Table 3.
Factor Arrays showing Statements and Rankings
| S | Statement | Factor | ||
|---|---|---|---|---|
| 1 | 2 | 3 | ||
| 1^ | Parents of children with TSC experience more stress than parents of children without TSC | 0 | −1 | 1 |
| 2 | Helping parents to think about their own thoughts and feelings about their child’s difficulties is important in a parenting intervention | 5 | 4 | 1* |
| 3^ | Parents own thoughts and feelings affect parenting behaviour | 3 | 5 | 4 |
| 4 | Giving parents time to talk about the worries they have about their child’s TSC is important in a parenting intervention | 3 | 2 | 0 |
| 5 | Learning skills to manage children’s anger is important in a parenting intervention for TSC | −1 | 1 | 0 |
| 6 | Learning skills to manage children’s anxiety is important in a parenting intervention for TSC | 2 | 4 | 0 |
| 7 | Learning skills to develop a parent–child relationship through play, warmth, praise and attention is important in a parenting intervention for TSC | 2 | 5 | 3 |
| 8^ | Learning skills to give children positive attention, praise and rewards is important in a parenting intervention for TSC | 3 | 3 | 4 |
| 9^ | Learning skills in giving and enforcing clear commands to children is important in a parenting intervention for TSC | −1 | −1 | 0 |
| 10^ | Learning skills to pay less attention to children’s negative behaviours is important in a parenting intervention for TSC | 1 | 1 | −1 |
| 11^ | Learning skills to apply consequences for negative behaviour (e.g., time out, grounding) is important in a parenting intervention for TSC | 0 | 0 | −1 |
| 12^ | Learning skills to manage children’s mood is important in a parenting intervention for TSC | 1 | 0 | 1 |
| 13^ | Providing information about techniques to manage children’s tics (e.g., exposure response prevention, habit reversal training) is important in a parenting intervention for TSC | 2 | 2 | 0 |
| 14 | Helping parents accept and adjust to their child’s difficulties is important in a parenting intervention for TSC | 6* | 2 | 2 |
| 15 | Providing education about tics is important in a parenting intervention for TSC | 3 | 2 | 0 |
| 16 | Providing information about medication (e.g., benefits, side effects) is important in a parenting intervention for TSC | 2* | −3* | −1* |
| 17 | Helping parents to develop children’s social skills is important in a parenting intervention for TSC | 1 | 1 | 3* |
| 18 | Making parents feel valued by providing a comfortable environment (e.g., snacks, breaks, resources) is important in a parenting intervention for TSC | 1 | 3 | 0 |
| 19^ | Parents would be worried that changing parenting techniques would make things worse | −2 | −2 | −2 |
| 20^ | Inviting parents to attend a parenting intervention for TSC would make them feel criticised | −1 | −2 | −2 |
| 21^ | If parents were given knowledge about psychological techniques (e.g., exposure response prevention, habit reversal) they would use these techniques to manage children’s tics | 0 | −1 | −1 |
| 22 | It would negatively affect the parent–child relationship if parents tried to change children’s tics using psychological techniques (e.g., exposure response prevention, habit reversal) | −3 | −4 | −6* |
| 23^ | Parents would be wary about a parenting intervention for TSC | −1 | −2 | −2 |
| 24^ | The difficulties of children with TSC frequently change so a parenting intervention would not be effective over time | −4 | −3 | −3 |
| 25 | Learning generalisable skills is important in a parenting intervention for TSC | 0 | 0 | 4* |
| 26^ | TSC are biological in origin so a parenting intervention will have no effect | −5 | −6 | −5 |
| 27^ | Parent interventions for TSC would be less effective than interventions that treat the child directly | −2 | −2 | −3 |
| 28^ | Parents of children with and without TSC have similar needs so interventions just for children with TSC are unnecessary | −4 | −3 | −4 |
| 29^ | Child and Adolescent Mental Health Services (CAMHS) should offer parenting interventions for TSC | 1 | 1 | 1 |
| 30 | Practical issues make it too difficult for parents to attend parenting interventions | −2 | −1 | 1 |
| 31^ | It is unreasonable to deliver an intervention through parents | −6 | −5 | −5 |
| 32 | Parents would not complete homework as part of a parenting intervention because they are too stressed | −1 | −2 | −1 |
| 33^ | Parents would not complete homework as part of a parenting intervention because they lack motivation | −3 | −3 | −3 |
| 34 | Diagnosing TSC is a barrier to parents accessing interventions. | 2* | −5* | −1* |
| 35^ | Parents would need repeated follow-ups to continue using the skills learned in a parenting intervention | 0 | 0 | −2 |
| 36^ | Only a small number of people would need a parenting intervention for TSC | −2 | −1 | −2 |
| 37^ | Parenting interventions for TSC are not a good use of NHS money | −5 | −4 | −4 |
| 38 | Parents would only attend a parenting intervention if it involved other parents with children with TSC | 0 | 0 | −2* |
| 39 | Meeting other parents of children with TSC would increase parents worry about their own child | −3 | −4* | −1 |
| 40^ | Social support from other parents is an important benefit of a group-based parenting intervention | 3 | 4 | 5 |
| 41^ | Between six and ten parents in a group parenting intervention group is a good size | 1 | 1 | 2 |
| 42 | Parents should be offered a parenting intervention shortly after their child is first diagnosed with TSC | 1 | 1 | −1 |
| 43^ | Parenting interventions are more appropriate for parents of younger children with TSC | −2 | −1 | −1 |
| 44 | Transition to adolescence can be difficult so parenting interventions should be offered to parents of adolescents with TSC | 0 | 1 | 2 |
| 45 | Shorter, weekly meetings are better than longer, monthly meetings in a parenting intervention for TSC | −2* | 0 | 0 |
| 46 | Parents need to discuss their child’s difficulties on an individual basis | −1 | −1 | −3 |
| 47 | If NHS resources are limited it is better for more parents to be seen in a group-based parenting intervention | −1* | 3 | 1 |
| 48 | Group-based parenting interventions for TSC are cost effective | 1 | 0 | 6* |
| 49 | Family functioning is related to children’s adjustment and quality of life | 4 | 2 | 3 |
| 50 | Positive child-parent interactions are important for children’s adjustment and quality of life | 4 | 6 | 4 |
| 51 | Teaching parents the most effective parenting strategies will help to strengthen children’s social, emotional and academic competence | 2 | 4 | 1 |
| 52 | Parents are less likely to participate in group-based parenting interventions than individual parenting interventions | −1 | −4* | −2 |
| 53 | Children’s perception of their parent’s views towards their TSC is important | 5 | 3 | 1* |
| 54^ | It is not children’s tics that cause most concern to parents, but common co-morbid conditions (e.g., anxiety, mood, anger, behavioural difficulties) | −1 | −1 | 1 |
| 55 | Parenting interventions for TSC should only be offered to parents of children with more severe tics | −4 | −2 | −4 |
| 56 | The differences in children’s TSC related difficulties are a barrier to group-based parenting interventions | −3 | −2 | −4* |
| 57 | All main caregivers of a child need to attend a parenting intervention for it to be effective | −2 | 0* | −2 |
| 58^ | Parents would accept and attend a parenting intervention for TSC | 0 | 1 | 2 |
| 59 | Professionals who run parenting groups for TSC must be experts in the treatment of tics | 0 | −2 | −3 |
| 60^ | It is important that parents have a positive relationship with the professionals that lead parenting interventions | 1 | 3 | 3 |
| 61 | The lack of research in parenting interventions for TSC is a barrier to treatment | −1 | 0 | 3* |
| 62^ | If a parenting intervention for TSC was in book form, professionals would be more likely to offer it | 0 | 0 | −1 |
| 63 | Siblings of children with TSC would benefit from their parents attending a parenting intervention | 2 | 1 | 0 |
| 64 | It is important to consider parents’ cultural differences in a parenting intervention for TSC | 3 | 1 | 3 |
| 65^ | Helping parents to feel more in control of their child’s difficulties is an important outcome of parenting interventions for TSC | 2 | 2 | 2 |
| 66 | Changing children’s tics is an important outcome of parenting interventions for TSC | −3 | −3 | 0* |
| 67 | Changing children’s common co-morbid difficulties (e.g., anxiety, anger, mood, behavioural difficulties) is an important outcome of parenting interventions for TSC | 0 | 2 | 1 |
| 68 | Helping parents to feel more positive about the future is an important outcome of parenting interventions for TSC | 4 | 2 | 5 |
| 69 | Parents prefer psychological interventions to medication for TSC | −2 | −1 | 2* |
| 70^ | Medication is more effective than psychological interventions for TSC | −4 | −3 | −3 |
| 71^ | Parenting interventions for TSC would be effective | 1 | 3 | 2 |
| 72 | Family members, friends, and teachers should be invited to attend parenting interventions for TSC | −3* | −1* | 2* |
| 73 | A lack of training and knowledge about TSC is a barrier to non-specialist services offering parenting interventions for TSC | 4* | 0 | 0 |
^ = statistically consensus statements (p > 0.01). * = statistically distinguishing statement for factor (p < 0.01)
TSC tic spectrum condition/tic disorder, NHS national health service