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IES Grant

Title: Early Intervention for Young Children with ADHD: Developing Strategies to Enhance Parent Engagement
Center: NCSER Year: 2012
Principal Investigator: DuPaul, George Awardee: Lehigh University
Program: Early Intervention and Early Learning in Special Education      [Program Details]
Award Period: 9/1/12-8/31/15 Award Amount: $1,207,209
Goal: Development Award Number: R324A120284
Description:

Co-Principal Investigator: Lee Kern

Purpose: Attention-deficit/hyperactivity disorder (ADHD) in young children is associated with significant impairment in behavioral, social, and pre-academic functioning, with affected children approximately two standard deviations below their non-ADHD counterparts in all three areas. Additionally, ADHD tends to be chronic, with research suggesting that at least 70 to 80 percent of preschool-aged children with this disorder will continue to exhibit significant ADHD symptoms during elementary school. One promising approach to intervention in the early years is to train parents to help address the issues of young children exhibiting early behavioral symptoms of ADHD. However, two major issues seem to limit the effectiveness of parent education programs: (1) the duration of many of the programs (e.g., 20 sessions) appears to severely limit parent completion; and (2) none of the parent education interventions have specifically targeted the multiple challenges that children with ADHD experience, such as poor parent-child interactions, difficulty with pre-academic skills, and a high injury rate.

The primary purpose of this project is to further develop and refine a parent education program to increase parent engagement with early intervention for young children with ADHD. A secondary purpose is to develop an alternative format (web-based) of parent education to increase parent accessibility to and engagement with the intervention. The end goal is for more consistent implementation of effective behavioral strategies for preschoolers.

Project Activities: Research activities will be conducted across three Phases. During Phase 1, an existing parent education program will be modified and streamlined, with the goal of increasing and maintaining parent engagement. During Phase 2, a web-based format of the parent education program will be developed and refined, which also aims to increase and maintain parent engagement. Phase 3 will compare parent engagement, implementation fidelity, and child outcomes between in-person and web-based delivery of parent education. Parent and child characteristics associated with differential parent preference for delivery model will also be examined.

Products: The expected products of this project include a fully developed, streamlined, and targeted parent education program in two formats (face-to-face and web-based) that will be suited for parents of young children with significant symptoms of ADHD; data on the feasibility and promise of the intervention; and peer-reviewed publications and presentations.

Structured Abstract

Setting: The research will take place in Pennsylvania, with parent education sessions conducted in community settings (e.g., school, health care office). Data will be collected in parent education sessions and in family homes.

Sample: Children identified with significant symptoms of ADHD between the ages of 3 and 6 will participate. A total of approximately 60 children and their parents will participate across all phases of the study (Phase 1 – 20, Phase 2 – 10, and Phase 3 – 30).

Intervention: The parent education program to be developed targets areas that are specifically problematic for young children with symptoms of ADHD: poor parent-child interactions, difficulty with pre-academic skills, and a high injury rate. The intervention will be implemented across 10 weeks, with each weekly session lasting about 2 hours. Session format includes didactic presentation of core content facilitated by PowerPoint slides and video-clip illustrations, with parent discussion, modeling, and role play interspersed throughout the session to facilitate understanding and practice strategies. In Phase 2, the intervention will be converted to a web-based format in a manner that maintains essential elements of the face-to-face program, enhances parent engagement through the use of multimedia approaches and interactive activities, and provides opportunities for parents to submit questions.

Research Design and Methods: In Phase I, the research team will gather input from a community development team consisting of relevant stakeholders (parents, preschool teachers, early interventionists, developmental pediatricians, and social workers) regarding the content of the existing parent education program. The input will be used to develop and refine the intervention into a condensed but targeted 10-week intervention with an accompanying manual. This draft intervention will be field tested, revised based on results of the field test (child outcomes, parent feedback, observations of parent implementation of the intervention), tested again with a different cohort of families, and then refined based on the results of this second field test. In Phase 2, the intervention will be converted into the web-based format, and the web version will then be tested and revised based on user input. In Phase 3, participating parents will participate in either the face-to-face or web-based version of the parent education program, and outcomes will be compared.

Control Condition: Due to the nature of the research design, there is no control condition. However, in Phase 3, comparisons will be made between the face-to-face and web versions of the intervention.

Key Measures: Measures will include community development team and parent ratings of intervention components; frequency of attendance/completion of parent education sessions; observation of parent adherence with prescribed intervention components; parent ratings of effectiveness, feasibility, and acceptability of the intervention; parent ratings and observations of child behavior; standardized measures of child reading and math achievement; and parent preferences for face-to-face or web-based parent education.

Data Analytic Strategy: Analyses will be primarily descriptive and oriented towards assessing parent education process variables that are related to parent engagement with the intervention. T-tests will be used in the pilot study to assess whether the face-to-face and web groups differ on parent and child outcome measures.


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