Day 40 of 99 Days to FASDay: Positive Parenting with Triple P


Today concludes our focus on positive parenting / family intervention programs. Although not specific to FASD, it is for children with developmental disabilities.

The information below comes directly from the report: Prenatal Alcohol Use and FASD: Diagnosis, Assessment and New Directions in Research and Multimodal Treatment, 2011, 64-107 CHAPTER 4: An Innovative Look at Early Intervention for Children Affected by Prenatal Alcohol Exposure by Heather Carmichael Olson and Rachel A. Montague.

Today’s positive parenting program is called the Stepping Stones Triple P Program.

The Stepping Stones Triple P Program is a positive parenting intervention, designed generally for young children with developmental disabilities and their families. The age range tested so far is from 2 to 7 years (but has been extended up to children aged 9 who may be lower functioning).

This intervention is based on principles of behavioral family intervention and parent management training. Parents learn to respond in a planned manner to their child’s behavior and set up activities to minimize chances for disruptive behavior.

The Stepping Stones Triple P intervention was adapted from the evidence-based Triple P Positive Parenting Program. Adaptations included making content and materials more sensitive to families of children with disabilities, and covering additional issues relevant to this type of parenting (e.g., adjusting to having a child with a disability).

Another adaptation was adding to the curriculum information about causes for behavior problems beyond those seen among children who are typically-developing, such as communication problems or disruptive efforts by the child to stop a disliked activity.  Behavior change protocols for common problems associated with developmental disabilities (such as self-injurious behavior, or eating non-food substances) were included.

Clinicians receive extensive specialized training and regular supervision.  The Stepping Stones Triple P Program is delivered in two-hour-long sessions. The 10-session curriculum includes examining causes of child behavior problems, and providing information on strategies for: developing positive relationships; encouraging desirable behavior; teaching new skills and behaviors; and managing misbehavior.

Care givers receive a family workbook and watch videotaped demonstrations of positive parenting skills. Parents self-select goals and strategies to practice in clinic and several home observation sessions.

In the original efficacy study, families with additional needs were offered additional sessions beyond the basic program to cover either Partner Support (marital communication and parenting teamwork) and/or Coping Skills (mood management and coping skills).

In a randomized control trial, an intervention group was compared with a waiting list control. Participants were preschoolers (up to age 7 years) with behavior problems and various developmental disabilities (none specifically identified as affected by prenatal alcohol exposure, or with FASD). When families had additional needs, the intervention included additional sessions offering training on partner support and/or coping skills for families with additional needs. Results were promising.

The Stepping Stones Triple P intervention was associated with reduced child behavior problems as reported by mothers and independent observers, improved maternal and paternal parenting style, and decreased maternal stress. Some effects were maintained at 6-month follow-up. Families were well satisfied with treatment.

Further testing compared use of the Stepping Stones Triple P Program with and without the enhancements of parent coping skills, relative to waiting list controls. Participants were again families raising preschoolers (up to age 5 years) with developmental disabilities and behavior problems, who appeared to have milder adaptive behavior deficits than did participants in the earlier efficacy trial. Both the basic and enhanced interventions were equally effective, so there was no evidence that adding adjunctive treatment was superior to the standard behavioral training.

After treatment, there were lower levels of observed negative child behavior, reduction in the number of care giving settings where children showed problem behavior, and improved parenting competence. No changes were seen in parent mood or couples adjustment. Families were again satisfied with treatment. Gains were maintained at one-year follow-up. The Stepping Stones Triple P Program has also very recently been tested with families raising children aged 2 to 9 years with autism spectrum disorders, with significant improvements in parent-reported child behavior and parenting styles that were maintained over a 6-month follow-up.

I did take the Triple P Parenting program when the maiden was young. Unfortunately they did not offer this particular program at the time. This one may be the best one in terms of accessibility, because if it’s not offered in your country, there is an on-line version. And while I’ve always found being in a group is the best, on-line is the next best thing.

Click here to check out their website to find a location near you.

If you know of any other specific programs for parenting a child with FASD leave a comment and let us know about it! Otherwise come back tomorrow for Day 41!

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