Lehigh University Lehigh Preserve Theses and Dissertations 2013 Early Intervention for Young Children with ADHD: Predictors of Parental Attendance Brigid Anne Vilardo Lehigh University Follow this and additional works at:http://preserve.lehigh.edu/etd Part of theEducation Commons Recommended Citation Vilardo, Brigid Anne, "Early Intervention for Young Children with ADHD: Predictors of Parental Attendance" (2013).Theses and Dissertations.Paper 1658. This Dissertation is brought to you for free and open access by Lehigh Preserve. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of Lehigh Preserve. For more information, please [email protected]. Early Intervention for Young Children with ADHD: Predictors of Parental Attendance by Brigid Anne Vilardo Presented to the Graduate and Research Committee of Lehigh University in Candidacy for the Degree of Doctor of Philosophy in School Psychology Lehigh University May 2012 EARLY INTERVENTION Copyright by Brigid Vilardo 2012 ii EARLY INTERVENTION Certificate of Approval Approved and recommended for acceptance as a dissertation in partial fulfillment of the requirements for the degree of Doctor of Philosophy. ___________________ ______________________________ Date George J. DuPaul, Ph.D. Dissertation Director Professor of School Psychology Chair, Education and Human Services ___________________ Accepted Date Committee Members: ______________________________ Patricia Manz, Ph.D. Associate Professor of School Psychology Program Director ______________________________ Lee Kern, Ph.D. Professor of Special Education Program Director ______________________________ Thomas Power, Ph.D. Professor of School Psychology in Pediatrics and Education University of Pennsylvania iii EARLY INTERVENTION ACKNOWLEDGEMENTS This dissertation would not have been possible without the support and assistance of many others. First, thank you to my adviser, Dr. George J. DuPaul. Without his guidance, consideration, humor, and encouragement, I would not be where I am in the School Psychology Program today. He has been a teacher, a sounding board, a role model, and— best of all—a colleague. I treasure what he has taught me. Second, thank you to the faculty, staff, and students in the Lehigh University College of Education. Your wisdom, laughter, and support have brightened many days and kept me on track. Special thanks to the members of my dissertation committee including Drs. Lee Kern, Patricia Manz, and Thomas Power. I am extremely grateful for the time and consideration you have devoted not only to this project but to me as well. Thank you, too, to Dr. Joan (Qiong) Fu who shared her advice, knowledge, and expertise in statistics in a way that made it accessible and who offered encouragement that made a real difference. Third, thank you to my families away from home--the Lyonses, the Hojnoskis, and the McGowans--and my extended family--the Woodburns, the Leggs, the Vilardos, and the Gutmans. They always were there for me when I needed a hot meal, a comfortable bed, a kind ear, or just a smile. Thank you to my close friends who checked in and provided their support throughout, especially Katie Gerwin and Liz Ganci. And thank you to Patrick Lyons. You were there for me when I needed it most. The love I feel from each of you has meant the world to me. Finally, I owe so much to my parents, Larry and Jeanne Vilardo; my siblings, Lauren and Alexander Vilardo; and my grandparents, Larry and Dolores Vilardo and Nancy and Carl Gambino. Through their example, my parents taught me how to work hard and molded me iv EARLY INTERVENTION into the person I am today. My siblings kept me happy even when my work seemed overwhelming, and my grandparents paved the way for all of us. The unconditional love of everyone in my family has carried me through. Thanks to all of you. v EARLY INTERVENTION TABLE OF CONTENTS CHAPTER I: INTRODUCTION .................................................................................................... 2 ADHD in Young Children ........................................................................................................................2 Parent Education .......................................................................................................................................3 Engagement ...............................................................................................................................................5 Predictors of Attendance ...........................................................................................................................6 CHAPTER II. LITERATURE REVIEW ..................................................................................... 12 Parent Education Programs .....................................................................................................................12 Engagement as a Critical Component to Behavioral Parent Education ..................................................19 Predictors of Attendance .........................................................................................................................20 Impact of Child Developmental Status on Possible Predictors ...............................................................34 Gaps in Prior Research ............................................................................................................................35 Contributions of the Current Study .........................................................................................................36 CHAPTER III: METHOD ............................................................................................................ 37 Participants ..............................................................................................................................................37 Setting .....................................................................................................................................................39 Measures .................................................................................................................................................39 Procedures ...............................................................................................................................................45 Data Analyses .........................................................................................................................................48 CHAPTER IV: RESULTS ............................................................................................................ 52 Demographic Characteristics ..................................................................................................................52 Descriptive Data and Correlations ..........................................................................................................52 Internal Consistency ................................................................................................................................53 Testing of Assumptions ..........................................................................................................................54 Missing Data Patterns .............................................................................................................................55 Research Question 1 ................................................................................................................................56 Research Question 2 ................................................................................................................................57 CHAPTER V: DISCUSSION ...................................................................................................... 59 APPENDIX ................................................................................................................................... 87 REFERENCES ............................................................................................................................. 90 vi EARLY INTERVENTION LIST OF TABLES Table 1. Participant Demographics .............................................................................................. 72 Table 2. Parent Education Sessions ............................................................................................. 73 Table 3. Between Group Analyses on Demographic and Study Variables ................................. 74 Table 4. Descriptive Statistics...................................................................................................... 75 Table 5. Correlations Between all Predictor and Outcome Variables ......................................... 76 Table 6. Differences between those with and without TARF data .............................................. 77 Table 7. Missing Data Patterns .................................................................................................... 78 Table 8. Comparison of parameter estimates for research question 1 across imputations .......... 79 Table 9. Comparison of block 1 and block 2 analyses for research question 1 across imputations ............................................................................................................................ 81 Table 10. Overall hierarchical regression analyses for research question 1 ................................ 82 Table 11. Comparison of parameter estimates across imputations for research question 2 ........ 83 Table 12. Comparison of regression analyses across imputation for research question 2 ........... 84 Table 13. Overall regression analyses for research question 2 .................................................... 85 vii EARLY INTERVENTION LIST OF FIGURES Figure 1. Participant recruitment and allocation to treatment. ..................................................... 86 viii EARLY INTERVENTION ABSTRACT Approximately 3% to 7% of all school-aged children are diagnosed with attention- deficit/hyperactivity disorder (ADHD; American Psychiatric Association [APA], 2000), and parental reports indicate increasing estimates of ADHD in the population (Visser, Bitsko, Danielson, Perou, & Blumberg, 2010). This disorder can lead to difficulties in attention and impulse control that can eventually result in everyday life impairments (APA, 2000; Pelham, Greiner, & Gnagy, 1998). As such, interventions must be implemented for young children that can ameliorate these symptoms at an early age and across settings. One intervention that has met criteria for being well established is parent education (Pelham & Fabiano, 2008). In order for parents and children to benefit from this intervention, however, parents must attend sessions. Nevertheless, previous studies have found parental attendance to be lacking (e.g., Kazdin & Mazurick, 1994). Therefore, the purpose of this study was to investigate predictors of parental attendance at behavioral parent education sessions for those with young children with ADHD. Participants included 135 children (M age = 4; SD = 0.69) and families who participated in an early intervention project, which included parent education. Results indicated that socio-economic status (SES) and marital status were statistically significant predictors of attendance at parent education sessions. Other variables, however, including ethnicity, parent stress, parent support, and child ADHD and ODD symptoms were not significant predictors of attendance. Therefore, future research should work to not only determine possible mediators and moderators between SES and marital status (e.g., parent acceptability of treatment), but also to find innovative ways to partner with parents in order to make parent education treatments relevant, feasible, and accepted. 1