***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The outcomes of a r and omized clinical trial of a new behavioral family intervention , Stepping Stones Triple P , for preschoolers with developmental and behavior problems are presented . Forty-eight children with developmental disabilities participated , 27 r and omly allocated to an intervention group and 20 to a wait-list control group .  Parents completed measures of parenting style and stress  , and independent observers assessed parent-child interactions . The intervention was associated with fewer child behavior problems reported by mothers and independent observers , improved maternal and paternal parenting style , and decreased maternal stress . All effects were maintained at 6-month follow-up The purpose of this study was to provide an experimental test of the theory of change put forth by A. T. Beck , A. J. Rush , B. F. Shaw , and G. Emery ( 1979 ) to explain the efficacy of cognitive-behavioral therapy ( CT ) for depression . The comparison involved r and omly assigning 150 out patients with major depression to a treatment focused exclusively on the  behavioral activation ( BA ) component of CT  , a treatment that included both BA and the teaching of skills to modify automatic thoughts ( AT ) , but excluding the components of CT focused on core schema , or the full CT treatment . Four experienced cognitive therapists conducted all treatments . Despite excellent adherence to treatment protocol s by the therapists , a clear bias favoring CT , and the competent performance of CT , there was no evidence that the complete treatment produced better outcomes , at either the termination of acute treatment or the 6-month follow-up , than either component treatment . Furthermore , both BA and AT treatments were just as effective as CT at altering negative thinking as well as dysfunctional attributional styles . Finally , attributional style was highly predictive of both short- and long-term outcomes in the BA condition , but not in the CT condition Objective : To examine the efficacy of teen online problem solving ( TOPS ) in improving executive function ( EF ) deficits following traumatic brain injury ( TBI ) in adolescence . Methods : Families of adolescents ( aged 11–18 years ) with moderate to severe TBI were recruited from the trauma registry of 2 tertiary-care children 's hospitals and then r and omly assigned to receive TOPS ( n = 20 ) , a cognitive-behavioral , skill-building intervention , or access to online re sources regarding TBI ( Internet re source comparison ; n = 21 ) . Parent and teen reports of EF were assessed at baseline and a posttreatment follow-up ( mean = 7.88 months later ) . Results : Improvements in self-reported EF skills were moderated by TBI severity , with teens with severe TBI in the TOPS treatment reporting significantly greater improvements than did those with severe TBI in the Internet re source comparison . The treatment groups did not differ on parent ratings of EF at the follow up . Conclusions : Findings suggest that TOPS may be effective in improving EF skills among teens with severe TBI Objective To describe a family-centered problem-solving intervention ( FPS ) for pediatric traumatic brain injury ( TBI ) , and to assess the efficacy of the intervention in a r and omized clinical trial . Participants Families of 32 school-aged children with moderate to severe TBI r and omly assigned to FPS or usual care ( UC ) group .  Main Outcome Measures Child Behavior Checklist , Brief Symptom Inventory , Conflict Behavior Question naire . InterventionS even-session problem-solving/skill-building intervention delivered over a 6-month period for the participating families . Results Parents in the FPS group reported significantly greater improvements in their children in internalizing symptoms , anxiety/depression , and withdrawal than did parents in the UC comparison group . Conclusions FPS holds promise for reducing child behavior problems , the most common and persistent sequelae of TBI Primary objectives : To explore the relative effectiveness of clinician-delivered vs family-supported interventions for children with chronic impairment after TBI . Research design : R and omized controlled clinical trial . Methods and procedures : Children aged 5–12 years in the chronic phase of their recovery were r and omly assigned to the clinician-delivered or to the family-supported intervention group ; both sample s received intensive services for 1 year ; physical outcome was measured by the SARAH scales , cognitive outcome by the WISC-III . Main outcomes and results : Parents in the family-supported intervention sample efficiently acquired the skills needed to deliver physical and cognitive interventions within the context of everyday routines of the child 's life at home ; family education level was not a factor . Although both groups demonstrated improvements , only the children in the family-supported intervention group demonstrated statistically significant — and clinical ly important — improvements on both outcome measures . Conclusions : This RCT provides compelling evidence for organizing cognitive and physical interventions and supports for children with TBI around the everyday routines of their lives , with intensive supports for their families This study examined whether an online problem-solving intervention could improve  parental adjustment  following pediatric traumatic brain injury ( TBI ) . Families of children with moderate-to-severe TBI were recruited from the trauma registry of a large children 's hospital and r and omly assigned to receive online family problem solving therapy ( FPS ; n = 20 )  or Internet re sources ( IRC ; n = 20 ) in addition to usual care . The FPS group reported significantly less global distress , depressive symptoms , and anxiety at follow-up than did the IRC group after controlling for baseline symptoms . The FPS group also reported significant improvements in problem-solving skills , although the groups did not differ significantly at follow-up . Findings suggest that an online , skill-building approach can be effective in facilitating parental adaptation after TBI Whilst the Triple P Positive Parenting Program has a large evidence base ( S and ers , Clinical Child and Family Psychology Review 2:71–90 , 1999 ; S and ers , Journal of Consulting and Clinical Psychology 68:624–640 , 2000 ) and preliminary evidence indicates that Stepping Stones Triple P is also efficacious ( Roberts , Journal of Clinical Child and Adolescent Psychology , 35(2):180–193 , 2006 ) , to date Stepping Stones has not been evaluated with the ASD population . Fifty-nine families with a child with ASD aged between 2 and 9 participated in this r and omized controlled trial . The results demonstrate significant improvements in parental reports of child behaviour and parenting styles with the treatment effects for child behaviour , parental over reactivity and parental verbosity being maintained at follow-up 6 months later . Further , the results suggest significant improvements in parental satisfaction and conflict about parenting as well as a sleeper effect for parental efficacy . The results indicate that Stepping Stones Triple P is a promising intervention for parents of children with ASD . Limitations and future research are also addressed OBJECTIVES The aim was to examine functional outcomes following traumatic brain injury ( TBI ) during early childhood , to investigate impairments up to 5 years postinjury and identify predictors of outcome . METHODS The study compared three groups of children ( mild = 11 , moderate = 22 , severe = 15 ) , aged 2.0 - 6.11 years at injury , to a healthy control group ( n = 17 ) . Using a prospect i ve , longitudinal design , adaptive abilities , behavior , and family functioning were investigated acutely , 6 , 30 months and 5 years postinjury , with educational progress investigated at 30 months and 5 years postinjury . RESULTS A strong association was suggested between injury severity and outcomes across all domains . Further , 5-year outcomes in adaptive and behavioral domains were best predicted by preinjury levels of child function , and educational performance by injury severity . CONCLUSION Children who sustain a severe TBI in early childhood are at greatest risk of long-term impairment in day-to-day skills in the long-term postinjury 
    Output:
    
Interventions that train parents may be a useful approach to alleviate behavioral and emotional disturbances after pediatric TBI .
Some evidence suggests that these interventions may help to improve parenting skill and adjustment .
However , all identified studies included interventions with multiple treatment components , so the effects attributable to parent training alone remain undetermined .