positive parenting program - nzaba · 2010-09-07 · discipline styles of … ylaxness (permissive...
TRANSCRIPT
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J. Huxtable, T. M. Foster, & C. Barber University of Waikato
NZABAUniversity of CanterburyChristchurch, 3 ‐ 5th Sept, 2010
The Positive Parenting ProgramTriple‐P is a behaviourally‐based parent training Triple P is a behaviourally based parent training programme that is supported as effective by data
It is designed to be tailored to the needs of parents, and has various levels of training and support
See http://www31.triplep.net/?pid=42
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Triple‐PThe Triple‐P organisation offers training programmes p g g p gand support world wide, providing seminars and a competency‐based accreditation process for those it has trainedAmongst the resources available are:
a self‐help book ‐ Every parent’s Self‐help Workbook(Markie‐Dadds, Sanders & Turner, 2007)a DVD Every Parent’s Survival Guide (Sanders, Markie‐Dadds & Turner, 2008)
Together these can provide a “self‐help” package for parents
AimTo assess the effects of this version of self‐help Triple‐P p pon parenting behaviour and child behaviour for parents who are concerned about their preschooler’s behaviour when they is minimal contact with the researcherThe Triple‐P programme aims to
decrease problem behaviours, pincrease pro‐social (good) behaviours and increase the parents’ knowledge, competence and use of effective behaviour strategies (i.e., the parenting practices)
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IssuesDifficulties in evaluating a ‘self‐help’ programmesDifficulties in evaluating a self help programmes
e.g., any data collection the participants are aware of can alter both the data and whether the participants complete (or even start) the program
There are data that show this… and these issues can’t be avoided … particularly if you
d l l b l dwant to try and use a multiple‐baseline design …We used self reported data and tried to keep the researchers contact as minimal as possible while still being able to collect the data …
Methods and MeasuresThere was minimal researcher contact with the There was minimal researcher contact with the families and no advice or feedback was offered to participants when the families were contacted and no incentives were offered for participation
Data on child behaviour was collected by the families using Parent Daily Report checklist covering the types of behaviour that occurred and filled in every weekday Data on parenting strategies came from checklists the parents filled in weekly
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Parent Daily Report Parents indicate if each 30 problems occurred in the last 3 pday … examples are …
1 Aggressiveness, hit ADULTS2 Argued, back‐talked ADULTS3 Bedwetting, wet pants, soiled4 Was competitive C l i d i i bl i5 Complained, was irritable, negative6 Was defiant, non‐compliant, didn’t listen7 Was destructive, purposefully damaged something8 Physically fought with other CHILDREN
Parent Daily Report They also indicate which of 30 good things happened at y 3 g g ppleast once… such as …
1 Accepted disappointment well2 Accepted punishment3 Used appropriate language 4 Complied to requests (minded) S id hi k h hild f l d5 Said something to make another child feel good6 Was co‐operative with other CHILDREN7 Spoke nicely to other ADULTS 8 Played nicely with other CHILDREN
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Parent Daily Report Parent Daily Report (PDR) is a partial‐interval y p ( ) precording system with the interval 24 hours long!
Can massively underestimate high rate problems and good behaviours – and has a measurement ceiling ‐but parents WILL fill it in (most times!)
There are two ‘scores’ From 0 to 30 for ‘problems’ From 0 to 30 for ‘good’ behaviour
Parenting Strategies Checklist PSC asks ‐How often in the last week did you use any PSC asks How often in the last week did you use any of the following strategies?
It lists both appropriate and inappropriate strategies
And says “The following is a list of 18 things that And says The following is a list of 18 things that parents/caregivers sometimes do when their child/tamaiti misbehaves (that is, does something s/he is not supposed to do) ”
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Parenting Strategies Checklist, e.g.,STRATEGY Never 1-3
Times4-6 Times
7-9 Times
10+ Times
1. Raised your voice (growled, scolded or yelled)
2. Noticed it but did not do anything about it
3 Ignored the behaviour on purpose to3. Ignored the behaviour on purpose to not give attention to it.
4. Threatened to punish him/her (but did not really punish him/her).
5. Gave several warnings for an incident of misbehaviour
Parenting Strategies ChecklistNext it gives a list of both appropriate and inappropriate
i f d b h i d l l strategies for good behaviour and also some general strategies
The following is a list of 11 things parents might do when their child/tamaiti behaves well or does a good job at something.☺
and
These are 3 other strategies that parents use that effect their child’s behaviour
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Parenting Strategies Checklist, e.g.,STRATEGY Never 1-3
Times4-6 Times
7-9 Times
10+ Times
1. Noticed it but did not do anything about it2. Let them stay up late
3. General praise – e.g. “good boy”
4. Praise that describes the behaviour, h “I ll lik d hsuch as “I really liked the way you
listened to me straight away and put the toys in the box like I asked” 5. Gave your child a hug, kiss, pat, handshake or “high five.”6. Told them wished their brother/sister behaved as well as they did
Other strategies … STRATEGY
12. Gave your child a treat and made him/her promise to be good before any misbehaviour happened. e.g., giving your child lollies before you have a visitor.13. Spent time with your child playing or doing fun things throughout the day. 14. Behaviour ChartsGive points or stars on a chartDo you have a behaviour chart – yes/no
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Regular EvaluationAfter each of the ten sections of the book was completed pthere was an evaluation questionnaire for that and for any accompanying DVD segment
Participants ranked six statements on a scale from 0 (not at all) to 10 (very much)
These statements assessed whether the particular weekly section provided useful skills and important ideas, their intention to use the skills/techniques, the helpfulness of watching the DVD clip, and their enjoyment of the reading and DVD.
Pre‐ and Post‐Measures The Eyberg Child Behavior Inventory (ECBI) (Eyberg & The Eyberg Child Behavior Inventory (ECBI) (Eyberg & Pincus, 1999)The Parenting Scale (PS) (Arnold et al., 1993)The Parenting Sense of Competence Scale (PSoC)(Gibaud‐Wallston & Wandersman, 1978)The Triple P Parenting Quiz (Morawska et al., 2009)p g Q 9The Parent Consumer Satisfaction Questionnaire (Forehand & McMahon, 1981).
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The Eyberg Child Behavior InventoryECBI (Eyberg & Pincus, 1999) assesses parental ECBI (Eyberg & Pincus, 1999) assesses parental perceptions of disruptive behaviour in children aged 2 to 16 years old
The Intensity score is derived by parents rating how often each of the 36 behaviours listed is currently occurring, on a 7‐point likert scale, with 1 (never) to 7 (always) (always). The Problem score counts how many of the 36 behaviours the parents consider to be a problem (yes‐no) with their child
The Parenting ScalePS (Arnold et al., 1993) is a 30‐item self‐report ( , 993) 3 pquestionnaire that assesses the dysfunctional discipline styles of …
Laxness (permissive parenting), Overreactivity (authoritarian discipline) and Verbosity (overly long reprimands or explanations)
Each item has two anchor points ‐ ineffective and ff i di i li effective discipline. Parents rate which point, on a 7‐point scale between these anchors, best fits their discipline practices Higher scores = greater dysfunctional parenting.
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Parenting Sense of Competence ScalePSoC scale (Johnston & Mash, 1989) is a 17‐item PSoC scale (Johnston & Mash, 1989) is a 17 item questionnaire that assesses competence on two scales
Satisfaction with the parenting role (frustration, anxiety, motivation) &Feelings of Efficacy as a parent (problem solving ability, capability in the parenting role)
Parents rate their level of agreement with a statement on ga 5‐point likert scale Higher scores indicate greater confidence in their performance as a parent
The Triple‐P Parenting Quiz
A 30‐item multiple‐choice questionnaire that assesses knowledge of effective parenting strategies that are promoted in the Triple P programme (Morawska et al., 2009)
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The Depression Anxiety Stress ScaleDASS (Lovibond & Lovibond, 1995) is a 42‐item DASS (Lovibond & Lovibond, 1995) is a 42 item questionnaire that measures symptoms of depression, anxiety and stress in adults over the past week.
Uses a 4‐point scale from “did not apply to me” (0) to “applied to me very much or most of the time” (3). Scores on each of the three subscales range from 0 to 42, corresponding to a range from Normal to Extremely corresponding to a range from Normal to Extremely Severe.
The Parent Consumer Satisfaction Questionnaire
PCSQ (Forehand & McMahon, 1981) was adapted for this Q 9 pstudy to fit with the techniques taught in this programme
38‐items rated on a 7‐point likert scale with 7 the most positive responseThese items cover parent’s perceptions of
the programme overall, child behaviour improvement, difficulty and usefulness of the treatment format, d cu ty a d use u ess o t e t eat e t o at,and the difficulty and usefulness of the specific parenting techniques that were taught
also allowed responses regarding what parents liked most and least about the programme and how the programme could be improved.
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ParticipantsParticipants were caregivers of a child aged 2‐5 years who were
d b h hild’ b h i concerned about that child’s behaviour Recruited via posters at childcare centres, kindergartens, KohangaReo, medical centres, public libraries, supermarkets, and the university intranet and notice‐boards
Caregivers included if they wereable read the local newspaper and if to be the person who did the weekly exercises and readings consistently
l d d fCaregivers excluded if child had a diagnosis of developmental disability (e.g. Autism, Global Developmental Delay) or was currently receiving professional help behaviour they were not able to read the Waikato Times (a local newspaper) without assistance
DesignWas to be a series of multiple‐baseline designs over p gfamilies using PDR as the main measure and including pre‐ and post‐measuresEnded up a ‘non‐concurrent’ multiple‐baseline design
Ten families started baselineFive of these did everything (including pre‐ and post‐Five of these did everything (including pre and postmeasures)Two completed over half the programme but no post‐measuresThree withdraw early – due to ‘life’
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Participants
Final Timing
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BaselineFirst the pre‐measures were taken …Then given a week’s supply of the PDR and PSC in one envelope and an empty envelope for the completed checklists
Asked to fill the PDR in each weekday and put the completed one in the second envelopeContact made weekly (phone, e‐mail, post or in person) to collect or to arrange collection these and a new set was provided
PDR scores (problem and good behaviour) totals were plotted d d h d lland data paths were inspected visually
When both data paths were judged to be stable or to be trending in a direction opposite to the desired change the intervention began
InterventionThe elected caregiver was given:The elected caregiver was given:
the Triple‐P work book (with its 10 sections)the DVD (which was linked to each section)a Supplementary Materials Booklet
an introduction on how to use the programme and reproductions of the material (forms etc) in the workbook and the Evaluation Questionnaires for each section of the self help the Evaluation Questionnaires for each section of the self‐help workbook
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Results ‐ PDR
Results ‐ PDRGood Behaviour: t(4) = 5.79 (p<.05) Cohen’s d = 2.589Bad Behaviour: t(4) = ‐3.00 (p<.05) Cohen’s d = ‐1.343
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PSCThe use of effective strategies for managing misbehaviour g g gincreased over the weeks of the intervention
Ineffective strategies for managing misbehaviour were rarely reported and so there was a measurement floor (could not go lower)
The use of effective strategies for fostering good behaviour increased or reached the measurement ceiling (could go no higher)
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ECBI ‐ Problem and Intensity
DASS
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PS
PSoC
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Triple‐P Quiz
Evaluation of material
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Parenting technique ratings
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ConclusionsMost participants’ data ‐ both pre‐ and post‐measures and p p p pthe PDR scores in the multiple baseline ‐ suggested gains in the expected directions with medium to large effect sizes for most measures
These changes were seen in spite of the fact some of the measures had measurement ceilings or floors which reduced their sensitivity to changes (including the PDR reduced their sensitivity to changes (including the PDR, the PSC, the DASS and the Triple‐P Quiz)
Participants’ reported that their use of a range of effective behaviour management strategies increased
ConclusionsThe data suggest this self‐help intervention is The data suggest this self help intervention is acceptable and is effective, for these preschoolers, in:
reducing the use of ineffective discipline, and decreasing problem and increasing pro‐social behaviour (as reported by the PDR) and is also effective in increasing caregivers’ satisfaction and improving their view of their efficacy as parents
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ConclusionsThe data provide support for the efficacy of this self‐help p pp y pintervention for these families, with no ‘therapist’ help and carried out in as natural a setting as possible
However, we cannot say the result would have been the same if the data had not been being collected regularly and if the researcher had not been evaluating the caregivers impressions of the programmeimpressions of the programme
All these contacts provided social contingencies for at least reading the material and filling in the check lists
Also cannot be sure of the degree to which the behaviour recording was reliable or valid
Finally …
This intervention is accessible, cost‐effective, and appears to be beneficial for caregivers who are concerned about their preschoolers’ behaviour and who self‐select to undertake the self‐directed Triple P intervention