Internet-Delivered Parent Training for Preschoolers with Conduct Problems: Do Callous-Unemotional Traits Moderate Efficacy and Engagement?

Abstract

Recent efforts to improve access to evidence-based parent training programs using online delivery have largely neglected findings that young children with callous-unemotional (CU)-type conduct problems receive less benefit from parent training than children with conduct problems alone. The current study aimed to examine the moderating effect of child CU traits on efficacy and engagement outcomes associated with Internet-delivered Parent-Child Interaction Therapy (iPCIT) versus standard, clinic-based PCIT. Forty families (57.6% non-Hispanic Caucasian) with a 3–5 year-old (M = 3.95 years, SD = 0.9; 83.5% boys) child with a disruptive behavior disorder were randomized to either iPCIT or clinic-based PCIT. Families participated in four assessments across time; child conduct problems, global functioning and treatment responder status, and parent-rated treatment satisfaction were measured. Analyses revealed that the negative influence of CU traits on functional gains was not uniform across treatment formats. Specifically, the detrimental effect of CU traits on functional gains was significantly more pronounced among children treated with iPCIT than clinic-based PCIT. CU traits also predicted lower parental treatment satisfaction across delivery formats, but this effect was more pronounced among iPCIT parents. In contrast, CU traits did not moderate differential effects across iPCIT and clinic-based PCIT for conduct problem severity or treatment response status. Findings suggest that iPCIT is a promising treatment option for early conduct problems, particularly when access-to-care barriers exist, but that further research is needed to determine whether strategic adaptations to online programs can more optimally address the distinct needs of children with clinically significant CU traits.

This is a preview of subscription content, access via your institution.

Notes

  1. 1.

    Since CU traits scores were continuous, model estimated means corresponding with low and high CU traits groups were generated by estimating the mean of each outcome variable at ±1 standard deviation above/below the sample mean of baseline CU traits scores (M = 3.4, SD = 1.9).

References

  1. Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA Preschool Forms & Profiles. Burlington, VT: Research Center for Children, Youth and Families, University of Vermont.

    Google Scholar 

  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). Washington, DC: Author.

    Book  Google Scholar 

  3. Baumel, A., Pawar, A., Mathur, N., Kane, J. M., & Correll, C. U. (2017). Technology-assisted parent training programs for children and adolescents with disruptive behaviors: A systematic review. The Journal of Clinical Psychiatry, 78(8), e957–e969. https://doi.org/10.4088/jcp.16r11063.

    Article  PubMed  Google Scholar 

  4. Bird, H. R., Canino, G., Rubio-Stipec, M., & Ribera, J. C. (1987). Further measures of the psychometric properties of the Children's global assessment scale. Archives of General Psychiatry, 44(9), 821–824. https://doi.org/10.1001/archpsyc.1987.01800210069011.

    Article  PubMed  Google Scholar 

  5. Bjørnebekk, G., & Kjøbli, J. (2017). Observed callousness as a predictor of treatment outcomes in parent management training. Clinical Child Psychology and Psychiatry, 22(1), 59–73. https://doi.org/10.1177/1359104515621961.

    Article  PubMed  Google Scholar 

  6. Brestan, E. V., Jacobs, J. R., Rayfield, A. D., & Eyberg, S. M. (1999). A consumer satisfaction measure for parent-child treatments and its relation to measures of child behavior change. Behavior Therapy, 30(1), 17–30. https://doi.org/10.1016/S0005-7894(99)80043-4.

    Article  Google Scholar 

  7. Bunte, T. L., Schoemaker, K., Hessen, D. J., van der Heijden, P. G., & Matthys, W. (2013). Clinical usefulness of the kiddie-disruptive behavior disorder schedule in the diagnosis of DBD and ADHD in preschool children. Journal of Abnormal Child Psychology, 41(5), 681–690. https://doi.org/10.1007/s10802-013-9732-1.

    Article  PubMed  Google Scholar 

  8. Byrd, A. L., Loeber, R., & Pardini, D. A. (2014). Antisocial behavior, psychopathic features and abnormalities in reward and punishment processing in youth. Clinical Child and Family Psychology Review, 17(2), 125–156. https://doi.org/10.1007/s10567-013-0159-6.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Chacko, A., Jensen, S. A., Lowry, L. S., Cornwell, M., Chimklis, A., Chan, E., Lee, D., & Pulgarin, B. (2016). Engagement in behavioral parent training: Review of the literature and implications for practice. Clinical Child and Family Psychology Review, 19, 204–215. https://doi.org/10.1007/s10567-016-0205-2.

    Article  PubMed  Google Scholar 

  10. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hilsdale, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  11. Comer, J. S., & Barlow, D. H. (2014). The occasional case against broad dissemination and implementation: Retaining a role for specialty care in the delivery of psychological treatments. American Psychologist, 69, 1–18. https://doi.org/10.1037/a0033582.

    Article  PubMed  Google Scholar 

  12. Comer, J. S., Chow, C., Chan, P. T., Cooper-Vince, C., & Wilson, L. A. (2013). Psychosocial treatment efficacy for disruptive behavior problems in very young children: A meta-analytic examination. Journal of the American Academy of Child & Adolescent Psychiatry, 52(1), 26–36. https://doi.org/10.1016/j.jaac.2012.10.001.

    Article  Google Scholar 

  13. Comer, J. S., Furr, J. M., Cooper-Vince, C., Madigan, R. J., Chow, C., Chan, P. T., Idrobo, F., Chase, R. M., McNeil, C. B., & Eyberg, S. M. (2015). Rationale and considerations for the internet-based delivery of Parent–child interaction therapy. Cognitive and Behavioral Practice, 22, 302–316. https://doi.org/10.1016/j.cbpra.2014.07.003.

    Article  PubMed  Google Scholar 

  14. Comer, J. S., Furr, J. M., Miguel, E. M., Cooper-Vince, C. E., Carpenter, A. L., Elkins, R. M., et al. (2017). Remotely delivering real-time parent training to the home: An initial randomized trial of internet-delivered Parent-child interaction therapy (I-PCIT). Journal of Consulting and Clinical Psychology, 85(9), 909–917. https://doi.org/10.1037/ccp0000230.

    Article  PubMed  Google Scholar 

  15. Corralejo, S. M., & Rodríguez, M. M. D. (2018). Technology in parenting programs: A systematic review of existing interventions. Journal of Child and Family Studies, 27, 2717–2731. https://doi.org/10.1007/s10826-018-1117-1.

    Article  Google Scholar 

  16. Costello, E. J., & Maughan, B. (2015). Annual research review: Optimal outcomes of child and adolescent mental illness. Journal of Child Psychology and Psychiatry, 56, 324–341. https://doi.org/10.1111/jcpp.12371.

    Article  PubMed  Google Scholar 

  17. Dadds, M. R., Cauchi, A. J., Wimalaweera, S., Hawes, D. J., & Brennan, J. (2012). Outcomes, moderators, and mediators of empathic-emotion recognition training for complex conduct problems in childhood. Psychiatry Research, 199(3), 201–207. https://doi.org/10.1016/j.psychres.2012.04.033.

    Article  PubMed  Google Scholar 

  18. Dadds, M. R., Whiting, C., & Hawes, D. J. (2006). Associations among cruelty to animals, family conflict, and psychopathic traits in childhood. Journal of Interpersonal Violence, 21(3), 411–429. https://doi.org/10.1177/0886260505283341.

    Article  PubMed  Google Scholar 

  19. Dadds, M. R., Thai, C., Mendoza Diaz, A., Broderick, J., Moul, C., Tully, L. A., Hawes, D. J., Davies, S., Burchfield, K., & Cane, L. (2019). Therapist-assisted online treatment for child conduct problems in rural and urban families: Two randomized controlled trials. Journal of Consulting and Clinical Psychology, 87(8), 706–719. https://doi.org/10.1037/ccp0000419.

    Article  PubMed  Google Scholar 

  20. Eisenstadt, T. H., McElreath, L., Eyberg, S., & McNeil, C. (1994). Interparent agreement on the Eyberg child behavior inventory. Child & Family Behavior Therapy, 16, 21–27. https://doi.org/10.1300/J019v16n01_02.

    Article  Google Scholar 

  21. Enebrink, P., Högström, J., Forster, M., & Ghaderi, A. (2012). Internet-based parent management training: A randomized controlled study. Behaviour Research and Therapy, 50(4), 240–249. https://doi.org/10.1016/j.brat.2012.01.006.

    Article  PubMed  Google Scholar 

  22. Eyberg, S., & Pincus, D. (1999). Eyberg child behavior inventory and Sutter-Eyberg student behavior inventory - revised: Professional manual. Odessa, FL: PAR.

    Google Scholar 

  23. Eyberg, S. M., & Funderburk, B. (2011). Parent-child interaction therapy protocol. Gainesville, FL: PCIT International.

    Google Scholar 

  24. Ezpeleta, L., Granero, R., de la Osa, N., & Domènech, J. M. (2015). Clinical characteristics of preschool children with oppositional defiant disorder and callous-unemotional traits. PLoS One, 10(9), e0139346. https://doi.org/10.1371/journal.pone.0139346.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Ezpeleta, L., Osa, N. D. L., Granero, R., Penelo, E., & Domènech, J. M. (2013). Inventory of callous-unemotional traits in a community sample of preschoolers. Journal of Clinical Child and Adolescent Psychology, 42(1), 91–105. https://doi.org/10.1080/15374416.2012.734221.

    Article  PubMed  Google Scholar 

  26. Fleming, G. E., Kimonis, E. R., Datyner, A., & Comer, J. S. (2017). Adapting internet-delivered Parent-child interaction therapy to treat co-occurring disruptive behavior and callous-unemotional traits: A case study. Clinical Case Studies, 16(5), 370–387. https://doi.org/10.1177/1534650117699471.

    Article  Google Scholar 

  27. Flom, M., & Saudino, K. J. (2017). Callous-unemotional behaviors in early childhood: Genetic and environmental contributions to stability and change. Development and Psychopathology, 29(4), 1227–1234. https://doi.org/10.1017/S0954579416001267.

    Article  PubMed  Google Scholar 

  28. Frick, P. J. (2001). Effective interventions for children and adolescents with conduct disorder. Canadian Journal of Psychiatry, 46, 597–608. https://doi.org/10.1177/070674370104600703.

    Article  PubMed  Google Scholar 

  29. Frick, P. J. (2012). Developmental pathways to conduct disorder: Implications for future directions in research, assessment, and treatment. Journal of Clinical Child & Adolescent Psychology, 41(3), 378–389. https://doi.org/10.1080/15374416.2012.664815.

    Article  Google Scholar 

  30. Frick, P. J., Ray, J. V., Thornton, L. C., & Kahn, R. E. (2014). Can callous-unemotional traits enhance the understanding, diagnosis, and treatment of serious conduct problems in children and adolescents? A comprehensive review. Psychological Bulletin, 140, 1–57. https://doi.org/10.1037/a0033076.

    Article  PubMed  Google Scholar 

  31. Frick, P. J., & White, S. F. (2008). Research review: The importance of callous-unemotional traits for developmental models of aggressive and antisocial behavior. Journal of Child Psychology and Psychiatry, 49(4), 359–375. https://doi.org/10.1111/j.1469-7610.2007.01862.x.

    Article  PubMed  Google Scholar 

  32. Funderburk, B. W., Eyberg, S. M., Rich, B. A., & Behar, L. (2003). Further psychometric evaluation of the Eyberg and Behar rating scales for parents and teachers of preschoolers. Early Education and Development, 14(1), 67–82. https://doi.org/10.1207/s15566935eed1401_5.

    Article  Google Scholar 

  33. Garcia, A. M., Graziano, P. A., & Hart, K. C. (2018). Response to time-out among preschoolers with externalizing behavior problems: The role of callous-unemotional traits. Child Psychiatry & Human Development, 49(5), 699–708. https://doi.org/10.1007/s10578-018-0788-6.

    Article  Google Scholar 

  34. Ghaderi, A., Kadesjö, C., Björnsdotter, A., & Enebrink, P. (2018). Randomized effectiveness trial of the family check-up versus internet-delivered parent training (iComet) for families of children with conduct problems. Scientific Reports, 8(1), 1–15. https://doi.org/10.1038/s41598-018-29550-z.

    Article  Google Scholar 

  35. Goffin, K. C., Boldt, L. J., Kim, S., & Kochanska, G. (2018). A unique path to callous-unemotional traits for children who are temperamentally fearless and unconcerned about transgressions: A longitudinal study of typically developing children from age 2 to 12. Journal of Abnormal Child Psychology, 46(4), 769–780. https://doi.org/10.1007/s10802-017-0317-2.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Guy, W., & Bonato, R. R. (1970). Clinical global impressions. Chevy Chase, MD: United States Department of Health and Human Services, NIH, NIMH.

    Google Scholar 

  37. Haas, S. M., Waschbusch, D. A., Pelham, W. E., King, S., Andrade, B. F., & Carrey, N. J. (2011). Treatment response in CP/ADHD children with callous/unemotional traits. Journal of Abnormal Child Psychology, 39(4), 541–552. https://doi.org/10.1007/s10802-010-9480-4.

    Article  PubMed  Google Scholar 

  38. Hawes, D. J., & Dadds, M. R. (2005). The treatment of conduct problems in children with callous-unemotional traits. Journal of Consulting and Clinical Psychology, 73, 737–741. https://doi.org/10.1037/0022-006X.73.4.737.

    Article  PubMed  Google Scholar 

  39. Hawes, D. J., Price, M. J., & Dadds, M. R. (2014). Callous-unemotional traits and the treatment of conduct problems in childhood and adolescence: A comprehensive review. Clinical Child and Family Psychology Review, 17(3), 248–267. https://doi.org/10.1007/s10567-014-0167-1.

    Article  PubMed  Google Scholar 

  40. Helander, M., Lochman, J., Högström, J., Ljótsson, B., Hellner, C., & Enebrink, P. (2018). The effect of adding coping power program-Sweden to Parent management training-effects and moderators in a randomized controlled trial. Behaviour Research and Therapy, 103, 43–52. https://doi.org/10.1016/j.brat.2018.02.001.

    Article  PubMed  Google Scholar 

  41. Högström, J., Enebrink, P., & Ghaderi, A. (2013). The moderating role of child callous-unemotional traits in an internet-based parent-management training program. Journal of Family Psychology, 27(2), 314–323. https://doi.org/10.1037/a0031883.

    Article  PubMed  Google Scholar 

  42. Hyde, L. W., Shaw, D. S., Gardner, F., Cheong, J., Dishion, T. J., & Wilson, M. (2013). Dimensions of callousness in early childhood: Links to problem behavior and family intervention effectiveness. Development and Psychopathology, 25(2), 347–363. https://doi.org/10.1017/S0954579412001101.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Corp, I. B. M. (2017). IBM SPSS statistics for windows, version 25.0. Armonk, NY: IBM Corp.

    Google Scholar 

  44. Jones, D. J., Forehand, R., Cuellar, J., Kincaid, C., Parent, J., Fenton, N., & Goodrum, N. (2013). Harnessing innovative technologies to advance children's mental health: Behavioral parent training as an example. Clinical Psychology Review, 33, 241–252. https://doi.org/10.1016/j.cpr.2012.11.003.

    Article  PubMed  Google Scholar 

  45. Kahn, R. E., Frick, P. J., Youngstrom, E., Findling, R. L., & Youngstrom, J. K. (2012). The effects of including a callous-unemotional specifier for the diagnosis of conduct disorder. Journal of Child Psychology and Psychiatry, 53(3), 271–282. https://doi.org/10.1111/j.1469-7610.2011.02463.x.

    Article  PubMed  Google Scholar 

  46. Kazdin, A. E. (2000). Perceived barriers to treatment participation and treatment acceptability among antisocial children and their families. Journal of Child and Family Studies, 9(2), 157–174. https://doi.org/10.1023/A:1009414904228.

    Article  Google Scholar 

  47. Keenan, K., Wakschlag, L. S., & Danis, B. (2001). Kiddie-disruptive behavior disorders schedule. Chicago, IL: University of Chicago.

    Google Scholar 

  48. Kimonis, E. R., Bagner, D. M., Linares, D., Blake, C. A., & Rodriguez, G. (2014). Parent training outcomes among young children with callous–unemotional conduct problems with or at risk for developmental delay. Journal of Child and Family Studies, 23, 437–448. https://doi.org/10.1007/s10826-013-9756-8.

    Article  PubMed  Google Scholar 

  49. Kimonis, E. R., Fanti, K. A., Anastassiou-Hadjicharalambous, X., Mertan, B., Goulter, N., & Katsimicha, E. (2016). Can callous-unemotional traits be reliably measured in preschoolers? Journal of Abnormal Child Psychology, 44(4), 625–638. https://doi.org/10.1007/s10802-015-0075-y.

    Article  PubMed  Google Scholar 

  50. Kimonis, E. R., Fanti, K. A., Frick, P. J., Moffitt, T. E., Essau, C., Bijttebier, P., & Marsee, M. A. (2015). Using self-reported callous-unemotional traits to cross-nationally assess the DSM-5 ‘with limited Prosocial emotions’ specifier. Journal of Child Psychology and Psychiatry, 56(11), 1249–1261. https://doi.org/10.1111/jcpp.12357.

    Article  PubMed  Google Scholar 

  51. Kimonis, E. R., Fleming, G. E., Briggs, N., Brouwer-French, L., Frick, P. J., Hawes, D. J., et al. (2019). Parent-child interaction therapy adapted for preschoolers with callous-unemotional traits: An open trial pilot study. Journal of Clinical Child & Adolescent Psychology, 48, S347–S361. https://doi.org/10.1080/15374416.2018.1479966.

    Article  Google Scholar 

  52. Kimonis, E. R., Frick, P. J., Skeem, J. L., Marsee, M. A., Cruise, K., Munoz, L. C., Aucoin, K. J., & Morris, A. S. (2008). Assessing callous–unemotional traits in adolescent offenders: Validation of the inventory of callous-unemotional traits. International Journal of Law and Psychiatry, 31(3), 241–252. https://doi.org/10.1016/j.ijlp.2008.04.002.

    Article  PubMed  Google Scholar 

  53. Kohlhoff, J., Wallace, N. M., Morgan, S., Maiuolo, M., & Turnell, A. (2019). Internet-delivered Parent-child interaction therapy: Two clinical case reports. Clinical Psychologist, 23, 271–282. https://doi.org/10.1111/cp.12184.

    Article  Google Scholar 

  54. Larsen, D. L., Attkisson, C. C., Hargreaves, W. A., & Nguyen, T. D. (1979). Assessment of client/patient satisfaction: Development of a general scale. Evaluation and Program Planning, 2(3), 197–207. https://doi.org/10.1016/0149-7189(79)90094-6.

    Article  PubMed  Google Scholar 

  55. Longman, T., Hawes, D. J., & Kohlhoff, J. (2016). Callous–unemotional traits as markers for conduct problem severity in early childhood: A meta-analysis. Child Psychiatry & Human Development, 47(2), 326–334. https://doi.org/10.1007/s10578-015-0564-9.

    Article  Google Scholar 

  56. Lundh, A., Kowalski, J., Sundberg, C. J., Gumpert, C., & Landén, M. (2010). Children's global assessment scale (CGAS) in a naturalistic clinical setting: Inter-rater reliability and comparison with expert ratings. Psychiatry Research, 177, 206–210. https://doi.org/10.1016/j.psychres.2010.02.006.

    Article  PubMed  Google Scholar 

  57. McNeil, C., & Hembree-Kigin, T. L. (2010). Parent-child interaction therapy. New York: Springer.

    Book  Google Scholar 

  58. Nock, M. K., & Kazdin, A. E. (2001). Parent expectancies for child therapy: Assessment and relation to participation in treatment. Journal of Child and Family Studies, 10, 155–180. https://doi.org/10.1023/A:1016699424731.

    Article  Google Scholar 

  59. O'Keefe, D. J. (2007). Brief report: Post hoc power, observed power, a priori power, retrospective power, prospective power, achieved power: Sorting out appropriate uses of statistical power analyses. Communication Methods and Measures, 1(4), 291–299. https://doi.org/10.1080/19312450701641375.

    Article  Google Scholar 

  60. Patrick, C. J., Fowles, D. C., & Krueger, R. (2009). Triarchic conceptualization of psychopathy: Developmental origins of disinhibition, boldness, and meanness. Development and Psychopathology, 21, 913–938. https://doi.org/10.1017/S0954579409000492.

    Article  PubMed  Google Scholar 

  61. Sawilowsky, S. S. (2009). New effect size rules of thumb. Journal of Modern Applied Statistical Methods, 8(2), 597–599 http://digitalcommons.wayne.edu/coe_tbf/4.

    Article  Google Scholar 

  62. Schalock, R. L. (2011). The evolving understanding of the construct of intellectual disability. Journal of Intellectual and Developmental Disability, 36(4), 227–237. https://doi.org/10.3109/13668250.2011.624087.

    Article  Google Scholar 

  63. Schlomer, G. L., Bauman, S., & Card, N. A. (2010). Best practices for missing data management in counseling psychology. Journal of Counseling Psychology, 57(1), 1–10. https://doi.org/10.1037/a0018082.

    Article  PubMed  Google Scholar 

  64. Shaffer, D., Gould, M. S., Brasic, J., Ambrosini, P., Fisher, P., Bird, H., & Aluwahlia, S. (1983). A children's global assessment scale (CGAS). Archives of General Psychiatry, 40(11), 1228–1231. https://doi.org/10.1001/archpsyc.1983.01790100074010.

    Article  PubMed  Google Scholar 

  65. Sheldrick, R. C., Kendall, P. C., & Heimberg, R. G. (2001). The clinical significance of treatments: A comparison of three treatments for conduct disordered children. Clinical Psychology: Science and Practice, 8(4), 418–430. https://doi.org/10.1093/clipsy.8.4.418.

    Article  Google Scholar 

  66. Speyer, R., Denman, D., Wilkes-Gillan, S., Chen, Y.-W., Bogaardt, H., Kim, J.-H., Heckathorn, D. E., & Cordier, R. (2018). Effects of telehealth by allied health professionals and nurses in rural and remote areas: A systematic review and meta-analysis. Journal of Rehabilitation Medicine, 50(3), 225–235. https://doi.org/10.2340/16501977-2297.

    Article  PubMed  Google Scholar 

  67. van Aar, J., Leijten, P., de Castro, B. O., & Overbeek, G. (2017). Sustained, fade-out or sleeper effects? A systematic review and meta-analysis of parenting interventions for disruptive child behavior. Clinical Psychology Review, 51, 153–163. https://doi.org/10.1016/j.cpr.2016.11.006.

    Article  PubMed  Google Scholar 

  68. Waller, R., Shaw, D. S., Neiderhiser, J. M., Ganiban, J. M., Natsuaki, M. N., Reiss, D., Trentacosta, C. J., Leve, L. D., & Hyde, L. W. (2017). Toward an understanding of the role of the environment in the development of early callous behavior. Journal of Personality, 85(1), 90–103. https://doi.org/10.1111/jopy.12221.

    Article  PubMed  Google Scholar 

  69. Willoughby, M. T., Mills-Koonce, W. R., Gottfredson, N. C., & Wagner, N. J. (2014). Measuring callous unemotional behaviors in early childhood: Factor structure and the prediction of stable aggression in middle childhood. Journal of Psychopathology and Behavioral Assessment, 36(1), 30–42. https://doi.org/10.1007/s10862-013-9393-y.

    Article  PubMed  Google Scholar 

  70. Willoughby, M. T., Waschbusch, D. A., Moore, G. A., & Propper, C. B. (2011). Using the ASEBA to screen for callous unemotional traits in early childhood: Factor structure, temporal stability, and utility. Journal of Psychopathology and Behavioral Assessment, 33(1), 19–30. https://doi.org/10.1007/s10862-010-9195-4.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Zhang, Y., Hedo, R., Rivera, A., Rull, R., Richardson, S., & Tu, X. M. (2019). Post hoc power analysis: Is it an informative and meaningful analysis? General Psychiatry, 32(4), e100069. https://doi.org/10.1136/gpsych-2019-100069.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Georgette E. Fleming.

Ethics declarations

Declarations of Interest

The authors declare no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 152 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Fleming, G.E., Kimonis, E.R., Furr, J.M. et al. Internet-Delivered Parent Training for Preschoolers with Conduct Problems: Do Callous-Unemotional Traits Moderate Efficacy and Engagement?. J Abnorm Child Psychol 48, 1169–1182 (2020). https://doi.org/10.1007/s10802-020-00660-5

Download citation

Keywords

  • Callous-unemotional traits
  • Conduct problems
  • Parent training
  • Internet-based treatment
  • Moderators