2011 OSEP Leadership Mega ConferenceCollaboration to Achieve Success from Cradle to Career 2.0

I-InTERACT RCT

"Internet-based Interacting Together Everyday:Recovery After Childhood TBI“

A Randomized Clinical Trial

Shari L. Wade, Ph.D.206 NR-S

Presentation #

Young children with Traumatic Brain Injury (TBI) often have trouble remembering, paying attention, “switching gears” and dealing with anger and frustration, which often lead to externalizing behavior problems. These problems affect every area of the child’s life.

Parents report a lot of stress and frustration, unsure of how to deal with their child’s behaviors.

Many families cannot access the help they need to cope with their child’s TBI because they live far from clinics, lack transportation, have no babysitting for siblings, cannot get off work during business hours for appointments, etc.

The ProblemThe Problem

The Need

We needed an accessible program for families of young children with TBI to

• Share what we know about what to expect after TBI

• Teach parents how to deal with behavior problems related to TBI

• Support parents & children after TBI

The SolutionThe Solution

Training in positive parenting skills • improves parenting skills &• reduces externalizing child

behavior problems

The most effective training in positive parenting skills includes• didactic information &• live coaching of the parent

interacting with the child

Positive Parenting Skills TrainingPositive Parenting Skills Training

10 self-guided web-sessions include• Parenting skills “how-to’s” (i.e., using labeled praise)• Stress and anger management &• Information about cognitive and behavioral changes

associated with TBI

10 therapist sessions include• 1 initial face-to-face session &• 9 synchronous coaching sessions using Skype, webcam,

and BlueTooth headsets.

I-InTERACT (I2): The InterventionI-InTERACT (I2): The Intervention

Families were randomized to receive either The I-InTERACT intervention OR Internet ResourcesParticipants: Children who sustained a moderate to severe TBI & were enrolled between the ages of 3 and 9Technology: All families received high-speed internet, computers, BlueTooth earpieces, webcams, and access to online resources on TBIPrimary outcomes: Parent & child behavior was assessed pre-, mid (3-months), and post-intervention (6-months)Parent behavior: was observed & coded at each I2 session

Study DesignRandomized Control Trial (RCT)

Study DesignRandomized Control Trial (RCT)

I-InTERACT (I2): The StudyI-InTERACT (I2): The Study

Participant CharacteristicsParticipant Characteristics

IRC (20) I2 (20)Caregiver Age 32.40 (6.81) 32.80 (7.36)ED < High School 55% 45%

Married 65% 45%Child’s Race 70% white

30% AA/mixed55% white45%AA/mixed

# of Children 2.70 (1.17) 3.30 (2.06)

I-InTERACT (I2): The StudyI-InTERACT (I2): The Study

0

2

4

6

8

10

12

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16

18

20

Baseline Follow-up

IRC

I-2

Overall Changes in Positive Parenting Behaviors Baseline to Follow-up

Overall Changes in Positive Parenting Behaviors Baseline to Follow-up

I-InTERACT (I2): The StudyI-InTERACT (I2): The Study

0

5

10

15

20

25

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35

Baseline Follow-up

IRC

I-2

I-InTERACT (I2): The StudyI-InTERACT (I2): The Study

Overall Changes in Negative Parenting Behaviors Baseline to Follow-up

Overall Changes in Negative Parenting Behaviors Baseline to Follow-up

I-InTERACT (I2): The StudyI-InTERACT (I2): The StudyI-InTERACT Intervention Family

BEFOREI-InTERACT Intervention Family

BEFORE

I-InTERACT (I2): The StudyI-InTERACT (I2): The StudyI-InTERACT Intervention Family

3 MONTHS LATERI-InTERACT Intervention Family

3 MONTHS LATER

Summary and Conclusions

• Delivering a web-based parenting skills Intervention to parents of children with TBI is feasible

• I-InTERACT results in significant increases in positive parenting behaviors and decreases in negative parenting behaviors

I-InTERACT (i2): ResultsI-InTERACT (i2): Results

Have a great day.Shari L. Wade, Ph.D., Research ProfessorKaren S. Oberjohn, M.A. Clinical Research CoordinatorCincinnati Children’s Hospital Medical Center

http://wadeprograms.org/i-interact

Shari.Wade@cchmc.org513-636-3370

Thank you!