Les troubles du spectre de l’autisme (TSA) affectent la qualité de vie familiale. Des programmes de formation aux habiletés parentales (PFHP) sont susceptibles d’entraîner une amélioration du stress parental et du comportement de l’enfant. Cette étude vise à développer et évaluer un PFHP francophone basé sur l’analyse appliquée du comportement. Ce PFHP a été évalué auprès d’un groupe pilote de 6 parents. Une augmentation des connaissances sur les TSA et les pratiques éducatives est observée ainsi qu’une amélioration du comportement de l’enfant. Les parents considèrent les objectifs ciblés comme importants, les procédures transmises comme acceptables et les effets observés comme satisfaisants. Le PFHP a été amélioré et évalué auprès de 18 parents. Une augmentation des connaissances et des pratiques éducatives est observée avec une amélioration des compétences sociales des enfants. Pour 16 parents, une amélioration au niveau du stress est remarquée. Un manuel de ce PFHP a été élaboré. / Parents of children with ASD face many challenges that affect their well-being. Parent trainings (PT) in young children with ASD are known for improving the child’s behaviors and reducing parenting stress. The purpose of this study is to develop and evaluate a French parent training that is based on applied behavior analysis. An initial efficacy study was conducted with 6 parents. Parents have significantly improved their knowledge in ASD and behavioral intervention strategies. They reported an improvement in their child’s behavior. The PT was considered by the parents as effective, the methods used as acceptable and the objectives targeted as important. This promising PT was then improved and evaluated on 18 more parents. Parents have again improved their knowledge in ASD and behavioral strategies whereas children’s socialization skills have improved as well. For 16 parents, the PT has an additional decreasing effect on stress. A manual has been developed with this PT.

Currently, very little is understood regarding the effectiveness of school-based Behavioral Parent Training (BPT) programs or associated attrition rates. The goal of the current study is to examine the effectiveness of school-based BPT programs, associated attrition rates, and possible moderator variables related to attrition. Searches within the databases EBSCOhost were conducted to find BPT programs located at schools as well as the associated attrition rates for each individual study. Mean associated attrition rates were calculated using the software Comprehensive Meta-Analysis. The mean weighted attrition rate across all trials of school-based studies was 42.2%. Significant moderators were also found to increase the risk of attrition in this study. For instance, interventions that were preventative or delivered at a Tier I level, were individually delivered, involved participants from non-disadvantaged backgrounds and targeted behaviors classified as mixed/comorbid. Additionally, the number of sessions and the average age of child/parent moderated the weighted associated attrition rate. Insignificant results were found for program provider and caregiver attending. Comparisons between results from this study and the clinic-based literature are discussed as well as directions for future research.

La présente étude vise à vérifier si la forme de maltraitance subie par l’enfant modère les effets d’un programme d’entrainement aux habiletés parentales (PEHP) sur la probabilité de fermeture du dossier de l’enfant et la probabilité que l’enfant fasse l’objet d’un nouveau signalement fondé aux services de protection de la jeunesse (PJ). L’étude porte sur 736 enfants ayant eu un dossier actif aux services de PJ de Montréal entre 2007 et 2015. Le groupe expérimental est composé de tous les enfants dont le parent a participé au PEHP Incredible Years (n=368). Un groupe contrôle a été apparié au groupe expérimental sur la base d’un score de propension. Des régressions de Cox ont révélé qu’à partir du moment où les parents ont participé au PEHP, la probabilité de fermeture du dossier des enfants suivis pour des motifs de négligence augmente davantage que celle des enfants suivis pour des motifs de mauvais traitements psychologiques. La participation au PEHP n’a pas d’effet sur la récurrence de la maltraitance signalée, et ce, peu importe la forme de mauvais traitements subis. Les résultats démontrent que la participation des parents à un PEHP permet d’augmenter la probabilité de fermeture du dossier de leur enfant, et donc, de diminuer les durées de prise en charge en PJ. / Abstract: The study examines whether the form of maltreatment experienced by the child moderates the effects of a parent training program (PTP) on the probability that the child’s case will be closed and that the child will be the subject of a new founded report to child protective services (CPS). This study involved 736 children on whom the Montreal CPS agency had an active file between 2007 and 2015. The experimental group was composed of all children with a parent who participated in the PTP Incredible Years (n=368). A control group was matched with the experimental group based on a propensity score. Cox regression revealed that once parents have participated in the PTP, the probability that their children’s cases will be closed increases more for children being followed because of neglect than for those being followed because of emotional maltreatment. Participating in the PTP has no effect on the recurrence of reported maltreatment, regardless of what form of maltreatment the child has been subjected to. Results show that a parent’s participating in a PTP increases the probability that his or her child’s CPS case will be closed and hence reduces the length of time that the child must receive protective services.

Caregivers of children with autism will likely meet with many school professionals once their children become school-aged. These meetings can be intimidating for caregivers who are unfamiliar with special education terminology and protocol, and caregivers may feel ineffective when communicating with school personnel. The purpose of this study is to describe a training curriculum to teach caregivers ways in which to communicate during meetings with school professionals, including the kinds of questions to ask/statements to make and when to ask or make them. A detailed overview of the training procedures, the participants, and the outcomes are described here. Preliminary data suggest the training produced increases in communication skills and that caregivers found the training effective and useful.

Parent-child interactions help set the foundation for a child's development. It is therefore important to investigate the relative efficiency and efficacy of procedures used to train them. One procedure that researchers continue to explore is video modeling. The current study evaluated the effect of a video model that displayed favorable parent-child interactions and a modified model with embedded instructions to determine if the introduction of either of these models would alter parent-child interactions. Both models were presented alone without supplemental guidance. Three families were involved in the study. The results showed no systematic change across families or conditions as a result of video viewing and are discussed within context of the needs of the parent, adequate stimulus control, community to support behavior change, measurement sensitivity, and influence of methodology. This study provided a great baseline for future studies to explore the necessary components to create an effective video model.

Parent training, utilizing the principles of applied behavior analysis to teach effective parenting skills, is a widely used intervention to decrease child behavior problems. The extent to which these interventions are successful in improving behavior, and the degree to which the effects are maintained, relies heavily on the behavior of the parent after the completion of the training. Research suggests that parents' ability to use the skills taught during training diminishes over time. One variable suggested to contribute to parent nonadherence is negative reinforcement. To further investigate, the current study first taught parents correct implementation of a time out procedure, then through a series of practice sessions, manipulated role-player behavior in an attempt to directly observe and measure the effects of negative reinforcement on parent integrity. However, due to lack of responding and contact with the contingency, the effects of negative reinforcement could not be assessed. The investigation did corroborate previous evidence on the effectiveness of the parent-training model used to teach participants the time out protocol. Several areas of future research are presented for parent training and collecting in-home naturalistic observations to assess parent and child behavior.

Many children in low-income areas are failing in schools, frequently due to substandard reading skills. Research has shown that early intervention can help alleviate this problem. However, most early intervention strategies are very expensive and labor intensive for school personnel. Furthermore, it is often not clear what programs will work with a certain student population due to their widely diverse backgrounds. In low-income schools, parents are often an ignored resource. Many teachers complain about lack of parent involvement, and yet most do nothing to solicit it. Using parents to help provide beginning reading practice for their children could be a way to involve families in the school and help children gain vital reading skills. This study investigated the effects of parent training in a fluency reading method called “Paired Reading” among low-income first grade students. A one-hour training sessions was offered at two different times to the parents of four first grade classes in an urban elementary school. Thirty-one participated. The children of these parents constituted the experimental group. This group was pretested and posttested to assess reading fluency, sight word recognition and reading attitudes. Forty-one students at a neighboring elementary school acted as the control group for this study. Qualitative interviews were also conducted on experimental group parents and teachers. The results indicated significant gains in reading fluency, sight word recognition and attitudes about reading. Also, there was a significant relationship between the minutes a child spent practicing Paired Reading with the parent and the amount of improvement the child made. Interview data suggested that parents welcomed this type of training session and enjoyed doing the activities with their children. Unfortunately, the interview data also indicated that teachers were negative about the efficacy of parent training sessions and had no immediate plans to implement such classes.

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Le trouble d’anxiété de séparation (TAS) est le trouble anxieux le plus prévalent chez les enfants. Il apparaît tôt et entraîne plusieurs conséquences négatives. La thérapie cognitivo-comportementale (TCC) a été reconnue efficace pour traiter les troubles anxieux. Toutefois, peu d’études ont vérifié son efficacité pour le traitement spécifique du TAS et très peu en ont examiné l’effet auprès d’enfants de moins de 7 ans. Les quelques interventions étudiées visant les moins de 7 ans ont en commun d’inclure le parent dans le traitement ou de l’offrir directement à celui-ci. L’objectif principal de cette thèse est de vérifier l’efficacité d’un programme d’entraînement parental de type TCC, adapté pour les parents d’enfants de 4 à 7 ans souffrant de TAS. Cette étude vise également deux objectifs spécifiques : observer la fluctuation des symptômes de TAS de l’enfant pendant le traitement et examiner l’impact du programme sur les variables parentales. Un devis à cas unique à niveaux de base multiples a été utilisé. Six familles ont pris part à l’étude. Des entrevues semi-structurées, des questionnaires auto-administrés et des calepins d’auto-observations quotidiennes ont été utilisés auprès des parents pour mesurer les symptômes anxieux des enfants, leurs pratiques parentales, le stress parental et leurs symptômes anxieux et dépressifs. Des questionnaires sur les difficultés de l’enfant incluant l’anxiété ont aussi été envoyés à l’éducatrice ou à l’enseignante. Tous les questionnaires ont été administrés aux trois temps de mesure (prétraitement, post-traitement et relance 3 mois). Les calepins d’auto-observations ont été remplis quotidiennement durant le niveau de base, pour toute la durée de l’intervention et pendant une à deux semaines à la relance. Les résultats de l’étude indiquent que cinq enfants sur six ne répondent plus au diagnostic de TAS suite au traitement ainsi que trois mois plus tard. Les résultats des calepins d’auto-observations montrent une amélioration claire des manifestations principales de TAS pour la moitié des enfants et plus mitigée pour l’autre moitié, de même qu’une amélioration systématique de la fréquence hebdomadaire totale de manifestations de TAS suite à l’intervention pour quatre enfants. Les résultats aux questionnaires remplis par les parents montrent une amélioration des symptômes d’anxiété et de TAS chez quatre enfants au post-test et/ou à la relance, tandis que les questionnaires de l’éducatrice (ou enseignante) suggèrent que les symptômes anxieux des enfants se manifestaient peu dans leur milieu scolaire ou de garde. L’impact du programme sur le stress parental et les pratiques parentales est également mitigé. Ces résultats suggèrent que le Programme d’entraînement parental pour les enfants souffrant d’anxiété de séparation (PEP-AS) est efficace pour réduire les symptômes de TAS chez les enfants d’âge préscolaire ou en début de parcours scolaire et appuient la pertinence d’offrir le traitement aux parents et d’inclure un volet relationnel. D’autres études seront cependant nécessaires pour répliquer ces résultats auprès d’un plus vaste échantillon. Il serait également intéressant de vérifier les effets indépendants des différentes composantes du traitement et d’évaluer les effets du programme sur davantage de pratiques parentales associées spécifiquement à l’anxiété. / Separation anxiety disorder (SAD) is the most prevalent anxiety disorder among children. It appears early in development and has multiple negative consequences. Cognitive-behavioral therapy (CBT) has been shown to be an effective treatment for anxiety disorders. However, few studies have examined the efficacy of CBT to treat SAD in particular, and even fewer have examined the impact of this form of therapy on children younger than 7 years old. The main objective of the present doctoral thesis was to evaluate the efficacy of a CBT parent-training program, that was adapted specifically for parents of children aged 4 to 7 years old suffering from SAD. This study had two specific objectives: to observe any fluctuations in the child’s SAD symptoms during the treatment and to examine the impact of the program on parental variables. A single-case multiple baseline across-subjects design was used. Six families with a child aged 4-7 years old and with a diagnosis of SAD participated. Semi-structured interviews, self-reported questionnaires and daily diaries were used with the parents to assess the child’s anxiety symptoms, parental practices, parenting stress, and the parents anxious and/or depressive symptoms. Questionnaires on child problems were also sent to the children’ teacher or educator. All questionnaires were administered at three times of measurement (pre-treatment, post-treatment and 3 months follow-up). Daily diaries were also completed by the parents at baseline, throughout the treatment, and during one to two weeks at follow-up. Results revealed that five of the six children no longer met the criteria of a SAD diagnosis after treatment and three months later. Findings from the daily diaries showed a clear reduction of the principal SAD symptoms for half of the children but mixed results for the other half of the children and that four of six children presented a systematic favourable change of the total weekly frequency of SAD symptoms after the intervention. The results of parent questionnaires showed an improvement of SAD symptoms for four children at post-treatment and/or follow-up. The teacher/educator questionnaires indicated low impact of anxiety symptoms. The impact of the program on parenting stress and parental practices is mixed with some parents showing improvement and others less so. The results support the efficacy of the Programme d’entraînement parental pour les enfants souffrant d’anxiété de séparation (PEP-AS) to reduce SAD symptoms in preschool age children and support the relevance of directing the treatment towards parents and including a relational component in the intervention. However, more research is needed to replicate these findings with larger samples and randomized control trials. It would also be interesting to dismantle the program and to examine the various components of the treatment in different combinations, and to explore more specifically the program effects on parental variables.