A Parenting Program to Reduce Disruptive Behavior in Hispanic Children with Acquired Brain Injury: A Randomized Controlled Trial Conducted in Mexico

Abstract

Children with acquired brain injury (ABI) are at risk of impairments in self-regulation and disruptive behavior. We aimed to investigate the effectiveness of the Signposts program to reduce disruptive behavior and improve self-regulation in Hispanic children with ABI, and reduce parental stress and improve parenting practices. Using a randomized controlled trial design, we assigned children (n = 71) and their parents to Signposts or generic telephone support. Blinded assessors conducted assessments at pre-intervention, immediately post-intervention, and at 3 months post-intervention. Signposts was effective in reducing dysfunctional parenting practices. Further, when analyzing participants at risk of behavioral disturbance (n = 46), Signposts was effective in reducing child disruptive behavior in the home environment and emotional self-regulation. No differences were found for parental stress, parent sense of competence, child disruptive behaviors at school, and child cognitive and behavioral selfregulation. The reduction in disruptive behavior was associated with the implementation of authoritative parenting practices (external regulation), and not associated with child self-regulation. ARTICLE HISTORY

Effectiveness of Training Programs for Reducing Adverse Psychological Outcomes in Parents of Children with Acquired Brain Injury: A Systematic Review and Meta-Analysis

“…Table 2 presents the characteristics of the included studies. Two RCTs were conducted in the USA [ 21 , 25 ], one RCT in Mexico [ 22 ], and one RCT in Australia [ 23 ]. Three RCTs were registered in a clinical trials database (Universal Trial Number U1111-1193689 [ 22 ], Clinicaltrials.gov NCT 01214694 [ 21 ], and Australian New Zealand Clinical Trials Registry ACTRN12610001051033 [ 23 ]).…”

“…Two RCTs were conducted in the USA [ 21 , 25 ], one RCT in Mexico [ 22 ], and one RCT in Australia [ 23 ]. Three RCTs were registered in a clinical trials database (Universal Trial Number U1111-1193689 [ 22 ], Clinicaltrials.gov NCT 01214694 [ 21 ], and Australian New Zealand Clinical Trials Registry ACTRN12610001051033 [ 23 ]). The study recruitment periods were reported for three RCTs (2010 to 2015 [ 21 ], March 2016 to May 2017 [ 22 ], and October 2010 to May 2012 [ 23 ]), and were not reported in one RCT [ 25 ].…”

“…Meta-analyses were conducted if at least two RCTs had sufficient clinical and statistical homogeneity for at least one outcome of interest. Outcomes data was extracted from the immediate post-intervention period for two RCTs [ 22 , 23 ], at 6 months follow-up for one RCT [ 21 ], and at 18–36 weeks follow-up in one RCT [ 25 ]. A summary of the outcome measures of interest in each study, and the characteristics of each instrument are shown in Table 1 .…”

Parent Interventions Improve Behavior After Pediatric Traumatic Brain Injury: A Systematic Review and Meta-analysis

“…Not surprisingly, poorer baseline behaviors may lead to more room for improvement in scores from pre-to postintervention, a result that was reflected in studies with children who had lower baseline behavior scores. 38,39 Taken together, child factors of age, baseline behavior, and time since injury are important considerations when examining the beneficial effects of parent interventions on child behavior, regardless of whether the behavior is internalizing or externalizing.…”

Is Pediatric Intensive Care Trauma-Informed? A Review of Principles and Evidence

“…Across all three reviews, the authors highlighted the general paucity of research on intervention studies for this population, despite great need. Studies tend to focus on families affected by pediatric traumatic brain injury in particular, though outcomes are mixed [ 91 , 92 , 93 , 94 , 95 ]. Of note, TIC is distinguished from these types of trauma-specific interventions designed to directly ameliorate the effects of past trauma [ 96 ].…”