(PS11-B49) Callous-unemotional Traits of Children: Predictor of Outcomes and Moderation by Technology-enhanced Behavioral Parent Training

Background: Behavioral Parent Training (BPT) has repeatedly been recognized as the most effective intervention for conduct disordered children. However, the role of children’s callous- unemotional (CU) traits in these interventions, particularly when behavioral observations are used as the outcome measure, has rarely been examined. The current secondary analyses aimed to (1) examine the role of baseline CU traits in predicting observations of key parent and child outcomes following BPT, and (2) examine if technology-enhanced BPT moderated the outcomes.

Method: A total of 101 children (3–8-years-old) with clinically significant problem behaviors from low-income households were randomized to two parallel conditions: Helping the Noncompliant Child (HNC) or Technology-Enhanced HNC (TE-HNC). HNC is an individual, family-focused, and clinic-based BPT program involving weekly sessions with a therapist. While all dyads received this format of treatment, participants randomized to the TE-HNC condition also received a digital companion, Tantrum Tamers, which allowed therapists to better monitor and tailor treatment based on each family’s progress as well as caregiver access to skills videos. Child CU traits were assessed at baseline, and behavioral observations were assessed at baseline, post-treatment, and the 3- and 6-month follow-ups. Primary analyses employed latent curve modeling to examine the interactive effect of child CU traits and treatment condition on the trajectory of change during treatment, maintenance of treatment gains, and levels of outcomes at the 6-month follow-up.

Results: Overall, findings indicated that families of children with higher CU traits at baseline tended to show fewer improvements in observed positive parenting at post-treatment (p < .05) and lower levels of observed child compliance at the distal follow-up (p < .05). However, significant interactions (p < .05) emerged indicating that TE-HNC buffered this detrimental impact such that baseline child CU traits had no differential impact on improvements in observed parenting or observed child behavior for families who received TE-HNC.

Discussion: The results indicate CU does affect behaviorally observed BPT outcomes, but the negative impact can be reduced by technology-enhanced treatment that supports progress monitoring, treatment tailoring, and caregiver access to features that facilitate home practice. Given that CU traits in childhood predict a host of negative outcomes later in life, such as increased antisocial behavior, risk-taking and delinquency, these findings have significant clinical and empirical implications. For example, findings suggest that families of children with more severe CU traits may benefit from added personalization of and extended exposure to treatment content. Although more research is warranted, the current study highlights a potential mechanism through which families of children with CU traits may be better supported.