Stepping Stones Triple P: A randomised controlled trial evaluating the added benefit of an enhanced parenting program in a neurodevelopmental clinical sample.

Neurodevelopmental disorders such as Autism and ADHD pose significant challenges for families. Parents face additional parenting challenges and stressors, and are more likely to experience mental health problems compared to the general population. This is associated with a more unfavourable course in the children. Still, it is unknown whether addressing parental mental health is of additional benefit for the children.Families with a child referred to a developmental clinic for neurodevelopmental problems, and a parent who was experiencing subclinical or clinical mental health symptoms, were recruited. One hundred and twenty-seven families (caregivers: female n = 119, male n = 23; children: female n = 37, male n = 90) were randomised into (1) standard Stepping Stones Triple P, a parenting program for children with neurodevelopmental issues (n = 63), or (2) Enhanced Stepping Stones Triple P (n = 64) which includes additional modules addressing parental mental health. Participants completed pre and post intervention surveys including the Adult Self Report (ASR) and the Child Behaviour Checklist (CBCL).Significantly greater improvements were seen in the Enhanced Stepping Stones Triple P ASR ADHD scores compared to the Stepping Stones Triple P group, however this was not significant after correcting for multiple testing. No additional benefits of the Enhanced Stepping Stones Triple P group were seen for the children's scores. In both groups, the CBCL oppositional defiance and ASR anxiety scores showed nominally significant improvements. None of these remained significant after correcting for multiple testing.The results highlight that families with concurrent parent and child mental health symptoms face unique challenges and increased burdens, and further research is needed in how to tailor programs that best suit their needs and to improve program engagement.