In this study, we investigated treatments for preschool children with disruptive behavior problems, in a stepped-care format. Our main research questions were: do behavior problems decrease and do parental practices improve after parent training? Are these changes related to each other? In case of remaining behavior problems, what works then best as a second step treatment, medication or a subsequent more intensive behavioral treatment?
Children’s disruptive behavior problems clearly improved after treatment with a 12-session behavioral parent training (n = 83, aged 2.5 - 6 years). Furthermore, maternal parenting skills and parenting sense of competence in both parents improved. Positive changes in parenting were related to a decrease of disruptive behavior problems
A substantial part of the children needed further treatment after parent training. In a randomized controlled pilot study (n = 35), we compared the effectiveness of two subsequent treatments, i.e. parent-child interaction therapy (PCIT) and treatment with medication. We found that both treatments may be effective, while the effect of methylphenidate on children’s disruptive behavior was superior to PCIT in this study. However, because of the small and biased sample, results cannot yet be used in clinical practice.
We were also interested if mothers and fathers evaluated the behavior problems of their child in the same way on a questionnaire, and if not, why this was the case. We found that, in general, fathers and mothers highly agreed, but if they experienced different levels of parenting stress, they disagreed more on ratings of their child’s behavior problems.