$2 million grant to examine a parent’s role in children’s behavior

Confronting behavioral issues in child welfare system families may ward off future problems, WUSTL expert says

A five-year, $2,050,300 grant awarded to the George Warren Brown School of Social Work at Washington University in St. Louis will be used to evaluate a parent-training program in the vulnerable child welfare population.


The Eunice Kennedy Shriver National Institute of Child Health and Human Development award will fund research regarding Pathways Triple P, an innovative parent training program.

Investigators will determine whether Triple P is effective when applied to families in the child welfare system, compared with treatment as usual.

State-run child welfare systems serve children who are the subjects of suspected mistreatment, and their families, making this a high-risk group that could benefit greatly from intervention.

“Pathways Triple P teaches strategies to manage parental anger, challenges negative parental attributes for child misbehavior, and seeks to help parents identify the effect of harsh disciple on their children while identifying causes of their harsh and critical parenting practices,” says Patricial Kohl, assistant professor of social work and lead investigator of the study.

What is Triple P?

Created 30 years ago in Australia, the Triple P-Positive Parenting Program works with a variety of parents to prevent behavioral, emotional and developmental problems in children from birth to age 16. Triple P consists of parent intervention at five increasing levels of intensity:

  • Level 1: Education about local resources;
  • Level 2: Individual or group consultation for those whose children have mild behavioral issues;
  • Level 3: Four-session training for parents of children with mild-to-moderate behaviors;
  • Level 4: Eight to 10 sessions for families with children who have more severe behavioral difficulties; and
  • Level 5: Individual help for families in conflict or those dealing with significant stress or depression.

Triple P has demonstrated success in other high-risk populations. But the program has not been tested within the child welfare system, a population particularly susceptible to behavioral issues, Kohl says.

“The majority of children enter the child welfare service system due to abuse and/or neglect, and may be at especially high risk of disruptive behavior problems,” Kohl says. “This further places them at risk for further adverse outcomes including the development of conduct disorder and juvenile delinquency, violent delinquency and juvenile court involvement.”

Study assesses impact and cost-effectiveness

During the randomized, controlled trial, Kohl and additional researchers will provide individual, in-home intervention to 70 families. Over a 21-month period, they will evaluate the serviced families and 70 others who make up the control group.

The Triple P study will focus on three questions:

  • How does the program impact disruptive behavior of 5-to-10-year-old children?
  • Does it prevent maltreatment recidivism, and if so, how?
  • How do the costs and benefits of the program compare with those of treatment as usual?

Maltreatment of children has a great financial cost as well as a human toll, Kohl says. Both costs escalate for the many children whose behaviors persist into adulthood.

“It is critical that we identify the least costly means for effective intervention which achieves optimal outcomes with this population,” Kohl says. “Our inclusion of a cost benefit analysis will allow us to inform state-wide policy and practice, including the potential large scale uptake of an empirically supported intervention.”

Kohl, whose research targets the safety and mental health of children who have entered the child welfare system, teaches “Social Work Practice in Early Childhood” and “Social Work Practice with Children in Families.”

For interviews, contact Nancy Fowler Larson at (314) 935-5251 or e-mail Nancy_Larson@aismail.wustl.edu until Jessica Martin returns Sept. 6, 2010.

Expert contact information: Patricia Kohl, (314) 935-7438, pkohl@wustl.edu