A Comparison of 2 Online Parent Skills Training Interventions for Early Childhood Brain Injury: Improvements in Internalizing and Executive Function Behaviors

• Published in: The journal of head trauma rehabilitation Vol. 34; no. 2; p. 65
• Main Authors: Aguilar, Jessica M, Cassedy, Amy E, Shultz, Emily L, Kirkwood, Michael W, Stancin, Terry, Yeates, Keith Owen, Taylor, H Gerry, Wade, Shari L
• Format: Journal Article
• Language: English
• Published: United States 01.03.2019
• Subjects: Brain Injuries, Traumatic - physiopathology; Brain Injuries, Traumatic - rehabilitation; Child; Child Behavior Disorders - physiopathology; Child Behavior Disorders - therapy; Child, Preschool; Computer-Assisted Instruction; Depression - epidemiology; Educational Status; Executive Function - physiology; Female; Humans; Male; Parents - education; Parents - psychology; Videoconferencing
• ISSN: 1550-509X
• DOI: 10.1097/HTR.0000000000000443

To examine the effectiveness of a web-based parenting intervention (Internet-Based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT]) and an abbreviated version (Express) in reducing executive dysfunction and internalizing problems among young children following traumatic brain injury (TBI). Parents of 113 children (ages 3-9 years) who had sustained a TBI were randomized to 1 of 3 treatment groups: I-InTERACT, Express, or an Internet Resource Comparison (IRC) group. Parents who participated in either I-InTERACT or Express completed self-guided web sessions and received live coaching of their parenting skills via videoconferencing with a therapist. I-InTERACT included additional psychoeducation, stress management, and family communication skills (eg, marriage, grief, pain, and sleep). Analyses of covariance were utilized to compare the groups on parent-reported executive function behaviors (ie, Behavior Rating Inventory of Executive Function) and internalizing symptoms (ie, Child Behavior Checklist) at baseline and 6 months. Parents who participated in Express reported significantly lower levels of executive dysfunction than those in I-InTERACT, β = -0.49; t(2, 73) = -2.47, P = .048, and significantly lower levels of withdrawal than those in the IRC group, β = -0.44; t(2, 74) = -2.22, P = .03. The Express group did not significantly differ from the IRC group on executive function behaviors or the I-InTERACT group on internalizing problems, all P > .05. Children with more problems at baseline, families with lower education levels, and parents with more symptoms of depression benefited most. A brief, online parent training intervention may be efficacious in improving executive dysfunction and internalizing problems following early TBI, particularly among children of lower socioeconomic status or with existing behavioral concerns.