In the 2021-2022 fiscal year, the monthly average number of children and youth in care in Ontario was 8,700 (OACAS, 2022ₑ). Most of these young people have histories of developmental trauma and require safety, consistency, and predictability in order to heal. As such, placement stability is a key goal within child welfare. However, placement disruptions are common and often result in widespread negative outcomes for young people in care. Within the context of the many supports that must be offered to youths and resource parents, one area of intervention includes parenting support for resource parents. The overall objective of this two-study dissertation was to assess youth and caregiver associations with the number of youth placement changes and to address some of these factors by evaluating an in-service trauma-informed parenting program. For Study 1, hierarchical regression analyses examined youth and resource parent variables associated with the number of placement changes among 1,624 Ontario youths aged 10-17 years. Study 1 utilized data from 2017 previously collected as part of the Ontario Looking After Children project, which is an initiative designed to improve developmental outcomes for young people in care in Ontario. For demographic variables, parent-model placements (i.e., foster, adoptive, kinship homes) were associated with fewer changes than residential placements. Also, younger age when first placed in care, older current youth age, and a higher number of maltreatment types experienced by the youth were associated with a greater number of placement changes. For youth variables, greater conduct problems, peer problems, and prosocial behaviour, as well as fewer internal developmental assets, were associated with greater placement changes. For caregiver variables, lower placement satisfaction was associated with a greater number of placement changes. These findings highlight the importance of considering both youth and caregiver factors that are associated with placement changes and as such, provides insight into possible areas of intervention to increase placement stability for youths in out-of-home care. Building on these results, Study 2 involved conducting a preliminary evaluation of the Resource Parent Curriculum (RPC), which is an in-service, group-based parenting program developed by the National Child Traumatic Stress Network. This 8-module program was delivered virtually to resource parents in Ontario on six occasions during 2020-2021, with a total of 43 research participants. Youth and caregiver outcomes were examined by way of a quasi-experimental design that included 22 resource parents in the experimental group and 21 in the waitlist control and involved baseline, post-program, and 2-month follow-up assessments. In terms of resource parents' reactions, quantitative and qualitative results suggested that resource parents were highly satisfied with the program's content and delivery. For learning outcomes, RPC resulted in improvements in resource parents' knowledge and beliefs in trauma-informed parenting. While not statistically significant, post-hoc exploratory analyses revealed some potential small effects for improvements in resource parents' tolerance of challenging youth behaviours and in parenting self-efficacy. For behavioural outcomes among resource parents, several potential effects (not statistically significant) were noted with small to medium effect sizes regarding possible improvements in resource parents’ attachment relationship with their youth, increased social supports, improved family functioning, and reduced parenting distress. Study 2 was novel in being the first to evaluate RPC using a quasi-experimental design within a Canadian context and through virtual delivery. Findings highlighted both the benefits of the program as well as resource parents' ongoing training needs and required supports to improve youth well-being and placement stability.

Parents of children with an autism spectrum disorder experience many stressors in their lives, including managing problem behaviors of their child. Parent training can effectively teach parents strategies to manage noncompliant behaviors; however, many parents spend months on wait lists before accessing this service. This study investigated the preliminary effects of both an expert-led and parent-led training for wait-listed parents. Thirteen parents of children currently on a waitlist to receive behavioral analytic services participated; most were highly educated, all were white and married. The study used a pyramidal training approach: a professional instructed one group of participants while a participant volunteer instructed the second group. Participants completed a training on several behavior management techniques. Training was conducted in a manner plausible for community clinics to implement. Checklists and direct observations of trainee behavior were taken to observe fidelity of training. Data were also collected using parent self-report measures using Likert-scales to report on their own behavior as well as their child’s behavior. Participants from both groups reported decreases in child noncompliant behavior and increases in parent self-efficacy, confidence and consistency in administering behavior management techniques, indicating that both expert-led and parent-led training are effective in decreasing reported noncompliant behavior and increasing parent-reported self-efficacy. Clinics and communities should seek to implement similar programs to address wait-list issues; using a pyramidal parent training module may allow more parents to access information in a more efficient fashion. Further research should be conducted on larger groups and additional levels of pyramidal training.

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The purpose of this study was to investigate the effectiveness of a seven week DIR/Floortime parent training on (1) the quality of the parent-child dyad and (2) the child's developmental level. The results of this study provide support for the notion that short term parent training significantly increases the quality of the parent/child interaction and also significantly increases the developmental level of the child with Autism Spectrum Disorder. These significant results were evidenced on the first two levels and the total scores on both the Functional Emotional Assessment Scale - Child (FEAS) and the Neuro-Developmental Disorders of Relating and Communication Functional Emotional Developmental Levels (NDRC-FEDL). / Educational Psychology

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that presents many challenges for parents and service providers. Unfortunately, there are limited examples of parent-mediated interventions for parents of children with ASD that can help manage behavioral problems, especially those that can be implemented in both urban and rural communities. COMPASS for Hope (C-HOPE) is an 8-week parent-mediated intervention that enhances parent knowledge, behavior management skills, and supportive strategies. Telehealth-based interventions can be especially effective for rural communities due to its ability to address common barriers of geographic location and lack of resources. When implementing this intervention, the ability to decrease child problem behaviors as well as increase parental activation, self-management, perceived competence, and knowledge are essential to determine the efficacy of this treatment. The purpose of the current study is to evaluate these outcomes in the implementation of C-HOPE via telehealth in rural versus urban communities. 20 parents with children from 3-12 years of age with a diagnosis of ASD were sampled from two rural sites and two urban sites in Kentucky. Few differences were noted between the participants in the rural versus urban group at pre-treatment. Following C-HOPE, in the urban area, there were significant treatment effects in parent knowledge outcomes. In the rural areas, a significant effect was found in change of parent self-management skills of toileting issues. Future directions for telehealth treatments for this population are discussed. / M.S. / ASD is a developmental disorder that presents many challenges for parents and providers. Unfortunately, there are limited behavioral treatment options for parents of children with ASD, especially those that can be utilized in both urban and rural communities. COMPASS for Hope (C-HOPE) is a parent intervention that improves parent knowledge, management, and supportive strategies. Technology-based interventions can be especially effective for rural communities due to its ability to address barriers of geographic location and lack of resources. In this intervention, the ability to decrease child problem behaviors as well as increase parental activation, self-management, competence, and knowledge are essential for this treatment to be effective. The current study evaluates these outcomes in C-HOPE using technology in rural versus urban communities. 20 parents with children with ASD, ranging from 3-12 years of age, were sampled from rural and urban areas in Kentucky. Few differences were noted between the participants in the rural versus urban group before treatment. After treatment, in the urban area, there were significant effects in parent knowledge outcomes. In the rural areas, a significant effect was found in change of parent self-management skills. Future directions for technology treatments for this population are discussed.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that presents many challenges for parents and providers while impacting a child's developmental trajectory across several domains, including disruptive behaviors. Unfortunately, due to limited access and affordability of care, especially during the pandemic or other situations that require people to stay at home, in-person services are not always feasible. Rural or underserved communities may face additional barriers, such as geographic isolation and lack of ASD resources. Accessibility of ASD treatment may be expanded through telehealth supports, such as mobile applications. When implementing these supports for autistic children, decreasing child problem behaviors while improving parent stress, knowledge, and competence is crucial. The current study investigated the feasibility and preliminary efficacy of a behavior consultation mobile application, Treks, to improve telehealth support for 26 parents (male = 2) of autistic children (3-13 years). Participants were randomly assigned to a one-session telehealth consultation with 1) the enhancement of the Treks app over the course of one month (TH) or 2) with access to mobile resources comparable to Treks for one month (CC). They were then administered measures at baseline, pre-Treks, and post-Treks to assess changes in parenting stress, knowledge, competence, and child behaviors as well as feasibility metrics. Results indicated that the mobile app was received positively across groups, showing significant improvement in participants enrolled in the TH group from pre- to post-Treks on parenting and child outcomes, in addition to moderate to high satisfaction. Future directions should examine the use of mobile supports to supplement parent training consultations for caregivers of autistic children who present with a range of behavioral difficulties. / Doctor of Philosophy / Autism spectrum disorder (ASD) presents with many challenges for parents and providers. Unfortunately, due to limited access and affordability of care, especially during the pandemic or other situations that require people to stay at home, in-person services are not always feasible. Rural or underserved communities may face additional barriers, such as geographic isolation and lack of ASD resources. Accessibility of ASD treatment can include telehealth (e.g., mobile applications), and should focus on decreasing child problem behaviors while improving parent stress, knowledge, and competence. The current study investigated the feasibility and preliminary efficacy of a behavior consultation mobile application, known as Treks, to improve telehealth support for 26 parents of autistic children (3-13 years). Participants were randomly assigned to a one-session telehealth consultation with access to 1) Treks for one month (TH) or 2) mobile resources comparable to Treks for one month (CC). They were then administered measures at baseline, pre-Treks, and post-Treks to assess changes in parenting stress, knowledge, competence, and child behaviors as well as feasibility. Results indicated that the mobile app was received positively across groups, showing significant improvement in participants enrolled in the TH group from pre- to post-Treks on parenting and child outcomes, in addition to moderate to high satisfaction. Future research should examine the use of mobile apps to supplement parent training for caregivers of autistic children who present with a range of behavioral difficulties.

<p>Parent training programmes is a wide phenomenon in Sweden today and is concidered to be the most effective method for parents with cildren who have conduct problems. The Komet programme is a manualbased parent training programe developed by the city of Stockholm to strengten interaction between parent and child as well as reducing conflicts in families. The aim of this study was to examine the puspose of the Komet programme as well as the influence it may have on interaction between parent and child. To fulfil the purpose six qualitative interviews were conducted, two interviews with professionals from the Komet programme and four interviews with parents who had participated in the Komet programme. A multidimensional tool for interpretation was used, containing normalisationperspective with focus on child upbringing, roletheory and attachmenttheory. The results showed that the parent’s participation in the Komet programme led to a reduction in conflicts within the family as well as improvement in interaction between parent and child. Further more the results showed that all of the parents where insecure in their parentrole before taking part in the Komet programme. After their participation in the Komet programme they all stated a feeling of having received new tools to better handle conflicts within the family. The overall results of the study led to the creation of two new conceptions introduced in the final discussion: The modern problem family and The manualbased parenthood.</p>

The present study examined the efficacy of two parent training programs in reducing perceived parental stress in a sample of Spanish speaking migrant farmworkers of Hispanic origin. Sixty-eight Spanish-speaking mothers, referred for parenting classes because one of their children was experiencing behavioral or emotional difficulties, were randomly assigned to one of four treatment conditions: (1) 1-2-3 Magic, a behaviorally-based program; (2) Systematic Training for Effective Parenting (STEP), an Adlerian-based program; (3) attention-placebo condition; and, (4) wait-list control group. All treatment conditions were presented in Spanish, and offered at convenient times and locations for participants. Parental stress was measured with the Spanish version of the Parenting Stress Index-Short Form (PSI-SF), using the Total Stress Score, and the three subscale scores: Parental Distress Score, Parent-Child Dysfunctional Interaction Score, and Difficult Child Score. Assessments were completed at pretest, posttest, and at a three-month follow-up. A repeated-measures multivariate analysis of variance on the dependent measures revealed significant differences for groups across the three assessment periods. Subsequent analyses indicated that the behaviorally-based program produced significantly greater reductions on the Total Stress Score and Parental Distress Score at posttest and follow-up than the Adlerian program, the attention-placebo group, and the wait-list group. The behaviorally-based program was also more effective in reducing parent-child dysfunctional interaction than the attention-placebo group at posttest and follow-up, and the wait-list control group at follow-up, but not in comparison to the Adlerian program. These results lend support for behaviorally-based parent training in reducing perceived parental stress in this migrant farmworker population. To ensure treatment integrity, a parent trainer validity check was used in which expert parent educators rated randomly selected videotaped segments of each parent training session on five criteria. Statistical analysis of treatment validity revealed no significant differences in mean scores of expert raters across parenting groups, suggesting that the parent trainer behaved consistently on the criteria across all treatment conditions. The results are also discussed in relation to the literature on parent training. In addition, the limitations of the present study, as well as future directions for research are discussed.

Research has shown that parents of children with disabilities, such as autism, experience significantly higher stress levels than parents of typically developing children. It has been suggested that parent education programs, in particular naturalistic communication training, will reduce parental stress. Most of the literature in this area has relied on parental reports and has only focused on decreasing stress and has not directly addressed increasing alternate feelings, such as happiness. In different but related areas of behavior analysis, an emphasis has been placed on the importance of happiness as a quality of life indicator and that the development of multileveled assessment is sorely needed. This study was designed to analyze one set of measures within a data-based intervention program for parents of toddlers with autism. The Family Connections Project (FCP) is a parent training project designed to enhance the quality of relationships for families who have toddlers with autism. Within this project parents are taught to identify and arrange opportunities to interact with their children in ways that will increase motivation and social responsivity. This study looked at the collateral effects of this training program and investigated if FCP affected the relationship between parents and their toddlers; of particular interest was parental happiness. Video taped assessments were used as a direct measure to collect indices of parental affect/happiness (e.g., smiles). Independent judges' ratings were used in comparison with a controlled parent-child dyad. Furthermore, pre and post parental goals, descriptions, and satisfaction surveys were analyzed in the context of the parental happiness indices. Results were evaluated in a multiple baseline design across child skills and are discussed in the context of parent and child's targeted behavior changes and collateral outcome measures.