An Analysis of Training, Generalization, and Maintenance Effects of Enhanced Primary Care Triple P for Parents of Preschool-Age Children with Disruptive Behavior

Abstract

A brief primary care intervention for parents of preschool-age children with disruptive behavior, Primary Care Triple P (PCTP), was assessed using a multiple probe design. PCTP teaches parents procedures such as praise, modeling, incidental teaching, differential rein-forcement, time-out, planned ignoring, least-to-most methods of prompting, and behavior management routines for noncompliance. Parents learn about causes of common behavior problems, goal-setting, and how to self-monitor their implementation, as well as their children's behavior change. The study examined if newly learned parenting skills would generalize from training to non-training settings, if generalized skills would result in corresponding decreases in child disruptive behavior in non-training settings, and if these decreases would generalize over time. The 4-session intervention was sequentially introduced within a multiple probe format to each of 9 families with a total of 10 children whose ages were between 3-to 7-years. Direct observation of parent-child interaction in the homes found PCTP to be associated with lower levels of child disruptive behavior in target training and various generalization settings. Parent report data also confirmed reductions in intensity and frequency of disruptive behavior, an increase in task-specific parental self-efficacy, improved scores on the Parent Experience Survey, and high levels of consumer satisfaction. However, no significant reductions in aversive parent behavior were shown, nor increases in parent management skills, although trends for both were in the predicted direction. Decreases in observed child disruptive behavior were maintained by most families in training and generalization settings at follow-up. Parent-reported changes in task-specific parental self-efficacy measured at post-intervention continued into follow-up, thus providing further support for the short-term durability of PCTP. Implications for the delivery of brief interventions to prevent conduct problems are discussed.