Prevent Child Maltreatment
Conditions
Keywords
prevention, evidence-based parenting intervention, children, disabilities, IDEA Part C, Stepping Stones Triple P
Brief summary
The purpose of the project is to assess the initial efficacy of Stepping Stones Triple P-Positive Parenting Program (SSTP) with parents of children below age two with developmental disabilities to strengthen families and prevent child maltreatment.
Detailed description
This study is an initial efficacy trial of SSTP for parents of children below age 2. The target population consists of 50 families of young children ages 11-23 months with developmental disabilities who are eligible to receive IDEA Part C (Individuals with Disabilities Education Act Part C) services in one region of South Carolina. Families will be randomly assigned to one of two conditions (1) IDEA Part C services as usual or (2) IDEA Part C services plus SSTP. Project goals are to strengthen parent competence, enhance parent confidence, and strengthen child social, emotional and behavioral functioning. Ultimately, this should result in a reduced likelihood of child maltreatment
Interventions
BEHAVIORALStepping Stones Triple P
10-12 session manualized intervention delivered in client homes
OTHERBabyNet Services As usual
BabyNet services as usual based on IFSP
Sponsors
Quality Improvement Center for Early Childhood
University of South Carolina
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
11 Months to 23 Months
Healthy volunteers
No
Inclusion criteria
* child age between 11 and 23 months of age * child eligible for IDEA Part C Services * parent english speaking * parent willing to allow in-home services
Exclusion criteria
* disability requiring extensive out of home treatment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Parenting Style | Baseline, 5 months | Parenting Scale (Total Score; measure of parenting style). 30 items on the scale, scores range from 1-7 for each item with higher scores indicating dysfunctional parenting styles (laxness, over-reactivity, hostility). Scores summed and divided by 30 for total score. |
| Child Behavior | Baseline, 5 months | Child Behavior Checklist 1/5-5. A parent report measure of child behavioral problems. The score used for this outcome was the CBCL Total Score, which is a T-Score. T scores average 50 with a standard deviation of 10. Scores above 65 considered in the clinical range. |
| Parenting Self-confidence | Baseline, 5 months | Toddler Care Questionnaire. Measures parent reported self-confidence in parenting a toddler. Parents rate their confidence in performing parenting tasks specific to toddlers. Higher scores indicate more confidence. Scores range from 37-185. The total sum score derived from adding the scores for the 37 items in this survey was used for this outcome measure. |
| KIPS | Baseline, 5 months | KIPS observational measure of the quality of the parent-child relationship. scores range from 1-5. Higher scores indicate a higher quality of relationship. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Parent Symptoms of Depression, Anxiety and Stress | baseline, 5 months | DASS-21, brief screening measure of symptoms of depression, anxiety, and stress. Scores on each scale range from 0-21. Higher scores indicate more symptoms in each area. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Stepping Stones Triple P Plus IDEA Part C Services as Usual 10-15 sessions of Level 4 Standard Stepping Stones Triple P delivered in family homes
Stepping Stones Triple P: 10-12 session manualized intervention delivered in client homes. Families also recieved IDEA Part C early intervention services as usual per the family IFSP. | 25 |
| IDEA Part C Services As Usual IDEA Part C services as usual based on IFSP | 24 |
| Total | 49 |
Baseline characteristics
| Characteristic | Stepping Stones Triple P Plus IDEA Part C Services as Usual | Total | IDEA Part C Services As Usual |
|---|---|---|---|
| Age, Continuous | 18.77 months STANDARD_DEVIATION 3.64 | 19.00 months STANDARD_DEVIATION 3.76 | 19.25 months STANDARD_DEVIATION 3.13 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 7 Participants | 12 Participants | 5 Participants |
| Race (NIH/OMB) More than one race | 3 Participants | 7 Participants | 4 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants | 4 Participants | 3 Participants |
| Race (NIH/OMB) White | 14 Participants | 25 Participants | 11 Participants |
| Region of Enrollment United States | 25 participants | 49 participants | 24 participants |
| Sex: Female, Male Female | 8 Participants | 18 Participants | 10 Participants |
| Sex: Female, Male Male | 17 Participants | 31 Participants | 14 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 25 | 0 / 24 |
| serious Total, serious adverse events | 0 / 25 | 0 / 24 |
Outcome results
Primary
Child Behavior
Child Behavior Checklist 1/5-5. A parent report measure of child behavioral problems. The score used for this outcome was the CBCL Total Score, which is a T-Score. T scores average 50 with a standard deviation of 10. Scores above 65 considered in the clinical range.
Time frame: Baseline, 5 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Stepping Stones Triple P Plus IDEA Part C Services as Usual | Child Behavior | CBCL Total Score Baseline | 53.56 T-score | Standard Deviation 8.54 |
| Stepping Stones Triple P Plus IDEA Part C Services as Usual | Child Behavior | CBCL Total Score Post-Tx | 53.45 T-score | Standard Deviation 10.91 |
| IDEA Part C Services As Usual | Child Behavior | CBCL Total Score Baseline | 51.00 T-score | Standard Deviation 10.67 |
| IDEA Part C Services As Usual | Child Behavior | CBCL Total Score Post-Tx | 51.61 T-score | Standard Deviation 9.09 |
Primary
KIPS
KIPS observational measure of the quality of the parent-child relationship. scores range from 1-5. Higher scores indicate a higher quality of relationship.
Time frame: Baseline, 5 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Stepping Stones Triple P Plus IDEA Part C Services as Usual | KIPS | Scores at 5 months | 3.52 scores on a scale | Standard Deviation 0.7 |
| Stepping Stones Triple P Plus IDEA Part C Services as Usual | KIPS | scores at Baseline | 3.39 scores on a scale | Standard Deviation 0.54 |
| IDEA Part C Services As Usual | KIPS | Scores at 5 months | 3.52 scores on a scale | Standard Deviation 0.63 |
| IDEA Part C Services As Usual | KIPS | scores at Baseline | 3.52 scores on a scale | Standard Deviation 0.59 |
Primary
Parenting Self-confidence
Toddler Care Questionnaire. Measures parent reported self-confidence in parenting a toddler. Parents rate their confidence in performing parenting tasks specific to toddlers. Higher scores indicate more confidence. Scores range from 37-185. The total sum score derived from adding the scores for the 37 items in this survey was used for this outcome measure.
Time frame: Baseline, 5 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Stepping Stones Triple P Plus IDEA Part C Services as Usual | Parenting Self-confidence | baseline | 152.32 units on a scale | Standard Deviation 21.93 |
| Stepping Stones Triple P Plus IDEA Part C Services as Usual | Parenting Self-confidence | midpoint | 157.45 units on a scale | Standard Deviation 19.68 |
| IDEA Part C Services As Usual | Parenting Self-confidence | baseline | 155.13 units on a scale | Standard Deviation 19.19 |
| IDEA Part C Services As Usual | Parenting Self-confidence | midpoint | 159.17 units on a scale | Standard Deviation 14.65 |
Primary
Parenting Style
Parenting Scale (Total Score; measure of parenting style). 30 items on the scale, scores range from 1-7 for each item with higher scores indicating dysfunctional parenting styles (laxness, over-reactivity, hostility). Scores summed and divided by 30 for total score.
Time frame: Baseline, 5 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Stepping Stones Triple P Plus IDEA Part C Services as Usual | Parenting Style | baseline Parenting Scale | 2.65 scores on a scale | Standard Deviation 0.57 |
| Stepping Stones Triple P Plus IDEA Part C Services as Usual | Parenting Style | Post-Tx Parenting Scale | 2.09 scores on a scale | Standard Deviation 0.73 |
| IDEA Part C Services As Usual | Parenting Style | baseline Parenting Scale | 2.61 scores on a scale | Standard Deviation 0.7 |
| IDEA Part C Services As Usual | Parenting Style | Post-Tx Parenting Scale | 2.21 scores on a scale | Standard Deviation 0.66 |
Secondary
Parent Symptoms of Depression, Anxiety and Stress
DASS-21, brief screening measure of symptoms of depression, anxiety, and stress. Scores on each scale range from 0-21. Higher scores indicate more symptoms in each area.
Time frame: baseline, 5 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Stepping Stones Triple P Plus IDEA Part C Services as Usual | Parent Symptoms of Depression, Anxiety and Stress | baseline DASS 21 depression | 4.80 scores on a scale | Standard Deviation 6.16 |
| Stepping Stones Triple P Plus IDEA Part C Services as Usual | Parent Symptoms of Depression, Anxiety and Stress | 5 month DASS 21 Depression | 3.00 scores on a scale | Standard Deviation 4.22 |
| Stepping Stones Triple P Plus IDEA Part C Services as Usual | Parent Symptoms of Depression, Anxiety and Stress | 5 month DASS 21 Anxiety | 3.45 scores on a scale | Standard Deviation 3.56 |
| Stepping Stones Triple P Plus IDEA Part C Services as Usual | Parent Symptoms of Depression, Anxiety and Stress | 5 month DASS 21 Stress | 9.55 scores on a scale | Standard Deviation 6.35 |
| Stepping Stones Triple P Plus IDEA Part C Services as Usual | Parent Symptoms of Depression, Anxiety and Stress | baseline DASS 21 anxiety | 3.68 scores on a scale | Standard Deviation 5.59 |
| Stepping Stones Triple P Plus IDEA Part C Services as Usual | Parent Symptoms of Depression, Anxiety and Stress | baseline DASS 21 stress | 11.20 scores on a scale | Standard Deviation 6.98 |
| IDEA Part C Services As Usual | Parent Symptoms of Depression, Anxiety and Stress | baseline DASS 21 anxiety | 3.50 scores on a scale | Standard Deviation 7.11 |
| IDEA Part C Services As Usual | Parent Symptoms of Depression, Anxiety and Stress | baseline DASS 21 depression | 4.58 scores on a scale | Standard Deviation 9.16 |
| IDEA Part C Services As Usual | Parent Symptoms of Depression, Anxiety and Stress | 5 month DASS 21 Stress | 10.70 scores on a scale | Standard Deviation 9.12 |
| IDEA Part C Services As Usual | Parent Symptoms of Depression, Anxiety and Stress | 5 month DASS 21 Depression | 4.09 scores on a scale | Standard Deviation 5.92 |
| IDEA Part C Services As Usual | Parent Symptoms of Depression, Anxiety and Stress | baseline DASS 21 stress | 10.83 scores on a scale | Standard Deviation 8.5 |
| IDEA Part C Services As Usual | Parent Symptoms of Depression, Anxiety and Stress | 5 month DASS 21 Anxiety | 2.96 scores on a scale | Standard Deviation 5.25 |