Restricted accessResearch articleFirst published online 2026
Addressing Early Childhood Disruptive Behavior and Parenting Stress Through Group Behavioral Parent Training: Effects of Socioeconomic Risk and Homework Completion
Behavioral parent training (BPT) interventions are an efficacious method to improve child disruptive behaviors and reduce parenting stress by teaching caregivers evidence-based techniques to address challenging behaviors across natural routines. Some evidence suggests BPT is less efficacious among families with significant socioeconomic (SE) stressors. The aim of the current study was to examine relationships among cumulative SE risk and BPT homework completion, child challenging behaviors, and parenting stress after a group BPT known as HOT DOCS. Hypotheses were (1) SE risk would be negatively associated with participant homework completion and (2) SE risk would be negatively associated with child disruptive behaviors and parenting stress after intervention. The sample included 254 caregivers in the Southeastern U.S. who participated in a group BPT for caregivers of birth-to-5-year-old children. Caregivers self-reported on their homework engagement, their child’s disruptive behavior, and their parenting stress. Results revealed a negative association between SE risk and homework completion and no association between SE Risk and child behavior or parenting stress outcomes. The findings suggest HOT DOCS may be efficacious for families across SE backgrounds, including those experiencing challenges completing active homework practice sessions.
AgazziH.SalinasA.WilliamsJ.ChiribogaD.OrtizC.ArmstrongK. (2010). Adaptation of a behavioral parent training curriculum for Hispanic caregivers: HOT DOCS Español. Infant Mental Health Journal, 31(2), 182–200.
2.
AgazziH.ChildresJ.ArmstrongK. (2020). Helping our toddlers, developing our children’s skills (HOT DOCS) (4th ed.). Department of Pediatrics, University of South Florida.
3.
AgazziH.HayfordH.ThomasN.DickinsonS.OrtizC.Salinas-MirandaA. (2022). Pandemic parenting: A pilot study of in-person versus internet-DOCS K-5 for caregivers of school-age children with disruptive behaviors. Clinical Child Psychology and Psychiatry, 27(3), 569–585. https://doi.org/10.1177/13591045221096313
4.
AgazziH.HayfordH.ThomasN.OrtizC.Salinas-MirandaA. (2021). A nonrandomized trial of a behavioral parent training intervention for parents with children with challenging behaviors: In-person versus internet-HOT DOCS. Clinical Child Psychology and Psychiatry, 26, 1076–1088. https://doi.org/10.1177/13591045211027559
5.
BhaskaranK.SmeethL. (2014). What is the difference between missing completely at random and missing at random?International Journal of Epidemiology, 43(4), 1336–1339.
6.
BoggsS. R.EybergS.ReynoldsL. A. (1990). Concurrent validity of the Eyberg child behavior inventory. Journal of Clinical Child Psychology, 19(1), 75–78.
7.
BrennanL. M.ShawD. S.DishionT. J.WilsonM. N. (2012). Longitudinal predictors of school-age academic achievement: Unique contributions of toddler-age aggression, oppositionality, inattention, and hyperactivity. Journal of Abnormal Child Psychology, 40(8), 1289–1300. https://doi.org/10.1007/s10802-012-9639-2
8.
BrennanL. M.ShawD. S.DishionT. J.WilsonM. N. (2015). The predictive utility of early childhood disruptive behaviors for school-age social functioning. Journal of Abnormal Child Psychology, 43(6), 1187–1199. https://doi.org/10.1007/s10802-014-9967-5
9.
CamisascaE.MiragoliS.Di BlasioP.FeinbergM. E. (2022). Pathways among negative co-parenting, parenting stress, authoritarian parenting style, and child adjustment: The emotional dysregulation driven model. Journal of Child and Family Studies, 31(11), 3085–3096. https://doi.org/10.1007/s10826-022-02408-9
10.
ChackoA.WymbsB. T.WymbsF. A.PelhamW. E.Swanger-GagneM. S.GirioE. L.PirvicsL.HerbstL.GuzzoJ.PhillipsC. A.O’ConnorB. C. (2009). Enhancing traditional behavioral parent training for single mothers of children with ADHD. Journal of Clinical Child and Adolescent Psychology, 38(2), 206–218. https://doi.org/10.1080/15374410802698388
11.
ChildresJ.AgazziH.ArmstrongK. (2011). Evaluating outcomes of a behavioral parent training program for caregivers of young children: Waitlist-control vs. immediate treatment. Journal of Early Childhood and Infant Psychology, 7, 25–44.
12.
CohenS. S.MiguelJ. (2018). Amor and social stigma: ASD beliefs among immigrant Mexican parents. Journal of Autism and Developmental Disorders, 48(6), 1995–2009. https://doi.org/10.1007/s10803-017-3457-x
13.
ColvinA.EybergS. M.AdamsC. D. (1999). Restandardization of the Eyberg Child Behavior Inventory [Doctoral dissertation]. University of Florida.
14.
ComerJ. S.ChowC.ChanP. T.Cooper-VinceC. E.WilsonL. A. (2013). Psychosocial treatment efficacy for disruptive behavior problems in very young children: A meta-analytic examination. Journal of the American Academy of Child and Adolescent Psychiatry, 52(1), 26–36. https://doi.org/10.1016/j.jaac.2012.10.001
15.
DanielsonM. L.HolbrookJ.BitskoR. H.NewsomeK.CharaniaS.McCordR.KoganM. D.BlumbergS. J. (2022). State-level estimates of the prevalence of parent-reported ADHD diagnosis and treatment among U.S. children and adolescents, 2016 to 2019. Journal of Attention Disorders, 26(13), 1685–1697. https://doi.org/10.1177/10870547221099961
16.
DankoC. M.BrownT. M.Van SchoickL.BuddK. S. (2015). Predictors and correlates of homework completion and treatment outcomes in Parent–Child Interaction Therapy. Child & Youth Care Forum, 45(3), 467–485. https://doi.org/10.1007/s10566-015-9339-5
17.
Deater-DeckardK. (2008). Parenting stress. New Haven, CT: Yale University Press.
18.
DishionT. J.PattersonG. R. (2015). The development and ecology of antisocial behavior in children and adolescents. In CicchettiD.CohenD. J. (Eds.), Developmental psychopathology: Risk, disorder, and adaptation (Vol. 3, pp. 503–541). John Wiley & Sons. https://doi.org/10.1002/9780470939406.ch13
19.
DunlapG.CarrE. G.HornerR. H.ZarconeJ. R.SchwartzI. (2008). Positive behavior support and applied behavior analysis: A familial alliance. Behavior Modification, 32(5), 682–698. https://doi.org/10.1177/0145445508317132
20.
EndersC. K.BandalosD. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8(3), 430–457.
21.
ErathS. A.El-SheikhM.CummingsE. M. (2009). Harsh parenting and child externalizing behavior: Skin conductance level reactivity as a moderator. Child Development, 80(2), 578–592. https://doi.org/10.1111/j.1467-8624.2009.01280.x
EybergS. M.PincusD. (1999). Eyberg child behavior inventory and sutter-eyberg student behavior inventory revised professional manual. Odessa, FL: Psychological Assessment Resources, Inc.
24.
EzpeletaL.NavarroJ. B.De La OsaN.PeneloE.DomenechJ. (2019). First incidence, age of onset outcomes and risk factors of onset of DSM-5 oppositional defiant disorder: A cohort study of Spanish children from ages 3 to 9. British Medical Journal Open, 9(3), Article e022493. https://doi.org/10.1136/bmjopen-2018-022493
25.
FernandezM. A.EybergS. M. (2008). Predicting treatment and follow-up attrition in parent–child interaction therapy. Journal of Abnormal Child Psychology, 37(3), 431–441. https://doi.org/10.1007/s10802-008-9281-1
26.
FoxL.DunlapG.PowellD. (2002). Young children with challenging behavior: Issues and considerations for behavior support. Journal of Positive Behavior Interventions, 4(4), 208–217.
27.
FunderburkB. W.EybergS. M.RichB. A.BeharL. (2003). Further psychometric evaluation of the Eyberg and Behar rating scales for parents and teachers of preschoolers. Early Education and Development, 14(1), 67–82. https://doi.org/10.1207/s15566935eed1401_5
28.
GridleyN.BlowerS.DunnA.BywaterT.BryantM. (2019). Psychometric properties of child (0–5 Years) outcome measures as used in randomized controlled trials of parent programs: A systematic review. Clinical Child and Family Psychology Review, 22(3), 388–405. https://doi.org/10.1007/s10567-019-00277-1
29.
HornerR. G.SugaiG. (2015). School-wide PBIS: An example of applied behavior analysis implemented at a scale of social importance. Behavior Analysis in Practice, 8, 80–85. https://doi.org/10.1007/s40617-015-0045-4
30.
IBM Corporation. (2021). IBM SPSS statistics for Windows (Version 28.0).
31.
LeijtenP.RaaijmakersM. A.de CastroB. O.MatthysW. (2013). Does socioeconomic status matter? A meta-analysis on parent training effectiveness for disruptive child behavior. Journal of Clinical Child & Adolescent Psychology, 42(3), 384–392. https://doi.org/10.1080/15374416.2013.769169
32.
LittleR. J. (1988). A test of missing completely at random for multivariate data with missing values. Journal of the American Statistical Association, 83(404), 1198–1202.
33.
LundahlB.RisserH. J.LovejoyM. C. (2006). A meta-analysis of parent training: Moderators and follow-up effects. Clinical Psychology Review, 26(1), 86–104. https://doi.org/10.1016/j.cpr.2005.07.004
34.
McDanielB. T.RadeskyJ. (2020). Longitudinal associations between early childhood externalizing behavior, parenting stress, and child media use. Cyberpsychology, Behavior, and Social Networking, 23(6), 384–391. https://doi.org/10.1089/cyber.2019.0478
35.
NiecL. N.BarnettM. L.PrewettM. S.Shanley ChathamJ. R. (2016). Group parent–child interaction therapy: A randomized control trial for the treatment of conduct problems in young children. Journal of Consulting and Clinical Psychology, 84(8), 682–698. https://doi.org/10.1037/a0040218
36.
NiecL. N.HemmeJ. M.YoppJ. M.BrestanE. V. (2005). Parent-child interaction therapy: The rewards and challenges of a group format. Cognitive and Behavioral Practice, 12(1), 113–125. https://doi.org/10.1016/S1077-7229(05)80046-X
37.
NixR. L.BiermanK. L.McMahonR. J. (2009). How attendance and quality of participation affect treatment response to parent management training. Journal of Consulting and Clinical Psychology, 77(3), 429–438. https://doi.org/10.1037/a0015028
38.
OggJ.Shaffer-HudkinsE.ChildresJ.FeldmanM.AgazziH.ArmstrongK. (2014). Attendance and implementation of strategies in a behavioral parent training program: Comparisons between English and Español programs. Infant Mental Health Journal, 35, 555–564.
39.
PostorinoV.GillespieS.LecavalierL.SmithT.JohnsonC. R.SwiezyN. B.AmanM. G.McDougleC. J.BearssK.AndridgeR.VitielloB.ScahillL. (2019). Clinical correlates of parenting stress in children with autism spectrum disorder and serious behavioral problems. Journal of Child and Family Studies, 28(8), 2069–2077. https://doi.org/10.1007/s10826-019-01423-7
40.
PowellD.DunlapG.FoxL. (2006). Prevention and intervention for the challenging behaviors of toddlers and preschoolers. Infants and Young Children, 19(1), 25–35. https://doi.org/10.1097/00001163-200601000-00004
41.
RosR.GrazianoP. A.HartK. (2017). Parental homework completion and treatment knowledge during group parent–child Interaction therapy. Journal of Early Intervention, 39, 299–320. https://doi.org/10.1177/1053815117718491
42.
SalinasA.SmithJ. C.ArmstrongK. (2011). Engaging fathers in behavioral parent training: Listening to father’s voices. Journal of Pediatric Nursing, 26, 304–311.
43.
SandersM. R.KirbyJ. N.TellegenC. L.DayJ. (2014). The triple P-Positive Parenting Program: A systematic review and meta-analysis of a multi-level system of parenting support. Clinical Psychology Review, 34(4), 337–357. https://doi.org/10.1016/j.cpr.2014.04.003
44.
SilvaL. M.SchalockM. (2012). Autism parenting stress index: Initial psychometric evidence. Journal of Autism and Developmental Disorder, 42(4), 566–574. https://doi.org/10.1007/s10803-011-1274-1
45.
TrentacostaC. J.ShawD. S. (2009). Emotional self-regulation, peer rejection, and antisocial behavior: Developmental associations from early childhood to early adolescence. Journal of Applied Developmental Psychology, 30(3), 356–365. https://doi.org/10.1016/j.appdev.2008.12.016
46.
Van Den AkkerA. L.HoffenaarP. J.OverbeekG. (2022). Temper tantrums in toddlers and preschoolers: Longitudinal associations with adjustment problems. Journal of Developmental and Behavioral Pediatrics, 43(7), 409–417. https://doi.org/10.1097/dbp.0000000000001071
47.
WakschlagL. S.ChoiS. W.CarterA. S.HullsiekH.BurnsJ.McCarthyK. J.LeibenluftE.Briggs-GowanM. J. (2012). Defining the developmental parameters of temper loss in early childhood: Implications for developmental psychopathology. Journal of Child Psychology and Psychiatry, 53(11), 1099–1108. https://doi.org/10.1111/j.1469-7610.2012.02595.x
48.
WardK. P.LeeS. J. (2020). Mothers’ and fathers’ parenting stress, responsiveness, and child wellbeing among low-income families. Children and Youth Services Review, 116, Article 105218. https://doi.org/10.1016/j.childyouth.2020.105218
49.
Webster-StrattonC. (1998). Preventing conduct problems in Head Start children: Strengthening parenting competencies. Journal of Consulting and Clinical Psychology, 66(5), 715–730. https://doi.org/10.1037/0022-006x.66.5.715
50.
WeiszJ. R.KrumholzL. S.SantucciL. C.ThomassinK.NgM. Y. (2015). Shrinking the gap between research and practice: Tailoring and testing youth psychotherapies in clinical care contexts. Annual Review of Clinical Psychology, 11(1), 139–163. https://doi.org/10.1146/annurev-clinpsy-032814-112820
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