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Stepping Stones Triple P: A randomised controlled trial evaluating the added benefit of an enhanced parenting program
Dana E Galligan1, Leanne Payne1,2, Ayu Paramecwari3
1Child Health Research Centre, University of Queensland, Brisbane, QLD, Australia.
Insights
Enhanced parenting programs focusing on parental mental health showed no additional benefits for children with neurodevelopmental disorders. Further research is needed to tailor interventions for families facing concurrent parental and child mental health challenges.
Area of Science:
- Child and Adolescent Psychiatry
- Developmental Psychology
- Clinical Psychology
Background:
- Families with children diagnosed with neurodevelopmental disorders (NDDs) experience significant parenting challenges and parental mental health issues.
- Parental mental health problems are linked to poorer outcomes for children with NDDs.
- The added benefit of addressing parental mental health in interventions for these families remains unclear.
Purpose of the Study:
- To investigate if an enhanced parenting program, including modules for parental mental health, offers additional benefits for children with NDDs compared to a standard program.
- To assess the impact of the enhanced intervention on both parental and child mental health outcomes.
Main Methods:
- A randomized controlled trial involving 127 families with children referred for NDDs.
- Families were assigned to either standard Stepping Stones Triple P or Enhanced Stepping Stones Triple P (including parental mental health modules).
- Pre- and post-intervention assessments used the Adult Self Report (ASR) and Child Behaviour Checklist (CBCL).
Main Results:
- The Enhanced Stepping Stones Triple P group showed nominally greater improvements in ASR ADHD scores, but this was not statistically significant after multiple testing correction.
- No significant additional benefits were observed for the children's outcomes in the enhanced group.
- Both groups showed nominal improvements in CBCL oppositional defiance and ASR anxiety, which did not remain significant after correction.
Conclusions:
- While enhanced parenting programs show potential for parental mental health, they did not demonstrate additional benefits for children with NDDs in this study.
- Families with co-occurring parental and child mental health symptoms present unique challenges requiring tailored interventions.
- Further research is necessary to optimize program engagement and effectiveness for these complex family needs.
Abstract:
Neurodevelopmental disorders such as Autism and ADHD pose significant challenges for families. Parents face additional parenting challenges and stressors, and are more likely to experience mental health problems compared to the general population. This is associated with a more unfavourable course in the children. Still, it is unknown whether addressing parental mental health is of additional benefit for the children.Families with a child referred to a developmental clinic for neurodevelopmental problems, and a parent who was experiencing subclinical or clinical mental health symptoms, were recruited. One hundred and twenty-seven families (caregivers: female n = 119, male n = 23; children: female n = 37, male n = 90) were randomised into (1) standard Stepping Stones Triple P, a parenting program for children with neurodevelopmental issues (n = 63), or (2) Enhanced Stepping Stones Triple P (n = 64) which includes additional modules addressing parental mental health. Participants completed pre and post intervention surveys including the Adult Self Report (ASR) and the Child Behaviour Checklist (CBCL).Significantly greater improvements were seen in the Enhanced Stepping Stones Triple P ASR ADHD scores compared to the Stepping Stones Triple P group, however this was not significant after correcting for multiple testing. No additional benefits of the Enhanced Stepping Stones Triple P group were seen for the children's scores. In both groups, the CBCL oppositional defiance and ASR anxiety scores showed nominally significant improvements. None of these remained significant after correcting for multiple testing.The results highlight that families with concurrent parent and child mental health symptoms face unique challenges and increased burdens, and further research is needed in how to tailor programs that best suit their needs and to improve program engagement.