Helping the Noncompliant Child (HNC; also known as the Parent Child Game) is a parenting intervention for parents who have concerns about the behaviour of a child between 3 and 5 years old. It is delivered by therapists to the parent and their child on a weekly or twice-weekly basis for a period of five to 12 weeks, depending on the family’s needs. Parents learn strategies for encouraging positive parent–child interaction and managing challenging child behaviour.
The information above is as offered/supported by the intervention provider.
3 to 5 years old
Individual
Helping the Noncompliant Child (HNC; also known as the Parent Child Game) is for parents who are having difficulties managing the behaviour of a child between the ages of 3 and 8 years.
It is delivered by a single therapist to the parent and their child on a weekly or twice weekly basis for a period of five to 12 weeks, depending on the parent and child’s needs.
HNC is delivered in two phases:
Parent learning is supported through practitioner modelling, role-play, home-work assignments, and instruction.
3 to 8 years old
Families with a child identified as having behavioural problems of symptoms associated with ADHD.
Disclaimer: The information in this section is as offered/supported by the intervention provider.
Science-based assumption
Young children naturally behave in challenging and non-compliant ways
Challenging child behaviours during preschool and primary school increase the risk of more serious behavioural problems occurring in adolescence.
Science-based assumption
Effective parenting behaviours can help children better regulate their own behaviour and reduce the risk of behavioural problems persisting
Ineffective parenting strategies can increase the risk of child behavioural problems persisting.
Science-based assumption
Parents experiencing difficulties with the behaviour of a child, including a child diagnosed with ADHD, frequently benefit from further support.
Intervention
Parents learn how to:
Promote positive parent–child interaction through non-directive play
Reinforce positive child behaviour through praise and rewards
Discourage challenging child behaviour through age-appropriate discipline.
Short-term
Parents implement effective parenting strategies in the home
Parents’ confidence increases
Parental stress reduces
Parent–child interaction improves.
Medium-term
Children’s self-regulatory capabilities and behaviour improves.
Long-term
Children are at less risk of antisocial behaviour in adolescence
Children are more compliant and better able to engage positively with others.
Parents who are having difficulties managing the behaviour of a child between the ages of 3 and 8 years old.
HNC is delivered in up to 12 sessions of approximately one hour.
The practitioner who delivers this intervention is typically a psychologist, counsellor, or social worker.
The practitioners have 32 hours of intervention training. Booster training of practitioners is not required.
It is recommended that practitioners are supervised by two host-agency supervisors with 32 hours of intervention training. It is also recommended that practitioners are supervised by one intervention developer supervisor.
Intervention fidelity is maintained through the following processes:
If practitioners are having difficulty delivering the intervention, an HNC consultant provides on-site booster sessions until proficient.
Contact person: Deborah J. Jones
Organisation: University of North Carolina at Chapel Hill
Email address: djjones@email.unc.edu
*Please note that this information may not be up to date. In this case, please visit the listed intervention website for up to date contact details.
HNC’s most rigorous evidence comes from a single RCT conducted in the United States, consistent with Foundations’ Level 3 evidence strength criteria.
This study identified statistically significant reductions in parent reports of their child’s symptoms of ADHD, defiant child behaviour, physical aggression, and inattention and hyperactivity in comparison to the reports of parents not receiving the intervention.
HNC can be described as evidence-based: it has evidence from at least one rigorously conducted RCT or QED demonstrating a statistically significant positive impact on at least one child outcome.
Reduced symptoms of ADHD
Immediately after the intervention
Improvement index
Interpretation
Study
Reduced defiant symptoms
Immediately after the intervention
Improvement index
Interpretation
Study
Reduced physical aggression
Immediately after the intervention
Improvement index
Interpretation
Study
Reduced inattention and hyperactivity
Immediately after the intervention
Improvement index
Interpretation
Study
| Identified in search | 3 |
| Studies reviewed | 3 |
| Meeting the L2 threshold | 0 |
| Meeting the L3 threshold | 1 |
| Contributing to the L4 threshold | 0 |
| Ineligible | 2 |
| Study design | RCT |
| Country | USA |
| Sample characteristics | 164 children between ages 3 and 5 living in New York City; 74% of the children met the diagnostic criteria for ADHD |
| Race, ethnicities, and nationalities |
|
| Population risk factors | None reported with the exception of the ADHD diagnosis |
| Timing |
|
| Child outcomes |
|
| Other outcomes |
|
| Study rating | 3 |
| Citations | Abikoff, H. B., Thompson, M., Laver-Bradbury, C., Long, N., Forehand, R. L., Miller Brotman, L., Klein, R. G., Reiss, P., Huo, L. & Sonuga-Barke, E., (2015) Parent training for preschool ADHD: A randomized controlled trial of specialized and generic programs. Journal of Child Psychology and Psychiatry. 56, 618–631. |
The following studies were identified for this intervention but did not count towards the intervention’s overall evidence rating. An intervention receives the same rating as its most robust study or studies.
Forehand, R. L., Merchant, M. J., Parent, J., Long, N., Linnea, K. & Baer, J. (2011) An examination of a group curriculum for parents of young children with disruptive behaviour. Behaviour Modification. 35, 235–251. This reference refers to a randomised control trial, conducted in the USA.
Wells, K. C. & Egan, J. (1988) Social learning and systems family therapy for childhood oppositional disorder: Comparative treatment outcome. Comprehensive Psychiatry. 29, 138–146. This reference refers to a randomised control trial, conducted in the USA.
Note on provider involvement: This provider has agreed to Foundations’ terms of reference (or the Early Intervention Foundation's terms of reference), and the assessment has been conducted and published with the full cooperation of the intervention provider.
Rated 1: Set up and delivery is low cost, equivalent to an estimated unit cost of less than £100.
Rated 2: Set up and delivery is medium-low cost, equivalent to an estimated unit cost of £100–£499.
Rated 3: Set up and delivery is medium cost, equivalent to an estimated unit cost of £500–£999.
Rated 4: Set up and delivery is medium-high cost, equivalent to an estimated unit cost of £1,000–£2,000.
Rating 5: Set up and delivery is high cost. Equivalent to an estimated unit cost of more than £2,000.
Set up and delivery cost is not applicable, not available, or has not been calculated.
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Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing child maltreatment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Enhancing school achievement & employment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing crime, violence and antisocial behaviour: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
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Rated 2: Has preliminary evidence of improving a child outcome from a quantitative impact study, but there is not yet evidence of causal impact.
Rated 2+: Meets the level 2 rating and the best available evidence is based on a study which is more rigorous than a level 2 standard but does not meet the level 3 standard.
Rated 3: Has evidence of a short-term positive impact from at least one rigorous study.
Rated 3+: Meets the level 3 rating and has evidence from other studies with a comparison group at level 2 or higher.
Rated 4: Has evidence of a long-term positive impact through at least two rigorous studies.
Rated 4+: Meets the level 4 rating and has at least a third study contributing to the Level 4 rating, with at least one of the studies conducted independently of the intervention provider.
Rating has a *: The evidence base includes mixed findings i.e., studies suggesting positive impact alongside studies, which on balance, indicate no effect or negative impact.
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