Education and Human Sciences, College of (CEHS)


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Chadwell, M. R. (2015). The impact of treatment exposure, trauma, and caregiver involvement in therapy on children's response to behavioral treatment (unpublished doctoral dissertation). University of Nebraska-Lincoln, Lincoln, NE.


A DISSERTATION Presented to the Faculty of The Graduate College at the University of Nebraska In Partial Fulfillment of Requirements For the Degree of Doctor of Philosophy, Major: Psychological Studies in Education (School Psychology), Under the Supervision of Professors Merilee McCurdy & Beth Doll. Lincoln, Nebraska: May, 2015

Copyright (c) 2015 Mindy R. Chadwell


Early childhood represents a time period during of rapid growth and development including physical development, language and communication, autonomy, and a wide variety of self-regulation skills (Campbell, 2006; Egger & Angold, 2006). Children vary in the rates at which they achieve these skills and they may challenge their parents through behaviors such as noncompliance and temper tantrums (Butler & Eyberg, 2006). Failure for children to adequately develop these basic skills can contribute to the development of behavior problems that lead to persistent problems throughout life (Whittaker et al., 2011). This study examined three factors that influence young children’s response to a multicomponent community-based day treatment program for young children with externalizing behavior problems, including treatment exposure, prior exposure to trauma, and caregiver involvement in therapy.

Participants were 50 caregivers of children receiving services at one of three day treatment centers in the Midwestern United States. Data were collected at the three day treatment centers over a nine-month period. Caregivers interested and who consented to participate in the study completed four rating scales during one visit: Child Behavior Checklist (CBCL), Parent Daily Report (PDR), Trauma Events Screening Inventory-Parent Report Revised, Brief (TESI-PRR-B), and Treatment Evaluation Inventory, Short Form (TEI-SF), which lasted approximately 30 minutes. A review of records provided information on pre-treatment externalizing symptoms (scores from the pre-treatment CBCL and pretreatment PDR measures) and demographic information.

Results indicated significant decreases in externalizing behaviors from Time 1 (pre-treatment) to Time 2 (concurrent treatment) on the CBCL and PDR. Results found no significant relation among the amount of time participants spent in treatment and decreases in externalizing behaviors on the CBCL or PDR. Participants with prior exposure to trauma presented with higher frequency of externalizing behaviors and experienced a greater decrease in externalizing behaviors. Finally, the current study provided preliminary evidence to support the hypothesis that level of caregiver involvement in treatment impacts reductions in externalizing behavior symptoms. Social validity data indicated high levels of caregiver acceptability of the day treatment program.

Advisors: Merilee McCurdy and Beth Doll