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Sanders, M. R., & Plant, K. (1989). Programming for generalization to high and low risk parenting situations in families with oppositional developmentally disabled preschoolers. Behavior Modification, 13(3), 283-305.

Model(s) Reviewed: Triple P - Home Visiting: Child Management Training Component
Manuscript screening details
Screening decision Screening conclusion
Passes screens Eligible for review
Study design details
Rating Design Attrition Baseline equivalence Reassignment Confounding factors
Moderate Single-case design Not applicable Not applicable Not applicable Not applicable


Submitted by user on Fri, 03/15/2019 - 14:29

The results from single-case design studies with a high or moderate rating are not factored into whether a model meets the <abbr title="Department of Health and Human Services">HHS</abbr> criteria unless additional criteria are met. Please read the <abbr title="Department of Health and Human Services">HHS</abbr> criteria for evidence-based models for more information.


Submitted by user on Fri, 03/15/2019 - 14:29

The portion of the study in the high-risk generalization setting rated moderate. The other two portions (training and low-risk generalization) rated low because there were not at least three attempts to demonstrate an effect with at least three data points per phase. The <abbr title="Home Visiting Evidence of Effectiveness">HomVEE</abbr> review focused on the Child Management Training component, which was the only one adjacent to a phase that included no Triple P components. The other phases were not reviewed for impacts.

Study characteristics
Study participants Participants were five two-parent families with preschool-age children with developmental disabilities who received services from what the authors described as “an Intellectual Services Handicap” program. All families were Caucasian. On average, mothers were age 29 years, fathers were 31, and children were 4. All families were described as lower middle or middle class. The children all scored within the mild range of developmental disability on the Merrill-Palmer Scale of Mental Tests. They also displayed high levels of noncompliant, demanding, and disruptive behavior and met the DSM III criteria for diagnosis of an oppositional disorder. All families self-referred to the program after reported difficulty managing their children.
Setting The study was conducted in Queensland, Australia.
Intervention services During the first four weeks, parents received Child Management Training (CMT). This began with two two-hour training sessions during which the therapist taught parents to use descriptive praise, star charts, and tangible reinforcers to encourage desired behavior. The therapist then used a process of instruction, discussion, modeling, rehearsal, and feedback to introduce eight procedures for managing specific oppositional behaviors. After completing the training sessions, the therapist conducted four home visits twice weekly for two weeks to observe parent-child interactions for 25 minutes and then discuss with the parent the use of praise and correction. The therapist also prompted parents to evaluate their own skills and behavior. The therapist provided parents with written feedback on the percentage of appropriate child behavior, parents’ use of praise statements and instruction, and parents’ fidelity to procedures. An independent observer coded these outcomes during the course of the home visit. Therapists and parents also established goals for between-session practice. During the final five weeks, parents received Planned Activities Training (PAT) home visits, but these services were not part of the HomVEE review.
Comparison conditions Baseline observations were conducted prior to instruction in the use of CMT.
Staff characteristics and training The second author served as the therapist who delivered both CMT and PAT .
Funding sources Not specified.
Author affiliation The first author is the developer of this model.
Study Registration: Identifier: None found

Findings details

Child development and school readiness
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Moderate Deviant Child Behaviors - percent of observed intervals - High Risk Generalization setting
FavorableUnfavorable or ambiguousNo Effect
Queensland 1989 2-8 weeks 3 children Not applicable Not applicable Not Reported Not applicable Not applicable

Outcome measure summary

Child development and school readiness
Outcome measure Description of measure Data collection method Properties of measure

Deviant Child Behaviors - percent of observed intervals - High Risk Generalization setting

Percentage of 25-second intervals in which an observer identified a deviant child behavior such as non-compliance, complaint, aversive mands, physical aggression, opposition, or non-interaction.

Pair of independent observers in the family home

Interobserver agreement = 97.3%