Executive Function and Parenting in Childhood

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Description

Deficits in executive functioning (EF) disproportionately impact children living in poverty and increase risk for psychopathology, particularly disruptive behavior disorders. This randomized clinical trial seeks to determine whether childhood EF, assessed across neural and behavioral units of analysis, is an experimental therapeutic target that can be directly modified through caregiver participation in the Chicago Parent Program (CPP), if increases in EF predict reduced disruptive behavior trajectories in low-income children over a short-term follow-up period, and identify which CPP-driven parenting skill improvements are the most influential in modifying EF. This work will contribute new knowledge as to whether a cost-efficient parenting intervention, developed for and with low-income families raising young children in poverty, can modify EF, a neural behavioral mechanism implicated in risk for childhood disruptive behavior problems.

Study Overview

Start Date
November 20, 2023
Completion Date
March 31, 2028
Enrollment
180
Date Posted
February 5, 2024
Accepts Healthy Volunteers?
No
Gender
All

Locations

Full Address
University of Illinois-Chicago
Chicago, Illinois 60612, United States

Eligibility

Minimum Age (years)
4
Eligibility Criteria
Inclusion Criteria:

Children must be between the ages of 4 years old and 5 years, 11 months old
Parent must be the legal guardian of the target child and must live with the child full-time
Parents will be 18 years and older (no maximum age limit)
Only one child and one parent per family can participate in the study
Child is Medicaid eligible, defined as receiving Medicaid or eligible based on family income (up to 142 percent of the federal poverty level)
At enrollment the child will have moderate-to-severe (i.e., (sub)clinical) impairments in executive functioning as indicated by having a global executive composite standardized score greater than or equal to 60 on the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P), which will be completed by parents at the initial screen
Given that some assessment materials are only validated in English, parents and children for this study will need to be English-speaking
Child does not have a prior or current diagnosis of a disruptive behavior disorder based on Diagnostic Statistical Manual, Fifth Edition (DSM-5) criteria
Child is not currently receiving mental health services
Child does not take medications to treat emotional or behavioral problems
Child does not have a medical condition, such as epilepsy, that would interfere with the completion of study tasks
Child does not have an intellectual or developmental disability (autism spectrum disorder)
Child is not actively suicidal
Child does not have a history of psychosis or currently psychotic
Parent does not have a medical condition that would interfere with the completion of the study
Parent does not have an intellectual disability that would interfere with their ability to complete the study
Parent does not have a severe mental illness, active suicidal ideation, or current alcohol/substance abuse/dependence that would interfere with their ability to participate in the study
Child can have a current or past histories of psychiatric disorders (anxiety, mood, attention deficit hyperactivity disorder)
Parent can have current or past history of psychiatric disorders
Parent can be taking medications to treat mental health problems

Exclusion Criteria:

Child is not between the ages of 4-5 years old
The parent is not the legal guardian of the target child
The parent does not live with the child full-time
The parent is younger than 18 years old
Child is not receiving Medicaid or Medicaid eligible
Child does not have (sub)clinical impairments in executive functioning as indicated by having a global executive composite standardized score greater than or equal to 60 on the BRIEF
Child and parent are not English-Speaking
Child has a prior or current diagnosis of a disruptive behavior disorder based on DSM-5 criteria
Child is currently receiving mental health services
Child currently takes medications to treat emotional or behavioral problems
Child has a medical condition, such as epilepsy, that would interfere with the completion of study tasks
Child has an intellectual or developmental disability (autism spectrum disorder)
Child is actively suicidal
Child has a history of psychosis or is currently psychotic
Parent is not willing to be randomly assigned to receive the Chicago Parent Program intervention or to the control condition where they will not receive an intervention
Parent has a medical condition that would interfere with the completion of the study
Parent has an intellectual disability that would interfere with their ability to complete the study
Parent has a severe mental illness and/or active suicidal ideation

Study Contact Info

Study Contact Name
Jennifer Suor, PhD
Study Contact Email
Study Contact Phone

Contact Listings Owner Form

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Other Details

FDA Regulated Drug?
No
FDA Regulated Device?
No
Detailed Description
Impairments in executive functioning (EF), cognitive processes that support self-regulation, disproportionately impact children living in poverty and increase vulnerability for childhood disruptive behavior, which trigger a cascade of mental health problems and psychosocial difficulties across the lifespan. Poverty-related stress and maladaptive parenting styles have been linked to alterations of neural and behavioral EF markers in children; despite this, no studies have studied if parenting prevention programs can directly target childhood EF, and through improving EF, reduce disruptive behaviors in at-risk children. The National Institute of Mental Health (NIMH) funded K23 Mentored Patient-Oriented Research Career Development Award project seeks to conduct a mechanistic randomized clinical trial to determine whether neural-behavioral indices of childhood EF is an experimental therapeutic target that can be modified via caregiver participation in the Chicago Parent Program. Consistent with the NIMH Research Domain Criteria framework, childhood EF will be assessed across brain and behavior measurement units. The second aim of the clinical trial seeks to evaluate whether increases in childhood neural-behavioral EF mediate the effects of CPP in reducing disruptive behavior problems over a short-term follow-up. A third exploratory aim of the project is to preliminarily test whether increases in specific parenting practices (discipline, scaffolding), previously linked to individual differences in EF, mediate the effects of CPP in predicting change in childhood neural-behavioral EF. The sample will include 90 Medicaid eligible parent-child (ages 4-5 years old) dyads and will employ a novel recruitment approach where the target child will have moderate-to-severe EF delays at baseline but does not meet diagnostic criteria for a disruptive behavior disorder.
NCTid (if applicable)
NCT06241300