A randomized controlled trial of technology-enhanced behavioral parent training: sustained parent skill use and child outcomes at follow-up

J Child Psychol Psychiatry. 2022 Sep;63(9):992-1001. doi: 10.1111/jcpp.13554. Epub 2021 Dec 9.


Background: Early-onset (3-8 years old) disruptive behavior disorders (DBDs) have been linked to a range of psychosocial sequelae in adolescence and beyond, including delinquency, depression, and substance use. Given that low-income families are overrepresented in statistics on early-onset DBDs, prevention and early-intervention targeting this population is a public health imperative. The efficacy of Behavioral Parent Training (BPT) programs such as Helping the Noncompliant Child (HNC) has been called robust; however, given the additional societal and structural barriers faced by low-income families, family engagement and retention barriers can cause effects to wane with time. This study extends preliminary work by examining the potential for a Technology-Enhanced HNC (TE-HNC) program to improve and sustain parent skill proficiency and child outcomes among low-income families.

Methods: A randomized controlled trial with two parallel arms was the design for this study. A total of 101 children (3-8-years-old) with clinically significant problem behaviors from low-income households were randomized to HNC (n = 54) or TE-HNC (n = 47). Participants were assessed at pre-treatment, post-treatment, 3-month, and 6-month follow-ups. Primary outcomes were parent-reported and observed child behavior problems. Secondary outcomes included observed parenting skills use (ClinicalTrials.gov Identifier: NCT02191956).

Results: Primary analyses used latent curve modeling to examine treatment differences in the trajectory of change during treatment, maintenance of treatment gains, and levels of outcomes at the 6-month follow-up. Both programs yielded improvements in parenting skills and child problems at post-treatment. However, TE-HNC families evidenced greater maintenance of parent-reported and observed child behavior and observed positive parenting skills at the 6-month follow-up.

Conclusions: Our findings contribute to an ongoing line of work suggesting that technology-enhanced treatment models hold promise for increasing markers of engagement in BPT and sustaining long-term outcomes among low-income families.

Keywords: Behavioral parent training; child behavior disorders; low-income families; technology.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Attention Deficit and Disruptive Behavior Disorders / therapy
  • Child
  • Child Behavior Disorders* / psychology
  • Child Behavior Disorders* / therapy
  • Child, Preschool
  • Follow-Up Studies
  • Humans
  • Parent-Child Relations
  • Parenting / psychology
  • Parents* / education
  • Technology

Associated data

  • ClinicalTrials.gov/NCT02191956