Research Review: Harnessing the power of individual participant data in a meta?analysis of the benefits and harms of the Incredible Years parenting program / Patty LEIJTEN in Journal of Child Psychology and Psychiatry, 59-2 (February 2018)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 59-2 (February 2018) . - p.99-109 Titre : Research Review: Harnessing the power of individual participant data in a meta?analysis of the benefits and harms of the Incredible Years parenting program Type de document : Texte imprimé et/ou numérique Auteurs : Patty LEIJTEN, Auteur ; Frances GARDNER, Auteur ; Sabine LANDAU, Auteur ; Victoria HARRIS, Auteur ; Joanna MANN, Auteur ; Judy HUTCHINGS, Auteur ; Jennifer BEECHAM, Auteur ; Eva?Maria BONIN, Auteur ; Stephen SCOTT, Auteur Article en page(s) : p.99-109 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Background Parenting programs aim to reduce children's conduct problems through improvement of family dynamics. To date, research on the precise benefits and possible harms of parenting programs on family well?being has been unsystematic and likely to be subject to selective outcome reporting and publication bias. Better understanding of program benefits and harms requires full disclosure by researchers of all included measures, and large enough numbers of participants to be able to detect small effects and estimate them precisely. Methods We obtained individual participant data for 14 of 15 randomized controlled trials on the Incredible Years parenting program in Europe (total N = 1,799). We used multilevel modeling to estimate program effects on 13 parent?reported outcomes, including parenting practices, children's mental health, and parental mental health. Results Parental use of praise, corporal punishment, threats, and shouting improved, while parental use of tangible rewards, monitoring, or laxness did not. Children's conduct problems and attention deficit hyperactivity disorder (ADHD) symptoms improved, while emotional problems did not. Parental mental health (depressive symptoms, self?efficacy, and stress) did not improve. There was no evidence of harmful effects. Conclusions The Incredible Years parenting program improves the aspects of family well?being that it is primarily designed to improve: parenting and children's conduct problems. It also improves parent?reported ADHD symptoms in children. Wider benefits are limited: the program does not improve children's emotional problems or parental mental health. There are no signs of harm on any of the target outcomes. En ligne : https://doi.org/10.1111/jcpp.12781 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=339 [article] Research Review: Harnessing the power of individual participant data in a meta?analysis of the benefits and harms of the Incredible Years parenting program [Texte imprimé et/ou numérique] / Patty LEIJTEN, Auteur ; Frances GARDNER, Auteur ; Sabine LANDAU, Auteur ; Victoria HARRIS, Auteur ; Joanna MANN, Auteur ; Judy HUTCHINGS, Auteur ; Jennifer BEECHAM, Auteur ; Eva?Maria BONIN, Auteur ; Stephen SCOTT, Auteur . - p.99-109. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 59-2 (February 2018) . - p.99-109 Index. décimale : PER Périodiques Résumé : Background Parenting programs aim to reduce children's conduct problems through improvement of family dynamics. To date, research on the precise benefits and possible harms of parenting programs on family well?being has been unsystematic and likely to be subject to selective outcome reporting and publication bias. Better understanding of program benefits and harms requires full disclosure by researchers of all included measures, and large enough numbers of participants to be able to detect small effects and estimate them precisely. Methods We obtained individual participant data for 14 of 15 randomized controlled trials on the Incredible Years parenting program in Europe (total N = 1,799). We used multilevel modeling to estimate program effects on 13 parent?reported outcomes, including parenting practices, children's mental health, and parental mental health. Results Parental use of praise, corporal punishment, threats, and shouting improved, while parental use of tangible rewards, monitoring, or laxness did not. Children's conduct problems and attention deficit hyperactivity disorder (ADHD) symptoms improved, while emotional problems did not. Parental mental health (depressive symptoms, self?efficacy, and stress) did not improve. There was no evidence of harmful effects. Conclusions The Incredible Years parenting program improves the aspects of family well?being that it is primarily designed to improve: parenting and children's conduct problems. It also improves parent?reported ADHD symptoms in children. Wider benefits are limited: the program does not improve children's emotional problems or parental mental health. There are no signs of harm on any of the target outcomes. En ligne : https://doi.org/10.1111/jcpp.12781 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=339

Treatment mechanism in the MRC preschool autism communication trial: implications for study design and parent-focussed therapy for children / Andrew PICKLES in Journal of Child Psychology and Psychiatry, 56-2 (February 2015)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 56-2 (February 2015) . - p.162-170 Titre : Treatment mechanism in the MRC preschool autism communication trial: implications for study design and parent-focussed therapy for children Type de document : Texte imprimé et/ou numérique Auteurs : Andrew PICKLES, Auteur ; Victoria HARRIS, Auteur ; Jonathan GREEN, Auteur ; Catherine ALDRED, Auteur ; Helen MCCONACHIE, Auteur ; Vicky SLONIMS, Auteur ; Ann LE COUTEUR, Auteur ; Kristelle HUDRY, Auteur ; Tony CHARMAN, Auteur ; THE PACT CONSORTIUM,, Auteur Article en page(s) : p.162-170 Langues : Anglais (eng) Mots-clés : Autism  measurement error  mediation  parent–child interaction  parent-focussed therapy Index. décimale : PER Périodiques Résumé : Background The PACT randomised-controlled trial evaluated a parent-mediated communication-focused treatment for children with autism, intended to reduce symptom severity as measured by a modified Autism Diagnostic Observation Schedule-Generic (ADOS-G) algorithm score. The therapy targeted parental behaviour, with no direct interaction between therapist and child. While nonsignificant group differences were found on ADOS-G score, significant group differences were found for both parent and child intermediate outcomes. This study aimed to better understand the mechanism by which the PACT treatment influenced changes in child behaviour though the targeted parent behaviour. Methods Mediation analysis was used to assess the direct and indirect effects of treatment via parent behaviour on child behaviour and via child behaviour on ADOS-G score. Alternative mediation was explored to study whether the treatment effect acted as hypothesised or via another plausible pathway. Mediation models typically assume no unobserved confounding between mediator and outcome and no measurement error in the mediator. We show how to better exploit the information often available within a trial to begin to address these issues, examining scope for instrumental variable and measurement error models. Results Estimates of mediation changed substantially when account was taken of the confounder effects of the baseline value of the mediator and of measurement error. Our best estimates that accounted for both suggested that the treatment effect on the ADOS-G score was very substantially mediated by parent synchrony and child initiations. Conclusions The results highlighted the value of repeated measurement of mediators during trials. The theoretical model underlying the PACT treatment was supported. However, the substantial fall-off in treatment effect highlighted both the need for additional data and for additional target behaviours for therapy. En ligne : http://dx.doi.org/10.1111/jcpp.12291 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=259 [article] Treatment mechanism in the MRC preschool autism communication trial: implications for study design and parent-focussed therapy for children [Texte imprimé et/ou numérique] / Andrew PICKLES, Auteur ; Victoria HARRIS, Auteur ; Jonathan GREEN, Auteur ; Catherine ALDRED, Auteur ; Helen MCCONACHIE, Auteur ; Vicky SLONIMS, Auteur ; Ann LE COUTEUR, Auteur ; Kristelle HUDRY, Auteur ; Tony CHARMAN, Auteur ; THE PACT CONSORTIUM,, Auteur . - p.162-170. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 56-2 (February 2015) . - p.162-170 Mots-clés : Autism  measurement error  mediation  parent–child interaction  parent-focussed therapy Index. décimale : PER Périodiques Résumé : Background The PACT randomised-controlled trial evaluated a parent-mediated communication-focused treatment for children with autism, intended to reduce symptom severity as measured by a modified Autism Diagnostic Observation Schedule-Generic (ADOS-G) algorithm score. The therapy targeted parental behaviour, with no direct interaction between therapist and child. While nonsignificant group differences were found on ADOS-G score, significant group differences were found for both parent and child intermediate outcomes. This study aimed to better understand the mechanism by which the PACT treatment influenced changes in child behaviour though the targeted parent behaviour. Methods Mediation analysis was used to assess the direct and indirect effects of treatment via parent behaviour on child behaviour and via child behaviour on ADOS-G score. Alternative mediation was explored to study whether the treatment effect acted as hypothesised or via another plausible pathway. Mediation models typically assume no unobserved confounding between mediator and outcome and no measurement error in the mediator. We show how to better exploit the information often available within a trial to begin to address these issues, examining scope for instrumental variable and measurement error models. Results Estimates of mediation changed substantially when account was taken of the confounder effects of the baseline value of the mediator and of measurement error. Our best estimates that accounted for both suggested that the treatment effect on the ADOS-G score was very substantially mediated by parent synchrony and child initiations. Conclusions The results highlighted the value of repeated measurement of mediators during trials. The theoretical model underlying the PACT treatment was supported. However, the substantial fall-off in treatment effect highlighted both the need for additional data and for additional target behaviours for therapy. En ligne : http://dx.doi.org/10.1111/jcpp.12291 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=259

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