Parenting interventions may improve the behavior of children with cerebral palsy

By Rob Goodier

NEW YORK (Reuters Health) - Acting out is common among children with cerebral palsy, but two programs can teach parents how to reduce their child's behavioral problems, a new study has found.

"My study shows how important it is to address behavioral problems in children with cerebral palsy and that it can be achieved with readily available and accessible interventions," Dr. Koa Whittingham, a postdoctoral research fellow at Queensland Cerebral Palsy and Rehabilitation Research Centre at University of Queensland in Brisbane, Australia, told Reuters Health by email.

Dr. Whittingham and her team reported their findings April 7 online ahead of print in Pediatrics.

They randomized 67 parents of children with cerebral palsy to three different groups: Stepping Stones Triple P, Stepping Stones Triple P with Acceptance and Commitment Therapy, or a waitlist control group (the Triple P stands for Positive Parenting Program.) They allowed some crossover from the control group.

The Stepping Stones program required six two-hour group sessions and three 30-minute phone calls with psychologists accredited in the program. It included discussion of the causes of behavioral problems, goal setting for changes in parent and child behavior, monitoring behavior and recording the frequency of tantrums, and learning to develop a positive parent-child relationship and encourage good behavior.

The Acceptance and Commitment Therapy program involved two two-hour group sessions. It included tools for coping with stress, identifying values such as being a more loving parent, and mindfulness exercises in meditation, living in the moment, and others.

The researchers reported that behavioral problems decreased by a mean difference of 6.04 on the Eyberg Child Behavior Inventory among children whose parents went through Stepping Stones Triple P and by a mean difference of 8.30 when parents went through both programs.

"Stepping Stones Triple P is readily accessible with training available to clinicians and trained practitioners in many communities. Further, the Association for Contextual Behavioral Science is warm and open with training in Acceptance and Commitment Therapy and resources available worldwide," Dr. Whittingham said.

As many as one in four children with cerebral palsy may have a behavioral disorder, according to a 2012 meta-analysis published in the same journal.

Dr. Whittingham and her team recommend that parenting interventions such as the ones they have studied be incorporated into the standard of care for these children.

SOURCE: http://bit.ly/1gcht1i

Pediatrics 2014.

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