Using the Adaptive Behavioral Counseling Decision Framework to Guide Single-Session Intervention for Preschool Behavioral Concerns in Pediatric Primary Care: A Feasibility Trial (ABD-DeF)

Adaptive Behavioral Counseling Decision Framework in Pediatric Primary Care

The goal of this clinical trial is to evaluate the feasibility, acceptability, and initial effectiveness of using the Adaptive Behavioral Counseling Decision Framework to provide behavioral counseling for common preschool behavior problems in pediatric primary care. The interventions will be provided by integrated behavioral health clinicians and provided to primary caregivers of children aged 18-65 months who screen positive on the Preschool Pediatric Symptom Checklist (PPSC) or otherwise identify a child behavior concern. Participants will receive behavioral guidance based on the Adaptive Behavioral Counseling Decision Framework during their child's medical visit or a single behavioral health visit. The main question[s] it aims to answer are:

• What is the feasibility and acceptability of using a decision framework to guide selection and delivery of a single-session intervention for early childhood behavior concerns in pediatric primary care?
• What is the initial effectiveness of framework-guided brief interventions in reducing parent-reported behavior concerns based on caregiver report?

The hypotheses are that the intervention will be delivered with fidelity in the time allotted, and that caregivers will rate the intervention as feasible and acceptable.

Study Overview

• Status: Not yet recruiting
• Conditions: Early Childhood Emotional and Behavioral Concerns
• Intervention / Treatment: Behavioral: Adaptive Behavioral Counseling Decision Framework

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Andrew Riley, PhD; Phone Number: 503-494-1724; Email: rileyand@ohsu.edu
• Study Contact Backup: Name: Cassidy McDermott, PhD; Email: mcdermott@ohsu.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Caregivers of children ages 18-65 months who screen positive on the Preschool Pediatric Symptom Checklist (PPSC) or otherwise identify a child behavior concern.
• Caregivers must be at least 18 years old.
• Caregivers must speak English or Spanish sufficiently to complete study procedures. Study procedures in other languages are not feasible.

Exclusion Criteria:

• Children with moderate to severe intellectual disabilities.
• Child and caregiver are already receiving more intensive behavioral parent training intervention (either at OHSU or in the community).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Adaptive Behavioral Counseling Decision Framework; The Adaptive Behavioral Counseling Decision Framework consists of a series of dichotomous questions about the nature of the child's behavior, which then indicate which brief behavioral intervention is likely to be most appropriate. The possible brief interventions include scheduled parent-child play, giving effective instructions, differential attention, strategic ignoring, specific praise, use of rewards, and time-out. Each of these behavioral interventions are strategies that are included in several well-established parenting treatment programs.

Behavioral: Adaptive Behavioral Counseling Decision Framework; The intervention components are common elements of evidence-based parenting interventions. In this study, they are distinguished by their delivery in the context of a single behavioral health consultation (about 20 minutes) during a pediatric health care visit.; Other Names: effective instruction delivery; praise; rewards; time-out; differential attention; strategic ignoring; scheduled play

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intervention Acceptability Survey	11-item, study-specific survey evaluating participants acceptance of the intervention. Each item is on a 4-point scale and total scores range from 11-44 with lower scores indicating higher acceptability.	Immediate post-intervention and 30-day follow-up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Top Problems Assessment	The Top Problems Assessment is a brief instrument to identify and monitor caregivers' top behavioral concerns. Caregivers may identify between 1-3 problems. The severity of each problem is rated from 0 (not a problem) to 4 (a very big problem).	Baseline and 30-day follow-up
Preschool Pediatric Symptom Checklist	The Preschool Pediatric Symptom Checklist (PPSC) is an 18-item validated screening tool used by caregivers to assess emotional and behavioral problems in children aged 18 to 65 months. Each item is on a 0-2 point scale, with a total possible range of 0-36, with higher scores indicating more severe problems.	Baseline and 30-day follow-up

Collaborators and Investigators

• Sponsor: Oregon Health and Science University
• Investigators: Principal Investigator: Andrew R Riley, PhD, Oregon Health and Science University

Study record dates

Study Major Dates

• Study Start (Estimated): June 1, 2026
• Primary Completion (Estimated): December 1, 2027
• Study Completion (Estimated): June 1, 2028

Study Registration Dates

• First Submitted: April 3, 2026
• First Submitted That Met QC Criteria: April 3, 2026
• First Posted (Actual): April 9, 2026

Study Record Updates

• Last Update Posted (Actual): April 9, 2026
• Last Update Submitted That Met QC Criteria: April 3, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: pediatrics; primary care; feasibility trial; early childhood; integrated behavioral health
• Additional Relevant MeSH Terms: Health Services Administration; Health Care Quality, Access, and Evaluation; Quality of Health Care; Quality Assurance, Health Care; Time Out, Healthcare
• Other Study ID Numbers: STUDY00029462

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Data will be available from the PI upon request .
• IPD Sharing Time Frame: 5 years from the end of the study.
• IPD Sharing Access Criteria: Anonymized data will be available from the PI upon request.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No