SuperKids!

SuperKid!

SuperParent,

Did you know?Conduct disorder is a major mental health problem for at least 10% of school-age children

Conduct disorder is a major mental health problem for at least 10% of school-age children

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It gets worseChildhood behavior disorders have been associated with later drug and alcohol abuse, family violence, crime, and psychiatric disturbance (Arnold, OLeary, Wolff, & Acker, 1993).

Without intervention, about half of children who have behavior problems during preschool will continue to have those problems even past adolescence (Connors, Edwards, & Grant, 2007).

Childhood behavior disorders have been associated with later drug and alcohol abuse, family violence, crime, and psychiatric disturbance (Arnold, OLeary, Wolff, & Acker, 1993).Without intervention, about half of children who have behavior problems during preschool will continue to have those problems even past adolescence (Connors, Edwards, & Grant, 2007).

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It gets worseMultiple studies have found that some ineffective discipline techniques are associated with childrens aggression and delinquency. Externalizing behavior problems of children become quite stable as early as 2 or 3, which suggests that prevention and early intervention efforts should begin long before children reach school age (Arnold, OLeary, Wolff, & Acker, 1993, 137-138)

Multiple studies have found that some ineffective discipline techniques are associated with childrens aggression and delinquency. Externalizing behavior problems of children become quite stable as early as 2 or 3, which suggests that prevention and early intervention efforts should begin long before children reach school age (Arnold, OLeary, Wolff, & Acker, 1993, 137-138)

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Does this sound familiar?

Does this sound familiar?Were here to help parents who have children age 3-6 and who want to learn more effective discipline strategies to decrease their childrens externalizing behavior.

The Logic Model

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Fewer tantrumsImproved family and sibling relationshipsImproved social ability

Decreased externalizing behaviorsIncreased confidence in parenting abilitiesImproved parent-child relationships

Parent outcomesRead the manualRead text remindersEmail questionsImplement strategies

Improved parenting behaviors

In-home intervention

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Fewer tantrumsImproved family and sibling relationshipsImproved social ability

Increased confidence in parenting abilitiesImproved parent-child relationshipsRead the manualRead text remindersEmail questionsImplement strategies

Child characteristics: temperament, physical/mental conditionParent availabilityResources

TimeSkillMotivation and InterestParent characteristicsDemographics

Teacher effectivenessAccessibilityTechnological resourcesRelationship between clinician and parent

In-home intervention

Decreased externalizing behaviors

Improved parenting behaviors

Parent outcomes

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Theoretical ApproachesExternal control. Behavior modification occurs through reinforcement; often in the form of punishment or reward.Relational. Behaviors will change when the relationship changes.Interventions focusing on improving the relationship not only treat existing problems, but also function in a preventative capacity. (Martinez & Forgatch, 2001)

There are two theoretical approaches: External control. Behavior modification occurs through reinforcement; often in the form of punishment or reward. Relational. Behaviors will change when the relationship changes.Interventions focusing on improving the relationship not only treat existing problems, but also function in a preventative capacity. (Martinez & Forgatch, 2001)

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This program is designed to address mild to moderate externalizing behaviors in toddlers and preschool-age children.Theoretical ApproachesThe overall efficacy of any intervention program is dependent upon one of two things:1. The severity of the problem2. Adherence to the intervention concepts (Gmeinder and Kratchowill ,1998)It is not intended to treat cognitive or behavioral disorders that necessitate professional psychiatric treatment.

According to Gmeinder and Kratchowill (1998), the overall efficacy of any intervention program is dependent upon one of two things:The severity of the problemAdherence to the intervention concepts This program is designed to address mild to moderate externalizing behaviors in toddlers and preschool-age children.It is not intended to treat cognitive or behavioral disorders that necessitate professional psychiatric treatment.

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Types of Interventions

In-Home VisitsEffect sizes are higher in home-visited children than in those who are not. (Sweet & Applebaum, 2004)Programs involving practical, in-home training for parents often yield positive, long-lasting results. (Sweet & Applebaum, 2004)

Programs involving practical, in-home training for parents often yield positive, long-lasting results. (Sweet & Applebaum, 2004)Offering parents an opportunity to practice new skills in a natural environment. (Kaminski, Valle, Filene, & Boyle, 2008)Providing guided, interactive models of parenting (Rotto & Kratochwill, 1994)Practitioners function as a sounding board and open source of information. (Mackay, McLaughlin, Weber, & Derby, 2001)

Effect sizes are higher in home-visited children than in those who are not. (Sweet & Applebaum, 2004)

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Such asOffering parents an opportunity to practice new skills in a natural environment. (Kaminski, Valle, Filene, & Boyle, 2008)Providing guided, interactive models of parenting (Rotto & Kratochwill, 1994)Practitioners function as a sounding board and open source of information. (Mackay, McLaughlin, Weber, & Derby, 2001)

The Downside Without continual implementation, its effectiveness [may diminish] with time. (Boescher & Sugawara, 1992, p. 202) These programs can also be costly and difficult to implement.

However, many in-home approaches may not provided the parents with enough time to generalize parenting strategies, both during the intervention and following its termination. Without continual implementation, its effectiveness [may diminish] with time. (Boescher & Sugawara, 1992, p. 202)

These programs can also be costly and difficult to implement.

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In-Home VisitsLevel of practitioner trainingParent and child involvementScheduling availability

Success depends largely on:

Their success depending largely on:Level of practitioner trainingParent and child involvementScheduling availability

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Self-Help ProgramsKnowledge of parenting practices or child development in and of itself has little influence on intervention effects.However, knowledge gained and applied in vivo increase effects on parent practices.

time- and cost-efficientrequire little training provide flexibility (Gmeinder & Kratchowill, 1998)(Kaminski, Valle, Filene, & Boyle, 2008)

Self-help programs are the most time- and cost-efficient, requiring little training and providing flexibility for both the parent and the practitioner. (Gmeinder & Kratchowill, 1998)

Knowledge of parenting practices or child development in and of itself has little influence on intervention effects.However, knowledge gained and applied in vivo increase effects on parent practices. (Kaminski, Valle, Filene, & Boyle, 2008)

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In-home program strengths+ self-help program strengthsSuperParent, SuperKid!

Hybrid ApproachHome visitsSupplemental self-help resourcesSuperParent, SuperKid! parenting manualSuperParent, SuperKid! website Featuring additional parenting information, ideas for relationship-building activities, parent discussion boards, and contact with practitionersReminders via email or text

This program employs a hybrid approach, involving both parents and children in home visits and supplementing intervention concepts with self-help resources:SuperParent, SuperKid! parenting manualReminders via email or textSuperParent, SuperKid! website Featuring additional parenting information, ideas for relationship-building activities, parent discussion boards, and contact with practitioners19

Visit 1

VISIT 1Practitioner observes the parent and child engaged in a ten-minute free play activity, followed by a five-minute directive task, evaluating parenting and child behaviors, using the Interpersonal Process Code. (Rusby, Estes, &, Dishion, 1991)

Practitioner observes the parent and child engaged in a ten-minute free play activity, followed by a five-minute directive task, evaluating parenting and child behaviors, using the Interpersonal Process Code.(Rusby, Estes, &, Dishion, 1991) 21

Interpersonal Process Code (IPC)

While the IPC is oriented toward older children and adolescents, it is easy to modify the codes for age-appropriate interaction. (Rusby, Estes, &, Dishion, 1991) (Hersen, 2006)ActivityAffect ContentContext or settingEmotional tone (happy, caring, neutral, distress, aversive, sad)Behavior Social impact (positive, negative, neutral)

The IPC is a widely used coding system, providing a framework for evaluating parent-child interactions, as well as some parent and child behaviors. (Hersen, 2006)Interactions are coded along three dimensions.Activity. Context or settingAffect. Emotional tone (happy, caring, neutral, distress, aversive, sad)Content. Two sub-dimensions: behavior (verbal, non-verbal, physical) and social impact (positive, negative, neutral)While the IPC is oriented toward older children and adolescents, it is easy to modify the codes to for age-appropriate interaction. (Rusby, Estes, &, Dishion, 1991) 22

Following the observation and evaluation, the parent completes two questionnaires, examining child behaviors and parenting practices:

Child Behavior Checklist (Achenbach, 2000)LIFT Parent Practices Interview (Webster-Stratton, 1998)

VISIT 1

Following the observation and evaluation, the parent completes two questionnaires, examining child behaviors and parenting practices:

Child Behavior Checklist (Achenbach, 2000)LIFT Parent Practices Interview (Webster-Stratton, 1998)

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Child Behavior Checklist (CBC)Physical DevelopmentSocioemotional DevelopmentLanguage DevelopmentProblem BehaviorsHas difficulty using the toiletPoorly coordinated or clumsyActs too young for ageDoesnt get along with other childrenDoes your child spontaneously say words?Does you child combine two or more words into phrases?Hits othersScreams a lotTemper tantrums

The CBC is one of the most frequently used behavior measures for young children, examining physical, socioemotional, and language development and problem behaviors. (Gmeinder & Kratochwill, 1998; Rotto & Kratochwill, 1994)Socioemotional developmentActs too young for ageDoesnt get along with other children

Physical developmentHas difficulty using the toiletPoorly coordinated or clumsyLanguage developmentDoes your child spontaneously say words?Does you child combine two or more words into phrases?

Problem behaviorsHits othersScreams a lotTemper tantrums

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LIFT Parent Practices Interview

15-item self-report questionnaire evaluating parenting beliefs, practices, and discipline

(Webster-Stratton, 1998)

The LIFT is a 15-item self-report questionnaire evaluating parenting beliefs, practices, and discipline. - Research has found that the self-reports adequately reflect actual parenting behaviors, both positive and negative.

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The practitioner offers some brief, immediate feedback and reviews the SuperParent, SuperKid! parenting manual and website, answering any questions the parent may have. VISIT 1

On the following day, the practitioner emails the parent more specific recommendations based on the results of all three evaluation measures, and the corresponding references in the manual.

The practitioner offers some brief, immediate feedback and reviews the SuperParent, SuperKid! parenting manual and website, answering any questions the parent may have.

On the following day, the practitioner emails the parent more specific recommendations based on the results of all three evaluation measures, and the corresponding references in the manual.

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Parenting Manual

Once a tantrum is over and your child has calmed down, (and probably not immediately after) you have the opportunity to teach correct behavior.Describe the skill. Kimmy, brushing our teeth is something we have to do. I expect that you do it calmly and happily. If you scream, kick, or spit, you will go to timeout until you calm down.Explain why it is important. Brushing helps keep our teeth clean and strong and keeps us from getting sick.Model the skill. See, Kimmy? This is how we brush our teeth.Practice the skill.Do this when the child is emotionally prepared to do so. It also helps to do it with them.Praise. When Kimmy brushes her teeth without having a tantrum, provide lots of immediate, positive feedback. Great job, Kimmy! Look how clean your teeth are! Im so proud of you.(Young, Black, Marchant, Mitchem, & West, 2000)

Look Inside!

Once a tantrum is over and the child has calmed down, parents have the opportunity to teach their child correct behavior. and probably not immediately after) you have the opportunity to teach correct behavior.Describe the skill. Kimmy, brushing our teeth is something we have to do. I expect that you do it calmly and happily. If you scream, kick, or spit, you will go to timeout until you calm down.Explain why it is important. Brushing helps keep our teeth clean and strong and keeps us from getting sick.Model the skill. See, Kimmy? This is how we brush our teeth.Practice the skill.Do this when the child is emotionally prepared to do so. It also helps to do it with them.Praise. When Kimmy brushes her teeth without having a tantrum, provide lots of immediate, positive feedback. Great job, Kimmy! Look how clean your teeth are! Im so proud of you.(Young, Black, Marchant, Mitchem, & West, 2000)

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Additional ResourcesThe SuperParent, SuperKid! website offers tools to augment lessons learned during home visits. Parenting discussion boardsAsk a ClinicianLinks to other parenting resourcesIdeas for relationship-building activities.Optional daily or weekly email or text message reminders from their practitioner

The SuperParent, SuperKid! website offers tools to augment lessons learned during home visits. Parenting discussion boards provide a place for parents to share insights and experiences with other parents.The Ask a Clinician feature allows parents to contact their practitioner between visits with questions or concerns as they arise.Links to other parenting resources, as well as ideas for relationship-building activities.Parents also have the option to receive daily or weekly reminders from their practitioner via email or text message, specific to their needs.

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Visit 2

Two weeks after the initial visit, the practitioner returns and directs the parent and child in three tasks, designed to evaluate:Parents ability to attend to/praise positive behaviors and ignore mildly inappropriate behaviors.Parents skill in delivering instructions to childParents performance in placing the child in timeout after serious misbehavior(Rotto & Kratochwill, 1994)

VISIT 2

Two weeks after the initial visit, the practitioner returns and directs the parent and child in three tasks, designed to evaluate:Parents ability to attend to/praise positive behaviors and ignore mildly inappropriate behaviors.Parents skill in delivering instructions to childParents performance in placing the child in timeout after serious misbehavior(Rotto & Kratochwill, 1994)

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The practitioner will then review each task with the parent, noting improvements from the first visit and offering further suggestions, referencing the manual.

VISIT 2

The practitioner will then review each task with the parent, noting improvements from the first visit and offering further suggestions, referencing the manual.

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Visit 3

Four weeks after the second visit, the practitioner returns and observes the parent and child engaged in another ten-minute free play activity and a five-minute directive task, evaluating parenting and child behaviors, using the Interpersonal Process Code.

VISIT 3

The parent will then complete the LIFT Interview and Child Behavior Checklist, as well as a program evaluation, reviewing their responses with the practitioner.

VISIT 3

Parent Program EvaluationProgram effectiveness is evaluated in two primary ways: Parent satisfaction with the intervention process and outcomes.Differences in measure results between first and final visit.Changes in Child Behavior Checklist and LIFT Interview scores over time reflect successful generalization of program principles. (Gmeinder & Kratchowill, 1998)

Program effectiveness is evaluated in two primary ways: Parent satisfaction with the intervention process and outcomes.Differences in measure results between first and final visit.Changes in Child Behavior Checklist and LIFT Interview scores over time reflect successful generalization of program principles. (Gmeinder & Kratchowill, 1998)

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