This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/
This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/
Child Welfare Outcomes: Child/family well-being
Type of Maltreatment: Not specified
Target Population: Parents of children (age 3-8 years old) who have noncompliance or other conduct problems.
Brief Description:(The information in this program outline is provided by the program representative and edited by the CEBC staff.)
Helping the Noncompliant Child (HNC) has been rated by the CEBC in the area of Disruptive Behavior Treatment (Child & Adolescent). HNC is a skills-training program aimed at teaching parents how to obtain compliance in their children ages 3 to 8 years old. The goal is to reduce conduct problems and prevent subsequent juvenile delinquency and other problem behaviors. The program is based on the theoretical assumption that noncompliance in children is a keystone behavior for the development of conduct problems; and that faulty parent-child interactions play a significant part in the development and maintenance of these problems.
Parents attend sessions with their children, and trainers teach the parents core skills necessary for increasing compliance in their children.
Helping the Noncompliant Child (HNC) consists of the following core components:
Population/Participants
Program
Parent Enhancement Therapy
Although not part of the basic program, an adjunctive module (“parent enhancement therapy”) has been developed and evaluated to address appropriate developmental expectations for the child, maternal personal adjustment, positive communication between parents, and relationships outside the family.
Helping the Noncompliant Child (HNC) was not designed to be conducted in a group.
Helping the Noncompliant Child (HNC) has been tested for use in a group setting.
Testing references:
Conners, N. A., Edwards, M. C., & Grant, A. S. (2007). An evaluation of a parenting class curriculum for parents of young children: Parenting the strong-willed child. Journal of Child and Family Studies, 16, 321-330.
The recommended group size is: 10-15 parents
Recommended intensity: 60 to 90-minute session once or twice a week
Recommended duration: The duration of the program is individualized, based on the parent’s attainment of behavioral criteria for each skill. The average number of sessions is 8-10, with a range of 5-14.
Helping the Noncompliant Child (HNC) includes a homework component.
Description: At the end of each session, parents receive a handout and record sheet pertaining to the session content. In the first phase of the program, parents practice skills daily in the context of a 10-15 minute session of Child’s Game, in which the parent and child engage in a play activity chosen by the child. In addition, parents learn to apply differential attention skills to relevant child behaviors. In Phase II, parents are given specific tasks concerned with giving clear instructions to their child, providing positive attention for compliance, and time out for noncompliance. Parents also practice setting up and explaining standing rules to their child, and applying the parenting skills to situations outside the home and to other children in the family.
Helping the Noncompliant Child (HNC) is typically conducted in a(n): Community Agency and Outpatient Clinic.
Helping the Noncompliant Child (HNC) was designed with a Parent Component.
Helping the Noncompliant Child (HNC) addresses the following presenting problems and symptoms: Parent of a noncompliant child
Helping the Noncompliant Child (HNC) was designed with a Child Component.
Helping the Noncompliant Child (HNC) addresses the following presenting problems and symptoms: Excessive noncompliance and other conduct problems
Age range(s): 3-8
Helping the Noncompliant Child (HNC) was not developed for children with developmental delays.
Helping the Noncompliant Child (HNC) has not been tested for children with developmental delays.
Helping the Noncompliant Child (HNC) has materials available in a language other than English.
Language(s) available:
Spanish. For information on which materials are available in this language, please check on the program's website or contact the program representative (all contact information is listed at the bottom of this page).
There is a manual that describes how to implement this program.
There is training available for Helping the Noncompliant Child (HNC).
Training contact: Robert J. McMahon, PhD, University of Washington, Department of Psychology, Phone: 206-685-9127, Email: mcmahon@u.washington.edu
Number of days/hours: Trainees are required to read and study the trainer’s manual prior to the training. This will take approximately 8 hours). Initial training is conducted in two consecutive 8-hour days. This is followed by a series of one-day (8 hours) booster trainings and regular consultation phone calls (60-90 minutes each).
Training is obtained: Training is typically provided onsite at the contracting agency.
There currently are additional qualified resources for training.
List of additional qualified resources: Rex Forehand, PhD, Department of Psychology, University of Vermont, Phone: 802-656-8674, Email: Forehand@uga.edu
Nick Long, PhD, Department of Pediatrics, University of Arkansas for Medical Sciences, Phone: 501-364-1021, Email: LongNicholas@uams.edu
The typical resources for implementing Helping the Noncompliant Child (HNC) are: A playroom-type of room that is large enough for the therapist, 1-2 parents, and the child. Room should be large enough so that there is room for the child to play with toys separately from where the parents and therapist are sitting.
Age-appropriate toys are required.
Practitioners should have a background in psychology or education, a Master’s level degree in some aspect of human services, and should be familiar with social learning principles and their application to child behavior. Ideally, the trainer would have experience working with young (3-8 year-old) children with conduct problems and their parents.
Supervisors should have at least a Master’s degree and prior experience implementing and/or supervising social learning-based parent management programs with young children.
Helping the Noncompliant Child (HNC) is rated a "3 – Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. For more information on the rating of a “3 – Promising Research Evidence,” please see the please see the Scientific Rating.
Peed, S., Roberts, M., & Forehand, R. (1977). Evaluation of the effectiveness of a standardized parent training program in altering the interaction of mothers and their noncompliant children. Behavior Modification, 1(3), 323-350.
Type of Study: Pre-test/Post-test with non-matched comparison group.
Number of participants: 12 mother-child pairs
Population:
Location/Institution: Not given
Summary: (To include comparison groups, outcomes, measures, notable limitations) Parents were observed in interaction with their children in the home and clinic before and after receiving training in behavior modification skills. Student observers used a coding system developed by the researchers to assess rewards, parent attention, questions, commands, criticisms, warnings, and time-outs. The children’s compliance and attention behaviors were also coded. Parent reports were assessed using scales from the Parent’s Attitude Test. Children in the treated group showed significant positive changes in behavior from the pretest to the posttest period, while comparison group children did not. Limitations include a small sample size and lack of a randomized design.
Length of post-intervention follow-up: None.
Forehand, R., Wells, K. C., & Griest, D. L. (1980). An examination of the social validity of a parent training program. Behavior Therapy, 11, 488-502.
Type of Study: Pretest/Posttest with non-matched comparison group.
Number of participants: 30 mother-child pairs
Population:
Location/Institution: Georgia
Summary: (To include comparison groups, outcomes, measures, notable limitations) Home observation was coded using a system developed by the authors for mother-child pairs receiving the intervention and for the comparison group. Mothers also completed the Home Attitude Scale and the Behavior Rating Scale from the Parent’s Attitude Test. Maternal adjustment was measured using the Beck Depression Inventory (BDI). At post-test, mothers in the treated group reported significant improvement in their children’s behavior, although they still perceived them as less well-adjusted than did mothers in the comparison group. Improvements were maintained at the two month follow-up. Limitations include lack of long-term follow-up and attrition of parents from the post-test period.
Length of post-intervention follow-up: 2 months
Well, K. C., Forehand, R., & Griest, D. L. (1980). Generality of treatment effects from treated to untreated behaviors resulting from a parent training program. Journal of Clinical Child Psychology, 9(3), 217-219.
Type of Study: Pretest/Posttest with non-randomized comparison group.
Number of participants: 24 mother-child pairs
Population:
Location/Institution: University of Georgia.
Summary: (To include comparison groups, outcomes, measures, notable limitations) Parent child interactions were coded using a system developed by the authors, focusing on compliance, non-compliance, and deviant behavior. Analysis found that the treated children significantly increased their compliant behavior to a comparable level to the untreated group following the parent training. This improvement generalized to behaviors not directly addressed by treatment. Limitations include small sample size, lack of long-term follow-up and use of a non-randomized design.
Length of post-intervention follow-up: None.
Breiner, J., & Forehand, R. (1981). An assessment of the effects of parent training on clinic-referred children’s school behavior. Behavioral Assessment, 3, 31-42.
Type of Study: Pretest/Posttest with a non-matched comparison group.
Number of participants: 32
Population:
Location/Institution: Georgia.
Summary: (To include comparison groups, outcomes, measures, notable limitations) Children were observed in interaction with their parent. Interactions were scored according to criteria developed by the authors, with attention to rewards, parent attention, commands, time-outs, oppositional behavior, and compliance. Similar behavior was also coded during classroom interaction with teachers. Analyses revealed an improvement in treated children’s behavior at home, but not in the classroom. The authors note that the clinic group did not appear to differ from the comparison group in classroom behavior even before treatment.
Length of post-intervention follow-up: None.
McMahon, R. J., Forehand, R., & Griest, D. L. (1981). Effects of knowledge of social learning principles on enhancing treatment outcome and generalization in a parent training program. Journal of Consulting and Clinical Psychology, 49(4), 526-532.
Type of Study: Pretest/Posttest
Number of participants: 20 mother-child pairs
Population:
Location/Institution: University of Georgia
Summary: (To include comparison groups, outcomes, measures, notable limitations) Mothers and children were assigned to receive either parent-training alone or parent training supplemented with instruction on social learning principles, designed to help parents learn how to encourage positive behaviors and discourage negative ones. Outcome measures included an assessment of knowledge of behavioral principles and home observation data focusing on parental attention, child attention, compliance, and deviant behavior. After treatment, mothers in the social learning group scored significantly higher on an assessment of behavioral principles. Children in this group were also found to be significantly more compliant than those in the parent-training only group.
Length of post-intervention follow-up: 2 months.
Griest, D. L., Forehand, R., Rogers, T., Breiner, J., Furey, W., & Williams, C. A. (1982). Effects of parent enhancement therapy on the treatment outcome and generalization of a parent training program. Behavior Research Therapy, 20, 429-436.
Type of Study: Pretest/Posttest with non-randomized comparison group.
Number of participants: 32 mother-child pairs.
Population:
Location/Institution: University of Georgia.
Summary: (To include comparison groups, outcomes, measures, notable limitations) Pairs of mothers and children were assigned to receive either parent training alone or an enhanced treatment that incorporated elements relating to parents’ perceptions of child behavior, parents’ personal psychological adjustment, marital adjustment and relationships outside the family. A comparison group receiving no treatment was also included in the analysis. Home observers of the treated groups coded parent child interactions on rewards, commands, use of time-out, child compliance and child deviant behavior. Analysis showed that enhanced parent training was more effective than parent training alone and also superior to the no-treatment comparison group. Limitations included small sample size and low inter-rater reliability on treatment outcome variables.
Length of post-intervention follow-up: None.
Forehand, R., & Long, N. (1988). Outpatient treatment of the acting out child: Procedures, long term follow-up data, and clinical problems. Advances in Behavior Research and Therapy, 10, 129-177.
Type of Study: Post-treatment follow-up with non-matched comparison group.
Number of participants: 42
Population:
Location/Institution: Not given.
Summary: (To include comparison groups, outcomes, measures, notable limitations) The participants were parent and child pairs who had previously participated in a training program aimed at alleviating problems with compliance and aggression. Follow-up measures included a battery of 8 questionnaires addressing child behavior, child emotional adjustment, and parenting, as well as observational data. In general, analysis showed the adolescents in the Parent Training group were functioning similarly to those in the comparison group. Higher scores were found for conflict behavior, according to parent ratings and for anxiety, according to teacher ratings. Children in the Parent Training group were also found to have more academic performance difficulties. Limitations of the study include a high attrition rate and lack of a matched comparison group.
Length of post-intervention follow-up: Approximately 4 and one-half years post-treatment.
Wells, K.C., & Egan, J. (1988). Social learning and systems family therapy for childhood oppositional disorder: Comparative treatment outcome. Comprehensive Psychiatry, 29(2), 138-146.
Type of Study: Randomized controlled trial
Number of participants: 19 families
Population:
Location/Institution: Not given.
Summary: (To include comparison groups, outcomes, measures, notable limitations) Participants were randomly assigned to receive Social Learning-Based Parent Training (SLPT) or Systems Family Therapy (SFT). Observational coding was conducted on parent rewards, attention, commands, and warnings, and on child compliance and noncompliance. Mothers also filled out the Beck Depression Inventory (BDI) and the Locke Wallace Marriage Inventory. No differences were found for maternal depression scores. Overall, participants in the SLPT group showed higher improvement on the symptoms of oppositional disorder and parenting behaviors. Limitations include a small sample size and lack of an untreated control group in the experimental design.
Length of post-intervention follow-up: None.
Long, P., Forehand, R., Wierson, M., & Morgan, A. (1994). Does parent training with young noncompliant children have long-term effects? Behavior Research Therapy, 32(1), 101-107.
Type of Study: Post-test with long-term follow-up and matched comparison group.
Number of participants: 26
Population:
Location/Institution: Not given.
Summary: (To include comparison groups, outcomes, measures, notable limitations) Young adults who had participated as children in a parent-training program were compared to a sample of youth from the community. Follow-up measures included the Conflict Behavior Questionnaire, assessing relationship with parents, the National Youth Survey, to assess delinquent behavior and the Michigan Alcohol Screening Test (MAST). Researchers also assessed emotional adjustment, using the Rosenberg Self Esteem Scale, and the Brief Symptom Inventory. Results showed that the treated group did not differ from the community sample on relationship with parents, delinquency, substance use or emotional adjustment (self-esteem) scores.
Length of post-intervention follow-up: Approximately 14 years after treatment.
Conners, N. A., Edwards, M. C., & Grant, A. S. (2007). An evaluation of a parenting class curriculum for parents of young children: Parenting the Strong-Willed Child. Journal of Child and Family Studies, 16, 321-330.
Type of Study: Pretest/Postest
Number of participants: 63
Population:
Location/Institution: Southern U.S.
Summary: (To include comparison groups, outcomes, measures, notable limitations) Participants were evaluated before and after the intervention and at a six-month follow-up. Assessments included the Eyberg Child Behavior Inventory (ECBI), the Parenting Scale, and the Parenting Stress Inventory (PSI). Parent reported significant improvement in child behavior after the treatment and also indicated improvements in their own self-reported parenting behavior. Scores on parenting stress did not differ across the testing period. Limitations include a small sample size and lack of an untreated comparison group.
Length of post-intervention follow-up: 6 months
Forehand, R., & Long, N. (2002). Parenting the strong-willed child (revised and updated ed.). New York: Contemporary Books/McGraw-Hill.
Long, N., & Forehand, R. (2000). Parenting the strong-willed child: Leader’s guide for the six-week parenting class. (Contact Nicholas Long, LongNicholas@uams.edu)
McMahon, R. J., & Forehand, R. (2003). Helping the noncompliant child: Family-based treatment for oppositional behavior (2nd ed.). New York: Guilford Press.
Contact name: Robert J. McMahon, PhD
Affiliation/Agency: University of Washington, Department of Psychology
Email: mcmahon@u.washington.edu
Phone: 206-543-5136
Fax: 206-685-3157