The relative efficacy of two brief treatments for sleep problems in young learning disabled (mentally retarded) children: a randomised controlled trial. Enhancing the effectiveness of self-administered videotape parent training for families with conduct-problem children. Bibliotherapy as an adjunct to stimulant medication in the treatment of attention-deficit hyperactivity disorder. Reducing sleep disruptions in young children: evaluation of therapist-guided and written information approaches: a brief report. Behavioral training for parents of retarded children: alternative formats based on instructional manuals. Self-administered videotape therapy for families with conduct-problem children: comparison with two cost-effective treatments and a control group. The long-term effectiveness and clinical significance of three cost-effective training programs for families with conduct-problem children.
Settling and night waking problems are particularly prevalent, persistent, and generally considered difficult to treat in children with a learning disability, although intervention trials are few. Scarce resources, however, limit access to proven behavioural treatments.
                To investigate the efficacy of a media based brief behavioural treatment of sleep problems in such children by comparing (1) face-to-face delivered treatment versus control and (2) booklet delivered treatment versus controls.
                The parents of 66 severely learning disabled children aged 2-8 years with settling and/or night waking problems took part in a randomised controlled trial with a wait-list control group. Behavioural treatments were presented either conventionally face-to-face or by means of a 14 page easy to read illustrated booklet. A composite sleep disturbance score was derived from sleep diaries kept by parents.
                Both forms of treatment were almost equally effective compared with controls. Two thirds of children who were taking over 30 minutes to settle five or more times per week and waking at night for over 30 minutes four or more times per week improved on average to having such settling or night waking problems for only a few minutes or only once or twice per week (H = 34.174, df = 2, p<0.001). These improvements were maintained after six months.
                Booklet delivered behavioural treatments for sleep problems were as effective as face-to-face treatment for most children in this population. Parents of 43 conduct-problem children, aged 3-8 years, were randomly assigned to one of two treatments: an individually self-administered video-tape modeling treatment (IVM) and IVM treatment plus therapist consultation (IVMC). Randomization also included a waiting-list control group (CON). Compared with the control group, both treatment groups of mothers reported significantly fewer child behavior problems, reduced stress levels, and less use of spanking. Home visit data indicated that both treatment groups exhibited significant behavioral changes. There were relatively few differences between the two treatment conditions. However, the IVMC children were significantly less deviant than the IVM children, suggesting that the IVMC (with therapist consultation) treatment was superior to self-administered treatment with no therapist involvement. The added benefits of therapist involvement are discussed. The effectiveness of bibliotherapy as an adjunct to stimulant medication in the treatment of children with attention-deficit hyperactivity disorder was investigated. Subjects were randomly assigned to the experimental group, or the control group. Parents in the experimental group received a written protocol (bibliotherapy) outlining behavioral techniques for managing oppositional child behavior. Results indicated significant differences favoring the experimental group on standardized measures of the intensity of behavior problems in the home, parental knowledge of behavioral principles, and teacher ratings of behavior. This bibliotherapy approach appears to offer an inexpensive adjunct to stimulant medication in the treatment of attention-deficit hyperactivity disorder when individual or group behavior management training is not feasible. Regular night waking of young children is one of the most common problems encountered by parents. This study compared a standardized night waking programme that involved organized bedtime routines, procedures for settling the child and for the handling of crying, calling out and getting out of bed, with a group which received written information only and a waiting list control group. The children receiving the standard programme and those receiving written information only showed significant improvement over children in the waiting list group. This result supports the use of written parent instructions with or without therapist support. A series of instructional manuals in behavior modification with retarded children was tested as a self-contained resource and as part of three larger training programs involving different amounts of professional assistance to parents: telephone consultations, training groups, training groups plus home visits. One hundred and sixty families were randomly assigned to the four training conditions or to a delayed-treatment control group. The 20-week treatment period emphasized the programming of self-help skills, but also provided an introduction to programming language skills and managing behavior problems. The manuals-alone format was as effective as the more expensive training formats in producing gains in children's self-help skills and fostering knowledge of behavioral principles in mothers. The two group-training formats produced more efforts at behavior-problem management, greater gains in knowledge of principles by fathers, and higher self-confidence as teachers. Telephone consultation was generally the least effective training format; the manuals-alone condition was surprisingly effective. Some implications of the results for future strategies of family intervention were discussed. nan We evaluated the long-term effectiveness of three cost-effective parent training programs for conduct-problem children. One year posttreatment, 93.1% of families (94 mothers and 60 fathers) were assessed on the basis of teacher and parent reports and home observations. Results indicated that all the significant improvement reported immediately posttreatment were maintained one year later. Moreover, approximately two thirds of the entire sample showed "clinically significant" improvements. There were very few differences between the three treatment conditions except for the "consumer satisfaction" measure indicating that the treatment combining group discussion and video-tape modeling was superior to treatments without both components.
These formats of delivering behavioural interventions for carers of children are worth considering in clinical practice. Media-based interventions may, in some cases, be enough to make clinically significant changes in a child's behaviour, and may reduce the amount of time primary care workers have to devote to each case. They can also be used as the first stage of a stepped care approach. Consequently this would increase the number of families who could possibly benefit from these types of intervention, releasing clinician time that can be reallocated to more complex cases. Media-based therapies would therefore appear to have both clinical and economic implications as regards the treatment of children with behavioural problems.