Evaluation of a parent training program to promote sharing between young siblings

BEHAVIORTHERAPY23, 299-318, 1992

Evaluation of a Parent Training Program to Promote Sharing Between Young Siblings GEORGIA LOUISE TIEDEMANN CHARLOTTE JOHNSTON

University of British Columbia This study examined the effectiveness of a 5-session parenting program in promoting sharing between young siblings. Individual and group formats of the program were each compared to a wait-list control condition. Forty-eight mothers with two young children participated and were randomly assigned to one of the three conditions. Each family was assessed before and after the parenting program and at a 6-week follow-up. The mother reported on her parenting approach and her children's behavior, and interactions between the mother and children were observed in a laboratory playroom. Fathers and preschool or kindergarten teachers also reported on the children's behavior. The program provided parents with information about the development of sharing and sibling relationships and taught behavioral parenting techniques to promote the development of child sharing skills. Positive effects of the program on observed and reported sharing behavior were demonstrated. These effects generalized across informants and, in some cases, nonsharing behaviors. Treatment effects were typically maintained over a 6-week follow-up period. Although the two treatment formats did not differ on most measures, only the individual format produced a significant change in observed child behavior. Implications of the program's success in promoting adaptive child competencies are discussed.

Behavioral parent training programs have proven useful in helping parents deal with a variety of child-rearing problems (c.f. Dangel & Polster, 1984; O'Dell, 1985). These programs have focused primarily on reducing inappropriate child behaviors such as noncompliance and aggression (Emery, Binkoff, Houts, & Carr, 1983; Lutzker, McGimsey, McRae, & Campbell, 1983). This research was part of a doctoral dissertation conducted by the first author at the University of British Columbia, under the direction of the second author, and was supported by a grant from the Laidlaw Foundation to the second author, and a SSHRC doctoral fellowship and APA Dissertation Award to the first author. We express appreciation to Robert J. McMahon for his contributions during the early development of this project, the families and other volunteers who participated in the study and to our research assistants: Kim Behrenz, Ren6e Patenaude, Sonia Pietzsch, Terry-Ann Sander, and Rosemary Toye. Requests for reprints should be addressed to Dr. Charlotte Johnston, Department of Psychology, University of British Columbia, Vancouver, B.C., Canada V6T IZ4. 299 0005-7894/92/0299-031851.00/0 Copyright 1992 by Association for Advancementof Behavior Therapy All rights of reproduction in any form reserved.

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In contrast, relatively little attention has been given to parents' skills in teaching and promoting specific adaptive behaviors such as assertiveness, problemsolving, and cooperative play (Webster-Stratton, 1985a). Yet, these childhood social competencies are highly correlated with adult responses to the child and with social acceptance in childhood, and are important in predicting adjustment in adulthood (Hops, Finch, & McConnell, 1985; Loeber, 1990). Programs aimed at parents and the family context would seem to be a logical place to begin building children's prosocial skills as the earliest social development is shaped primarily in the home. For example, a recent study by Ross, Tesla, Kenyon, and Lollis (1990) found that mothers frequently intervened in instances of object conflict between toddlers. Interestingly, these maternal actions often were not explained to the child and, where explanations were offered, they were inconsistent in endorsing the principles governing toy sharing. These results suggest that parents may need assistance in developing strategies to enhance children's social competencies. In addition to parental influences, siblings also play a major role in children's social development. Siblings often provide the most extensive opportunities for peer interaction during the preschool years and sibling conflict is a frequent parent concern (Dunn & Kendrick, 1982; Lamb & Sutton-Smith, 1982). Although only a few parent-implemented treatments have targeted sibling conflict (e.g., Leitenberg, Burchard, Burchard, Fuller, & Lysaght, 1977; O'Leary, O'Leary, & Becker, 1967; Olson & Roberts, 1987), encouraging results, both in training parents and improving sibling relations, have been reported. Again, however, the focus has been on reducing undesirable behaviors rather than teaching specific, positive sibling interaction skills. A program focused on training parents to teach social skills to young siblings in the home would not only promote positive, adaptive behavior, but would capitalize on the powerful socialization effects of parents and siblings. Thus, such a program may help to overcome the limited generalization and maintenance noted with programs conducted in out-of-home settings by professional staff (Hops et al., 1985; Ollendick & Winett, 1985). Reviewing previous research indicates: that social skills programs with a specific focus tend to have better outcomes than more ambitious, global interventions; and that precise definition and individualized selection of developmentally-appropriate target behaviors are key ingredients of success (Hops et al., 1985; Ollendick & Winett, 1985). Based on the effectiveness of programs targeting specific and developmentally-appropriate behaviors, sharing in the context of sibling play was selected as the focus of the present study. Among young children, sharing is a central skill in determining social competence and acceptance. It is one of the few child behaviors that reliably elicits positive peer responses, predicts increased social activity and status, and serves as an effective strategy for entering and maintaining peer interactions (Day, Fox, Shores, Lindeman, & Stowitschek, 1983; Strain, 1985). Given the frequency of sibling conflict (Dunn & Kendrick, 1982; Furman & Buhrmester, 1985), sibling interactions appear as a prime area in which to encourage the development of sharing. Thus, the focus of this research on sharing in the context of sibling relations serves to address the promotion of a key social behavior within the frequently problematic context of sibling relationships.

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In 1979, Barton and Ascione published a study demonstrating the utility of a behavioral treatment package in promoting sharing between young children. Other studies using the Barton and Ascione program, or revisions thereof, have similarly found it effective in increasing sharing behavior (e.g., Barton & Bevirt, 1981; Barton, Olszewski, & Madsen, 1979; Benton-GaiUard, CardenSmith, & Budd, 1983; Bryant & Budd, 1984; Kohler & Fowler, 1985). A component analysis of the program (Barton, 1981) revealed that instructions and peer modeling had minimal effects on sharing; behavioral rehearsal with feedback and praise brought some increases; and the addition of prompts and praise each brought substantial improvements in children's sharing. Program effects have been shown to generalize across settings and behaviors (Barton & Bevirt, 1981; Benton-Gaillard et al., 1983), and to untrained children during play with trained children; and treatment gains have been maintained up to 4 weeks (Kohler & Fowler, 1985). Thus, the effectiveness of the Barton and Ascione-type sharing program is well established and generalization data are encouraging, although longer-term follow-ups and comparisons with notreatment controls are infrequent. Similarly, the program has been implemented only by professional staff, and parents have not been trained to use the program with their own children. Based on its documented effectiveness and specific, behavioral format, the Barton and Ascione-type sharing program was judged suitable for adaptation to the family context. Accordingly, this study examined the efficacy of a parent-led version of the program to teach sharing skills to young siblings. As a first step in evaluating this new application of the program with parents as trainers, the study sought to determine if the entire treatment package could, under optimal conditions, bring about changes in sibling sharing beyond those expected through maturation. It was predicted that, in contrast to a notreatment control, parents in the sharing program would demonstrate increased knowledge of children's sharing and strategies for facilitating sibling sharing. Most importantly, it was predicted that parents would increase their use of strategies taught in the program and that children would demonstrate more appropriate sharing skills and fewer inappropriate sharing-related behaviors. Finally, these effects were expected to be maintained over a 6-week follow-up period. Secondary effects of the program on parents' feelings of competence, children's social behavior in general, children's sharing outside of the home, and the sibling relationship were also explored. The relative efficacy of two formats of the program was also examined. One format followed procedures typically used in individual parent-training and the other employed a typical group format. Considerable research has investigated the relative effectiveness of these two formats for delivering parenttraining programs, primarily to clinic populations (for a review, see O'Dell, 1985). Several studies have documented equivalent therapeutic effectiveness for the two formats (e.g., Webster-Stratton, 1984), and an advantage for group delivery in increased cost-effectiveness, parent-rated acceptability and convenience, and social support and self-confidence (Gray & Wandersman, 1980; Rosenfarb & Hayes, 1984). Other investigators have found superior effectiveness for individual programs, and increased client satisfaction with more personal attention (Eyberg & Matarazzo, 1980; McMahon & Forehand, 1983).

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Given these conflicting findings, specific predictions regarding differences in the group versus individual formats were not made in this study.

Method

Subjects Forty-eight families were recruited by means of community notices offering a program dealing with sibling sharing problems. To increase sample homogeneity, participation was limited to married women with at least a Grade 10 education, and a family socioeconomic status (SES) of semiskilled worker or above on the Hollingshead Four-Factor Index (Hollingshead, 1975). These women were required to have two children between the ages of 2 years 6 months and 6 years 11 months, with no older children. A roughly equivalent level of social and educational experience among the children was attained by requiring each to have had some form of ongoing group experience (e.g., group lessons, preschool). Given the focus of the program on increasing sharing rather than dealing with general child management, participation was also limited to children who, aside from parent-reported difficulties in sibling interaction, were developing normally, for example, within the normal range on the Vineland Adaptive Behavior Scales (Sparrow, Balla, & Cicchetti, 1984) and the Child Behavior Checklist (Achenbach & Edelbrock, 1983). Mothers were not paid for participation, but were offered travel expenses, a videotape of their children playing, and "sharing diplomas" for their children. Of 144 prospective participants, 78 did not fit the inclusion criteria. Most of these were single mothers or had children outside the selected age range. Another 11 mothers met the criteria but declined participation in the study. The remaining 55 mothers attended an introductory interview in which detailed information about the study was provided and screening measures were administered. At this time, 4 mothers declined participation and 1 family was referred elsewhere because of extreme child problems. Of the remaining 50 families, 1 served as a pilot subject and their data are not reported. One mother completed the pre-treatment assessment, was assigned to the group program condition, and dropped out following the first treatment session. Thus, 48 families completed the study. Of these, 7 had a family composition of older boy and younger girl, 14 had an older girl and younger boy, 14 had two boys and 13 had two girls. On average, mothers were 36 years old, older children averaged 64.1 months of age, and younger children averaged 38.0 months of age. A wide range of SES was represented, with the mean score falling in the middle to upper-middle class range. Average scores on adultreport measures indicated that, although siblings shared appropriately in approximately half their interactions, they had "somewhat of a problem" with sharing and experienced sharing-related conflicts several times a week.

Design A treatment-comparison with wait-list control design was employed. Families were randomly assigned to one of three conditions, with blocking for family composition (sex and age of siblings): 16 families received immediate individual

SHARING BETWEEN SIBLINGS

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treatment (INDIV), 16 families received immediate group treatment (GROUP), and 16 families received treatment after the follow-up assessments were completed (WAIT). Assessments were conducted on each block of three families (with yoking within blocks for time between assessments) on the following occasions: following the introductory interview and preceding the INDIV and GROUP families beginning the sharing program (PRE), within a week following the last program session for the INDIV family (POST), and at a followup appointment 6 weeks after the POST assessment (FU). Waitlist families participated in the format of their choice after the FU assessments, and their responses to treatment are not reported in this study.

Sharing Program As noted above, the sharing program was adapted from Barton and Asclone (1979) and Bryant and Budd (1984). The program provided children with specific training in component skills of sharing, detailed rationales and instructions regarding sharing, and information about inappropriate sharingrelated behavior. The program began with the introduction of the entry skills of Inviting and Requesting, followed by training in Granting Requests and Accepting Invitations. The many different ways to share and play together once an invitation or request has been accepted (Making Sharing Work) were also included in the program, as were the skills of using Appropriate Refusals and the reciprocal behavior of Handling Refusals. The final component of the sharing program was labeled Problem-Solving and included strategies for handling anger and constructive alternatives to disputes. The techniques used to teach parents to deliver this program have been extensively researched and validated with families of young children (Forehand & McMahon, 1981; O'Dell, 1985). The individual parent-training condition (INDIV) provided two informational sessions and three active skill-learning sessions. Families in the GROUP condition (three to five mothers per group) covered the same material and received all the same handouts in five sessions. The first author, a doctoral candidate in clinical psychology with several years of experience in parent training, served as the instructor for all families. Mothers in both conditions received basic developmental and behavior management information in the first two sessions through lecture, discussion, reading material, and instructor modeling. In the first session, information was provided regarding the development of sharing and sibling relationships, and mothers were assisted in establishing age-appropriate expectations for sibling sharing. In the second session, the parenting techniques of using antecedent strategies (e.g., using toys and books that facilitate sharing); providing sharing-related information and rationales to children; and modeling (including puppet modeling), prompting, and reinforcing sharing behavior were introduced. Each technique was described, discussed, and modeled by the instructor. INDIV families then received three sessions of direct behavioral training in child and adult skills on an individual basis. Mothers received immediate feedback on their approach to teaching the component sharing skills to their children, weekly monitoring of homework progress, and problem-solving assistance from the instructor. For the GROUP families, the initial two sessions were

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the same as above and were followed by three sessions with the instructor presenting training in the sharing program by means of lecture, group discussion, reading material, and modeling.

Assessment Procedures 1 During the introductory interview, written consent, and screening measures were obtained and children were introduced to the laboratory playroom. At each of the PRE, POST, and FU assessments, mothers completed questionnaires, the children were interviewed individually, and the mother and children were videotaped in the laboratory playroom. This playroom was furnished to resemble a living room, with a standard, limited selection of age-appropriate toys available. The toys were selected, on the basis of pilot testing, to be highly desirable and difficult for children to share (e.g., only one doll with clothes, only a few attractive lego pieces and one building base, an odd number of toys such as small trucks or plastic animals). The limited toy selection was designed to necessitate cooperative toy sharing rather than parallel use of any one class of toys by the siblings. At each assessment, 20 minutes of interaction between the mother and children were videotaped using equipment concealed behind a one-way mirror. For half of the interaction (10 minutes), the mother was given questionnaires to complete and asked to use her usual strategies to encourage the children not to bother her. For the other 10 minutes, she was unoccupied and asked to make herself at home and do as she wished.

Measures Treatment Fidelity To ensure that the treatment was implemented as planned, checks at each INDIV session noted homework completed and the children's and mother's mastery of each skill. In addition, one session for each INDIV family and one session for each group was randomly selected and audiotaped. An observer rated each section of the session (e.g., Homework Review, Instructor Demonstration of Skill) on a 5-point scale according to how closely the section followed the treatment manual. A reliability rater rated 10 randomlyselected sessions. A Pearson correlation conducted between raters' scores summed across sections of the Treatment Fidelity scale indicated strong agreement (r = .84, p < .01). A paired-sample t-test revealed no significant difference between scores from the two raters.

Primary Outcome Measures A range of measures were included that directly reflected skills or concepts taught in the program. i Because this report focuses on effects of the treatment program, not all measures or procedures that were employedare reported. The child interview, maternal screening measures, and differences in observed interactions with mothers busy versus free to interact are considered in separate reports. It should be noted that group equivalence was demonstrated on the maternal screening variables (e.g., measures of social skill and attitude toward the treatment program).

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Observational coding system. Behavioral coding of the videotaped motherchild interactions was conducted using a modified version of the Bryant and Budd (1984) system, with additions from systems used by Abramovitch, Pepler, and Corter (1982) and Barton and Ascione (1979).2 Partial-interval coding of child and mother behaviors was conducted using 10-second intervals. One primary category of behavior directed to the sibling was coded for each child: positive sharing-related behavior such as asking politely, turn taking, trading toys, or mutual play with the same toy (Share Positive). Share Positive (e.g., attending to, prompting, or modeling sharing behavior) was also coded for the mother. Observers were trained using a written manual and group coding sessions. Training continued until each observer's coded frequencies correlated, across a number of interaction segments, .80 or greater with a criterion coding and produced frequency levels similar to the criterion. Regular practice sessions were held throughout the coding. Interobserver reliability was assessed by having a second observer code a randomly selected 5-minute portion of each family's interactions at PRE, POST, and FU. Intraclass correlations for the total score for each behavior provided by primary and secondary observers for the 5-minute segment were calculated. For Share Positive, the correlations for mothers ranged from .88 to .96 across the PRE, POST, and FU observations, with an average of .93. For older children, correlations averaged .95 across the three observations (range from .89 to .98), and for younger children the average correlation was .95 (range from .90 to .98). Scores from the primary observers were used in all analyses. Sharing Knowledge Questionnaire. To assess the mother's understanding of material presented in the program, a 25-item Sharing Knowledge Questionnaire was developed using both multiple-choice and short-answer questions. Parenting Strategies Questionnaire (PSQ). Adapted from a previously-used measure (McMahon, Cross Calvert, Davies, & Flessati, 1986), the PSQ lists 33 specific parenting techniques, including all of the techniques taught in the sharing program. The parent indicated the total number of techniques they have used in the past month. Sharing and Sibling Interaction Questionnaire (SSIQ). This 18-item measure was developed to assess adult perceptions of sibling sharing. Informants rated the frequency or intensity of specific sharing-related problems and a total score was calculated. Sibling Interaction Record (SIR). In an effort to supplement the laboratory observations with a measure of home behavior, mothers completed the SIR. For each of the 5 days, mothers chose, in advance, an hour when they knew their children would be together. They unobtrusively attended to their children's interactions during that hour and then rated how much time the children chose to spend together, whether they had any sharing-related difficulties, and the general tone of the interaction. Scores were summed over days and scales. The detailedcoding manualis available from the first author.

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Generalization Measures Observational coding system. Three generalization categories of behavior directed to the sibling were coded for each child: negative sharing-related behavior such as demanding or grabbing an object (Share Negative), nonsharing-related positive behavior such as talking or hugging (Other Positive), and non-sharing-related negative behavior such as criticizing or hitting (Other Negative). The same three behaviors were coded for the mother: Share Negative (e.g., criticism or power assertion related to child sharing), Other Positive (e.g., talk or touch unrelated to toy sharing), and Other Negative (e.g., scolding or demands unrelated to sharing). Examination of the data after coding indicted that Other Negative was rare among both mothers and children and this category was c o m b i n e d with Share Negative to form a general Negative category. For Other Positive, intraclass correlations for the mother averaged across PRE, POST, and FU observations ranged from .79 to .95 with an average of .88. For older children, correlations for Other Positive ranged from .52 to .72 with an average of .60, and for younger children the correlations ranged from .69 to .74 with an average of .71. For the general Negative category, the intraclass correlations for mothers across the PRE, POST, and FU observations averaged .48 with a range from .26 to .643. For older children, correlations for Negative averaged .75 (range .48 to .93) and for younger children correlations averaged .93 (range .79 to .98). Parenting Sense of Competence Scale (PSOC; Gibaud-Wallston & Wandersman, 1978; Johnston & Mash, 1989). Included to determine if the sharing program affected mothers' self-esteem as a parent, this scale measures selfefficacy and satisfaction with parenting. Items were summed to yield a total score. Sharing and Sibling Interaction Questionnaire (SSIQ). To gather information from a variety of sources and situations, the SSIQ was completed by an adult other than the mother who regularly observed the siblings together (e.g., father, nanny). In addition, a modified version (16 items) was given to one adult who regularly observed the younger child apart from the sibling and interacting with other children (e.g., daycare worker, neighbor), and one such adult who regularly observed the older child apart from the sibling. Vineland Socialization Scale (Vineland; Sparrow et al., 1984). To assess behavioral generalization, general social functioning of the children was assessed by the raw total Socialization scale of the Vineland. Reports of both children's social functioning on this measure were obtained from the mother and the three additional informants described above. Child Behavior Checklist (CBCL; Achenbach & Edelbrock, 1983). The raw total behavior problem score from an age-appropriate CBCL (2 to 3 or 4 to 3 Negativebehaviors occurred at a very low frequency for mothers. For example, at the PRE assessment, wherethe intraclass coefficientwas only .26, 50a70of the mothers werecoded as never showing negativebehavior. Among mothers who did display Negativebehavior, the rates were low, with most showing only one instance of this behavior. Given that intraclass coefficientsare calculated as variance ratios, the limited variability in mother Negativescores contributed to the low coefficients.

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16 year old version) was used to assess generalization across a range of problem behaviors.

Consumer Satisfaction Client Satisfaction Questionnaire (CSQ; Larsen, Attkisson, Hargreaves, & Nguyen, 1979). This measure assesses general satisfaction with the program. As well as at the POST and FU assessments of treated families, the CSQ was administered at every second session to track changes in satisfaction as the program progressed. Parents" Consumer Satisfaction Questionnaire (PCSQ). This questionnaire was adapted from Forehand and McMahon (1981) and asks respondents to rate the usefulness and difficulty, as well as satisfaction with, the program. A total score summarizes overall degree of satisfaction. This measure was completed at POST and FU by INDIV and G R O U P mothers.

Results Treatment Fidelity Audiotapes of 22 sessions were rated for fidelity. The mean rating per session (on a 1 to 5 scale) was 4.25, with a range of 3 to 5. A t-test indicated no significant difference between fidelity ratings for INDIV and G R O U P families. No INDIV mothers missed sessions, but three G R O U P mothers missed one to three sessions. Written materials were provided when mothers missed sessions. Instructor progress checks indicated that INDIV mothers completed 76o70 of assigned homework, and 98°70 o f the skills taught were demonstrated by mothers and children in practice sessions.

General Approach to Outcome Analyses The effects of the sharing program on the primary outcome measures were explored through the use of repeated-measures analyses of covariance (ANCOVAs) with the PRE score for each measure used as the covariate to reduce within-group variability. There was one between-groups variable o f condition (INDIV vs. GROUP vs. WAIT), and one repeated-measures variable of time (POST vs. FU), with an additional within-subject variable o f child (YOUNG vs. OLD) where appropriate. Reported means are adjusted for the effect of the PRE covariate. To control for experiment-wise error rate, the analyses of the primary measures were used to guide the analyses o f generalization measures. These generalization measures were examined only if the related primary measure revealed a significant effect. Given the large number of related generalization measures, MANCOVAs for groups of variables were used where possible in these secondary tests. Throughout the analyses, alpha was set at .05, although theoretically interesting trends are also reported.

Observational Data Share Positive for mothers, the primary measure reflecting mother behaviors taught in the program, was analyzed by a 3 x 2 ANCOVA (Condition × Time).

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This analysis revealed no significant condition or time effects. For children, Share Positive was also the p r i m a r y measure o f behaviors targeted in the program. A 3 x 2 x 2 A N C O V A (Condition x Time x Child)revealed a significant condition effect, F(2,44) = 3.73, p = .03 and a significant Time x Child interaction, F(1,45) = 4.72, p = .03. Follow-up Newman-Keuls analyses o f the condition effect revealed a significant difference between I N D I V and W A I T means (p < .05). The G R O U P m e a n did not differ significantly f r o m either I N D I V or W A I T means. Tests o f simple main effects indicated a significant time effect for b o t h older and younger children (F(1,94) = 32.99, p < .001 and F(1,94) = 7.22, p < .01, respectively). However, the child effect was significant only at FU, F(1,94) = 7.35, p < .01. Thus, the interaction indicated that older children showed a greater increase in sharing f r o m P O S T to F U t h a n did younger children. Means for Share Positive are presented in Table 1. Because significant effects were f o u n d for Share Positive for the children, the generalization behaviors o f Other Positive and Negative were examined. N o significant effects were found. In sum, I N D I V children showed significantly more sharing-related behavior as a result o f the program, although condition effects were not found in mothers' behaviors. Generalization to negative and non-sharing behaviors was not evident.

Maternal Self-Report The p r i m a r y measure, the Sharing Knowledge Questionnaire, was examined by a 3 x 2 (Condition x Time) ANCOVA. Because 15 mothers did not complete the short-answer p o r t i o n o f this measure, only the multiple-choice

TABLE 1 ADJUSTED MEANS FOR MOTHER AND CHILDREN OBSERVED BEHAVIOR Post-treatment Share Positive Younger Child INDIV GROUP WAIT Older Child INDIV GROUP WAIT Mother INDIV GROUP WAIT

Follow-up

Mean

SD

Mean

SD

34.9a 29.5 24.6

(26.5) (23.3) (20.9)

43.3 30.6 18.3

(25.0) (26.9) (10.3)

34.3 29.7 24.6

(25.9) (23.0) (20.9)

45.2 31.7 18.7

(25.0) (29.1) (9.0)

31.3 34.9 25.8

(14.2) (12.6) (15.6)

31.6 30.4 24.0

(19.9) (13.2) (13.5)

a Scores are expressed as percentage of intervals in which behavior occurred.

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TABLE 2 ADJUSTED MEANS FOR MATERNAL SELF-REPORT MEASURESOF PARENTING Post-treatment Mean

Follow-up SD

Mean

SD

Sharing Knowledge Questionnaire a INDIV

13.5

(1.2)

14.0

(1.4)

GROUP

14.1

(1.0)

14.2

(1.1)

WAIT

12.5

(1.5)

11.6

(3.0)

Parenting Strategies Questionnaire b INDIV

28.8

(3.2)

28.5

(6.0)

GROUP

29.9

(1.8)

29.5

(4.0)

WAIT

29.7

(3.6)

28.9

(4.2)

Parenting Sense of Competence Scale c INDIV

65.2

(10.4)

71.5

(9.7)

GROUP

66.2

(9.2)

69.8

(10.4)

WAIT

62.3

(10.9)

62.6

(10.2)

a Maximum score on the Sharing Knowledge Questionnaire is 19. b Maximum score on the Parenting Strategies Questionnaire is 33. c Maximum score on the Parenting Sense of Competence Scale is 102.

questions were analyzed. Means are shown in Table 2. Only the main effect for condition was significant, F(2, 44) = 9.55, p < .001. Newman-Keuls tests indicated that both INDIV and GROUP mothers demonstrated greater knowledge than did WAIT mothers (ps < .01). INDIV and G R O U P mothers did not differ. Given this significant primary measure effect, a 3 × 2 (Condition × Time) MANCOVA was conducted on the two generalization self-report measures of parenting (PSQ and PSOC). Means for these measures are also shown in Table 2. The multivariate effect for time was significant, F(3, 43) = 5.53, p = .003, and the effect for condition approached significance, F(4,86) = 2.27, p = .068. No other significant effects were found. Follow-up univariate analyses revealed no significant effects for the PSQ. For the PSOC, the main effect for condition was significant, F(2, 43) = 3.63,p = .035. Although the means for INDIV and G R O U P mothers were larger than the mean for WAIT, Newman-Keuls tests failed to reach significance. The main effect for time on the PSOC was significant, F(1, 45) = 16.29, p < .001, indicating that all mothers reported greater feelings o f parenting competence at FU than at POST. In sum, treatment effects were evident in mothers' knowledge about sharing and sibling relationships, but did not reach significance on measures of parenting strategies or parenting sense of competence.

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TABLE 3 ADJUSTEDMEANSFOR ADULT REPORTSOF SHARINGAND SIBLINGINTERACTIONS Post-treatment Mean

SD

Follow-up Mean

SD

Sharing and Sibling Interaction Questionnaire-In Home a Mother INDIV GROUP WAIT Father INDIV GROUP WAIT

57.9 59.9 65.8

(11.1) (15.3) (10.0)

47.5 52.2 67.4

(11.6) (12.8) (11.1)

56.1 59.3 66.3

(15.8) (12.8) (13.7)

46.3 46.4 67.9

(15.7) (16.1) (11.5)

32.5 32.1 42.7

(10.8) (6.5) (11.9)

28.7 28.3 43.2

(10.6) (8.7) (10.4)

Sibling Interaction Record b INDIV GROUP WAIT

Sharing and Sibling Interaction Questionnaire-Out of Home c Informant for Younger Child INDIV GROUP WAIT Informant for Older Child INDIV GROUP WAIT

39.8 40.2 50.9

(10.8) (11.3) (12.3)

32.4 35.2 51.8

(11.3) (10.6) (10.3)

32.3 31.8 43.4

(7.4) (12.1) (12.7)

26.9 27.4 47.8

(10.4) (11.5) (11.6)

170.5 171.8 106.2

(17.3) (17.7) (17.9)

182.2 185.2 104.6

(21.4) (18.6) (22.2)

212.5 216.8 152.0

(18.0) (13.6) (26.8)

221.5 225.7 154.5

(17.5) (13.1) (24.1)

Vineland and Child Behavior Checklist-Mother Vineland d Younger Child INDIV GROUP WAIT Older Child INDIV GROUP WAIT

(continued) Adult Reports of Sharing and Sibling Interaction A s a p r i m a r y m e a s u r e , t h e S S I Q s u m m a r y scores f r o m t h e m o t h e r a n d fat h e r (or o t h e r i n - h o m e i n f o r m a n t ) w e r e a n a l y z e d by a 3 × 2 × 2 ( C o n d i t i o n x T i m e × P a r e n t ) A N C O V A . M e a n s for this a n a l y s i s are p r e s e n t e d in T a b l e

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TABLE 3 (continued) Post-treatment

Child Behavior Checklist e Younger Child INDIV GROUP WAIT Older Child INDIV GROUP WAIT

Follow-up

Mean

SD

Mean

SD

20.7 13.5 29.9

(19.0) (9.0) (14.8)

14.5 8.2 26.6

(14.2) (8.2) (10.7)

13.1 16.3 25.8

(14.9) (14.4) (10.1)

10.8 10.7 27.4

(15.8) (10.5) (12.6)

144.6 148.2 132.2

(29.2) (18.9) (28.7)

149.9 155.6 136.1

(25.1) (20.6) (18.3)

183.1 191.2 178.2

(17.3) (18.7) (33.7)

188.0 188.6 173.8

(21.7) (11.7) (23.4)

140.4 146.6 131.6

(28.O) (28.2) (17.2)

141.4 159.7 143.9

(27.6) (27.4) (18.1)

173.2 191.7 178.6

(21.7) (24.8) (28.2)

176.3 194.6 182.6

(17.9) (25.2) (25.1)

Vineland-Other Informants Out-of-Home Informant Younger Child INDIV GROUP WAIT Older child INDIV GROUP WAIT Father Younger Child INDIV GROUP WAIT Older Child INDIV GROUP WAIT

a Maximum score on the Sharing and Sibling Interaction Questionnaire-In Home is 126, with lower scores indicating more positive interactions. b Maximum Sharing Interaction Record score is 105, with lower scores indicating more positive interactions. c Maximum score on the Sharing and Sibling Interaction Questionnaire-Out-of-Home is 112, with lower scores indicating more positive interactions. d Vineland scores are raw total Socialization Scale scores. e Child Behavior Checklist scores are raw total behavior problem scores.

3. The effect for condition was significant, as was the effect for time. However, these effects were modified by a significant Condition × Time interaction, F(2, 44) = 9.97, p < .001, so tests of simple main effects were conducted. No other effects reached significance. The test o f simple main effects for time was significant for INDIV families, F(1, 93) = 21.74, p < .001, and for G R O U P families, F(1, 93) -- 14.77, p <

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.001, indicating reports of more positive sharing-related behavior at FU than at P O S T in the treatment groups. The simple effect for time was not significant for WAIT families. Looking at simple effects for condition, a significant effect was found at POST, F(2, 134) = 9.37, p < .001. Newman-Keuls tests indicated that WAIT families reported significantly less positive sharing-related behavior than did I N D I V or G R O U P families, p s < .05. I N D I V and G R O U P families did not differ. At FU, a significant effect for condition was also found, F(2, 134) = 53.43, p < .001. Newman-Keuls tests again indicated that WAIT families reported significantly less sharing-related behavior than did I N D I V and G R O U P families (ps < .01), who did not differ. Thus, the Condition x Time interaction represents an increase over time in reported positive sibling interaction only for treated families. The second primary adult-report measure of children's sharing was the SIR 5-day sharing report completed by mothers. A 3 × 2 ANCOVA (Condition × Time) produced a significant effect for condition, F(2, 44) = 10.97, p < .001. No other effects were significant. Newman-Keuls tests indicated less positive sibling interaction in the daily reports of WAIT mothers than in those of G R O U P or I N D I V mothers, ps < .01. I N D I V and G R O U P reports did not differ. Means for this measure are reported in Table 3. Given these significant effects on primary measures, the generalization measures from out-of-home informants on the SSIQ, mother Vineland and C B C L reports, and father and other informant Vineland reports were examined. The modified version of the SSIQ for the two out-of-home informants was analyzed by a 3 × 2 × 2 (Condition × Time × Child)ANCOVA. Means for this analysis are presented in Table 3. The effect for condition was significant as was the effect for time, but both were modified by a significant Condition × Time interaction, F(2, 45) = 5.61, p = .007. No other effects reached significance. The test of simple main effects for time for I N D I V families was significant, F(1, 93) = 10.32, p < .01, as it was for G R O U P families, F(1, 93) = 5.68, p < .025, with reports of more positive sharing-related behavior at FU than at POST. Time was not significant for WAIT families. Looking at simple effects for condition, no significant effect was found at POST. At FU, a significant effect for condition was found, F(2, 138) = 83.19, p < .001. Newman-Keuls tests indicated that informants for WAIT families reported significantly less positive sharing-related behavior than did those for I N D I V and G R O U P families (ps < .01), who did not differ. Thus, the Condition x Time interaction represents an increase from P O S T to FU in positive sharing for I N D I V and G R O U P children but not for WAIT children, with a significant treatment effect only at FU. The mothers' scores for the Vineland and CBCL were treated with a 3 x 2 × 2 MANCOVA (Condition × Time × Child). The analysis indicated a significant main effect for time, F(2, 43) = 20.47, p < .001. Main effects for child and condition were significant but modified by a significant interaction, F(4, 84) = 5.34, p = .001. Follow-up univariate analyses revealed significant time effects on both the Vineland, F(1, 44) = 35.24, p < .001 and the CBCL, F(1, 44) = 11.15,p = .002. Both measures revealed improved behavior at follow-

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up. The Condition × Child interaction was also significant for both the Vineland, F(2, 42) = 5.45, p = .008 and the CBCL, F(2, 42) = 5.67, p = .007. Simple main effects for Vineland scores revealed the expected developmental effect; in all conditions older children received higher scores than younger children [INDIV, F(1, 62) = 109.84, p < .001; GROUP, F(1, 62) = 121.48, p < .001; WAIT, F(1, 58) = 142.68, p < .001]. Similarly, at both ages, the effect for condition was significant [YOUNG, F(2, 120) = 471.84, p < .001; OLD, F(2, 120) = 441.40, p < .001]. Newman-Keuls at both ages revealed that children in the two treated groups did not differ, but were rated as significantly more socially mature that children in the WAIT condition (ps < .01). Simple main effects for CBCL scores revealed that younger children had marginally more behavior problems than older children only in the INDIV condition, F(1, 62) = 3.13, p < .10. Condition effects were significant at both the younger, F(2, 143) = 36.96, p < .01, and older, F(2, 143) = 30.27, p < .01 ages. Post hocs for both the younger and older children revealed that INDIV and GROUP children had fewer behavior problems than WAIT children. Averaged across child age and time o f assessment, the mean raw scores for INDIV, GROUP, and WAIT children were comparable to Tscores of 41, 39, and 49 respectively. Thus, for Vineland scores the Condition x Child interaction revealed the expected significant treatment and developmental effects. For CBCL scores, the interaction indicated significant treatment effects and a possible developmental effect in the INDIV condition. Analyses o f Vineland scores from the father and out-of-home informants was conducted using a 3 × 2 × 2 × 2 ANCOVA (Condition × Time x Child × Informant) and means are shown in Table 3. The effect for child was significant, F(1, 28) = 4.21, p = .05 revealing expected developmental effects. The time effect was also significant, F(1, 29) = 5.43, p = .027, with informants reporting more mature social behavior at follow-up than at post. The condition effect approached significance, F(2, 28) = 3.01, p = .069, but Newman-Keuls indicated no significant between-condition differences. In sum, out-of-home informants reported higher levels of positive sharingrelated behavior for INDIV and GROUP children than for WAIT children. Mothers reported generalization of these treatment effects to increased levels of social skill and decreased behavior problems. For other informants, this generalization to social skill occurred only marginally.

Consumer Satisfaction The CSQ was administered twice during the program, then at POST and again at FU. Scores were investigated by a 2 x 4 ANCOVA (Condition × Time). The only significant effect was for condition, F(1, 26) = 4.46, p = .04. This indicated that the program was rated more positively by INDIV mothers (M = 28.28) than by G R O U P mothers (M = 25.52). The PCSQ was administered at POST and FU and scores were investigated by a 2 × 2 ANCOVA (Condition x Time). The effect for condition approached significance, F(1, 30) = 2.91, p = .099. INDIV mothers rated the program more positively (M = 379.9) than G R O U P mothers (M = 358.7).

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Discussion Positive effects of the sharing program on reports of siblings' sharing-related behavior were demonstrated and observations indicated a significant effect for children in the INDIV condition compared to those in the WAIT condition. In general, treatment effects maintained over a 6-week follow-up period and appeared to generalize across informants and, in some cases, nonsharing behaviors. In addition to their statistical significance, the treatment effects were judged to be clinically meaningful. For example, the difference in children's observed positive sharing behavior in the INDIV versus WAIT conditions represented a difference of approximately .75 standard deviations. The typical effect size on questionnaire measures of parent and child characteristics ranged from .75 to 1.5. Finally, consumer satisfaction reports indicated that families liked the program and saw it as having positive effects. Observations of behavior, both as recorded in the home by mothers and in the laboratory by objective coders, provide the most direct support for the predicted increase in children's sharing, particularly in the individual training format. This finding is congruent with previous sharing intervention studies conducted in preschools (e.g., Barton, 1981; Bryant & Budd, 1984). However, the changes observed in this study are particularly impressive given that the effects of previous interventions have often not been demonstrated against maturational controls, or have weakened over follow-up periods shorter than that used in the present study (e.g., Barton & Bevirt, 1981; Barton et al., 1979; Kohler & Fowler, 1985). Thus, the effects of this parent-led sharing program appear equivalent, if not superior, to previous programs conducted by staff in school or daycare settings. It is rather puzzling that, although the program was delivered through the mother, behavioral changes were observed only for the children. It is possible that mothers' behavior in the home had changed and that, although the mothers were not displaying these changes in the observation situation, either because they were too self-conscious to use the new strategies or because all mothers were able to "look good" for this brief period, the effects of home-based changes in children's behavior generalized to the lab situation. Alternately, subtle changes in the mother's behavior, not detected by the rather molar codes in this observation system, may have been influencing the children in the laboratory situation. Finally, on a methodological note, it is possible that, by having the mothers busy with paperwork and essentially ignoring the children for half of the observation session, the time over which observations of mothers' interactions with their children were made was reduced below the level where group differences could be detected. Despite the lack of observed behavioral effects for mothers, mothers in both treatment conditions demonstrated greater knowledge of information covered in the sharing program than mothers who had not yet participated. This finding suggests, not only that mothers in the program retained what they were taught, but that mothers in general may not have acquired this information from other sources. Given the differences reported for observed child behavior and reported mother knowledge, it is unclear why group differences on self-reports of parenting strategies and parenting efficacy were not apparent. It is possible

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that these measures were too global to detect changes in parenting related specifically to managing sibling interactions. This possibility was explored by analyzing a subscale of the SSIQ, on which parents reported the use of specific parenting strategies taught in the sharing program. The results of a 3 x 2 x 2 (Condition x Time x Parent) ANCOVA indicated a significant effect of condition, F(2, 39) = 8.12, p = .001, and no significant effect for parent. Newman-Keuls tests indicate that GROUP and INDIV parents reported more use of these specific parenting techniques than did WAIT parents. Thus, on this measure targeting the particular strategies taught in the sharing program, positive effects were apparent. On the questionnaire measures reflecting sharing and sibling interactions both at home and outside, children in both treatment conditions were reported to display more positive sharing-related behavior than WAIT children. Moreover, on the SSIQs completed both by in-home and out-of-home information, sharing behavior for children in the treatment conditions was reported to increase from post-treatment to the follow-up visit, and this was not the case for WAIT children. These results suggest that the positive effects of the treatment program may intensify over time. This continued improvement in social behavior is consistent with sharing's key role in social development (Day et al., 1983; Strain, 1985) and with the utility of targeting specific, adaptive behaviors in the promotion of social competence (Ollendick & Winett, 1985). It is interesting to note, given the lack of direct father involvement in the program, that there was no difference found between mother and father reports on the measure of sharing and sibling interactions. Consistent with previous research in the parent training literature (e.g., Martin, 1977), structured inclusion of fathers in treatment does not appear necessary to create positive changes in specific mother or child behavior immediately or shortly following treatment. Whether the lack of structured father involvement would negatively affect longer-term outcomes of this sharing program, as has been demonstrated with other parenting programs (Webster-Stratton, 1985b), is unknown. In assessing the generalization of treatment effects, on the Vineland, mothers reported that children in both treatment conditions showed more advanced levels of general social skill than wait-list children. These differences appeared to be due to a reported acceleration of social development among INDIV and GROUP children rather than any detrimental effects within the WAIT condition. Generalized improvements in inappropriate behavior, as measured by the CBCL, were also reported by mothers in both treatment conditions, but not in the WAIT group. Thus, there is evidence that the sharing program, although targeting only one specific prosocial behavior, had a broader impact on social development and behavior problems as well. These generalization effects support the central role of sharing in children's social behavior and offer evidence of the utility of the sharing program in affecting meaningful change across a range of child behaviors. This study provided only minimal indication of treatment format differences. The two formats did not differ in effect on observed mother behavior, measures of parent knowledge or parenting strategies, questionnaire reports of children's sharing, and sibling interaction from several informants, nor

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mothers' reports of general child behavior. However, compared to the control condition, only the individual format produced significant effects on observed child behavior and the individual format was rated more highly than the group format on consumer satisfaction measures. It may be that components of the individual format, such as behavioral rehearsal, homework tracking, and individualized therapist feedback are necessary to produce effects large enough to be detected in a brief, laboratory observation session. Therefore, if parent satisfaction or observed behavior change are judged as important determinants of treatment choice, the individual format appears to offer an advantage. In contrast, if treatment efficiency is used as the deciding factor, the less therapist-intensive group format might be chosen. Given the relatively small sample sizes in this study the possibility of insufficient power obscuring format differences must be considered. Further research using large samples, a variety of measures, and different populations is needed to gain a clearer understanding of format differences or interactions between treatment format and family characteristics. The results of this study can only be generalized over a restricted population, given the non-clinic, intact, primarily middle-class volunteer families involved in this study. Although the limits put on this sample were designed to make it maximally responsive to the intervention, it should be noted that a normal range within these limits was represented. For example, families ranged in SES from semiskilled worker to professional, scores on screening and maternal measures represented the range typical of normative samples, and children's CBCL scores ranged up to the 90th percentile. Mean baseline reports of children's sharing behavior and sibling interaction indicated a moderate level of difficulty. Thus, the group appears representative of families in the community who are experiencing difficulties with sibling interactions. Future evaluations will be needed to address the utility of the program in other parent populations, to identify the essential components in the program, and to track the effects over a longer follow-up period. Similarly, further research is needed to assess generalization beyond the one therapist used in this report, and to control for potential biases arising when the experimenter serves as therapist. In conclusion, a parent-training intervention was demonstrated to have positive effects on children's sharing behaviors in sibling interactions. From a mental health promotion point of view, this intervention appeared to facilitate the growth of competencies known to be important in the social development of this age group. Given the c o m m o n nature of sibling conflict and the importance of sharing as a social skill among young children, this study represents an important contribution to the literature on mental health promotion and prevention of adjustment difficulties in children.

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