Evaluation of adapted parent training for challenging behaviour in pre-school children with moderate to severe intellectual developmental disabilities: A randomised controlled trial.

Autor: Royston R; Division of Psychiatry, University College London, London, United Kingdom., Absoud M; Evelina London Children's Hospital, St Thomas' Hospital, and King's College London, London, United Kingdom., Ambler G; Department of Statistical Science, University College London, London, United Kingdom., Barnes J; Department of Psychological Sciences, Birkbeck University of London, London, United Kingdom., Hunter R; Research Department of Primary Care and Population Health, Royal Free Medical School, London, United Kingdom., Kyriakopoulos M; 1st Department of Psychiatry National and Kapodistrian University of Athens, Greece and South London and Maudsley NHS Foundation Trust and Department of Child and Adolescent Psychiatry, King's College London, London, United Kingdom., Ondruskova T; Division of Psychiatry, University College London, London, United Kingdom., Oulton K; Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom., Paliokosta E; The Tavistock and Portman NHS Foundation Trust, Kentish Town Health Centre, London, United Kingdom., Panca M; Research Department of Primary Care and Population Health, Royal Free Medical School, London, United Kingdom., Sharma A; Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust & Newcastle University, Walkergate Park Centre for Neurorehabilitation and Neuropsychiatry, Newcastle, United Kingdom., Slonim V; Evelina London Children's Hospital, St Thomas' Hospital, and King's College London, London, United Kingdom., Summerson U; Contact, London, United Kingdom., Sutcliffe A; Institute of Child Health, University College London, London, United Kingdom., Thomas M; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom., Qu C; Department of Statistical Science, University College London, London, United Kingdom., Hassiotis A; Division of Psychiatry, University College London, London, United Kingdom.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Aug 13; Vol. 19 (8), pp. e0306182. Date of Electronic Publication: 2024 Aug 13 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0306182
Abstrakt: Objectives: There is limited evidence on the effectiveness of parenting interventions to improve disruptive behaviour in children with intellectual developmental disabilities. This clinical trial evaluated whether an adapted group parenting intervention for preschool children with intellectual developmental disabilities who display challenging behaviour is superior to treatment as usual in England.
Study Design: 261 children aged 30-59 months with moderate to severe intellectual developmental disabilities and challenging behaviour were randomised to either the intervention (Stepping Stones Triple P) and treatment as usual or treatment as usual alone. The primary outcome was the parent-rated Child Behaviour Checklist at 52 weeks after randomisation. A health economic evaluation was also completed.
Results: We found no significant difference between arms on the primary outcome (mean difference -4.23; 95% CI: -9.99 to 1.53; p = 0.147). However, a subgroup analysis suggests the intervention was effective for participants randomised before the COVID-19 pandemic (mean difference -7.12; 95% CI: -13.44 to -0.81; p = 0.046). Furthermore, a complier average causal effects analysis (mean difference -11.53; 95% CI: -26.97 to 3.91; p = 0.143) suggests the intervention requires participants to receive a sufficient intervention dose. The intervention generated statistically significant cost savings (-£1,057.88; 95% CI -£3,218.6 to -£46.67) but the mean point estimate in Quality Adjusted Life Years was similar in both groups.
Conclusion: This study did not find an effect of the intervention on reducing challenging behaviour, but this may have been influenced by problems with engagement. The intervention could be considered by services as an early intervention if families are supported to attend, especially given its low cost.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Royston et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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