Reducing Externalising Behaviour Problems in Children with Type 1 Diabetes: A Controlled Evaluation of the Triple P-Positive Parenting Program.
Children with Type 1 Diabetes: evaluating the Triple P Positive Parenting Program compared to Standard Diabetes Care for reducing externalising behaviour problems.
Murdoch Children’s Research Institute
80 participants
Aug 1, 2008
Interventional
Conditions
Summary
The purpose of this project is to test the usefulness of a parenting program in reducing and/or preventing behaviour problems and improving metabolic control in children who have developed diabetes in the past couple of years. If the program is helpful, we hope that this will improve the emotional and physical wellbeing of these children in the future. Previous research has shown that children who have behaviour problems before, or soon after they develop diabetes, are at an increased risk for ongoing emotional difficulties, as well as being more likely to have poorly controlled diabetes. We plan to invite the families of children who have diabetes and behaviour problems to take part in this project. Half of these families will be offered a parenting program and the other half will receive the standard care from the Diabetes Clinic. We are also interested in finding out whether this parenting program may prevent behaviour problems developing in the future. We also plan to invite families of children who have diabetes and do not have behaviour problems to take part. Half the families will take part in the parenting program and half will receive the standard care. This will allow us to see whether the parenting program can prevent the development of behaviour problems in children who do not have problems at the moment. We are hoping 80 families will take part in this project.
Eligibility
Inclusion Criteria3
- Children with diagnosed Type 1 Diabetes (of a minimum of 6 months duration) who attend the Diabetes Clinic at the Royal Children's Hospital Melbourne (RCH).
- Children with clinically significant emotional problems and/or behaviour problems (i.e., Internalising T Score > 60 or Externalising T score > 60) will be eligible to participate and will be allocated on the basis of their Externalising or Internalising behaviour problem T score.
- Children without clinically significant emotional or behaviour problems (i.e., (i.e., Internalising T Score < 60 + Externalising T score < 60).
Exclusion Criteria5
- Children whose mothers exhibit significant psychopathology (cut-off score of 12 for depression; Nieuwenhuijsen, de Boer, Verbeek, Blonk, & van Dijk, 2003) will not be invited to participate further in this study as previous research has shown that the Triple P intervention is less effective when mothers have untreated mental health problems. Children and mothers excluded on this basis will be offered assistance getting appropriate clinical services should they want them.
- Children who commence or significantly modify psychotropic medication regimes (which may affect behaviour) during the research and follow-up periods. These children will continue to receive the Triple P Intervention or Standard Diabetes Care (SDC) but their data will not be included in analysis.
- Children with a developmental disorder (such as Autism Spectrum Disorder) and children currently attending at a Special Education School or who qualify for Integration Aide Assistance. These children represent a special population for which individually tailored programs are required.
- ?non-English speaking families;
- ?children with complex medical disease in addition to Type 1 diabetes (e.g., cystic fibrosis, cancer, Traumatic Brain Injury).
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Interventions
Triple P Positive Parenting Intervention: Following Sanders (1999), parents randomly assigned to this condition will be taught 17 core child management strategies. Ten of the strategies are designed to promote children’s competence and development (i.e., quality time; talking with children; physical affection; praise; attention; engaging activities; setting a good example; ‘Ask’, ‘Say Do’; incidental teaching; and behaviour charts), and 7 strategies are designed to help parents manage misbehaviour (i.e., setting rules; directed discussion; planned ignoring; clear, direct instructions; logical consequences; quiet time; and time out). Parents will further be taught a six-step planned activities routine to enhance the generalization and maintenance of parenting skills (i.e., plan ahead, decide on rules, select engaging activities, decide on rewards and consequences, and hold a follow-up discussion with child). Each family will receive *Every Parent (Sanders, 1992) and a workbook, *Every Parent’s Family Workbook (Markie-Dadds, Sanders, & Turner, 2001). Parents will also receive active skills training and support from a trained practitioner (Liz Westrupp) as described by Sanders and Dadds (1993). Active skills training methods will include modelling, role-plays, feedback, and the use of specific homework tasks. On average, parents will attend approximately 10 individual appointments with the practitioner and complete approximately 10 hours of intervention in this condition.
Locations(1)
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ACTRN12609000710224