Parenting Programs for Preschoolers' Mental Health Issues

Overseen By Mageau Geneviève, Ph.D.

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Mireille Joussemet

Disqualifiers: Previous How-to program, Non-French speakers

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

Compensation: Varies

Number of Visits: 10

Duration: 6 weeks

320 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this randomized control trial (RCT) is to assess the superiority of the How-to Parenting Program in improving autonomy support and preschoolers' mental health (i.e., decreases externalizing problems) among vulnerable families. The main question it aims to answer is: Can teaching concrete parenting skills that target empirically-based parenting dimensions (via the How-to Parenting Program) have an added value for improving parental autonomy support and child mental health, compared to a parenting program that does not focus on teaching parenting skills (Nobody's Perfect program \[NP\])? Early childhood centers providing services to parents of 3-4 years olds will be randomly assigned to one of two 6-week programs. Parents will fill out questionnaires before (T1) and after (T2) programs delivery as well as at 6-month (T3) and 1-year follow-ups (T4). They and their child will also engage in filmed parent-child interactions at T1 and T3 during predetermined activities, to obtain observational measures of parenting and child socioemotional competences. Researchers will compare the How-to and NP conditions to see if there was an accentuated increase in parental autonomy support and child mental health in the How-to condition. As secondary analyses, researchers will compare the How-to and NP conditions on parenting quality, child socioemotional competences, and parental cognitions as well as explore the conditions in which NP could be equal (or superior) to the How-to Parenting Program.

Will I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment 'How to Talk So Kids Will Listen & Listen So Kids Will Talk' for preschoolers' mental health issues?

The 'How to Talk So Kids Will Listen & Listen So Kids Will Talk' program is designed to improve children's mental health by promoting optimal parenting, which includes structure, affiliation, and autonomy support. While specific results for this program are not detailed, similar parent training programs have shown effectiveness in reducing behavior problems and improving parenting skills, suggesting potential benefits for this treatment as well. ^{1 2 3 4 5}

Is the parenting program 'How to Talk So Kids Will Listen & Listen So Kids Will Talk' safe for preschoolers' mental health issues?

The available research does not specifically address safety concerns for the 'How to Talk So Kids Will Listen & Listen So Kids Will Talk' program, but structured parent education programs in general have been shown to produce positive changes in children's behavior without reported safety issues. ^{2 3 5 6 7}

How is the 'How to Talk So Kids Will Listen & Listen So Kids Will Talk' treatment unique for preschoolers' mental health issues?

This treatment is unique because it focuses on improving parenting skills by addressing key dimensions like structure, affiliation, and autonomy support, which are crucial for promoting children's mental health. Unlike other programs, it emphasizes communication skills to foster optimal parenting, which is directly linked to better mental health outcomes for children. ^{3 8 9 10 11}

Research Team

Joussemet Mireille, Ph.D.

Principal Investigator

Université de Montréal

Eligibility Criteria

This trial is for parents with a child aged 3 to just under 5 years who haven't attended the How-to Parenting Program. It's not for those who can't communicate in French. The study aims to help families improve their parenting skills and boost preschoolers' mental health.

Inclusion Criteria

I have a child aged 3 to 4 years old.

Exclusion Criteria

Parents who have previously attended a How-to Parenting Program

I cannot communicate in French.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Parents participate in either the How-to Parenting Program or the Nobody's Perfect Program, delivered over six consecutive 2-hour weekly sessions

6 weeks

6 visits (virtual)

Follow-up

Participants are monitored for changes in parental autonomy support and child mental health at multiple follow-up points

14 months

4 follow-up assessments (virtual)

Treatment Details

Interventions

• How-to talk so kids will listen and listen so kids will talk
• Nobody's Perfect

Trial Overview The trial compares two parenting programs: 'How-to talk so kids will listen' which teaches specific parenting skills, and 'Nobody's Perfect', which doesn’t focus on skill teaching. Parents attend one of these programs at early childhood centers and are observed over time.

Participant Groups

Group I: How-to Parenting Program Experimental Treatment 1 Intervention

The How-to Parenting Program is a highly structured and skill-based program. It is manualized, teaches 30 concrete, specific, easy-to-grasp (e.g., taught using comic strips), and readily applicable skills. It also optimizes learning with exercises (e.g., perspective taking; role-playing) and practice, and addresses parents' readiness and motivation to change. The program is delivered over six consecutive 2-hour weekly sessions (12 hours in total).

Group II: Nobody's Perfect Program Active Control 1 Intervention

Based on andragogy principles, parents following the Nobody's Perfect curriculum will learn how to solve problems with their child and engage in theme-related activities meant to increase awareness of parents' own needs, child behaviors, development, health, and safety. There is no pre-determined order for themes and time devoted to each one varies according to parents' needs. The program is delivered over six consecutive 2-hour weekly sessions (12 hours in total).

Who Is Running the Clinical Trial?

Mireille Joussemet

Lead Sponsor

Trials

1

Recruited

320+

Canadian Institutes of Health Research (CIHR)

Collaborator

Trials

1,417

Recruited

26,550,000+

Findings from Research

In a study of 127 Norwegian children aged 4-8 with oppositional defiant disorder or conduct disorder, both parent training and parent training combined with child therapy significantly reduced conduct problems compared to a waiting-list control group, with about two-thirds of treated children functioning within normal limits after treatment.

The Incredible Years program not only improved child behavior but also enhanced parental strategies, leading to increased use of positive parenting techniques and reduced harsh discipline, highlighting its effectiveness in addressing severe conduct issues in young children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treatment of oppositional defiant and conduct problems in young Norwegian children : results of a randomized controlled trial. Larsson, B., Fossum, S., Clifford, G., et al.[2021]

A preventive mental health intervention for low-income parent-child dyads showed significant improvements in children's attention deficit and internalizing symptoms when compared to a minimal treatment control group, with 89 parents and 96 children participating in the study.

The experimental intervention also led to observable improvements in parent-child interactions, as assessed by blind observers, indicating that the intervention not only helped children's behavior but also positively influenced parenting practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reduction of attention deficit and internalizing symptoms in preschoolers through parent-child interaction training. Strayhorn, JM., Weidman, CS.[2007]

The study is the first randomized controlled trial (RCT) testing the 'How to talk so kids will listen & listen so kids will talk' parenting program, which aims to improve children's mental health by enhancing parenting practices over a seven-week period.

Children whose parents participated in the program will be compared to a wait-list control group, with assessments of children's psychological problems and mental health indicators conducted at multiple time points, highlighting the program's potential efficacy in promoting better mental health outcomes for children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How to talk so kids will listen & listen so kids will talk: a randomized controlled trial evaluating the efficacy of the how-to parenting program on children's mental health compared to a wait-list control group. Joussemet, M., Mageau, GA., Larose, MP., et al.[2021]

In a study involving 908 children aged 3-12, parent training programs significantly reduced child behavior problems and ADHD symptoms, with about half of parents reporting their children no longer exhibited clinically significant issues after the intervention.

Behavioral programs (Comet, Cope, and Incredible Years) were found to be more effective than the nonbehavioral program (Connect), leading to improved parenting competence and reduced parental stress and depressive symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A national evaluation of parenting programs in Sweden: The short-term effects using an RCT effectiveness design. Stattin, H., Enebrink, P., Özdemir, M., et al.[2018]

A systematic review of 16 studies found that group-based parent education programs can effectively improve behavior problems in children aged 3 to 10, leading to positive changes in both parental perceptions and children's behavior.

Despite the promising results, the review highlighted significant variability in the interventions and populations studied, suggesting that more controlled studies are needed before broadly applying these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavior problems and group-based parent education programs. Barlow, J., Stewart-Brown, S.[2019]

The Houston Parent-Child Development Center program successfully reduced behavior problems in children for 5 to 8 years after completion, indicating long-term efficacy in primary prevention.

Teachers reported that children who participated in the program exhibited significantly fewer aggressive and hostile behaviors compared to control children, highlighting the program's positive impact on social behavior.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Primary prevention of behavior problems in Mexican-American children. Johnson, DL., Walker, T.[2021]

The BPEC (Behavioral Parent Education with Coaching) program significantly reduced disruptive behaviors in children, including oppositional behaviors and ADHD symptoms, as reported by 119 parents in a randomized control trial.

Improvements in the parent-child relationship were also noted, with positive effects maintained even 3 months after the program, indicating the long-term efficacy of the BPEC intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Incorporating emotion coaching into behavioral parent training program: evaluation of its effectiveness. Chan, CKY., Fu, K., Liu, SKY.[2022]

Psychoeducation and problem-solving are the most common and effective elements in universal mental health programs for children aged 3-11, as identified through a review of program manuals and peer-reviewed articles.

The skills are primarily taught through role-plays and modeling, which can enhance the dissemination and adaptation of these programs to improve children's mental health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Common Elements of Childhood Universal Mental Health Programming. Boustani, MM., Frazier, SL., Chu, W., et al.[2021]

Parents Plus (PP) programs are effective interventions for families dealing with child behavior problems, showing a significant impact on child behavior, parental satisfaction, and stress reduction across 17 studies involving over 1,000 families.

The meta-analysis of 10 controlled studies revealed a moderate effect size of 0.57 for child behavior problems, and even higher effect sizes for goal attainment (1.51) and parental satisfaction (0.78), indicating that PP programs are comparable to other established parent training programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parents Plus Systemic, Solution-Focused Parent Training Programs: Description, Review of the Evidence Base, and Meta-Analysis. Carr, A., Hartnett, D., Brosnan, E., et al.[2018]

The review highlights the importance of broadening prevention programs for conduct problems in early childhood to include not just parenting skills but also family-based interventions, especially for families in impoverished communities.

It emphasizes the need to utilize community resources and innovative techniques like motivational interviewing to enhance family engagement in mental health services, aiming to better support at-risk young children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

New Directions and Challenges in Preventing Conduct Problems in Early Childhood. Shaw, DS., Taraban, LE.[2023]

A systematic review of 42 Australian studies found that parenting-focused programs significantly reduced externalizing behaviors in young children, with a moderate effect size of -0.56, while programs targeting internalizing symptoms showed a smaller improvement in anxiety symptoms (-0.25).

The review highlighted a need for more inclusive programs, as Aboriginal and Torres Strait Islander children were underrepresented, and emphasized the importance of community-driven approaches to better support disadvantaged families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Targeted community-based programmes for children's mental health: A systematic review and meta-analysis of the Australian literature. Savaglio, M., Yap, MB., O'Donnell, R., et al.[2023]

References

1. Germany pubmed.ncbi.nlm.nih.gov

Treatment of oppositional defiant and conduct problems in young Norwegian children : results of a randomized controlled trial. [2021]

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

Reduction of attention deficit and internalizing symptoms in preschoolers through parent-child interaction training. [2007]

3. England pubmed.ncbi.nlm.nih.gov

How to talk so kids will listen & listen so kids will talk: a randomized controlled trial evaluating the efficacy of the how-to parenting program on children's mental health compared to a wait-list control group. [2021]

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

A national evaluation of parenting programs in Sweden: The short-term effects using an RCT effectiveness design. [2018]

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

Behavior problems and group-based parent education programs. [2019]

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

Primary prevention of behavior problems in Mexican-American children. [2021]

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

Incorporating emotion coaching into behavioral parent training program: evaluation of its effectiveness. [2022]

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

Common Elements of Childhood Universal Mental Health Programming. [2021]

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

Parents Plus Systemic, Solution-Focused Parent Training Programs: Description, Review of the Evidence Base, and Meta-Analysis. [2018]

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

New Directions and Challenges in Preventing Conduct Problems in Early Childhood. [2023]

11. England pubmed.ncbi.nlm.nih.gov

Targeted community-based programmes for children's mental health: A systematic review and meta-analysis of the Australian literature. [2023]