Co-Principal Investigator: Mike Epstein

Purpose: Youth with emotional and behavioral disorders are more likely to experience poor education outcomes than those from any other disability group. Although the effectiveness of parental involvement in improving academic outcomes of students is supported by research, students with emotional disturbance (ED) are the least likely to have families who are involved in their education. Because effective interventions for this population have not yet been established in schools, there is a need to evaluate the efficacy of family support programs.

The purpose of this project is to evaluate the efficacy of Parent Connectors, an innovative parent-to-parent intervention developed to support the families of middle-school youth with ED, using a longitudinal, randomized controlled trial. The investigators aim to examine: (1) the outcomes of the intervention on caregiver strain and self-efficacy (proximal outcomes), parent and child participation in education and mental health services, and child behavioral and educational outcomes in school (intermediate outcomes); (2) whether these outcomes are maintained in the subsequent school-year following the completion of services; and (3) how various factors and processes may mediate or moderate outcomes. More specifically, the study will examine (a) how child demographics and parent characteristics may moderate proximal and intermediate outcomes; (b) how processes such as implementation level may mediate proximal and intermediate outcomes; and (c) how proximal outcomes may mediate intermediate outcomes, which may then mediate improvement in child academic performance (distal outcomes).

Project Activities: The research team will conduct a longitudinal, randomized controlled trial with three cohorts of families of middle school students with ED. Families will be randomly assigned to Parent Connectors or services as usual, with stratification by school. Data on proximal, intermediate, and distal parent and child outcomes for both groups will be collected at pre-test and post-test, with a 12-month follow-up data collection to examine the sustainability of outcomes following the conclusion of Parent Connectors services.

Products: The research products include analysis of the efficacy of Parent Connectors on middle school students with ED and their families, peer-reviewed publications, and presentations.

Structured Abstract

Setting: The research will take place in middle schools in Nebraska.

Sample: Participants will include 236 families of middle school students with ED who spend a significant amount of their time in special education settings.

Intervention: Parent Connectors is an intervention designed to provide individualized support to help parents navigate and participate in the school and community-based mental health services for their child. The intervention uses peers—other parents who have successfully navigated the middle-school years with a child with ED—to provide support for the parents through weekly 30- to 60-minute phone calls during the school year. These peers, called Parent Connectors, provide emotional, informational, and instrumental support and promote the benefits of taking action and having positive expectations.

Research Design and Methods: The project will use a randomized controlled design to evaluate the effects of Parent Connectors on the proximal, intermediate, and distal outcomes for middle school youth with ED and their parents. Randomization at the family level will be stratified by school. Three cohorts of families will be randomly assigned to the Parent Connectors program or to receive school and community-based services as usual. The first cohort will start participation during Year 1, with pre-testing, intervention or business as usual, and post-testing. The second cohort will begin participation in Year 2, and the third cohort in Year 3. For each cohort, follow-up assessments will take place 12 months after the post-tests and intervention have been completed, in the spring of the subsequent school year.

Control Condition: Middle school students and parents in the control condition will receive services as usual from school and community-based sources.

Key Measures: Proximal indicators will be measured through parent surveys of self-efficacy, behavioral intentions, and other experiences related to advocating for a child's services; efficacy beliefs relating to a child's educational services; caregiver strain resulting from caring for a child with ED; perception of social norms toward involvement in mental health and education services; and expected benefits of involvement with these services. Intermediate outcomes will be measured with a parent and teacher questionnaire on parental engagement in education; parent survey of their youth's service history; archival school data on students such as attendance, suspension, and office referrals; teacher and parent report of their youth's social skills and problem behaviors using the Social Skills Improvement System (SSIS); and a parental satisfaction survey. Distal outcomes will be measured with teacher report on the academic competence scale of the SSIS; quarterly grades; and standardized state test math and reading scores. Finally, demographic variables will be gathered through parent interview, and implementation fidelity and therapeutic alliance (working relationship between the parent and the Parent Connector) will be measured through a variety of parent and Parent Connector reports. All parent measures will be obtained through telephone interviews; all teacher measures will be obtained through pencil-and-paper surveys.

Data Analytic Strategy: The researchers will apply generalized linear mixed models to analyze binary, continuous, and Poisson repeated measurement data. To account for nesting of subjects within schools, hierarchical linear models will be implemented through the generalized linear mixed models. These models will be expanded to examine moderators, and joint significance tests will be used to examine mediators. The researchers will also adjust for multiple comparisons and use multiple imputation methods to address missing data.

Products and Publications

Journal article, monograph, or newsletter

Duppong Hurley, K.L., January, S.-A.A., and Lambert, M.C. (in press). Using Caregiver Strain to Predict Participation in a Peer-Support Intervention for Parents of Children With Emotional or Behavioral Needs. Journal of Emotional and Behavioral Disorders. doi:10.1177/1063426616649163