Parent–Child Interaction Therapy for Disruptive Behavior in Children with Mental Retardation: A Randomized Controlled Trial

Abstract

This article presents results of a randomized controlled trial examining the efficacy of Parent–Child Interaction Therapy (PCIT) for treating disruptive behaviors of young children (ages 3 to 6) with mental retardation (MR) and comorbid oppositional defiant disorder. Thirty families were randomly assigned to an immediate treatment (IT) or waitlist (WL) control group. Results indicated that IT mothers interacted more positively with their children after treatment than WL mothers, and their children were more compliant after treatment. On parent-report measures, IT mothers reported fewer disruptive behaviors at home and lower parenting stress related to difficult child behavior than WL mothers after treatment. Whether evidence-based treatments for disruptive behavior require modification before application to children with MR is discussed.

This study was funded by the National Institute of Mental Health (F31-MH-068947); American Psychological Association, Division 53; Children's Miracle Network, Shands Hospital, University of Florida; and Center for Pediatric Psychology and Family Studies, University of Florida. Portions of the data were previously presented at the 2006 American Psychological Association, Washington, D.C. and the Sixth Annual Parent-Child Interaction Therapy Conference in Gainesville, FL. This research is based on a dissertation by Daniel M. Bagner, supervised by Sheila M. Eyberg. We thank the members of the Child Study Laboratory for their contributions to this research.

Notes

^a n = 15

^b n = 15

^c Father n = 22, df = 20, in this group comparison

Note: Interobserver reliability was calculated for 51 of the 153 5-min Dyadic Parent–Child Interaction Coding System (DPICS) situations observed at the two assessment points.

^a Percent agreement calculated by summing agreements across participants (and assessment points) and dividing by agreements plus disagreements across participants

Note: CDI = Child-Directed Interaction; IT = immediate treatment; WL = waitlist control

^a One WL family completed the Time 2 assessment by phone and was unable to come in for the observation due to lack of transportation, resulting in a sample size of 21 mother–child dyads for analyses of observational data

^b Adjusted Time 2 scores based on analyses of covariance

^c Cohen's d = effect size between IT and WL groups at Time 2 based on adjusted mean scores

^d CDI skills were coded during the child-led play situation of the Dyadic Parent–Child Interaction Coding System

^e Child compliance was coded during the parent-led play and clean-up situations of the Dyadic Parent–Child Interaction Coding System

Note: Raw scores are reported. Time 1 scores do not differ between groups (all ps > .20). IT = immediate treatment; WL = waitlist control; DI = Dysfunctional Interaction

^a Cohen's d = effect size between IT and WL groups at the Time 2 assessment based on adjusted mean scores

Note: CBCL = Child Behavior Checklist; ECBI = Eyberg Child Behavior Inventory

^a The reliable change index (RCI) was used to determine whether the magnitude of change exceeded the margin of measurement error. The RCI was calculated by dividing the magnitude of change between Time 1 and Time 2 scores for each child by the standard error of the sample difference scores. RCIs greater than 1.96 were considered sufficient in magnitude

^b A child was determined to have made a clinically significant change if the child's score was in the clinically significant range at pretreatment and the normal range at posttreatment, and the change in the child's score from pre- to posttreatment was statistically reliable as defined using the RCI

Additional information

Notes on contributors

Daniel M. Bagner

Daniel M. Bagner is now affiliated with the Brown Center for the Study of Children at Risk, The Warren Alpert Medical School of Brown University, Women & Infants Hospital of Rhode Island, Providence, RI

Sheila M. Eyberg

Sheila M. Eyberg is affiliated with the Department of Clinical and Health Psychology, University of Florida, Gainesville, FL