1 - (SYM 120) Improving an Understudied Implementation Determinant of Behavioral Interventions in Preschool: The Parent-teacher Relationship

Objective: Racially and ethnically minoritized (REM) children are less likely to be identified as needing behavioral supports and to receive appropriate behavioral interventions for ADHD (even with a diagnosis) compared to White children, despite ADHD recommendations from the American Academy of Pediatrics. REM children who display symptoms of ADHD and related disorders are at an elevated risk of being expelled from preschool, placing some REM children on negative long-term behavioral health trajectories. This presentation will highlight the critical role of parent-teacher relationship as a determinant believed to impact the potency (and use) of behavioral interventions in preschools.

Methods: Using a community-partnered approach we implemented the discover, design/build and test (DDBT) framework to iteratively design and test a parent-teacher relationship intervention (Parent-Educator Action Response; PEAR) at local preschools that serve a high proportion of REM families. PEAR is designed to target individual-level determinants associated with behavior change – attitudes, subjective norms, self-efficacy- using motivational behavior change strategies. The current presentation will focus on the results of the discover and design/build phase. Discover Phase. Conducted interviews with parents and teachers to discover: a) barriers to relationships among parents and preschool teachers and b) stakeholder-informed strategies to address these barriers. Design/Build Phase. An advisory board and rapid prototyping to iteratively design and build PEAR. 

Results: The discover phase consisted of interviews with 9 REM parents and 6 lead teachers of a preschool child. Results of the interviews indicate that despite both sides wanting a relationship (defined by honest, frequent communication and partnership), teachers and parents face barriers to establishing their desired relationship. In partnership with our advisory board we are in the process of designing and building PEAR. Rapid prototyping to test and refine PEAR with 3 parents and 3 preschool teachers will take place this fall (preliminary results will be presented).  

Conclusion: The research highlighted has clear implications for clinical psychology and education and is in line with several of this year’s ABCT themes including identifying facilitators of the implementation of interventions and addresses an urgent need to reduce disparities in the early identification and treatment of ADHD and related disorders among vulnerable young children.