None listed
Conditions
Brief summary
Children with acquired brain injury (ABI) present with challenging behavior. and their families present with high levels of stress. Poor self regulation is the core deficit of challenging behavior. The aims of this study are to investigate the effectiveness and feasibility of an intervention (Signposts for building better behavior) which has been adapted to Mexican population in improving behavior and self-regulation (SR) in Mexican children with ABI compared to telephone support. To investigate the effectiveness and feasibility of the intervention in improving parenting skills, parent self-efficacy, quality of parent child-relationship and decreasing parental stress in parents of children with ABI compared to telephone support. Our secondary aims are (1) to explore the impact that parent characteristics (depressive and anxiety symptoms, social risk, family burden and self-regulation) have on the intervention outcomes; (2) to investigate if parenting and child-behavior changes are maintained 3 months after the intervention. We hypothesize that on completion of the Signposts intervention, and at 3-months post-intervention: (i) parents of children with ABI will report improved child behavior and SR compared to those in the telephone support group; (ii) parents of children with ABI will report reduced stress, improved parenting skill and parent self-efficacy compared to the telephone support group; (iii)parenting and child-behavior changes will be maintained. This is the first study that will evaluate the efficacy and feasibility of a parenting program for Mexican parents of children with ABI.
Interventions
Signposts for building better behavior (Signposts). The Spanish version includes a workbook translated to Spanish with permission from the Parenting Research Centre, Victoria, Australia, and the module "Dealing with a Head Injury in the Family” translated with permission of Damith Woods. Two Signpost’s certified practitioners reviewed the translation to assure that the content was accurate. The parents are able to take notes during the sessions and a sheet listing the key concepts of the session
Signposts for building better behavior (Signposts). The Spanish version includes a workbook translated to Spanish with permission from the Parenting Research Centre, Victoria, Australia, and the module "Dealing with a Head Injury in the Family” translated with permission of Damith Woods. Two Signpost’s certified practitioners reviewed the translation to assure that the content was accurate. The parents are able to take notes during the sessions and a sheet listing the key concepts of the session is provided. The provider is a clinical neuropsychologist and a certified Signposts practitioner. The content per session is the following: Introduction, dealing with a head injury in the family and measuring your child behavior (Session 1); Systematic use of daily interactions (Session 2); Replacing difficult behavior with useful behavior (Session 3); Planning for better behavior (Session 4); Teaching your child new skills (Session 5); Dealing with stress and your family as a team (Session 6). Signposts is a manualized parenting program that aims to develop skills in parents to improve behavior. Signposts promotes parental self-regulation because the parent chooses the goals, measures and monitors the child behaviors, chooses the strategies and evaluates the effectiveness. This parenting program is delivered in 6 face to face weekly sessions of 2.5 hours each. The sessions are delivered in groups of a maximum of 8 parents. The intervention is conducted at Iskalti-Condesa, one of the clinics of Iskalti Centre of Psychological and Educational Support. This clinic is close to the center of Mexico City and is well equipped to conduct neuropsychological assessments and provide the intervention program. To improve intervention adherence a checklist with the topics of each session is included and filled by the certified practitioner who delivers the program.
Sponsors
Vicki Anderson
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
6 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1) Parents must have a child aged between six and twelve years of age (2) The child has a diagnosis of an ABI (defined as damage to the brain that occurs after birth) (3) Child with a medical reference stating type of brain injury (4) The injury is diagnosed at least 3 months previous to the start of the pre intervention assessment (5) Enough medical history to determine injury level of severity (Glasgow coma scale in a medical report or neuroimaging evidence of mass lesion or neurological deficits reported by the treating medical clinician) (6) Mothers or fathers can participate together or individually (7) Parents must have an active and current parenting role with the child (8) Parents must be able to comply with the study intervention and assessment protocols as is determine by the researcher during initial contact with the parent (9) Parents must be over 18 years (10) Parents must be able to write and read in Spanish.
Exclusion criteria
(1) Parent with symptoms of psychosis or borderline personality (determined by a face to face interview) (2) Child with incomplete treatment of chemotherapy (3) Child programmed for neurosurgery (4) Child receiving other kinds of behavior modification therapy (5) Parent or child with history of psychiatric illness (6) Uncontrolled seizures in the child (7) Parent does not have current access to child
Outcome results
None listed