(PS6-94) Treatment Acceptability as a Predictor of Parent Behavior in BPT for Children with ADHD

            Behavioral parent training (BPT) is documented as an effective, non-pharmacological treatment for children with ADHD (Evans et al., 2018). Interventions taught via BPT have increased positive parenting and parental competence, and reduced behavior problems and ADHD symptoms over a sustained follow-up period (Doffer et al., 2023; van der Oord & Tripp, 2023). Treatment acceptability affects adherence to treatment (Mash & Johnston, 2008). Although the immediate impacts of treatment acceptability on session attendance and strategy implementation have been examined (Nock et al., 2007), the sustained effects of treatment acceptability on intervention implementation have not been thoroughly evaluated. Thus, this study will examine whether post-treatment parent ratings of treatment acceptability of a BPT program for preschoolers exhibiting ADHD symptoms predict parent implementation of strategies at 6-mo follow up. 

            Parents of 34 preschoolers (ages 3-5) exhibiting significant ADHD symptoms participated in a 10-session BPT program. Parents completed a measure of treatment acceptability (Intervention Rating Profile [IRP-15]; Martens et al. 1985) at post treatment and measures of parent attribution (Parental Attribution Measure [PAM]; Sawrikar et al., 2019), stigma (Parent Affiliate Stigma Scale [PASS]; Mikami et al., 2015), and child inattention/hyperactivity (Conners Early Childhood - Inattention/Hyperactivity subscale [C-IA/HI]; Conners, 2009) at 6-mo follow-up. P</span>arents rated the frequency of their use of BPT strategies (i.e., setting expectations, behavior specific praise (BSP), prevention strategies, teaching strategies, and response strategies) at 6-mo follow-up. Parents’ negative perception of their child, the severity of the child’s behavior, and various demographic characteristics have all influenced parent engagement and ratings of treatment acceptability (Chase & Peacock, 2016). Therefore, while controlling for child ADHD and parent education levels, and parental stigma and attribution, post-treatment acceptability ratings were examined as predictors of parent-reported use of behavioral strategies at 6-mo follow-up using a multiple linear regression analysis. 

            Regression models for BSP revealed a significant relationship at 6-mo follow up (R² = .54, p < .001; R² = .55, p = .001). No significant relationships were found in the remaining models (R² values from .02 to .26). Parent stigma (ꞵ= -.09; p < .001) was negatively associated with BSP. Child inattentive and hyperactivity levels (ꞵ= .03; p = .03) were positively associated with BSP. This suggests that parents who report lower levels of stigma associated with parenting a child with ADHD and parents of children with higher levels of ADHD symptoms are more likely to use BSP at 6-mo follow-up. Although a larger sample size is necessary to substantiate these findings, initial analyses demonstrate parents’ perceptions of their child’s ADHD symptoms impact the use of BSP 6-mo after completing BPT. Future research may examine the reason for the sustained use of BSP in comparison to the other BPT strategies over time. Further discussion surrounding the implementation of optimistic parenting strategies during BPT to help reduce parent stigma is necessary.