The Effect of School-Based Stepping Stones Triple P on Child and Parent Outcomes

This paper investigated the effectiveness of delivering Stepping Stones Triple P (SSTP), a parenting intervention program, in special education settings and by education professionals to positively influence the potential of families of children with a disability. Questionnaire responses from 216 parents of children with a disability who received SSTP in special education settings and by education staff were extracted from a pre-existing dataset. The questionnaires were administered before and after the program and again 12 months later. Questionnaires included measures of child problem behaviour, parenting practices, parental adjustment, parental self-efficacy, and program satisfaction. Results from a series of MANOVA and ANOVAs revealed significant improvements in parent-reported child behaviour, parenting practices, parental adjustment and parental efficacy. Results were maintained at 12-month follow-up. Qualitative comments revealed that 35% of parents continued to seek support from education professionals due to the positive experience. Overall, these findings suggest that school-based SSTP is effective in enhancing the behaviour of children with disabilities by augmenting the skillset and confidence of their parents. An avenue for future research is to specifically explore the effect of school-based SSTP on the partnership between home and school.

Related papers:

title: Meaningful Differences in the Everyday Experience of Young American Children
abstract: by Betty Hart, Todd R. Risley, Baltimore: Brookes, 1995 268 pages

title: Toward an Experimental Ecology of Human Development.
abstract: A broader approach to research in hu- j man development is proposed that focuses on the pro- \ gressive accommodation, throughout the life span, between the growing human organism and the changing environments in which it actually lives and grows. \ The latter include not only the immediate settings containing the developing person but also the larger social contexts, both formal and informal, in which these settings are embedded. In terms of method, the approach emphasizes the use of rigorousj^d^igned exp_erjments, both naturalistic and contrived, beginning in the early stages of the research process. The chang- ing relation between person and environment is con- ceived in systems terms. These systems properties are set forth in a series of propositions, each illus- trated by concrete research examples.

title: Ecological influences on parenting and child development
abstract: Gordon Jack began his career in social work in 1974, working in three local authority social services departments in the north of England. He has always worked with children and families— eleven years as a practitioner and five years as a manager—with special emphases on adoption and fostering, child protection and direct work with children. Since 1991 he has been lecturing in social work at Exeter University, where he is now Head of Social Work Studies. He is involved in qualifying and post-qualifying training, as well as writing and research into child-care issues.

title: EXAMINING CONGRUENCE WITHIN SCHOOL–FAMILY PARTNERSHIPS: DEFINITION, IMPORTANCE, AND CURRENT MEASUREMENT APPROACHES
abstract: The purpose of this article is to explore the construct of congruence, particularly with regard to school–family collaboration and partnerships. An in-depth review of the empirical and theoretical literature supporting a shift in focus from encouraging family involvement to creating effective school–family partnerships is presented, followed by an investigation into the construct of congruence and the methodological challenges it presents. The authors define congruence, discuss its role in creating and maintaining effective school–family partnerships, and critically review common approaches to measuring congruence and similar constructs. The implications for researchers and practitioners are discussed.

title: School/Family/Community Partnerships: Caring for the Children We Share
abstract: When schools form partnerships with families and the community, the children benefit. These guidelines for building partnerships can make it happen.

title: Effects of parental involvement on academic achievement: a meta-synthesis
abstract: The impact of parental involvement on student academic achievement has been recognized by teachers, administrators, and policy-makers who consider parental involvement to be one of the integral parts of new educational reforms and initiatives. This study synthesized the results of nine meta-analyses that examined this impact and it identified generalizable findings across these studies. The results indicated that the relationship between parental involvement and academic achievement was positive, regardless of a definition of parental involvement or measure of achievement. Furthermore, the findings revealed that this relationship was strongest if parental involvement was defined as parental expectations for academic achievement of their children. However, the impact of parental involvement on student academic achievement was weakest if parental involvement was defined as homework assistance. Finally, the relationship between parental involvement and academic achievement was found to be consistent across different grade levels and ethnic groups. However, the strength of that relationship varied based on the type of assessment used to measure student achievement.

title: FAMILY-SCHOOL PARTNERSHIPS: INFORMATION AND APPROACHES FOR EDUCATORS
abstract: Educators across the nation have long declared the importance of family involvement in children’s education. Considering the large amount of time children spend outside of school, up to 87% of waking hours, it is easy to see how families have a profound impact on children’s educational lives. Families dramatically influence the degree to which children are engaged in school and how they identify themselves as learners. A strong family-school partnership will improve both academic and behavioral outcomes for children.

title: Improving Student Behavior and School Discipline with Family and Community Involvement
abstract: This study reports the results of efforts of school officials to implement family and community involvement activities to reduce the number of disciplinary actions and to ensure a school climate focused on learning. Using longitudinal data from elementary and secondary schools, analyses indicate that regardless of schools’prior rates of discipline, the more family and community involvement activities were implemented, the fewer students were disciplined by being sent to principals’offices or given detention or in-school suspension. Activities for two types of involvement, parenting and volunteering, were most predictive of reducing the percentages of students who were subject to discipline. Also, schools that improved the quality of their partnership programs reported fewer students in need of discipline. The results suggest that creating more connections and greater cooperation among the school, family, and community contexts may be one way for schools to improve student behavior and school discipline.

title: Emotional and behavioural problems in children with visual impairment, intellectual and multiple disabilities.
abstract: Children with multiple impairments have more complex developmental problems than children with a single impairment.



We compared children, aged 4 to 11 years, with intellectual disability (ID) and visual impairment to children with single ID, single visual impairment and typical development on 'Child Behavior Check List/4-18' (CBCL/4-18), Parent Report.



Children with ID and visual impairment had more emotional and behavioural problems than other groups of children: with single impairment and with typical development (F = 23.81; d.f.1/d.f.2 = 3/156; P < 0.001). All children with special needs had more emotional and behavioural problems than children with typical development. The highest difference was found in attention problems syndrome (F = 30.45; d.f.1/d.f.2 = 3/156; P < 0.001) where all groups of children with impairments had more problems. Children with visual impairment, with and without ID, had more somatic complaints than children with normal vision.



Intellectual disability had greater influence on prevalence and kind of emotional and behavioural problems in children than visual impairment.

title: A randomized controlled trial of group Stepping Stones Triple P: a mixed-disability trial.
abstract: Stepping Stones Triple P (SSTP) is a parenting program designed for families of a child with a disability. The current study involved a randomized controlled trial of Group Stepping Stones Triple P (GSSTP) for a mixed-disability group. Participants were 52 families of children diagnosed with an Autism Spectrum Disorder, Down syndrome, Cerebral Palsy, or an intellectual disability. The results demonstrated significant improvements in parent-reported child behavior, parenting styles, parental satisfaction, and conflict about parenting. Results among participants were similar despite children's differing impairments. The intervention effect was maintained at 6-month follow-up. The results indicate that GSSTP is a promising intervention for a mixed-disability group. Limitations of the study, along with areas for future research, are also discussed.

title: Using Family Context to Inform Intervention Planning for the Treatment of a Child with Autism
abstract: Children with autism often engage in problem behavior that can be highly disruptive to ongoing family practices and routines. This case study demonstrated child and family outcomes related to two distinct treatment approaches for challenging behavior (prescriptive vs. contextualized) in a family raising a child with autism. The processes of behavior change directed either solely by the interventionist (prescriptive) and in collaboration with the family (contextualized) were compared. The family-directed intervention involved an assessment of family context (i.e., via discussion of daily routines) to inform the design of a behavioral support plan. Information gathered from the assessment of family routines was used to (a) help select specific behavioral strategies that were compatible with family characteristics and preferences, and (b) construct teaching methods that fit with the family's ongoing practices, routines, and interaction goals. More favorable results (i.e., reductions in challenging behavior, an increase in on-task behavior) were observed within the contextualized treatment-planning phase than were observed within the prescriptive treatment-planning phase. The procedures and results are discussed in relation to the emerging literature documenting the importance of contextualizing behavioral supports applied within family settings.

title: Coercive family processes: A replication and extension of Patterson’s coercion model
abstract: Patterson hypothesized that aggressive behavior develops in families when parents use coercion as the primary mode for controlling their children. The model has been tested with boys and older children. In this paper, through confirmatory factor analysis, we examine how well the coercion model generalizes to 5-year-old children (boys and girls). Our results suggest that the model fits the data similarly for boys and girls. Few sex differences in child antisocial behavior were found on observed or parent-rated measures, nor were differences found in observed parent aversive responses to child behavior. This implies that similar coercion processes apply to both boys and girls.  2001.

title: Self‐reported and actual use of proactive and reactive classroom management strategies and their relationship with teacher stress and student behaviour
abstract: This study investigated the relationship between primary school teachers’ self‐reported and actual use of classroom management strategies, and examined how the use of proactive and reactive strategies is related to teacher stress and student behaviour. The total sample consisted of 97 teachers from primary schools within Melbourne. Teachers completed four questionnaires which gathered information on demographics, disruptive student behaviour, teacher management strategies, and teacher self‐reported stress. In addition, 20 of the 97 teachers were observed in their classrooms while teaching, with teacher behaviour management strategies and student on‐task behaviour recorded. Observation and questionnaire data were then matched. The findings indicated that teacher self‐reports accurately reflect actual practice, that relatively minor forms of student misbehaviours are a common concern for teachers, and that teachers are spending a considerable amount of time on behaviour management issues. The findings also revealed that the use of predominantly reactive management strategies has a significant relationship with elevated teacher stress and decreased student on‐task behaviour. These findings have important implications for teaching practices and student learning.

title: Stepping Stones Triple P: the theoretical basis and development of an evidence‐based positive parenting program for families with a child who has a disability
abstract: Stepping Stones Triple P is the first in a series of programs based on the Triple P – Positive Parenting Program that has been specifically designed for families who have a child with a disability. This paper presents the rationale, theoretical foundations, historical development and distinguishing features of the program. The multi‐level intervention adopts a self‐regulation framework in consulting with parents that involves the promotion of parental self‐sufficiency, self‐efficacy, self‐management skills, personal agency and problem‐solving skills. This paper describes the key program design features, intervention techniques, model of clinical consultation, its clinical applicability, and empirical base. The 10‐session individually administered version of the program, known as Standard Stepping Stones Triple P is described and the important role of training, supervision and agency support in disseminating the program is discussed.

title: Experience and outcomes of stepping stones triple P for families of children with autism.
abstract: This study investigated the experience and perceived outcomes of a behavioural family intervention, standard stepping stones triple P (SSTP), for parents of children with autism. An indepth, prospective, mixed-methods, multiple case-study design was employed. Parent participants and SSTP practitioners took part. Participation in SSTP was consistently associated with improved parental self-efficacy, and was also associated with improved parental psychological well-being and decreased perceived need for behavioural services for some families. Three key themes emerged from the qualitative interview data, reflecting changes attributed to participation in SSTP: (1) changes in the "attribution of cause" of misbehaviour, (2) "Who's the boss?" reflecting a change to parents feeling more in charge of their child's behaviour, daily routines and choices, and (3) "Rewarding is rewarding!" reflecting appreciation of a positive approach to behaviour management. Practitioners discussed their impressions of appropriate participants, timing, structure, and session preferences for SSTP, and implications related to the professional qualifications of practitioners delivering SSTP. Clinical implications for the use of SSTP with families of children with autism are discussed.

title: Behavioral Family Intervention for Children With Developmental Disabilities and Behavioral Problems
abstract: The outcomes of a randomized clinical trial of a new behavioral family intervention, Stepping Stones Triple P, for preschoolers with developmental and behavior problems are presented. Forty-eight children with developmental disabilities participated, 27 randomly allocated to an intervention group and 20 to a wait-list control group. Parents completed measures of parenting style and stress, and independent observers assessed parent-child interactions. The intervention was associated with fewer child behavior problems reported by mothers and independent observers, improved maternal and paternal parenting style, and decreased maternal stress. All effects were maintained at 6-month follow-up.

title: Stepping Stones Triple P seminars for parents of a child with a disability: a randomized controlled trial.
abstract: Parents of children with a developmental disability require tailored parenting support, as their families have special needs and are at risk of increased burden. The aim of this study was to evaluate the efficacy of the Stepping Stones Triple P seminars, a brief group intervention for parents of a child with a disability. There were two seminars that presented parenting strategies to improve both child behavior and parenting variables implicated in the development and maintenance of child problem behavior. Fifty-three parents participated in this randomized controlled trial. Each had a child, aged two to ten, with a disability. The results indicated significant reductions in child behavior problems, the use of dysfunctional parenting styles, and parental conflict reported by parents in the intervention group compared to a waitlist group. The results were maintained at 3-month follow-up and there was evidence of a sleeper effect for parenting confidence. This study demonstrated that the seminars provide a promising intervention for parents of children with a disability. Limitations and implications for future research are also discussed.

title: Stepping Stones Triple P-Positive Parenting Program for children with disability: a systematic review and meta-analysis.
abstract: This systematic review and meta-analysis evaluated the treatment effects of a behavioral family intervention, Stepping Stones Triple P (SSTP) for parents of children with disabilities. SSTP is a system of five intervention levels of increasing intensity and narrowing population reach. Twelve studies, including a total of 659 families, met eligibility criteria. Studies needed to have evaluated SSTP, be written in English or German, contribute original data, and have sufficient data for analyses. No restrictions were placed on study design. A series of meta-analyses were performed for seven different outcome categories. Analyses were conducted on the combination of all four levels of SSTP for which evidence exists (Levels 2-5), and were also conducted separately for each level of SSTP. Significant moderate effect sizes were found for all levels of SSTP for reducing child problems, the primary outcome of interest. On secondary outcomes, significant overall effect sizes were found for parenting styles, parenting satisfaction and efficacy, parental adjustment, parental relationship, and observed child behaviors. No significant treatment effects were found for observed parenting behaviors. Moderator analyses showed no significant differences in effect sizes across the levels of SSTP intervention, with the exception of child observations. Risk of bias within and across studies was assessed. Analyses suggested that publication bias and selective reporting bias were not likely to have heavily influenced the findings. The overall evidence base supported the effectiveness of SSTP as an intervention for improving child and parent outcomes in families of children with disabilities. Limitations and future research directions are discussed.

title: Stepping Stones Triple P: An RCT of a Parenting Program with Parents of a Child Diagnosed with an Autism Spectrum Disorder
abstract: Whilst the Triple P Positive Parenting Program has a large evidence base (Sanders, Clinical Child and Family Psychology Review 2:71–90, 1999; Sanders, Journal of Consulting and Clinical Psychology  2000) and preliminary evidence indicates that Stepping Stones Triple P is also efficacious (Roberts, Journal of Clinical Child and Adolescent Psychology, 35(2):180–193, 2006), to date Stepping Stones has not been evaluated with the ASD population. Fifty-nine families with a child with ASD aged between 2 and 9 participated in this randomized controlled trial. The results demonstrate significant improvements in parental reports of child behaviour and parenting styles with the treatment effects for child behaviour, parental over reactivity and parental verbosity being maintained at follow-up 6 months later. Further, the results suggest significant improvements in parental satisfaction and conflict about parenting as well as a sleeper effect for parental efficacy. The results indicate that Stepping Stones Triple P is a promising intervention for parents of children with ASD. Limitations and future research are also addressed.

title: Evidence-Based Parenting Programs: Integrating Science into School-Based Practice
abstract: The quality of parenting children receive has a pervasive impact on children’s development including how well they do at school academically and socially. This chapter explores how schools can assist parents to support their children’s academic and social development at school and at home. After reviewing literature that shows that parenting influences social and emotional problems, classroom behaviour, academic attainment, and peer relationships at school, we argue that a multilevel system of parenting support is needed that blends universal and targeted parenting programs. Schools can be an ideal setting for normalizing and destigmatizing parenting programs. A case example is used to illustrate the application of Resilience Triple P, a parenting program that targets children’s peer relationships at school. Schools have great potential to enhance the wellbeing and academic success of children by encouraging parental involvement in evidence-based parenting programs.

title: Child Adjustment and Parent Efficacy Scale-Developmental Disability (CAPES-DD): First psychometric evaluation of a new child and parenting assessment tool for children with a developmental disability.
abstract: This study examined the psychometric properties of the Child Adjustment and Parent Efficacy Scale-Developmental Disability (CAPES-DD), a brief inventory for assessing emotional and behavioral problems of children with developmental disabilities aged 2- to 16-years, as well as caregivers' self-efficacy in managing these problems. A sample of 636 parents participated in the study. Children's ages ranged from 2 to 15. Exploratory and confirmatory factor analyses supported a 21-item, three-factor model of CAPES-DD child adjustment with 13 items describing behavioral (10 items) and emotional (3 items) problems and 8 items describing prosocial behavior. Three additional items were included due to their clinical usefulness and contributed to a Total Problem Score. Factor analyses also supported a 16-item, one factor model of CAPES-DD self-efficacy. Psychometric evaluation of the CAPES-DD revealed scales had satisfactory to very good internal consistency, as well as very good convergent and predictive validity. The instrument is to be in the public domain and free for practitioners and researchers to use. Potential uses of the measure and implications for future validation studies are discussed.

title: Using Text Messaging to Improve Attendance and Completion in a Parent Training Program
abstract: This study examines the efficacy of using text message reminders to increase attendance and completion in a sample of parents at high risk for child maltreatment participating in a 10-week parent training program. Study participants (N = 117) were randomized to the Standard (control) or Text Message (intervention) group. Hierarchical regression models were used to test the relation between group and two outcomes—attendance and program completion—after controlling for demographics and baseline parenting stress scores. Attendance rates were similar for the Standard and Text Message groups, with no statistically significant differences in bivariate and multivariate analyses. Program completion rates were higher in the Text Message group than the Standard group in bivariate analysis. The final model testing the relation between the Text Message group and completion, after controlling for parenting stress, was statistically significant. Results suggest that sending text message reminders increased completion rates. The strategy appears to keep participants connected to the program, making them more likely to attend makeup sessions and fulfill requirements to complete the program. Results are promising regarding the use of text messages to improve parent training program completion rates. Future research should further evaluate this strategy in other parent training programs.