(PS11-B30) Parent Cognitive Capacities as a Moderator for Treatment Success

Parent management programs (PMTs) are highly promising and effective in managing symptoms associated with pediatric ADHD. However, the poor engagement and high dropout rates among these programs interfere with families’ ability to actually benefit from them. Attempts to identify barriers have focused primarily on family psychosocial factors and demanding protocols, yet relatively little work has elucidated ADHD treatment moderators, and those that have been identified, are separated from theory. This is problematic because it limits how basic mechanisms involved in ADHD translate to useful clinical application or practice.  Given that ADHD is a highly heritable neurodevelopmental disorder which impacts cognitive functioning, parents of children presenting with ADHD symptoms are statistically likely to have cognitive deficits themselves that may impact treatment. 

This study explores the potentially moderating effects of parent cognitive functions on treatment success. The overall aim is to determine who benefits from a common evidence-based parenting program in which treatment success relies heavily on parent cognitive skills. This study adheres to a single-subject research design. Participants consist of twenty biological parents (n=20) of children between 2-6 years old presenting with high levels of disruptive behavior, and symptoms consistent with ADHD and/or an ADHD diagnosis. The independent variables are individual parent cognitive capacities across four areas implicated in adult ADHD (attention, verbal working memory, response inhibition, and processing speed), which will be assessed with well-established programmed computerized tests (e.g., go-no/go, attention network test, simple reaction time, reading span, stop signal task).  Cognitive capacities are compared to the dependent variable, treatment success in PCIT, defined in two ways: (1) number of sessions for each parent to reach PCIT-defined mastery criteria and (2) reduction in child problem behaviors from baseline to mastery. The relationship between parent psychological functioning (parent stress, depression, anxiety) on treatment success is also explored, as general mental well-being is known to impact cognitive functioning. Data will be analyzed using multiple regression analyses. Results from the study are forthcoming. 
This study has the potential to optimize both treatment retention and success in parent-child treatments by informing strategies to individualize treatment delivery according to parent cognitive strengths and weaknesses.. Other contributions include exploring theory-driven mechanisms in behavioral treatment, while determining the utility of integrating cognitive assessment with clinical work to identify which families actually benefit from these programs.