Systematic Review and Meta‐analysis of Stepping Stones Triple P for Parents of Children with Disabilities

• Author: AIlbhe Ruane,Alan Carr
• DOI: http://doi.org/10.1111/famp.12352
• Date: 01 March 2019
• Published date: 01 March 2019

Systematic Review and Meta-analysis of Stepping

Stones Triple P for Parents of Children with

Disabilities

AILBHE RUANE*

ALAN CARR*

The aim of this systematic review and meta-analysis was to examine the effectiveness of

Stepping Stones Triple P (SSTP) parent training programs on child behavior problems

and parenting outcomes in families of children with developmental disabilities. Sixteen

suitable studies including data from over 900 families were identified in a search for

English language published and unpublished controlled outcome studies. SSTP has five

levels on a graded continuum of increasing intensity targeting families with differing

degrees of treatment need from low intensity media-based parenting infor mation

campaigns at level 1, through brief interventions at levels 2 and 3, to more intensive parent

training and family therapy interventions at levels 4 and 5. Analyses were conducted on

the combination of all levels of SSTP and separately for each level. For combined levels,

significant overall effect sizes were found for parent-reported child problems (d=0.46),

researcher observed child behavior (d=0.51), parenting style (d=0.70), parenting

satisfaction/self-efficacy (d=0.44), parental adjustment (d=0.27), and coparental rela-

tionship (d=0.26), but not researcher-observed parent behavior. Strong support was

found for level 4 SSTP as an effective intervention for improving child and parent out-

comes in families of children with disabilities who have clinically significant problems.

Less intensive SSTP interventions for cases with circumscribed difficulties yielded fewer

significant treatment effects, and there were relatively few studies of such interventions.

Keywords: Parent Training; Triple P; Disability

Fam Proc 58:232–246, 2019

INTRODUCTION

Asubstantial amount of research has demonstrated that children with developmental

disability exhibit increased levels of behavioral problems compared to their nondis-

abled peers (e.g., de Ruiter, Dekker, Verhulst, & Koot, 2007) and that they are three times

more likely to be rated in the clinical range compared to typically developing children

(e.g., Totsika, Hastings, Vagenas, & Emerson, 2014). It has been shown that increased

levels of behavior problems emerge at least by the preschool years (e.g., Baker, Blacher,

Crnic, Edelbrock, & Low, 2003) and can persist across middle childhood into adolescence

and even into adulthood (e.g., Einfeld et al., 2006).

Parenting plays a significant role in the development and exacerbation of child problem

behaviors (e.g., Totsika et al., 2014) as well as the amelioration of such behaviors (e.g.,

*Clinical Psychology, School of Psychology, University College Dublin, Dublin 4, Ireland.

Correspondence concerning this article should be addressed to Alan Carr, Clinical Psychology, School of

Psychology, Newman Building, University College Dublin, Belfield, Dublin 4, Ireland. E-mail:

alan.carr@ucd.ie

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Family Process, Vol. 58, No. 1, 2019 ©2018 Family Process Institute

doi: 10.1111/famp.12352