Face-To-Face Vs. Online Behavioral Parent Training for Young Children with ADHD: Child and Parent Outcomes

Behavioral parent training is a first-line psychosocial intervention for young children with Attention-Deficit/Hyperactivity Disorder. Traditional face-to-face delivery is limited by access to therapists, feasibility, and/or affordability, which may be addressed by online Behavioral parent training. This study (a) evaluated outcomes for face-to-face vs. asynchronous online Behavioral parent training relative to a wait-list control condition in a large sample of young children with Attention-Deficit/Hyperactivity Disorder and (b) extended outcome measurement beyond parent ratings to masked assessment of child behavior self-regulation and home observation of parent-child interactions.

Participants were 196 young children with Attention-Deficit/Hyperactivity Disorder (65% male, Mage = 50.08 months; SD = 8.55) and primary caregivers randomly assigned to face-to-face Behavioral parent training (n = 66), online Behavioral parent training (n = 65), or WLC (n = 65). BPT comprised 10 sessions of behavior management and optimism training (cognitive-behavioral intervention to reduce pessimistic parenting attributions) that were equivalent across Behavioral parent training delivery modes.

Intent-to-treat analyses found no significant differences in session attendance, outcomes, or treatment acceptability for face-to-face and online Behavioral parent training with both conditions yielding significant medium magnitude reductions (ds range from 0.41 to 0.74) in child Attention-Deficit/Hyperactivity Disorder and defiant/aggressive behavior and parent pessimism, along with increases in observed positive parenting behavior relative to wait-list control. No significant differences were found for child self-regulation skills or observed parent or child negative behaviors.

Asynchronous online Behavioral parent training may be a viable option for families who have limited access to clinic-based treatment due to feasibility or affordability challenges.