Psychological Distress Trajectories of Parents of Children With Developmental Disabilities Participating in a Parenting Intervention.

The study was nonrandomized, so it is impossible to determine if the improvements in distress were caused by the intervention or by other factors such as natural changes over time or external support. The 'Rapid Improvement' group was very small (19 parents), making the findings about intervention levels in this group less reliable. Parents chose their own intervention level, leading to an imbalanced distribution that may have influenced the results. The study only measured distress at three time points, so it could not detect complex, nonlinear changes in distress over time. Most participants were mothers (88.8%), so the findings may not reflect the experiences of fathers. Data on whether parents received additional interventions between the 3-month and 12-month follow-up was not reliably collected.

The Triple P program is owned by the University of Queensland, which receives royalties from published resources. Author M.R. Sanders is the founder of Triple P and a consultant to Triple P International. Authors M.R. Sanders and K. Sofronoff receive royalties and consultancy fees from Triple P International. Authors B.J. Tonge, S.L. Einfeld, and K.M. Gray are authors of the Developmental Behaviour Checklist (DBC2) used in the study.

Do not assume that the most intensive intervention level (Level 4) produced the best outcomes. In the small group that improved rapidly, Level 3 was associated with a steeper decline in distress than Level 4. Additionally, because there was no control group, you cannot conclude that the intervention caused the reduction in distress; improvements may have occurred regardless of the programme.