The Pro-Parenting Study: Helping Parents Reduce Behavior Problems in Preschool Children With Developmental Delay

Behavior problems are a common and concerning challenge among children with developmental
delay (DD). Approximately 50% of children with DD have a comorbid mental disorder or serious
behavior problems- a prevalence three times as high as that found in typically developing
youths. Behavioral parent training (BPT) is the gold-standard intervention for treating child
behavior problems in typically developing children and in children with DD. However, high
levels of parental stress are associated with reduced or no response to BPT for children with
DD. Consequently, parental stress may attenuate the efficacy of the gold-standard,
empirically supported treatment for behavior problems among children with DD. As such,
parental stress is a critical point of intervention for improving both parent and child
outcomes in families of children with DD. The purpose of this study is to quantify the
therapeutic benefit of adding a parent stress-reduction intervention prior to delivering BPT
in order to more effectively reduce child behavior problems, and to investigate the
mechanisms through which intervention outcomes occur.

Inclusion Criteria:

- Parent has a child ages 3 to 5 years with an agency-identified DD in one or more
functional areas who is receiving early intervention or early childhood/ preschool
special education through an individualized family service plan (IFSP) or
individualized education plan (IEP);

- Parent reports elevated child behavior problems, as indicated by a T-score of 60 or
above on the Total Problems scale of the Child Behavior Checklist;

- Parent reports elevated parenting stress, as indexed by a total score above the
recommended cutoff at the 85th percentile on the Parenting Stress Index-4.

Exclusion Criteria:

- Parent screens positive for active psychosis, substance abuse, or suicidality;

- Parent is currently receiving any form of psychological or behavioral treatment at the
time of referral; or

- The child has sensory impairments or nonambulatory conditions that would necessitate
the need for significant modifications to the lab and home visit protocols.