforce intervention for EI service coordinators; 40 families on their caseloads were then randomly assigned to receive EI services as usual with or without SSTP. Attrition from treatment was limited to 20%. No differential impact was seen on child behavior; a trend was noted post-treatment on parent symptoms of depression and on the observed parent-child relationship. At 12-month follow-up, there was a trend favoring improvement in the intervention group in parenting style; statistically significant impact was also seen on the observed quality of the parent-child relationship. SSTP shows promise as a selective preventive intervention for an early intervention population. Reasons for the differential findings between the two studies are explored and suggestions for future research are provided.
authors.affiliation: University of South Carolina, United States. Electronic address: cshapiro@mailbox.sc.edu.
authors.forename: Cheri J
authors.initials: CJ
authors.lastname: Shapiro
authors.affiliation: South Carolina First Steps to School Readiness, United States.
authors.forename: Janice
authors.initials: J
authors.lastname: Kilburn
authors.affiliation: University of South Carolina, United States.
authors.forename: James W
authors.initials: JW
authors.lastname: Hardin
mesh_terms: D000328:Adult; D017028:Caregivers / Q000193:education / Q000523:psychology; D002653:Child Behavior Disorders / Q000517:prevention & control* / Q000523:psychology; D003863:Depression / Q000517:prevention & control / Q000523:psychology; D002658:Developmental Disabilities / Q000451:nursing / Q000523:psychology / Q000534:rehabilitation*; D019988:Children with Disabilities / Q000523:psychology / Q000534:rehabilitation*; D004314:Down Syndrome / Q000451:nursing / Q000523:psychology / Q000534:rehabilitation; D055317:Evidence-Based Practice; D005260:Female; D006699:Home Care Services; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D010287:Parent-Child Relations; D016487:Parenting; D010290:Parents / Q000193:education* / Q000523:psychology; D055815:Young Adult
keywords: Children; Disabilities; Evidence-based parenting intervention; Home-based intervention; Parenting; Randomized design