Comparison of the Effectiveness of Online and Face-to-Face Parent Training for Parents of Children With Developmental Disabilities.

Background: Parent training (PT) is an effective intervention for improving children's behavioral problems and enhancing parental mental health in those caring for children with developmental disabilities (DD). Recent studies report the effectiveness of online PT (ON-PT). ON-PT encompasses both the on-demand type and the real-time type, which involves real-time online group PT delivered through web conferencing systems. However, the efficacy of the on-demand type has been established through comparisons with face-to-face PT (F2F-PT), whereas the real-time type of ON-PT has been assessed exclusively in single-arm studies, underscoring the need for comparative analyses with F2F-PT to validate its effectiveness. This study aims to compare the effectiveness of the real-time type of ON-PT and F2F-PT for parents of children with DD using a retrospective study design.

Methods: The analysis included data from 13 parent-child pairs in the F2F-PT and 27 parent-child pairs in the ON-PT. Assessment scales included parental depression and stress, evaluated using the Beck Depression Inventory-Second Edition (BDI-II) and Parenting Stress Index (PSI), respectively, as well as children's behavioral problems, measured with the Eyberg Child Behavior Inventory (ECBI). A two-way repeated-measures ANOVA assessed the impact of different PT delivery methods and time on the outcome variables.

Results: Attendance and dropout rates were similar between ON-PT (82%, 18.7%) and F2F-PT (80.3%, 18.1%). A two-way repeated-measures ANOVA showed that the interaction effect was marginally significant for PSI ( = 0.066) and statistically significant for both the child domain of PSI ( = 0.049) and ECBI ( = 0.013). Simple main effects analysis indicated that pre-test mean scores for PSI ( < 0.001), the child domain of PSI ( = 0.001), and ECBI ( = 0.002) were significantly higher than post-test scores in the ON-PT compared with the F2F-PT. Furthermore, although a higher proportion of participants in the ON-PT were within the clinical range of ECBI at the pre-test (70.4%) compared to the F2F-PT, this proportion decreased to 44.4% at the post-test.

Conclusion: This study suggests that ON-PT may be as effective as or potentially more effective than F2F-PT. The adoption of online formats should be considered for families facing challenges, as ON-PT may improve children's behavioral problems and reduce parental stress. Nonetheless, the retrospective study design warrants caution in interpreting the findings, and a future study with a prospective, rigorous validation design will be essential to effectively compare the effectiveness of ON-PT and F2F-PT.