Maternal Executive Function and Stress and Children’s Behavior Problem Treatment Outcomes

This prospective, observational study was designed to investigate the relationship of mothers’ executive function capacities and parenting stress to early dropout, appointment attendance, and outcomes of in-clinic delivery of parent management training to address children’s behavior problems. We hypothesized that mothers’ executive functions (EFs) would be prospectively and positively associated with adherence to children’s behavioral treatment appointments and reduction in children’s behavior problems and that mothers’ stress levels would be inversely related to these outcomes. Mothers (n = 288) completed the Behavior Rating Inventory of Executive Function for Adults (EF) and Parenting Stress Index at the beginning of treatment. Children were 2–12 years old. Regression models evaluated the extent to which deficits in maternal EF and clinical levels of parenting stress contributed to the three outcomes. The 11% of mothers with clinically significant deficits in executive functioning were significantly (3 times) more likely to drop out early compared to mothers in the normal range. Almost one third of mothers reported clinically significant parenting stress. Their children were half as likely to achieve a positive behavior outcome, although stress was not significantly associated with attendance. Remaining in treatment is fundamental to being able to learn and practice the parenting skills necessary to manage young children’s age-inappropriate behavior in positive ways. Clinical consideration of mothers’ EF challenges may help prevent early treatment attrition and clinical management of parenting stress may further help improve children’s treatment outcomes.