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UBC Theses and Dissertations

Preventative family-centred positive behaviour support for families of children with Down syndrome Fawcett, Susan


Family-centred positive behaviour support (FCPBS) for children with developmental disabilities and problem behaviour has been well studied at the tertiary, individualized level of intervention, but no studies have addressed its implementation at the secondary prevention level. Group parent training programs are well substantiated and, therefore, offer evidence-based models for a secondary-tier FCPBS approach. Based on key features of FCPBS and best practice in group parent training, a 14-week, FCPBS parent training program was designed for families of young children with Down syndrome (DS) who engaged in mild to moderate problem behaviour. Program content included understanding problem behaviour, universal positive behaviour support strategies, mindfulness practices, and cognitive-behaviour change strategies. An initial version of the program was trialled in a Stage 1 study with two families. Focus groups were conducted with the participants, and revisions were made. A randomized controlled trial comprised of experimental and waitlist control groups was then employed to evaluate the effects of the revised program. Eleven families of children with DS participated in the intervention. Direct observations of child problem behaviour, child positive engagement, and parent intervention fidelity were conducted in one target family routine per family. Indirect measures included child behaviour in two generalization routines per family, sense of parenting competence, parenting stress, and family quality of life. Data were gathered pre- and postintervention and at the 6-month follow up with the experimental group. In contrast to the waitlist control group, families in the experimental group showed statistically significant improvements in child problem behaviour and positive engagement in both the target family routine and one generalization routine. Significant improvements for mothers were found for parenting sense of competence, parenting stress, and family quality of life. In contrast, fathers did not show improvements in global measures of child behaviour or family functioning. The study makes two unique contributions to the PBS literature: It is the first study to evaluate a secondary prevention model of FCPBS and the first to examine the efficacy of FCPBS for children with DS. A secondary-tier approach to FCPBS appears to be a promising, cost-effective intervention for ameliorating problem behaviour in children with DS.

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