Research Article
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Published Online: 9 November 2020

Tantrum Tool: Development and Open Pilot Study of Online Parent Training for Irritability and Disruptive Behavior

Publication: Journal of Child and Adolescent Psychopharmacology
Volume 30, Issue Number 9


Objectives: Parent management training is an effective treatment for disruptive behavior disorders but it is often underutilized in clinical settings. Access to care is limited due to logistical barriers as well as limited service availability. This study examines in an open trial the acceptability, feasibility, and clinical effects of a digital parent management training intervention that includes videoconference coaching, called “Tantrum Tool.”
Methods: Fifteen children, ages 3–9 years, participated in an open trial of an 8-week intervention. The primary symptom measure was the Disruptive Behavior Rating Scale (DBRS), and the secondary outcome measure was the Affective Reactivity Index (ARI) completed by the primary caregiver before and after treatment.
Results: Treatment retention was high (80%), and parents reported a high level of satisfaction with the program. There was a significant reduction in the mean DBRS score from 13.5 ± 5.5 at baseline to 7.3 ± 3.4 at endpoint, p < 0.001. There was also a significant reduction in the mean ARI irritability score from 7.2 ± 2.6 at baseline to 3.75 ± 2.1 at endpoint, p < 0.01.
Conclusions: This open pilot study supports the feasibility and acceptability of a digital parent training program for young children with disruptive behavior. Findings provide preliminary support for a clinically meaningful reduction of both disruptive behavior and irritability. Using the Tantrum Tool to deliver online treatment for children could increase access to first-line treatments for disruptive behavior and irritability in young children. NCT03697837.

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Published In

cover image Journal of Child and Adolescent Psychopharmacology
Journal of Child and Adolescent Psychopharmacology
Volume 30Issue Number 9November 2020
Pages: 558 - 566
PubMed: 33035067


Published online: 9 November 2020
Published in print: November 2020
Published ahead of print: 9 October 2020


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    Andrea Diaz-Stransky [email protected]
    Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA.
    Sonia Rowley
    Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA.
    Eitan Zecher
    Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA.
    David Grodberg
    Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA.
    Denis G. Sukhodolsky [email protected]
    Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA.


    Funding: This study was supported by the National Institute of Mental Health (Grant No. T32MH018268), the Yale Child Study Center Faculty Development Fund, and the American Academy of Child and Adolescent Psychiatry Elaine Schlosser Lewis Fund.
    Address correspondence to: Andrea Diaz-Stransky, MD, Yale Child Study Center, 230 South Frontage Road, New Haven, CT 06519, USA [email protected]
    Denis G. Sukhodolsky, PhD, Yale Child Study Center, 230 South Frontage Road, New Haven, CT 06519, USA [email protected]


    D.G., MD is a founder of MindNest Health, a digital health company that focuses on pediatric behavioral health. D.G.S., PhD receives royalties from Guilford Press. A.D.-S., MD, S.R., and E.Z. have no disclosures.

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