One-year follow-up of a transdiagnostic telepsychology parenting program for children at neurological risk: Who benefits the most?

Abstract

Internet-Based Interacting Together Everyday: Recovering After Childhood Traumatic Brain Injury (I-InTERACT)-North is a telepsychology parenting intervention designed to improve behavior in children at neurological risk. This study aimed to (a) examine the maintenance of behavior improvement approximately 1 year after completing I-InTERACT-North and (b) assess moderating variables associated with treatment outcomes. Families were recruited based on their prior participation in I-InTERACT-North between 2019 and 2022 at the Hospital for Sick Children. Participants completed the Eyberg Child Behavior Inventory (ECBI) to assess child behavior problems and intensity. Changes in ECBI Intensity and Problem Scores were analyzed across pre-, post-, and 1-year follow-up assessments using one-way repeated measure analysis of variance (ANOVA)s. Mixed-effect ANOVAs considered the impact of proposed moderator variables (i.e., parental education, baseline parental stress, child’s baseline behavior, diagnosis, age, and gender). Of 66 families who completed I-InTERACT-North, 37 (56%) were included in the 12-month follow-up study. Children included were 3–10 years old at follow-up (M = 7.70, SD = 1.82) diagnosed with neurological only (29.73%), neurodevelopmental only (35.14%), or comorbid neurological and/or neurodevelopmental conditions (35.14%). Among all participants, ECBI Problem Scores were significantly lower immediately postintervention but not 1 year later. Baseline ECBI Scores moderated treatment success, such that children with higher baseline scores (i.e., higher initial symptoms) demonstrated improvements in both ECBI Intensity and Problem Scores immediately postintervention, which were maintained at 1-year follow-up. No other variables moderated treatment outcomes. The maintenance of improvement in those with higher initial symptoms suggests a promising targeted application for this telepsychology intervention. What is the significance of this article for the general public?—This virtual stepped-care parenting program successfully reduced behavioral problems, with lasting effects among those with higher baseline symptoms. Integrating this early intervention through clinical care to reach those most vulnerable has the potential to optimize parenting, prevent the onset or worsening of mental health conditions, and reduce economic and health care costs. (PsycInfo Database Record (c) 2024 APA, all rights reserved)