Programe for parents of preschoolers getting results

Nov. 29, 2013 — The results indicated that completion of the HOPE-20 program generated significant improvement in the children's mastery of preschool concepts and language skills, reduced the children's behavior problems, lowered the stress of their parents, and fostered the parents' sense of competence.

With sponsorship of Lo Ying Shek Chi Wai Foundation, the Department of Applied Social Sciences of The Hong Kong Polytechnic University (PolyU), and the Department of Social Work and Social Administration of The University of Hong Kong (HKU) have developed the HOPE-20 training program for parents of two-year-old children. This is one of the first locally-developed evidence-based parent education programs for such young children.

The study titled "The efficacy of the HOPE-20 program for parents of 2-year-old children" was jointly completed by Professor Cynthia Leung, Department of Applied Social Sciences, PolyU, and Dr Sandra Tsang JP, Associate Professor, Department of Social Work and Social Administration, HKU. The study evaluated the efficacy of the HOPE-20 program for parents of 2-year-old children, using a randomized controlled trial design. The results indicated that completion of the HOPE-20 program generated significant improvement in the children's mastery of preschool concepts and language skills, reduced the children's behavior problems, lowered the stress of their parents, and fostered the parents' sense of competence.

HOPE-20 is a parent education program conducted through 20 two-hour group sessions designed for parents of two-year-old children. The content included strategies to enhance parent-child relationship, promote child learning and language, and strategies to increase positive behavior and manage inappropriate behavior. Each session consisted of mini-lectures, discussion, and role play. Parents must complete five-minute daily activities with their children between sessions. The program was delivered by trained social workers in nursery schools.

The program was locally developed and fine-tuned after a pilot test. A randomized controlled trial was then conducted to evaluate the efficacy of the program. A total of 173 parents of two-year-old children from 18 nursery schools participated in the study and were randomly assigned into the intervention group, or the wait-list control group, which received the intervention only after the comparison study was completed. The intervention group included 110 participants from 10 nursery schools. At post-intervention, it was found that the children of the intervention group participants showed significant improvements in their mastery of preschool concepts and language skills. The intervention group participants reported fewer child behavior problems, lower parental stress and higher parenting sense of competence.

Professor Cynthia Leung says, "The results indicated that HOPE-20 was an effective universal parent training program, bringing benefits to both the parents and their children." Dr Sandra Tsang adds, "Though we ask parents to spend more time with their children, they do not necessarily know how to interact with their children. The HOPE-20 program provides a concrete and practical set of activities."

With policy support and close collaboration with social services centers, the team hopes nursery schools territory-wide will adopt this program to enhance the development of young children and the competence of their parents.

Sponsored by the Lo Ying Shek Chi Wai Foundation, the HOPE-20 project team is offering three training workshops for practitioners in the field, including psychologists, health professionals, social workers, and early childhood educators. Upon completion of the compulsory sessions, participants will be eligible to collect the program manual and relevant materials and deliver the HOPE-20 program in their work settings.

Dr Lo Ka Shui, Chairman of the Advisory Committee of the Foundation, says, "Although the design of this parental training program may have just ended, this is only the beginning of a long endeavor. We hope NGOs and district groups will continue to refine the parental training program and proactively incorporate parental training into their services. At the same time, we are advocating for the Government to increase its investment in this area, so as to make parental training a core component of early childhood development and facilitate the introduction of parental training to all nurseries in Hong Kong."

Ms Christine Fang BBS JP, Chief Executive of The Hong Kong Council of Social Service, adds, "Early intervention is the key to resolving many family issues. The HOPE-20 program provides an opportunity for social workers to get in closer touch with parents of young children and help them develop healthy parenting habits and attitudes."

View the original article here

Clinician observations of preschoolers' behavior help to predict ADHD at school age

Oct. 1, 2013 — Don't rely on one source of information about your preschoolers' inattention or hyperactivity. Rather, consider how your child behaves at home as well as information from his or her teacher and a clinician. This advice comes from Sarah O'Neill, of The City College of New York, based on research she conducted at Queens College (CUNY), in an article published in Springer's Journal of Abnormal Child Psychology. The study examines how well parent, teacher, and clinician ratings of preschoolers' behavior are able to predict severity and diagnosis of attention deficit hyperactivity disorder (ADHD) at age six.

Characterized by developmentally inappropriate levels of inattention, hyperactivity, and impulsivity, ADHD is one of the most frequently diagnosed childhood psychiatric disorders. Although many studies focusing on school-aged children have shown that parents and teachers -- rather than clinician observations alone -- are more likely to assess ADHD accurately, scant evidence exists to support similar conclusions with preschoolers.

To fill this gap in the research, O'Neill and colleagues followed a group of 104 hyperactive and/or inattentive three- and four-year-olds for a period of two years. Both parents and teachers rated the preschoolers' behavior. In addition, clinicians, who were blind to parent and teacher reports, completed ratings of preschoolers' behavior during a psychological testing session. By the time the children reached age six, more than half (53.8 percent) had been diagnosed with ADHD. The likelihood of such a diagnosis increased when all three informants had rated the child as high on symptoms at age three or four. Furthermore, after analyzing the reports separately, the research team found that parents' reports were critical, particularly when combined with either teacher or clinician reports.

Teacher reports alone were not as useful, and the research team ascribed the relative inability of educators' reports to predict a child's ADHD status over time to possible situational variables. Preschoolers may initially have difficulty adjusting to the structured classroom setting, but this disruptive behavior is time-limited to the transition to school. Teachers' perceptions of "difficult" behavior may also be affected by factors such as classroom setting and size as well as their expectations of children's behavior.

As a result of the study findings, O'Neill and her team emphasize the importance of using information from multiple informants who have seen the child in different settings. Parent reports of preschoolers' behavior appear to be crucial, but these alone are not sufficient. Augmenting the parent report with that of the teacher and/or clinician is necessary. Also important are clinician observations of preschoolers during psychological testing, which are predictive of an ADHD diagnosis and its severity over time. Being able to identify children at risk for poorer outcomes may help educators and clinicians to plan appropriate interventions.

"Consider a preschool child's behavior in different contexts," O'Neill emphasized. "Although parents' reports of preschoolers' inattention, hyperactivity, or impulsivity are very important, ideally we would not rely solely on them. At least for young children, the clinician's behavioral observations appear to hold prognostic utility."

View the original article here