Abstract
Zusammenfassung. Das Ziel vorliegender Studie bestand in einer Überprüfung der Akzeptanz und Teilnehmerzufriedenheit eines Gruppentrainings für Eltern von Kindern mit Lese- und/oder Rechtschreibschwierigkeiten. Zudem sollten erste Indikatoren bezüglich der Wirksamkeit des Programmes untersucht werden. Dazu wurden Daten von 25 Müttern zu 2 Messzeitpunkten (Post-Test, 3-Monats-Follow-up) analysiert. Die Probandinnen nahmen über einen Zeitraum von 3 Monaten an 5 Sitzungen des Programms «Mein Kind mit Lese- und Rechtschreibschwierigkeiten verstehen, stärken und unterstützen: Heidelberger Elterntraining zum Umgang mit LRS» teil. Ein Paper-Pencil-Fragebogen diente zum Post-Test der Erhebung von Teilnahmeparametern, der Zufriedenheit mit dem Training, der Relevanz einzelner Themen und der wahrgenommenen Veränderungen in wichtigen Zielbereichen. Zusätzlich kam eine für das Gruppensetting adaptierte Form des Goal Attainment Scaling zum Einsatz, um das Erreichen persönlich relevanter Ziele unmittelbar nach dem Training sowie 3 Monate später zu erfassen. Die Analyse des Fragebogens zeigte eine hohe Partizipationsbereitschaft der Mütter. Die Rahmenbedingungen des Trainings (Gruppengröße, Dauer des Trainings und der Sitzungen) sowie die didaktischen Methoden wurden als ideal und die Themen als relevant eingeschätzt. Die Mütter sahen sich in der Lage, die Inhalte im Alltag anzuwenden und nahmen positive Veränderungen hinsichtlich Einfühlungsvermögen, Unterstützung des Kindes, Hausaufgabensituation und Beziehung zum Kind wahr. Das Ausmaß des Erreichens individueller Ziele zum Post-Test variierte je nach Zielbereich: Einfühlen und Verstehen (75 %), Optimierung der Hausaufgabensituation (76 %), Unterstützung psychosozialer Entwicklung (86 %), Lese-Rechtschreibförderung (60 %) und war auch 3 Monate später noch vergleichbar hoch. Die Überprüfung der Wirksamkeit hinsichtlich einer Belastungsreduktion und Kompetenzstärkung seitens der Eltern erfolgt aktuell im Vergleich zu einer unbehandelten Kontrollgruppe.
Abstract.Background: Children with dyslexia show a variety of comorbid disorders like behavior and adaptive disorders, hyperkinetic and anxiety disorders (Bäcker & Neuhäuser, 2003; Schulz et al., 2003). Raising and educating a child with dyslexia is a challenging task. Studies show that parents of children with dyslexia suffer under depressive symptoms and higher parenting stress (Antshel & Joseph, 2006; Snowling et al., 2007). To support the child's academic development many parents of children with dyslexia practice reading and writing more often and show controlling and maladaptive behavior. As a result learning motivation of the child and later homework situations are influenced in a negative way (Gasteiger Klicpera et al., 2001). Consequently, it is necessary to provide parent training on appropriate behavior with academic exercises, in order to raise parent's competences, reduce parenting stress and promote learning motivation of the child. Brock and Shute (2001) found positive effects of a cognitive-behavioral group-based parent training for parents of learning disabled children on dealing with parenting stress, self-blame and emotional attachment to the child. In the German-speaking area there is a lack of elaborated and evaluated programs for parents of dyslexic children. Therefore, a group program that especially addresses the needs of these parents was devised. It is designed to complement child-centered dyslexia therapy. The intervention program consists of 5 sessions held biweekly. A cognitive behavioral approach was chosen. A randomized controlled study of the University of Heidelberg (Children's Hospital) aims at evaluating the effects of the training on both children and parents. For the present study only data of the intervention group were used. Aims: The first aim of the present study was to examine the satisfaction of the mothers who participated in the intervention. The second aim was to research one aspect of effectiveness of the program by analyzing whether changes in relevant situations happened and personal goals could be reached. Methods: The group-based parent training was attended by 25 mothers of children with dyslexia. Data of children and their mothers were collected prior to intervention, directly after intervention and 3 months after intervention. At pretest the reading, writing and cognitive abilities were measured with standardized instruments. Only children who performed in the normal range on the test measuring cognitive abilities (IQ > 70) and who scored below average in at least one test measuring reading or writing (T-Score < 40) were included. Children with significant deficits in hearing or vision, pervasive developmental disorder or genetic disorders were excluded. For the post-test a paper/pencil questionnaire assessed parents' satisfaction with the training, level of attendance and the relevance of topics included. Furthermore, questions measuring perceived changes in competences in supporting academic development, mastering homework situations and attachment to the child were included. A form of Goal Attainment Scaling (GAS) that was adapted for group setting was used to assess the extent of goal achievement. Therefore, at the first session mothers chose 3 out of a list of 20 specific observable aims like “I would like to do daily writing exercises with my child.” and rated their relevance on a 10-point Likert scale (1 = unimportant, 10 = important). In the last session and 3 month after intervention mothers rated to which extent the goals set could be reached (scale: 0 to 100 %). The training follows a cognitive-behavioral approach and aims at knowledge transfer about dyslexia, raising parent's empathy for the child's difficulties in reading and writing, promoting parent's competencies and self-efficacy in handling dyslexia within the family context and during homework situations, sensitization for opportunities of integrating reading and writing into daily life and reduction of parental stress. A parent group consists of maximum 10 participants. The main topics covered are requirements and phases of acquisition of written language, the causes of dyslexia, helpful strategies for managing homework and exercises, facilitation of literacy in everyday life and dealing with dyslexia. Methods used are brief lectures, example cases, group discussions and practice, as well as homework tasks. Written handouts summarizing important topics are given at every session. Statistical analyses were performed using PASW 18. Differences in goal attainment were analyzed by using t-tests. For interpreting open-ended questions coding categories were developed. Results: Mean attendance rate was 87.2 %. According to the mothers written handouts were read always or often by 64 % and in each session homework tasks were completed by at least 60 %. The mothers rated the duration of the group-based program and its sessions as ‘just right’. Participants were satisfied with the group size. With regard to program structure (M = 3.67) and written handouts (M = 3.72) a high satisfaction was found (4-point Likert-scale). Mothers rated all elements of the training as very relevant (M = 4.12 to M = 4.84 on a 5-point Likert-scale). Strategies for handling of homework situations and dyslexia in general were reported to be the most important topics. Analysis of open-ended questions indicated that for example the following topics could be added to the program: communication with teachers about dyslexia (n = 4) and foreign language acquisition (n = 3). Overall satisfaction with the training was high (M = 3.60, 4-point Likert-scale) and most of the mothers reported that they would recommend the program to other parents (M = 4.60, 5-point Likert-scale). Furthermore, program ratings indicated that mothers were able to transfer the strategies into everyday life (M = 4.60) and to change their behavior towards their children (M = 4.28) (5-point Likert-scale). Analyzing the open-ended question different forms of behavioral change were observed e. g. more patience (n = 12), giving more praise (n = 11), having better insight into the difficulties of the child (n = 7) and changing parent behavior in homework situations (n = 6). Mothers reported feeling more confident in supporting child’s literacy acquisition (M = 4.40) and in handling homework and exercise situations (M = 4.26) (5-point Likert-scale). Ratings suggest that after the training mothers are more able to empathize with the child (M = 4.16) and that emotional attachment to the child improved (M = 4.28) (5-point Likert-scale). The mean relevance of selected GAS goals was high (M = 9.53, 10-point Likert-scale). Goals of different thematic categories varied in the extent of achievement at the post-test: 1. empathizing with the child (74.78 %), 2. dealing with homework situations (76.11 %), 3. support of social and emotional development (86.0 %) and 4. promoting child's acquisition of reading and writing (60.17 %). At the follow-up goal achievement was still at the same level as directly after intervention. Discussion: In this study we examined parent satisfaction and first effectiveness of the developed group-based program for parents of children with dyslexia. In Germany there seem to be no structured and evaluated parent programs aiming at counselling and reducing stress in parents of dyslexic children. The data show that mothers were highly motivated and participated actively. Mean attendance rate was comparable to data of other studies (George & Kidd, 2011; Hartung et al., 2010; Todd et al., 2010). Participants were satisfied with the general conditions of the program (group size, duration, structure). All topics included were rated as relevant indicating that the content of the program meets the needs of mothers of a dyslexic child. The thematic focus of the intervention (managing homework situations, dealing with dyslexia and facilitating acquisition of reading and writing) seems to match the target group. Analysis of open ended questions revealed further information demand concerning the topics of cooperation with teachers and foreign language acquisition. The addition of one further session might be necessary in order to meet mothers' needs for further information. Overall satisfaction with the training was high, indicating that acceptance of the program as one requirement for effectivity on parental stress reduction is fulfilled. In measures of effectiveness, mothers reported positive changes regarding empathy, dealing with homework situations, giving praise and attachment to the child. After the program, participants felt more confident in facilitating children's acquisition of written language and supporting homework. Achievement of the personal goals set by the mothers varied between 60 to 86 % at the post-test and was still comparable after a period of 3 month. Mothers rated chosen goals as very important indicating that the prepared list of aims was appropriate for GAS in a group-based training. Goals regarding empathy, homework situations and discovering strengths of the child were reached to a higher extent than goals concerning fostering reading and writing. The latter seem to also depend on the behavior of the child and therefore, can be achieved to a lesser extent. Summarizing the developed group-program seems to be well accepted. Mothers reported positive changes in relevant aspects and could reached personal goals to a certain extent. Nevertheless the study has a number of limitations. All mothers participating were interested in the program and showed high motivation and expectations. Demand effects cannot be excluded. Conventions for judging the extent of goal attainment haven’t been developed yet. Therefore, the evaluation of the percentages reached is unclear. For more information on the effectiveness of the program research of the long-term effects, the use of objective data and a comparison with a non-intervention group are necessary.
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