Feldman, M. A., Case, L., & Sparks, B. (1992). Effectiveness of a child-care training program for parents at-risk for child neglect. Canadian Journal of Behavioural Science, 24(1), 14–28. https://doi.org/10.1037/h0078698

Type of Study: Randomized controlled trial
Number of Participants: 34

Population:

• Age — Adults: 16–42 years; Children: 1–23 months
• Race/Ethnicity — 31 Caucasian-Canadian, 1 Japanese-Canadian, 1 Afro-Canadian, and 1 Chinese-Canadian
• Gender — Adults: 34 Female; Children: 21 Male and 13 Female
• Status — Participants were mothers with intellectual disabilities.

Location/Institution: Canada

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate home-based parent training [now called Step-by-Step Parenting Program] consisting of instructions, picture books, modeling, feedback, and tangible reinforcement to teach crucial child-care skills (e.g., diapering, bathing, feeding, safety) to low IQ mothers considered at-risk for child neglect. Participants were randomly assigned to training or a control group, and also compared to a group of nonhandicapped mothers with similar-aged children. Measures utilized include observational checklists. Results indicate that after training, the mean percent correct score of the training group was similar to that of the nonhandicapped comparison mothers, with both significantly greater than the mean of the control group. The training group maintained improvements following training, and the control group, when subsequently trained, had a mean score of 92%. Finally, where it could be observed, the health of the children improved with the parents learning proper child-care (e.g., elimination of diaper rash, increased rate of weight gain, toilet training). Limitations include the small sample size, the length of follow-up, and that it may not be generalizable to other populations due to the ethnic composition of the group.

Length of controlled postintervention follow-up: Average=28 weeks.

Feldman, M. A., Sparks, B., & Case, L. (1993). Effectiveness of home-based early intervention on the language development of children of mothers with mental retardation. Research in Developmental Disabilities, 14(5), 387–408. https://doi.org/10.1016/0891-4222(93)90010-H

Type of Study: Randomized controlled trial
Number of Participants: 28

Population:

• Age — Not specified
• Race/Ethnicity — 96% Caucasian-Canadian and 4% Japanese-Canadian
• Gender — 100% Female
• Status — Participants were mothers with intellectual disabilities.

Location/Institution: Canada

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the effects of a home-based parent training program [now called Step-by-Step Parenting Program] for mothers with mental retardation on the language development of their children who were at risk for language delay. Participants were randomly assigned to either an interaction training or attention-control group. A comparison group of nonmentally retarded mothers was also examined. Measures utilized include the Wechsler Adult Intelligence Scales-Revised (WAIS-R), the Bayley Scales of Infant Development (BSID), and the Kent Adaptation of the BSID. Results indicate that after training, the interaction training group scores were no longer lower than those of the comparison group of mothers without mental retardation and were also significantly higher than the scores of the control group on all maternal positive interactions, child vocalizations, verbalizations, language, and social domains. Speech emerged significantly sooner in the interaction training group as compared to the control group. Limitations include the small sample size, variability in the length of follow-up, and high drop-out rate in follow-up.

Length of controlled postintervention follow-up: Varied - 13 to 82 weeks

Feldman, M. A., & Case, L. (1997). The effectiveness of audiovisual self-instructional materials in teaching child-care skills to parents with intellectual disabilities. Journal of Behavioral Education, 7(2), 235–257. https://doi.org/10.1023/A:1022897226255

Type of Study: Other quasi-experimental
Number of Participants: 13

Population:

• Age — Adults: 20–40 years; Children: 2–40 months
• Race/Ethnicity — Not specified
• Gender — Adults: 11 Female and 2 Male; Children: Not specified
• Status — Participants were parents with intellectual disabilities referred via court order or referral by child protection agencies, advocates, family members, family physicians, and public health nurses.

Location/Institution: Canada

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the efficacy of the Step-by-Step [now called Step-by-Step Parenting Program] self-instructional pictorial child-care manuals with and without accompanying audiotaped instruction for parents with intellectual disabilities. Participants were randomized to (a) audiotape + manual, (b) manual alone, or (c) a no training control group. Measures utilized include the Bayley Scales of Infant Development (BSID) and the Wide Range Achievement Test-Revised (WRAT-R). Results indicate that self-instructional materials were effective in teaching 22 of 26 skills to levels seen in parents without intellectual disabilities. Eighty-one percent of the skills were maintained over a follow-up period and self-learning effects were replicated when the parents received self-instructional materials for the original no-training control skill. Despite the low literacy skills of the parents, for most of them no advantage was found in adding the audiotape to the illustrations. Three parents only reached criterion after an audiotape was added to the manual alone skill. Consumer satisfaction ratings were uniformly high, and those parents who stated a preference preferred the pictorial manuals without, as opposed to with, the audiotape. Limitations include the small sample size and length of follow-up.

Length of controlled postintervention follow-up: 1, 3, and 6 months.

Feldman, M. A., Garrick, M., & Case, L. (1997). The effects of parent training on weight gain of nonorganic-failure-to-thrive children of parents with intellectual disabilities. Journal on Developmental Disabilities, 5, 47–61.

Type of Study: Other quasi-experimental
Number of Participants: 2

Population:

• Age — Adults: 23.5–31 years, Children: 7–11.5 months
• Race/Ethnicity — Not specified
• Gender — 100% Female
• Status — Participants were parents with intellectual disabilities with children who have been diagnosed with failure to thrive.

Location/Institution: Not specified

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the effects of parent training [now called Step-by-Step Parenting Program] in conjunction with ongoing medical involvement on the weight gain of two children with non-organic failure to thrive (NOFT). Participants received medical involvement from a team of medical professionals before being assigned parent training. After being assigned to parent training, they received both treatments in conjunction to evaluate the effects on weight gain. Measures utilized include the Bayley Scales of Infant Development (BSID). Results indicate that parent training, combined with ongoing medical advice and supervision, increased the children's weights to the point where they were no longer considered failure to thrive. Limitations include the small sample size, the small number of data points, and that data on the statistical significance of the results was not presented.

Length of controlled postintervention follow-up: 28–58 months.

Feldman, M. A., & Case, L. (1999). Teaching child-care and safety skills to parents with intellectual disabilities through self-learning. Journal of Intellectual and Developmental Disability, 24(1), 27–44. https://doi.org/10.1080/13668259900033861

Type of Study: Other quasi-experimental
Number of Participants: 10

Population:

• Age — 26–34 years
• Race/Ethnicity — Not specified
• Gender — 90% Female
• Status — Participants were parents with intellectual disabilities.

Location/Institution: Canada

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the efficacy of self-instructional audiovisual child-care manuals of a parent training program [now called Step-by-Step Parenting Program]. Participants received treatment in a time-series staggered design. Some participants received the parent training program first, while others did not receive the training until the first wave of participants revealed training effects. Measures utilized include the Wide Range Achievement Test-Revised (WRAT-R). Results indicate that self-instruction was effective with 9 out of 10 parents with 11 out of 12 skills. Additionally, consumer satisfaction was uniformly high. Limitations include the small sample size and that data on the statistical significance of the results was not presented.

Length of controlled postintervention follow-up: 1, 3, and 6 months.

Feldman, M. A., Ducharme, J. M., & Case, L. (1999). Using self-instructional pictorial manuals to teach child-care skills to mothers with intellectual disabilities. Behavior Modification, 23(3), 480–497. https://doi.org/10.1177/0145445599233007

Type of Study: Other quasi-experimental
Number of Participants: 10 parent/child dyads

Population:

• Age — Adults: 19–39 years; Children: 3–22.5 months
• Race/Ethnicity — Not specified
• Gender — Adults: 10 Female; Children: 6 Male and 4 Female
• Status — Participants were parents with intellectual disabilities.

Location/Institution: Canada

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the effectiveness of self-learning pictorial-parenting manuals of a parent training program [now called Step-by-Step Parenting Program] in teaching basic child-care skills (e.g., diapering, treating diaper rash, bathing, safety) to parents with intellectual disabilities who were being monitored by child protection agencies. Participants received the parent training program in a multiple-probe-design after their home observation baseline. Measures utilized include the Wechsler Adult Intelligence Scales Revised (WAIS-R) and the Bayley Scales of Infant Development. Results indicate that the manuals alone increased child-care skills (to levels seen in parents without disabilities) in mothers in the study, and in 12 of 13 child-care skills. The remaining skill was acquired with the full training package. Limitations include the small sample size.

Length of controlled postintervention follow-up: Approximately 47.4 weeks.