1. 2011 OSEP Leadership Mega Conference Collaboration to Achieve Success from Cradle to Career 2.0 I-InTERACT RCT "Internet-based Interacting Together Everyday: Recovery After Childhood TBI“ A Randomized Clinical Trial Shari L. Wade, Ph.D. 206 NR-S Presentation #

2. Young children with Traumatic Brain Injury (TBI) often have trouble remembering, paying attention, “switching gears” and dealing with anger and frustration, which often lead to externalizing behavior problems. These problems affect every area of the child’s life. Parents report a lot of stress and frustration, unsure of how to deal with their child’s behaviors. Many families cannot access the help they need to cope with their child’s TBI because they live far from clinics, lack transportation, have no babysitting for siblings, cannot get off work during business hours for appointments, etc. The Problem

3. The Need We needed an accessible program for families of young children with TBI to Share what we know about what to expect after TBI Teach parents how to deal with behavior problems related to TBI Support parents & children after TBI

4. The Solution Training in positive parenting skills improves parenting skills & reduces externalizing child behavior problems The most effective training in positive parenting skills includes didactic information & live coaching of the parent interacting with the child Positive Parenting Skills Training

5. 10 self-guided web-sessions include Parenting skills “how-to’s” (i.e., using labeled praise) Stress and anger management & Information about cognitive and behavioral changes associated with TBI 10 therapist sessions include 1 initial face-to-face session & 9 synchronous coaching sessions using Skype, webcam, and BlueTooth headsets. I-InTERACT (I 2 ): The Intervention

6. Families were randomized to receive either The I-InTERACT intervention OR Internet Resources Participants: Children who sustained a moderate to severe TBI & were enrolled between the ages of 3 and 9 Technology: All families received high-speed internet, computers, BlueTooth earpieces, webcams, and access to online resources on TBI Primary outcomes: Parent & child behavior was assessed pre-, mid (3-months), and post-intervention (6-months) Parent behavior: was observed & coded at each I 2 session Study Design Randomized Control Trial (RCT) I-InTERACT (I 2 ): The Study

7. Participant Characteristics IRC (20)I 2 (20) Caregiver Age32.40 (6.81)32.80 (7.36) ED < High School55%45% Married65%45% Child’s Race70% white 30% AA/mixed 55% white 45%AA/mixed # of Children2.70 (1.17)3.30 (2.06) I-InTERACT (I 2 ): The Study

8. Overall Changes in Positive Parenting Behaviors Baseline to Follow-up I-InTERACT (I 2 ): The Study

9. Overall Changes in Negative Parenting Behaviors Baseline to Follow-up

10. I-InTERACT (I 2 ): The Study I-InTERACT Intervention Family BEFORE

11. I-InTERACT (I 2 ): The Study I-InTERACT Intervention Family 3 MONTHS LATER

12. Summary and Conclusions Delivering a web-based parenting skills Intervention to parents of children with TBI is feasible I-InTERACT results in significant increases in positive parenting behaviors and decreases in negative parenting behaviors I-InTERACT (i 2 ): Results

13. Have a great day. Shari L. Wade, Ph.D., Research Professor Karen S. Oberjohn, M.A. Clinical Research Coordinator Cincinnati Children’s Hospital Medical Center http://wadeprograms.org/i-interact Shari.Wade@cchmc.org 513-636-3370 Thank you!