Children with conduct disorder have difficulty following rules and behaving in a socially acceptable manner. They may bully, destroy property, lie or steal, or hurt people or animals. It is important that children learn how to appropriately express and control their emotions while they are very young. Parents can play a major role by receiving training that teaches them to manage their child's behavior and emotional problems.
Since behavioral health services can be difficult for some to access, researchers wanted to determine whether an Internet-assisted intervention would be effective in improving symptoms in children with behavioral problems. The study, published in JAMA Psychiatry, found that Internet-assisted parent training may improve behavior in preschool children with disruptive behavioral problems.
About the Study
The 2 parallel group randomized controlled trial included 464 parents of children aged 4 years old with disruptive behavioral problems. In the first group, 232 participants were randomized to an 11-session Internet-assisted parent training group aimed at developing skills to strengthen parent-child relationships, reinforce positive behavior, reduce conflict, manage transitions, plan for difficult situations, and encourage prosocial behavior. Sessions included exercises, instructional videos, and audio clips demonstrating the application of new skills. Interactions within the website were personalized with the child's name, problems, strengths, and preferred activities. In the second group, 232 parents were randomized to an education control group that included access to a website for a brief introduction to positive parenting. The Internet-assisted parent training group had weekly telephone coaching while the educational control group had 1 telephone coaching session that lasted 45 minutes. Study results were measured using checklists given to parents before the study and at 6 and 12 months after participants were randomized.
At the 12-month follow-up, the Internet-assisted parent training group had significantly greater parent-rated improvement in the child's:
- Aggression
- Sleep
- Withdrawal
- Anxiety
- Emotional problems
There was no significant difference between groups in regards to parental stress, anxiety, or depression.
How Does this Affect You?
A randomized trial is considered the most reliable form of research, but how the research is done will affect its reliability. For example, this study had many participants who did not follow-up with researchers during the 6- and 12-month follow-up periods. Only 82% of parents completed the 6-month follow-up and only 78% of parents completed the 12-month follow-up. Only 75% completed both. However, all participants were included in the analysis. Furthermore, the intervention group received 2 different types of interventions: Internet-based training and telephone coaching. More studies will need to be done to determine whether the Internet-based training, the telephone calls, or both resulted in the reported improvement.
Parent training is an important part of the overall treatment plan of children with conduct disorders. There are different types of parent training programs available. If you are interested in learning how to best parent a child with conduct disorder, talk to your child's doctor about whether there is a parent training program available near you that best meets the needs of you and your child.
RESOURCES
American Psychological Association http://www.apa.org
Healthy Children—American Academy of Pediatrics http://www.healthychildren.org
References
Conduct disorder. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T114669/Conduct-disorder . Updated January 2, 2017. Accessed January 4, 2017.
Sourander A, McGrath PJ, et al. Internet-assisted parent training intervention for disruptive behavior in 4-year-old children: a randomized clinical trial. JAMA Psychiatry. 2016 Apr;73(4):378-387.