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Predictors of changes in child behaviour following parent management training: Child, context, and therapy factors
Kristine Amlund Hagen1, Terje Ogden2
1Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Oslo), Oslo, Norway.
Insights
Parent management training (PMTO) effectively improves child behavior, especially for girls with conduct problems. Higher initial symptom scores and increased parental encouragement predict better outcomes in child behavior and social skills.
Area of Science:
- Child Psychology
- Behavioral Therapy
- Clinical Research
Background:
- Conduct problems in children are a significant concern.
- Parent management training (PMTO) is a widely used intervention.
- Identifying predictors of treatment success is crucial for optimizing outcomes.
Purpose of the Study:
- To examine predictive factors of behavior change in children undergoing PMTO.
- To identify child, parent, and therapy variables associated with improved externalizing behavior and social skills.
Main Methods:
- Non-randomised study of 331 children (ages 3-12) with conduct problems.
- Utilized multi-informant (parent, teacher) ratings of child behavior and social skills.
- Analyzed child, parent, and therapy-level variables as predictors of change.
Main Results:
- PMTO led to significant improvements (1 SD parent-rated, 0.5 SD teacher-rated) in externalizing behavior.
- Children with higher pre-treatment symptom scores and lower social skills showed greater improvement.
- Girls demonstrated greater improvements; ADHD symptoms appeared to hinder social skills gains.
- Increased parental skill encouragement, therapist satisfaction, and child therapy hours predicted better outcomes.
Conclusions:
- Predictive factors for PMTO success include baseline symptom severity, social skills, and child engagement.
- Parental involvement and therapist factors significantly influence treatment effectiveness.
- PMTO is an effective intervention for child conduct problems, with specific factors enhancing its impact.
Abstract:
This non-randomised study examined a set of predictive factors of changes in child behaviour following parent management training (PMTO). Families of 331 Norwegian girls (26%) and boys with clinic-level conduct problems participated. The children ranged in age from 3 to 12 years (Mage = 8.69). Retention rate was 72.2% at post-assessment. Child-, parent- and therapy-level variables were entered as predictors of multi-informant reported change in externalising behaviour and social skills. Behavioural improvements following PMTO amounted to 1 standard deviation on parent rated and ½ standard deviation on teacher rated externalising behaviour, while social skills improvements were more modest. Results suggested that children with higher symptom scores and lower social skills score at pre-treatment were more likely to show improvements in these areas. According to both parent- and teacher-ratings, girls tended to show greater improvements in externalising behaviour and social skills following treatment and, according to parents, ADHD symptomology appeared to inhibit improvements in social skills. Finally, observed increases in parental skill encouragement, therapists' satisfaction with treatment and the number of hours spent in therapy by children were also positive and significant predictors of child outcomes.
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