Home  «  Program  «  Helping The Noncompliant Child  « 

Helping the Noncompliant Child (HNC)

Scientific Rating:
3
Promising Research Evidence
See scale of 1-5
Child Welfare Relevance Level:
Medium

See descriptions of 3 levels

Brief Description

The information in this program outline is provided by the program representative and edited by the CEBC staff. The Helping the Noncompliant Child (HNC) program has been rated by the CEBC in the area of: Disruptive Behavior Treatment (Child & Adolescent).

  • Types of Maltreatment: Does not target any specific kind of maltreatment
  • Target Population: Parents of children (age 3-8 years old) who have noncompliance or other conduct problems.

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.

Essential Components

Helping the Noncompliant Child (HNC) consists of the following core components:

Population/Participants

  • Presenting problem is excessive child noncompliance.
  • Child age from 3 to 8 years.
  • Sessions typically conducted with individual families rather than in groups (although HNC has been adapted for use in groups).
  • Participants include the parent(s) (both mothers and fathers, whenever possible) and child.
  • Child attends and participates in all treatment sessions.

Program

  • Series of parenting skills to increase positive attention for appropriate child behavior (attends, rewards), ignore minor inappropriate behaviors, provide clear instructions to the child, and provide appropriate consequences for compliance (positive attention) and noncompliance (time out, standing rules).
  • Parenting skills are taught using active teaching methods, such as extensive demonstration, role plays, and direct practice with the child in the training setting and at home.
  • Progression from one skill to the next is based upon demonstrated proficiency by the parent (i.e., competency-based).
  • HNC consists of two phases:
    • In Differential Attention (Phase I), parents learn to increase the frequency and range of social attention to the child (attends, rewards), ignore minor inappropriate behaviors, and reduce the frequency of competing verbal behavior.
    • A major goal is to break out of the coercive cycle by establishing a positive, mutually reinforcing relationship between the parent and child.
    • In Compliance Training (Phase II), parents are taught to use the Clear Instructions Sequence to provide direct, concise instructions to the child; to allow the child sufficient time to comply; and to provide appropriate consequences for compliance (i.e., positive attention) or noncompliance (i.e., time out).
    • Parents also learn standing rules to supplement the Clear Instructions Sequence.
    • Finally, parents learn to implement the parenting skills in situations outside the home (e.g., riding in the car, shopping, visiting others).

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.

Child Component

Helping the Noncompliant Child (HNC) was designed with a child component that addresses the following presenting problems and symptoms:

  • Excessive noncompliance and other conduct problems.

Age range: 3 – 8

Developmental Delays:

This program was not developed for children with developmental delays, and has not been tested for children with developmental delays.

Parent / Caregiver Component

Helping the Noncompliant Child (HNC) was designed with a parent/caregiver component that addresses the following presenting problems and symptoms:

  • Parent of a noncompliant child.

Group Format

Helping the Noncompliant Child (HNC) was not designed to be conducted in a group setting; but has been tested for use in a group setting.

Recommended group size:

10-15 parents

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.

Delivery Settings

This program is typically conducted in a(n):

  • Community Agency
  • Outpatient Clinic

Homework

Helping the Noncompliant Child (HNC) includes a homework component:

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.

Languages

Helping the Noncompliant Child (HNC) has materials available in a language other than English:

Spanish

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program 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.

Minimum Provider Qualifications

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.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:
  • Robert J. McMahon, PhD
    University of Washington
    dept.: Department of Psychology

    phone: (206) 685-9127
Training is obtained:

Training is typically provided onsite at the contracting agency.

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).

Additional Resources:

There currently are additional qualified resources for training:

  • 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

Relevant Published, Peer-Reviewed Research

This program 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 study) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

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:

  • Age range — Intervention: 63.5 months; Comparison: 59.6 months, on average
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Participants recruited through physicians, teachers or the media.

Location / Institution: Not Specified

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:

  • Age range — Intervention: 58.4 months; Comparison: 63.9 months.
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Self-referred by parent or by professionals in the community. Comparison group recruited through the media.

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:

  • Age range — Treatment: 60.3 months; Comparison: 59.7 months, on average.
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Children being treated at the University of Georgia Psychology Clinic for behavior problems.

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:

  • Age range — 67 months, on average
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Clients of the University of Georgia Psychology clinic and their classmates.

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:

  • Age range — Approximately 62 months
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Mother-child pairs referred to the Psychology Clinic for treatment of non-compliance.

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:

  • Age range — Approximately 59 months.
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Mothers and children referred to the University of Georgia Psychological clinic for behavior problems, or by newspaper announcements.

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:

  • Age range — 11-14 years at follow-up.
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Parents and children who had previously participated in a training program.

Location / Institution: Not Specified

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:

  • Age range — 3 to 8 years
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Children referred to an outpatient clinic and diagnosed for Oppositional Disorder.

Location / Institution: Not Specified

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:

  • Age range — 2-7 years at treatment
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Participants in a training program for parents with non-compliant children.

Location / Institution: Not Specified

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:

  • Age range — 2-8
  • Race/Ethnicity — Caucasian, 50.7%; African American, 40.8%; Hispanic, 4.2%, Other, 4.2%.
  • Gender — Not Specified
  • Status — Parents of children enrolled in Head Start programs.

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

References

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 Information

Name: Robert J. McMahon, PhD
Agency/Affiliation: University of Washington
Department: Department of Psychology
Email:
Phone: (206) 543-5136
Fax: (206) 685-3157

Date Reviewed: May 2009