Enhancing Preschool Children's Attention and Behaviour: Parent-Focused Program

NCT ID: NCT07083037

Last Updated: 2025-07-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-01

Study Completion Date

2027-08-31

Brief Summary

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This study aims to evaluate the feasibility and efficacy of the Building Regulation in Dual Generations (BRIDGE) program for caregivers with significant mental health concerns and preschool and young children (3-7 years old) with elevated attention and/or behavior problems. The BRIDGE program focuses on supporting parental psychological distress and improving young children's self-regulation (SR), thereby reducing their attention and behavior problems (Bridgett et al., 2015; Brikell et al., 2015; Landstedt and Almquist, 2019). The long-term goal of this work is to improve family well-being and social-emotional development for young children by implementing an accessible and scalable dual-regulation program. We will achieve this through the following key objectives:

1. Assess the feasibility and accessibility of BRIDGE for preschool and young children (3-7 years old) with significant attention and behavior programs through questionnaires asking about attendance, satisfaction, and unmet needs.
2. Examine the efficacy of BRIDGE compared to control group at improving maternal mental health and child attention and behavioral difficulties in young children (primary outcomes). We will also examine parenting stress (secondary outcome).
3. Identify predictors of academic readiness skills in preschool and young children. We hypothesize that an increase in parental and child emotion-regulation skills and reduced attention, as well as behavioral problems, will lead to increased pre-academic skills in children.

Detailed Description

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Early exposure to parent psychological distress and mental health challenges (e.g. elevated depression, anxiety, sleep problems and parenting stress) is as a crucial risk factor for the development of children's own difficulties through the intergenerational transmission of maternal mental health framework (Landstedt and Almquist, 2019). The Building Regulation in Dual Generations (BRIDGE) program was designed to improve maternal mental health challenges (e.g. depression, anxiety, trauma, stress) and promote positive parenting thereby improving child behavior and mental health. It brings together evidence-based programs, including Dialectical Behavior Therapy (DBT), behavior management, emotion socialization and mindfulness parenting strategies, and has made significant improvement in maternal depression, as well as the mental health of their children, with greater changes observed in mothers with higher psychological distress (Penner-Goeke et al., 2023).

This project addresses a gap in the current literature by focusing on parent-focused support for preschool and young children with attention and behavior problems. It aims to empower parents with tools and strategies to positively impact their children's behavior. The expected contribution includes understanding effective family-focused supports that address both parental and child challenges early on, promoting positive family well-being. This research has broader implications for clinicians, educators and policymakers by offering practical strategies to improve young children's' behaviors and manage parental mental health challenges, ultimately enhancing overall child well-being and aligning with broader goals in child development and early education. The results will be disseminated through academic publication, and directly communicated within our network of community agencies, programs, clinics and school-systems in both Quebec, Ontario and Manitoba.

The current study will conduct a non-randomized parallel assignment feasibility pilot design to evaluate the feasibility and potential efficacy of the BRIDGE program in addressing parents' mental health difficulties and children's attentional and behavioral problems. We aim to recruit sixty parent-child dyads (30 participants and 30 controls) to take part in the study. Participants in the intervention group will complete the 12-week online BRIDGE program, along with in-person assessments at three time points: pre-intervention (week 0-1;T1), post-intervention (week 12; T2), and follow-up (3 months; T3). The control group will complete the same in-person assessments without participating in the intervention.

Our primary aim is to examine the feasibility of BRIDGE on maternal mental health and their children's mental wellbeing, executive functioning, and social-emotional development. Our secondary aims are to evaluate the efficacy of BRIDGE therapy in improving parenting stress and decreasing harsh parenting tendencies. Supplementary aims of this study include observing differences or changes for both mothers and children, in sleep quality, mental wellbeing, relationships, as well as child academic readiness before and after the BRIDGE program.

Conditions

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Maternal Depression Self-Regulation, Emotion Child Mental Disorder Child Development Attention Problems Behaviour Problems Parental Stress

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

The study will recruit a group of caregivers who meet the current criteria for elevated symptoms of psychological distress as measured by a score of 5 and indicate symptoms to "somewhat cause difficulties" above on the Patient Health Questionnaire 9-item, AND who have children with elevated levels of attention and/or behavior problems as measured by a CBCL ADHD subscale T-Score score of \> 65 OR confirmation of attention/behavior problems through a clinical interview. Eligible female caregivers (mothers, grandmothers, aunts, guardians) will be recruited, and the recruitment will occur concurrently over 12 weeks, will incorporate intervention materials from Dialectical Behavior Therapy (DBT) and parent skills training (BRIDGE).
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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BRIDGE arm

The BRIDGE program is a manualized therapy program that provides participants with parenting and DBT skills through video training modules and in-group sessions. Participants in the BRIDGE arm will participate in 12 weeks of 20-60-minute DBT and parenting skills training that will be delivered asynchronously via video (participants will access these by logging onto a password-protected website). The BRIDGE condition also includes weekly synchronous 1-hour virtual group therapy sessions as well as DBT and parenting skills worksheets to complete between sessions.

Group Type EXPERIMENTAL

Building Regulation in Dual Generations (BRIDGE; DBT + Parenting)

Intervention Type BEHAVIORAL

The BRIDGE intervention includes 12 weeks of 20-60-minute DBT and parenting skills training videos, delivered asynchronously via an online website requiring a participant login. Video content was drawn from concepts outlined in the DBT Skills Training Manual 2nd Edition (Linehan, 2015). Parenting videos will provide mothers with parenting skills education based on best practices in evidence-based positive parenting interventions (e.g., Parent Management Training, Positive Parenting, Kazdin, 1997; Sanders et al., 2014). The BRIDGE condition also includes weekly synchronous 1-hour virtual group therapy sessions and worksheets to complete weekly (as an opportunity to practice skill use).

Support As Usual

Control group participants in the SAU arm will receive a list of local mental health and parenting resources, curated by our research team. Participants can access any intervention or resource participants would like throughout the duration of the program.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Building Regulation in Dual Generations (BRIDGE; DBT + Parenting)

The BRIDGE intervention includes 12 weeks of 20-60-minute DBT and parenting skills training videos, delivered asynchronously via an online website requiring a participant login. Video content was drawn from concepts outlined in the DBT Skills Training Manual 2nd Edition (Linehan, 2015). Parenting videos will provide mothers with parenting skills education based on best practices in evidence-based positive parenting interventions (e.g., Parent Management Training, Positive Parenting, Kazdin, 1997; Sanders et al., 2014). The BRIDGE condition also includes weekly synchronous 1-hour virtual group therapy sessions and worksheets to complete weekly (as an opportunity to practice skill use).

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

BRIDGE Therapy Group:

Participants are deemed eligible for the BRIDGE therapy group if they meet the following criteria:

1. Above the age of 18.
2. Self-identify as a mother of a child between the age of 3-7 years old.
3. Currently living in Quebec, Ontario, or Manitoba
4. Fluency in English.
5. Mothers must have clinically significant symptoms of depression (mild to moderate on the Patient Health Questionnaire and indicate symptoms to "somewhat cause difficulties") currently affecting them. Participants also need to report symptoms of depression during pregnancy or shortly after birth.
6. Their child has attention and/or behavior problems (T-score \> 65 on the Child Behavior Checklist (CBCL) ADHD subscales) or confirmed attention and/or behavior problems through clinical interview.

Control Group:

Participants are deemed eligible for the Control group if they meet the following criteria:

1. Above the age of 18
2. Self-identify as a mother of a child between the age of 3-7 years old
3. Currently living in Quebec, Ontario, or Manitoba
4. Fluency in English or bilingual
5. Mothers must NOT have clinically significant symptoms of depression (mild to moderate on the Patient Health Questionnaire)
6. Their child DOES NOT have attention and/or behavior problems (T-score \> 65 on the Child Behavior Checklist (CBCL) ADHD subscales).


Furthermore, eligible participants were invited to complete a semi-structured intake interview with principal investigator (PI) Dr. Tasmia Hai or a graduate student trainee under Dr. Hai's supervision, during which further questions about their mental health and child behavior were asked to ensure their eligibility. Based on the clinical suitability interview, participants may be excluded if they are deemed to be ineligible based on A) the mother's absence of clinically significant mental health symptoms, and/or B) the child's absence of attention and/or behavior problems. When relevant, participants may be identified to participate in the control group instead if eligibility is met.

Control Group:

Exclusion Criteria

BRIDGE Therapy Group:
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of Manitoba

OTHER

Sponsor Role collaborator

Social Sciences and Humanities Research Council of Canada

OTHER

Sponsor Role collaborator

McGill University

OTHER

Sponsor Role lead

Responsible Party

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Tasmia Hai

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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University of Manitoba - Department of Psychology

Winnipeg, Manitoba, Canada

Site Status NOT_YET_RECRUITING

McGill University - Department of Education and Counselling Psychology

Montreal, Quebec, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Tasmia Hai, PhD

Role: CONTACT

(416) 660-9291

Kayley Leurquin, BA Hons

Role: CONTACT

Facility Contacts

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Melanie Soderstrom, PhD

Role: primary

204-474-9360

Department Chair of the Educational and Counselling Psychology

Role: primary

514-398-3441

References

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Proceedings of the 8th meeting of the European Pineal Society. Tours, France, 3-7 July 1999. Reprod Nutr Dev. 1999 May-Jun;39(3):275-408. No abstract available.

Reference Type BACKGROUND
PMID: 10507827 (View on PubMed)

Leung CK, Shiu RP. Morphological and proliferative characteristics of human breast tumor cells cultured on plastic and in collagen matrix. In Vitro. 1982 May;18(5):476-82. doi: 10.1007/BF02796476.

Reference Type BACKGROUND
PMID: 6749655 (View on PubMed)

Brikell I, Kuja-Halkola R, Larsson H. Heritability of attention-deficit hyperactivity disorder in adults. Am J Med Genet B Neuropsychiatr Genet. 2015 Sep;168(6):406-413. doi: 10.1002/ajmg.b.32335. Epub 2015 Jun 30.

Reference Type BACKGROUND
PMID: 26129777 (View on PubMed)

Gwee AL. Brain drain. Med J Aust. 1974 Aug 17;2(2):suppl:20-1. No abstract available.

Reference Type BACKGROUND
PMID: 4422221 (View on PubMed)

Other Identifiers

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430-2024-00718

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

24-06-073

Identifier Type: -

Identifier Source: org_study_id

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