(PS1-C73) Predictors of Parent Adherence in BPT for Preschoolers with ADHD

Researchers have consistently demonstrated the effectiveness of behavioral parent training (BPT) for youth with ADHD (e.g., improved self-regulation; Lee et al., 2012). Further, parent adherence (e.g., behavioral strategy use) is important for BPT success (Rooney et al., 2018; Villodas et al., 2014) and represents a critical factor to address when adapting treatments to families’ needs. Among limited research examining predictors of parent adherence to BPT for school-aged children with ADHD, associations between parent psychopathology (i.e., ADHD, anxiety, depression) and between-session strategy usage, have emerged (e.g., Friedman et al., 2020). Given the importance of parent involvement (Hayes et al., 2018) for addressing behavioral challenges in early childhood (Campbell et al., 2014), the aim of the current study was to extend evaluations of parent and child characteristics as predictors of parent adherence in BPT to preschool-aged children with/at-risk for ADHD.
 

Parents of 60 preschoolers (ages 3-5) with/at risk for ADHD who participated in a 10-session, BPT program completed measures of child symptomatology (Conners Early Childhood - Inattention/Hyperactivity subscale [C-IA/HI]; Conners, 2009), parent stress (Parent Stress Index [PSI]; Abidin, 2012), adult ADHD symptoms (Adult ADHD Self-Report Scale [ASRS]; Adler et al., 2006), knowledge of behavioral strategies, and perceived parental competence (Family Empowerment Scale - Competence subscale [FES]; Singh et al., 1995) at pre-treatment. Parents rated the frequency of their own use of strategies taught in the program (i.e., setting expectations [SE], teaching strategies [TS], prevention strategies [PS], response strategies [RS], behavior-specific praise) at post-treatment. While controlling for baseline parent knowledge of behavioral strategies, pre-treatment child and parent characteristics were examined as predictors of post-treatment strategy use in separate multiple linear regression analyses for each behavioral strategy.
 

Regression models for behavior-specific praise and response strategies revealed significant relationships (i.e., p < .05; , both R2 = .40), whereas no significant relationships were found in remaining models (R2 range: .17 - .29). Further, pre-treatment FES positively predicted parent reported behavior-specific praise frequency at post-treatment (ꞵ= .45; p = .028), and pre-treatment ASRS negatively predicted parent-reported response strategies frequency at post-treatment (ꞵ = -.53; p = .007). Thus, parents exhibiting higher levels of perceived parental competence prior to BPT may deliver behavior-specific praise more frequently at post-treatment. However, parents reporting higher levels of ADHD symptomology at pretreatment may use response strategies less frequently after BPT. These findings emphasize parental characteristics that influence adherence to critical components of BPT and the importance of assessing families’ unique needs to optimize treatment outcomes for youth with ADHD.