Chicago Parent Program for Child Behavioral Disorders

(EPIC Trial)

Overseen By Jennifer Suor, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Illinois at Chicago

Must not be taking: Behavioral medications

Disqualifiers: Disruptive behavior disorder, Epilepsy, Psychosis, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 12

Duration: 11 weeks

180 Participants Needed

Trial Summary

What is the purpose of this trial?

Deficits in executive functioning (EF) disproportionately impact children living in poverty and increase risk for psychopathology, particularly disruptive behavior disorders. This randomized clinical trial seeks to determine whether childhood EF, assessed across neural and behavioral units of analysis, is an experimental therapeutic target that can be directly modified through caregiver participation in the Chicago Parent Program (CPP), if increases in EF predict reduced disruptive behavior trajectories in low-income children over a short-term follow-up period, and identify which CPP-driven parenting skill improvements are the most influential in modifying EF. This work will contribute new knowledge as to whether a cost-efficient parenting intervention, developed for and with low-income families raising young children in poverty, can modify EF, a neural behavioral mechanism implicated in risk for childhood disruptive behavior problems.

Will I have to stop taking my current medications?

The trial requires that children do not take medications to treat emotional or behavioral problems, but parents can continue taking medications for mental health issues.

What data supports the effectiveness of the treatment Chicago Parent Program (CPP) for child behavioral disorders?

The Chicago Parent Program (CPP) is a group-based parent training program that has been shown to be effective in improving behavior problems in children, especially in low-income and underserved communities. It was developed with input from African-American and Latino parents, and studies have shown that similar community-based parent training programs can lead to significant improvements in child behavior and are more cost-effective than individual clinic-based programs. ^{1 2 3 4 5}

Is the Chicago Parent Program safe for children?

The Chicago Parent Program is a parent training program designed to help improve child behavior, and there is no specific safety data mentioned in the research articles. However, parent training programs in general are considered safe as they focus on improving parenting skills and reducing child behavior problems. ^{1 2 6 7 8}

How is the Chicago Parent Program treatment different from other treatments for child behavioral disorders?

The Chicago Parent Program (CPP) is unique because it is a group-based parent training program specifically developed with input from African-American and Latino parents to address the needs of low-income and underserved families, unlike other treatments that may not be tailored to these populations. ^{1 2 6 8 9}

Eligibility Criteria

This trial is for children with executive function issues, often living in poverty, who may be at risk for disruptive behavior disorders like ADHD. It's designed to see if improving parenting skills through the Chicago Parent Program can help these kids.

Inclusion Criteria

Child is Medicaid eligible, defined as receiving Medicaid or eligible based on family income (up to 142 percent of the federal poverty level)

Child does not have a history of psychosis or currently psychotic

Child can have current or past histories of psychiatric disorders (anxiety, mood, attention deficit hyperactivity disorder)

Exclusion Criteria

Child has an intellectual or developmental disability (autism spectrum disorder)

Child is not receiving Medicaid or Medicaid eligible

Parent has a medical condition that would interfere with the completion of the study

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in the Chicago Parent Program, consisting of 12 group sessions over 11 weeks, focusing on positive parenting and child behavior management skills.

11 weeks

12 group sessions (in-person)

Follow-up

Participants are monitored for changes in executive function and disruptive behavior through various assessments.

16 months

Treatment Details

Interventions

• Chicago Parent Program

Trial Overview The study tests whether the Chicago Parent Program can improve children's executive functions and reduce disruptive behaviors. Researchers will track changes in brain function and behavior to see if better parenting skills lead to improvements.

Participant Groups

Group I: Chicago Parent Program Experimental Treatment 1 Intervention

Half of the dyads will be randomized to participant in the Chicago Parent Program (CPP), an evidence-based parenting preventive intervention for urban poor parents with children between the ages of 2-8 with behavior problems. The Chicago Parent Program consists of 12 groups sessions (11 weekly, 1 booster session). The groups are co-facilitated by two certified group leaders. Parents learn positive parenting and effective child behavior management skills, strategies to support the child's attention, literacy, and social skills, and stress management and problem solving techniques. Skill building is accomplished through watching videos of real-life parents and children during parent-child interactions, group discussion, role-playing, and weekly homework assignments.

Group II: Control Condition Active Control 1 Intervention

Half of the dyads will be randomized to the no intervention arm.

Who Is Running the Clinical Trial?

University of Illinois at Chicago

Lead Sponsor

Trials

653

Recruited

1,574,000+

National Institutes of Health (NIH)

Collaborator

Trials

2,896

Recruited

8,053,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Findings from Research

This randomized trial compares the effectiveness of two parent training programs, the Chicago Parent Program (CPP) and Parent-Child Interaction Therapy (PCIT), involving 262 parents of children aged 2 to 5 from low-income, predominantly African-American backgrounds.

The study aims to determine if CPP, designed specifically for underserved populations, can effectively reduce child behavior problems and improve parenting, potentially offering a cost-effective alternative to the established PCIT program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Study protocol for a comparative effectiveness trial of two parent training programs in a fee-for-service mental health clinic: can we improve mental health services to low-income families? Gross, DA., Belcher, HM., Ofonedu, ME., et al.[2021]

In an effectiveness trial of parent management training as part of the Prevention Program for Externalizing Problem Behavior (PEP), a significant percentage of children (32.6% to 60.7%) were identified as having clinically relevant externalizing behavior issues at the start of the study.

After three months of treatment, between 24.8% and 60.4% of these children showed recovery, indicating that parent management training can lead to meaningful improvements in managing externalizing behavior problems.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does parent management training for children with externalizing problem behavior in routine care result in clinically significant changes? Hautmann, C., Stein, P., Hanisch, C., et al.[2015]

Child-parent psychotherapy (CPP) demonstrated lasting improvements in children's behavior problems and mothers' distress six months after treatment ended, based on a study of 75 diverse child-mother dyads.

The results suggest that CPP is an effective intervention for addressing symptoms in traumatized preschoolers, emphasizing the importance of the parent-child relationship in therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Child-parent psychotherapy: 6-month follow-up of a randomized controlled trial. Lieberman, AF., Ghosh Ippen, C., VAN Horn, P.[2019]

A randomized trial involving families of junior kindergartners showed that community-based large group parent training programs are more effective in improving children's behavior problems at home compared to individual clinic-based training, especially for immigrant families and those with severe behavior issues.

The community-based approach was also found to be over six times more cost-effective than individual training programs, making it a more accessible option for families in need of mental health assistance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Large group community-based parenting programs for families of preschoolers at risk for disruptive behaviour disorders: utilization, cost effectiveness, and outcome. Cunningham, CE., Bremner, R., Boyle, M.[2022]

Collaborative & Proactive Solutions (CPS) is an effective treatment model for behaviorally challenging youth, showing at least equivalent effectiveness to the standard Parent Management Training in improving behavioral outcomes.

CPS not only improves behavior but also enhances parent-child interactions and children's skills, suggesting additional benefits beyond traditional treatment methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Collaborative & Proactive Solutions (CPS): A Review of Research Findings in Families, Schools, and Treatment Facilities. Greene, R., Winkler, J.[2020]

The paper by Ward et al. highlights the development of a new program aimed at parents of children at high risk for behavioral problems in a deprived South African township, indicating a focus on early intervention in challenging environments.

It raises important questions about the necessity of creating new programs when effective ones already exist, suggesting a need for collaboration among program developers to identify the most effective strategies for different populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Commentary: Do we need new parenting programmes for different cultural groups or should we adapt those that already exist: a commentary on Ward et al. (2019). Thompson, M., Thompson, C.[2021]

Children who participated in the Title I Child-Parent Centers (CPC) had significantly lower rates of substantiated child maltreatment by age 17 compared to those in alternative kindergarten programs, showing a 52% reduction (5.0% vs. 10.5%).

Longer participation in CPC programs (4 to 6 years) was linked to even lower maltreatment rates (3.6% vs. 6.9%), highlighting the importance of sustained family support and educational services in high-poverty areas.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

School-based early intervention and later child maltreatment in the Chicago Longitudinal Study. Reynolds, AJ., Robertson, DL.[2019]

In a pilot study involving 21 program directors and 25 practitioners from 19 agencies, it was found that 37.1% of the parent training programs were developed by the agencies themselves, while the majority were adaptations of existing interventions.

Only a few of the identified parent programs had strong empirical support, but many incorporated key features commonly associated with effective, evidence-based parenting programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The State of Parent Training: Program Offerings and Empirical Support. Kohl, PL., Schurer, J., Bellamy, JL.[2019]

Parent management training is the most effective treatment for younger children with conduct disorder, while older children benefit from this training supplemented with problem-solving skills, both of which are supported by research.

Despite their effectiveness, these therapies face challenges such as high drop-out rates among parents and the fact that many youths improve but do not reach typical functioning levels, highlighting the need for ongoing monitoring and potentially more comprehensive prevention programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Behavior therapy in children with aggressive dyssocial disorders]. Brezinka, V.[2018]

References

1. England pubmed.ncbi.nlm.nih.gov

Study protocol for a comparative effectiveness trial of two parent training programs in a fee-for-service mental health clinic: can we improve mental health services to low-income families? [2021]

2. England pubmed.ncbi.nlm.nih.gov

Does parent management training for children with externalizing problem behavior in routine care result in clinically significant changes? [2015]

3. United States pubmed.ncbi.nlm.nih.gov

Child-parent psychotherapy: 6-month follow-up of a randomized controlled trial. [2019]

4. England pubmed.ncbi.nlm.nih.gov

Large group community-based parenting programs for families of preschoolers at risk for disruptive behaviour disorders: utilization, cost effectiveness, and outcome. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Collaborative & Proactive Solutions (CPS): A Review of Research Findings in Families, Schools, and Treatment Facilities. [2020]

6. England pubmed.ncbi.nlm.nih.gov

Commentary: Do we need new parenting programmes for different cultural groups or should we adapt those that already exist: a commentary on Ward et al. (2019). [2021]

7. United States pubmed.ncbi.nlm.nih.gov

School-based early intervention and later child maltreatment in the Chicago Longitudinal Study. [2019]

8. United States pubmed.ncbi.nlm.nih.gov

The State of Parent Training: Program Offerings and Empirical Support. [2019]

9. Switzerland pubmed.ncbi.nlm.nih.gov

[Behavior therapy in children with aggressive dyssocial disorders]. [2018]