Parent Training Interventions for Preschool-Age Children

Introduction There is a substantial and growing body of evidence concerning the important role that familial risk factors play in facilitating young children’s entry and progression along the “early-starter” pathway of conduct problems. This pathway is characterized by three elements: the onset of conduct problems (such as developmentally excessive levels of aggression, noncompliance, and other oppositional behaviour) in the preschool and early school-age years; a high degree of continuity throughout childhood and into adolescence and adulthood; and a poor prognosis. The most comprehensive family-based formulation for the early-starter pathway has been the coercion model developed by Patterson and his colleagues. The model describes a process of “basic training” in conduct-problem behaviours that occur in the context of an escalating cycle of coercive parent-child interactions in the home, beginning prior to school entry. The proximal cause for entry into the coercive cycle is thought to be ineffective parental management strategies, particularly in regard to child compliance with parental directives during the preschool period. Types of parenting practices that have been closely associated with the development of child conduct problems include inconsistent discipline, irritable explosive discipline, low supervision and involvement, and inflexible rigid discipline. As this process of ineffective parent management continues over long periods, significant increases in the rate and intensity of child coercive behaviours occur as family members are reinforced by engaging in aggressive behaviours. Other family risk factors that may have direct or indirect effects on parenting practices include maladaptive social cognitions, personal (e.g., antisocial behaviour, substance use, maternal depression) and interparental (e.g., marital problems) distress, and greater social isolation (e.g., insularity).