Behavioral Parent Training to Address Early Childhood Disruptive Behavior Using the Helping Our Toddlers, Developing Our Children's Skills (HOT DOCS) Program and the Developing Our Children's Skills Kindergarten-5th Grade (DOCS K-5) Program

Child behavior problems are analyzed at pre- and post-intervention using the Intensity scale of the Eyberg Child Behavior Inventory (ECBI). Caregivers used a 7-point Likert scale (1 = never to 7 = always) to rate intensity of child problem behaviors (e.g., aggression, whining, noncompliance). Intensity scores range from 36 to 252, and a score of 131 or higher indicates a clinically significant behavior problem and higher scores = worse outcome. The ECBI has high test-retest reliability, internal consistency reliability, and inter-rater reliability (αs = .75, .93, and .79, respectively) and strong content and construct validity.

Parenting stress is analyzed using the DOCS Parenting Stress Measure at pre- and post-intervention (DOCS PSM, adapted from the Autism Parenting Stress Index. The APSI was designed to measure caregivers' ability to cope with the demands of raising a child with autism and includes 13 items related to daily living, development, and adaptation. The adaptation involved slightly re-wording some items (e.g., changing your child's diet to your child's feeding difficulties) and adding four items on the impact parenting has on other aspects of the caregiver's life, like the time and financial resources parenting takes. Like the ASPI, the 17-item DOCS PSM uses Likert-scale responses ranging from 0 = not stressful to 4 = so stressful sometimes you feel you can't cope with total scores ranging from 0-68, higher scores = more stress and worse outcome. The ASPI has demonstrated good internal consistency and test-retest reliability (αs = .83, .88, respectively).

The Therapy Attitude Inventory (TAI) is administered at post-test to assess participant satisfaction. The TAI has 10 items covering discipline techniques taught in the course and caregiver confidence with using them, and strategies for teaching modeled through the course etc. The TAI uses a 5-point Likert scale with responses ranging from no satisfaction or improvement (e.g., 1 = nothing, much worse than before, etc.) to high levels of satisfaction or improvement (e.g., 5 = greatly improved, very satisfied, etc.) and overall scores range from 10-50 with higher scores = better outcome. The TAI has demonstrated excellent reliability, good test-retest reliability and acceptable internal consistency (αs = .91, .85, and .78, respectively.

The Developmentally Appropriate Discipline Inventory is administered at post-test to assess participant knowledge of developmentally appropriate discipline strategies as a result of participating in the DOCS intervention. The DADI has 10 items covering discipline techniques taught in the intervention. The DADI uses a 5-point Likert scale with responses ranging from strongly disagree (e.g., 1 = strongly disagree, etc.) to strongly agree (e.g., 5 = strongly agree.) and overall scores range from 10-50 with higher scores = better outcome.