Treatment Outcomes for At-Risk Young Children With Behavior Problems: Toward a New Definition of Success

Fung, Michael Fung Kee; Fox, Robert; Harris, Sara

doi:10.1080/01488376.2014.915283

Cited by 10 publications

(9 citation statements)

References 57 publications

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“…These results are similar to previous studies using EP (Fox & Holtz, 2009;Fung, Fox, & Harris, 2014). The results of this present study also are comparable with the results of TF-CBT research, which also used an RCT methodology (Sheeringa, Weems, Cohen, Amaya-Jackson, & Guthrie, 2011).…”

Section: Discussionsupporting

confidence: 92%

“…(f) The child and primary caregiver completed the comprehensive intake evaluation and at least five treatment sessions. Previous studies conducted with a similar population with behavior problems without trauma used a minimum number of 3 treatment sessions as part of treatment completion criteria (Fung, Fox, & Harris, 2014). Given the complex nature of trauma, it was hypothesized that more minimum treatment sessions would be needed to produce change, and therefore participants were included in the final sample only if they completed at least five or more treatment sessions.…”

Section: Participantsmentioning

confidence: 99%

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Home-Based Parent Child Therapy for Young Traumatized Children Living In Poverty: A Randomized Controlled Trial

Love

Fox

2017

Journ Child Adol Trauma

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A randomized control trial was used to evaluate the effectiveness of a home-based, parent-and-child therapy program specifically developed for toddlers and preschoolers living in poverty with trauma symptoms. Sixty-four children 5-years of age and younger were referred to a community-based clinic for behavior problems and emotional difficulties. All children had experienced one or more potentially traumatic events and met the DSM-5's criteria for Post-Traumatic Stress Disorder in Children Six Years of Age and Younger. All families received government assistance indicating that their income met the federal definition for poverty. Participants were randomly assigned to either immediate treatment or wait list control groups. Significant between-group differences on all post-treatment measures were found. After the waitlist group completed treatment, significant improvements for both groups were found on all measures at six-weeks follow-up. Outcomes included reductions in challenging behaviors and emotional symptoms of trauma, improved caregiver-child relationships, and increased caregiver adherence to treatment strategies. This study offers support for early intervention of children with trauma symptoms and identifies the clinical challenges and advantages of providing therapy services in a home setting for very young children in poverty.

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Section: Discussionsupporting

confidence: 92%

Section: Participantsmentioning

confidence: 99%

Home-Based Parent Child Therapy for Young Traumatized Children Living In Poverty: A Randomized Controlled Trial

Love

Fox

2017

Journ Child Adol Trauma

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“…A unique strength of this study is that it is one of the first studies where all of the participants representing diverse populations were living in poverty and receiving a home-based treatment program. This study adds to the positive outcomes of previous studies supporting the use of EP with very young children in poverty (e.g., Fox et al, 2013; Fung, Fox, & Harris, 2014; Gresl et al, 2014) by examining treatment outcomes using a randomized treatment control methodology. After EP treatment, parents reported significant improvements in their child’s disruptive behaviors and an increase in their child’s positive prosocial behaviors.…”

Section: Discussionmentioning

confidence: 95%

Early Pathways Therapy for Young Children in Poverty

Harris

Fox

Love

2015

Counseling Outcome Research and Evaluation

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Early Pathways is a home-based, parent and child therapy program for the treatment of disruptive behaviors among young children living in poverty. In this study, 199 clinically referred children were randomly assigned to an immediate treatment (IT) or wait-list control (WL) conditions. Results indicated that parents in the IT condition reported significant improvements in their child's disruptive and prosocial behaviors and increased nurturing and decreased use of corporal and verbal punishment by their parents compared to the WL families. Gains were maintained for children in both the IT and WL conditions at 3-month follow-up.

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“…Past treatment outcomes for EPP have demonstrated decreased frequency of the child’s challenging behaviors, increased positive parent–child interactions during play, decreased parental reliance on verbal and corporal punishment for discipline, improved parental expectations, and higher levels of nurturing at posttreatment (Fox & Holtz, 2009; Harris, Fox, & Love, 2015). These results have been shown to be effective across ethnicity, with low-income African American, Caucasian, and Latino families showing similar levels of improvement with treatment (Gresl et al, 2014); with children both with and without mild developmental delays (Holtz, Carrasco, Mattek, & Fox, 2009); and for achieving long-term maintenance of treatment gains at 1-year follow-up (Fung, Fox, & Harris, 2014).…”

Section: Methodsmentioning

confidence: 99%

Development of a barriers scale to predict early treatment success for young children in poverty with behavior problems.

Gresl¹,

Fox²,

Besasie³

2016

Clinical Practice in Pediatric Psychology

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Research has demonstrated that participation in parent and child therapy (PCT) programs significantly reduces problematic behaviors while increasing positive behaviors in the child. However, PCT programs report rates of early termination as high as 60% among families in poverty. Research to reduce these early termination rates has historically focused on barriers to treatment including logistical conflicts, socioeconomic status, child age, and symptom severity. Despite attempts to address these variables and reduce early termination rates, progress has been slow in advancing the research in this area. In addition, few measures have been designed to accurately assess how barriers to treatment impact treatment attendance and participation, particularly for families of young children living in poverty. The purpose of this study was to develop and pilot a clinician-report screening tool, the Treatment Barriers Scale (TBS), to assess barriers to treatment participation in primarily low-income, urban minority families receiving home-based therapy for their young child’s challenging behaviors. Data from 330 families consecutively referred to a mental health clinic for behavior problems were analyzed to identify the initial psychometric and predictive properties of this new tool in screening treatment barriers in this population. The resulting 17-item scale consisted of two factors, labeled Treatment Process Barriers and Operational Barriers. Each factor demonstrated acceptable levels of internal consistency (.82 and .80, respectively). Children with more-severe challenging behavior at pretest were more likely to be successful by the third session in treatment. Families with higher TBS scores were more likely to be less successful early in treatment. Limitations of the study and implications for future research and practice were discussed.

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Treatment Outcomes for At-Risk Young Children With Behavior Problems: Toward a New Definition of Success

Cited by 10 publications

References 57 publications

Home-Based Parent Child Therapy for Young Traumatized Children Living In Poverty: A Randomized Controlled Trial

Home-Based Parent Child Therapy for Young Traumatized Children Living In Poverty: A Randomized Controlled Trial

Early Pathways Therapy for Young Children in Poverty

Development of a barriers scale to predict early treatment success for young children in poverty with behavior problems.

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