Background: Evidence-based psychosocial interventions, like parent training programs, are strongly recommended as first-line treatment for preschool-age children with or at-risk of Attention Deficit/Hyperactivity Disorder (AD/HD).Objective: Evaluate the effectiveness of the Incredible Years Basic Parent Training (IY) in hyperactive and inattentive behaviors of Portuguese preschoolers. Methods: One hundred children, between three and six years-old, with AD/HD behaviors, who were part of a larger randomized controlled trial in which participants were allocated to either an intervention or control group. In this subsample analysis, there were 52 participants in the intervention condition (IYC) and 48 in the waiting-list control condition (WLC). Multi-informants and multi-measures of child and parenting behaviors were taken before and after the 14-week intervention. Results: Medium-to-large intervention effects were found in primary caregivers' reported measures of children's AD/HD behaviors and on self-reported parenting practices. Independent observations indicated significant short-term effects on positive parenting and coaching. Primary caregivers had a high attendance rate and reported high satisfaction with the program. Additionally, 43% of children in the IYC clinically improved in the primary AD/HD outcome measure, compared with 11% in the WLC. Conclusions:Preliminary results suggest that IY parent training seems to be an effective tool, making the difference in the behavior of Portuguese preschoolers with early signs of AD/HD and their mothers.
The aims of this study were to examine the efficacy of the Incredible Years program (IY) with Portuguese families of preschoolers, moderator and mediator effects, and sustainability of results. Design: randomized controlled design with pre-and postintervention, 12 and 18 months assessments. Participants: 124 children aged 3-6 years, at risk of disruptive behavior problems. Children in the IY group showed significant reduction in behavior problems and increase in social skills; caregivers improved parenting practices and self-confidence. Positive clinical and functional impacts were demonstrated. IY was efficacious with a wide range of families. The moderating effect of the child's age suggests that IY prevents a decrease in social skills for the ages covered by this study. Changes in parental self-efficacy affected changes in parental practices, promoting changes in children's behavior. Positive effects were maintained over time.
Externalizing behavior disorders in children are difficult to cope with and might have a negative impact both on parent-child interactions and couples relationships, as well as on parents' psychological adjustment. The present study evaluates the effectiveness of a parent training program (Incredible Years Basic Program) for improving positive relationships in Portuguese families of preschoolers showing symptoms of oppositional/defiant disorder (ODD). Eighty three families randomly assigned to an Incredible Years (IY) intervention (n = 44) or to a waiting list control group (n = 39) were evaluated at baseline and six months after (post-intervention), on the following variables: mothers observed positive parenting practices and coaching skills; mothers' self-reported dysfunctional parenting practices; mothers' depressive symptoms; perceived couples intimacy; and children's behavior. Moreover, families who had received the IY program were also assessed in the same variables 12-months after baseline. Observed and self-reported positive parenting practices, couples openness to exterior and children's oppositional behavior improved more significantly from pre-to post-assessment in the intervention group than in the control group (medium to large effect sizes). Changes observed in the intervention group were sustained at the 12-month follow-up. However, the improvements in coaching skills previously observed at the post-intervention assessment in the intervention group decreased over time. The findings indicate that the IY Parent Program is a promising intervention to promote more positive parent-child relationships, decrease children's oppositional behaviors and develop couple's willingness to open to the exterior, from the mother's point of view.
To evaluate the 12-month efficacy of a parent-based intervention programme on children's and mothers' outcomes in a sample of Portuguese preschoolers displaying early hyperactive and inattentive behaviours (AD/HD behaviours), 52 preschool children whose mothers had received the Incredible Years basic parent training (IY) were followed from baseline to 12 months of follow-up. Reported and observational measures were used. Effects were found in the children's reported AD/HD behaviours at home and at school after 12 months. Large effect sizes were also found in mothers' variables: a decrease in self-reported dysfunctional parenting practices and an improved sense of competence and observed positive parenting. However, the improvements in coaching skills that have been observed after 6 months of follow-up decreased over time. No other significant differences were found between 6 and 12 months follow-up, with small effect sizes indicating that the significant post-intervention changes in child and parenting measures were maintained. After 12 months of follow-up, there was a clinically important reduction of over 30 % in reported AD/HD behaviours in 59 % of children. The sustained effects observed both for children and their mothers suggest long-term benefits of IY. Therefore, efforts should be made by Portuguese policy makers and professionals to deliver IY as an early preventive intervention for children displaying early AD/HD behaviours.
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