Symposia
Child / Adolescent - Externalizing
Michelle Kuhn, Ph.D. (she/her/hers)
Acting Assistant Professor
University of Washington School of Medicine
Seattle, Washington
Michelle Kuhn, Ph.D. (she/her/hers)
Acting Assistant Professor
University of Washington School of Medicine
Seattle, Washington
Aleks Bacewicz, MD
Resident
Seattle Children's
Seattle, Washington
Yesenia Garcia, B.A.
Clinical Research Coordinator I
Seattle Children’s Hospital
Seattle, Washington
Emma Whitmyre, PhD
Post-Doctoral Fellow
Children's National
Washington, District of Columbia
Kari Gillenwater, MD
Clinical Professor
University of Washington
Seattle, Washington
Elana Feldman, MD
Clinical Assistant Professor
University of Washington
Seattle, Washington
Erin Gonzalez, PhD
Principal Investigator
Seattle Children's Hospital
Seattle, Washington, United States of America
Method: 22 foster and kinship caregivers (60% Caucasian; 66% foster caregivers) attended a 6-week adapted PBMT program for children (58% BIPOC; Mage=6.04 years) with early adversity. Pre and post-group surveys assessed satisfaction, caregiver self-efficacy, and strain (Caregiver Strain Questionnaire), and child behavior (Disruptive Behavior Disorder Rating Scale). Baseline questionnaires also included demographics and assessed trauma (Child Trauma Screen). PSE included alcohol, nicotine, and other recreational drugs. Results: Average CTS score at baseline was 6.08 (clinical trauma reaction symptoms cutoff = 6.0). Caregivers reported entering group feeling unprepared (47%) or only somewhat prepared (38%) to address their children’s behavioral concerns. Following group, most (57%) caregivers reported that they did not currently need additional support. Caregiver strain decreased (9% on average) following intervention, as did child inattention (11%) and oppositional behavior (18%). Hyperactivity remained stable. Of n=15 caregivers asked about PSE, 73% reported prenatal polysubstance exposure. Children with PSE had higher initial symptom levels, but slightly greater decreases in inattention (18%) and oppositionality (22%) than the total sample. Caregivers requested content about supporting siblings and ways to share content with parenting partners. Conclusions: Adapted PBMT is a promising approach for supporting foster and kinship caregivers caring for children with early adversity, including PSE. Limitations include a small sample size that precludes comparative statistics and incomplete data regarding PSE.
Background: Children in kinship and foster placements are more likely to have experienced early adversities including neglect, abuse, adverse childhood experiences, and prenatal substance exposure (PSE). These sources of adversity are associated with increased rates of developmental differences (i.e., adaptive delays, ADHD) and mental health conditions (i.e., PTSD). Behavioral concerns are also common and are often complicated by co-occurring developmental and mental health conditions. Children with early adversity and their caregivers require approaches adapted for these underlying factors. This study (1) evaluated the feasibility, acceptability, and initial efficacy of a parent behavior management training group (PBMT) adapted for foster and kinship caregivers; and (2) explored the efficacy of adapted PBMT for children with PSE, who have previously been thought not to respond to PBMT.
