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Ahun MN, Ali NB, Hentschel E, Jeong J, Franchett E, Yousafzai AK. A meta-analytic review of the implementation characteristics in parenting interventions to promote early child development. Ann N Y Acad Sci 2024; 1533:99-144. [PMID: 38354095 DOI: 10.1111/nyas.15110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
This review summarizes the implementation characteristics of parenting interventions to promote early child development (ECD) outcomes from birth to 3 years. We included 134 articles representing 123 parenting trials (PROSPERO record CRD42022285998). Studies were conducted across high-income (62%) and low-and-middle-income (38%) countries. The most frequently used interventions were Reach Up and Learn, Nurse Family Partnership, and Head Start. Half of the interventions were delivered as home visits. The other half used mixed settings and modalities (27%), clinic visits (12%), and community-based group sessions (11%). Due to the lack of data, we were only able to test the moderating role of a few implementation characteristics in intervention impacts on parenting and cognitive outcomes (by country income level) in the meta-analysis. None of the implementation characteristics moderated intervention impacts on cognitive or parenting outcomes in low- and middle-income or high-income countries. There is a significant need in the field of parenting interventions for ECD to consistently collect and report data on key implementation characteristics. These data are needed to advance our understanding of how parenting interventions are implemented and how implementation factors impact outcomes to help inform the scale-up of effective interventions to improve child development.
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Affiliation(s)
- Marilyn N Ahun
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Nazia Binte Ali
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Elizabeth Hentschel
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
| | - Joshua Jeong
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Emily Franchett
- Department of Applied Psychology, New York University Steinhardt School of Culture, Education, and Human Development, New York, New York, USA
| | - Aisha K Yousafzai
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Savaglio M, Yap MB, O'Donnell R, Skouteris H. Targeted community-based programmes for children's mental health: A systematic review and meta-analysis of the Australian literature. Aust N Z J Psychiatry 2023; 57:197-212. [PMID: 36113092 DOI: 10.1177/00048674221124506] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE No synthesis of the Australian evidence regarding targeted prevention and early intervention for mental health concerns among young children exists. This review aimed to (1) describe the types of targeted community-based mental health programmes evaluated in Australia to support children aged 1-9 years exhibiting internalising and/or externalising symptoms and (2) examine their impact on children's internalising and externalising symptoms and disorder diagnosis. METHOD A systematic review and meta-analysis was conducted (PROSPERO: CRD42021255257). Four databases (PsycINFO, PsycArticles, MEDLINE and CINAHL) were searched for Australian studies published in the past 10 years that quantitatively evaluated the impact of a targeted programme on children's mental health. The National Institute of Health Quality Assessment Tools were used to evaluate the study quality. RESULTS Forty-two studies were included; the majority (67%) were medium quality. The mean sample size was 142 (SD = 170), children's average age was 5.78 years (SD = 2.44) and 58% were male. Aboriginal and Torres Strait Islander children were underrepresented. Studies evaluated 16 programmes that targeted (1) externalising symptoms (n = 20 studies, n = 6 programmes), (2) internalising symptoms (n = 14 studies, n = 7 programmes) or (3) both, termed transdiagnostic programmes (n = 8 studies, n = 3 programmes). Externalising programmes achieved a significant moderate mean reduction in externalising behaviours (standardised mean differences = -0.56), internalising programmes yielded a small mean improvement in anxiety symptoms (standardised mean differences = -0.25) and 57% reduced odds of anxiety disorder diagnosis. Evidence supporting transdiagnostic programmes was inconclusive. CONCLUSION Parenting-focused programmes targeting young children's internalising or externalising behaviours have the largest local evidence base supporting their effectiveness. Limitations include a lack of engagement with fathers, triangulation of outcomes, homogeneity and implementation reporting. Greater implementation and evaluation of community-driven integrated and systemic approaches that identify, engage and support Australia's most disadvantaged cohorts of young children and their families are needed.
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Affiliation(s)
- Melissa Savaglio
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Marie Bh Yap
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Renee O'Donnell
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Warwick Business School, University of Warwick, Coventry, UK
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Azhari A, Bizzego A, Esposito G. Parent-child dyads with greater parenting stress exhibit less synchrony in posterior areas and more synchrony in frontal areas of the prefrontal cortex during shared play. Soc Neurosci 2023; 17:520-531. [PMID: 36576051 DOI: 10.1080/17470919.2022.2162118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Parent-child dyads who are mutually attuned to each other during social interactions display interpersonal synchrony that can be observed behaviorally and through the temporal coordination of brain signals called interbrain synchrony. Parenting stress undermines the quality of parent-child interactions. However, no study has examined synchrony in relation to parenting stress during everyday shared play. The present fNIRS study examined the association between parenting stress and interbrain synchrony in the prefrontal cortex (PFC) of 31 mother-child and 29 father-child dyads while they engaged in shared play for 10 min. Shared play was micro-analytically coded into joint and non-joint segments. Interbrain synchrony was computed using cross-correlations over 15-, 20-, 25-, 30- and 35-s fixed-length windows. Findings showed that stressed dyads exhibited less synchrony in the posterior right cluster of the PFC during joint segments of play, and, contrary to expectations, stressed dyads also showed greater synchrony in the frontal left cluster. These findings suggest that dyads with more parenting stress experienced less similarities in brain areas involved in emotional processing and regulation, whilst simultaneously requiring greater neural entrainment in brain areas that support task management and social-behavioral organization in order to sustain prolonged periods of joint interactions.
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Affiliation(s)
- Atiqah Azhari
- Psychology Programme, School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, Singapore, Singapore
| | - Andrea Bizzego
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
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Trauma-Directed Interaction (TDI): An Adaptation to Parent-Child Interaction Therapy for Families with a History of Trauma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106089. [PMID: 35627624 PMCID: PMC9140737 DOI: 10.3390/ijerph19106089] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 12/29/2022]
Abstract
Parent-Child Interaction Therapy (PCIT) is one of the strongest evidence-based treatments available for young children and their families. Research has supported the use of PCIT for children with a history of trauma; however, the treatment does not directly address trauma in the child. PCIT is a dyadic treatment; yet, the impact of the carer’s trauma on the carer-child relationship is not assessed or incorporated into treatment. For these reasons, therapists, families, agencies, and funders tend to view PCIT as a trauma treatment with skepticism. PCIT therapists who currently address trauma within the intervention do so without a standardized approach. Trauma-Directed Interaction (TDI) is an adaptation developed to directly address these concerns. TDI maintains the key elements and theoretical underpinnings of PCIT while adding sessions to cover psychoeducation about trauma, carer response to a child’s trauma reactions (SAFE skills), and coping skills to aid both the child and the carer to manage trauma activators (COPE skills). The TDI module creates a consistent strategy for PCIT therapists to address trauma, thus allowing research and replication which will advance the dual fields of PCIT and family trauma. The theoretical conceptualization of TDI is presented along with next steps in its evaluation.
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Phillips ST, Mychailyszyn MP. Parent-Child Interaction Therapy for Preschool Aged Youth: A Meta-Analysis of Developmental Specificity. CHILD & YOUTH CARE FORUM 2022. [DOI: 10.1007/s10566-022-09694-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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The Impact of Attachment-Based Parenting Interventions on Externalizing Behaviors in Toddlers and Preschoolers: A Systematic Narrative Review. CHILD & YOUTH CARE FORUM 2021. [DOI: 10.1007/s10566-021-09667-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kohlhoff J, Cibralic S, Morgan S. A qualitative investigation of consumer experiences of the child directed interaction phase of parent–child interaction therapy with toddlers. CLIN PSYCHOL-UK 2021. [DOI: 10.1111/cp.12216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jane Kohlhoff
- University of New South Wales, Sydney, New South Wales, Australia,
- Karitane, Villawood, New South Wales, Australia,
| | - Sara Cibralic
- University of New South Wales, Sydney, New South Wales, Australia,
- Karitane, Villawood, New South Wales, Australia,
| | - Sue Morgan
- Karitane, Villawood, New South Wales, Australia,
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Garcia D, Blizzard AM, Peskin A, Rothenberg WA, Schmidt E, Piscitello J, Espinosa N, Salem H, Rodriguez GM, Sherman JA, Parlade MV, Landa AL, Davis EM, Weinstein A, Garcia A, Perez C, Rivera JM, Martinez C, Jent JF. Rapid, Full-Scale Change to Virtual PCIT During the COVID-19 Pandemic: Implementation and Clinical Implications. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:269-283. [PMID: 33586056 PMCID: PMC7882248 DOI: 10.1007/s11121-021-01211-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2021] [Indexed: 11/20/2022]
Abstract
Health agencies call for the immediate mobilization of existing interventions in response to numerous child and family mental health concerns that have arisen as result of the COVID-19 pandemic. Answering this call, this pilot study describes the rapid, full-scale change from a primarily clinic-based Parent–Child Interaction Therapy (PCIT) model to a virtual service model (i.e., I-PCIT) in an academic and community-based program in Miami, Florida. First, we describe the virtual service training model our program developed and its implementation with 17 therapists (MAge = 32.35, 88.2% female, 47.1% Hispanic) to enable our clinic to shift from providing virtual services to a small portion of the families served (29.1%) to all of the families served. Second, we examine the effect of I-PCIT on child and caregiver outcomes during the 2-month stay-at-home period between March 16, 2020, and May 16, 2020, in 86 families (MChildAge = 4.75, 71% Hispanic). Due to the rapid nature of the current study, all active participants were transferred to virtual services, and therefore there was no comparison or control group, and outcomes represent the most recently available scores and not treatment completion. Results reveal that I-PCIT reduced child externalizing and internalizing problems and caregiver stress, and increased parenting skills and child compliance with medium to large effects even in the midst of the COVID-19 pandemic. Finally, the study examined components of our virtual service training model associated with the greatest improvements in child and caregiver outcomes. Preliminary findings revealed that locally and collaboratively developed strategies (e.g., online communities of practice, training videos and guides) had the strongest association with child and caregiver outcomes. Implications for virtual service delivery, implementation, and practice in the midst of the COVID-19 pandemic are discussed.
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Affiliation(s)
- Dainelys Garcia
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA.
| | - Angela M Blizzard
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Abigail Peskin
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - W Andrew Rothenberg
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA.,Duke University Center for Child and Family Policy, Coral Gables, 33146, USA
| | - Ellyn Schmidt
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Jennifer Piscitello
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Natalie Espinosa
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Hanan Salem
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Gabriela M Rodriguez
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, 46202, USA
| | - Jamie A Sherman
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Meaghan V Parlade
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Alexis L Landa
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Eileen M Davis
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Allison Weinstein
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Angela Garcia
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Camille Perez
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Jessica M Rivera
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Chary Martinez
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Jason F Jent
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
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Cañas M, Ibabe I, De Paúl J. Promising observational instruments of parent-child (0-12 years) interaction within the child protection system: A systematic review. CHILD ABUSE & NEGLECT 2020; 109:104713. [PMID: 32971348 DOI: 10.1016/j.chiabu.2020.104713] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/27/2020] [Accepted: 08/31/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Parent-child interaction (PCI) is considered a critical environmental factor that affects child development. In the field of child and family intervention, assessment of caregiver-child interaction has great relevance for decision-making. OBJECTIVE The aim of this study is to report the results of a systematic review of the best observational instruments to assess the quality of PCI, taking into account the most advanced protocols. METHODS Firstly, one search was conducted to identify eligible observational instruments, and a second search was conducted to identify studies reporting on the psychometric properties of the instruments previously identified. To assess and rate the quality of the psychometric properties of the tools, the COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) checklist was applied. RESULTS The nine PCI observational tools selected (with category B - promising) are widely used by researchers and clinicians across different stages of childhood. The Keys to Interactive Parenting Scale (2-71 months) obtained the highest rating. CONCLUSIONS The most reported and robust psychometric property was inter-rater reliability, but validity evidence is understudied. This systematic review can help clinicians keep up-to-date, provide evidence for policymakers to judge risks and benefits of health care behaviors, as well as assess the evaluation programs in child abuse and neglect context.
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Affiliation(s)
- María Cañas
- Department of Clinical and Health Psychology and Research Methodology, University of the Basque Country UPV/EHU, Avda. Tolosa 70, 20018, Donostia-San Sebastián, Spain..
| | - Izaskun Ibabe
- Department of Clinical and Health Psychology and Research Methodology, University of the Basque Country UPV/EHU, Avda. Tolosa 70, 20018, Donostia-San Sebastián, Spain..
| | - Joaquín De Paúl
- Department of Social Psychology, University of the Basque Country, Avda. Tolosa 70, 20018, Donostia-San Sebastián, Spain..
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Kohlhoff J, Cibralic S, Wallace N, Morgan S, McMahon C, Hawkins E, Eapen V, Briggs N, Huber A, McNeil C. A randomized controlled trial comparing parent child interaction therapy - toddler, circle of security- parenting™ and waitlist controls in the treatment of disruptive behaviors for children aged 14-24 months: study protocol. BMC Psychol 2020; 8:93. [PMID: 32867832 PMCID: PMC7457749 DOI: 10.1186/s40359-020-00457-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/05/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND It is common for toddlers to display disruptive behaviors (e.g., tantrums, aggression, irritability) but when these become severe and persistent they can be the start of a trajectory towards poor outcomes in childhood and adolescence. Parent Child Interaction Therapy - Toddler is an intervention model designed to meet the specific developmental needs of toddlers aged 12-24 months presenting with disruptive behaviors. METHODS This study will use a randomized controlled design to evaluate the efficacy of the Parent Child Interaction Therapy - Toddler intervention for children aged 14-24 months with disruptive behaviors. Ninety toddlers with parent-reported disruptive behavior will be randomly allocated to either Parent Child Interaction Therapy - Toddler, Circle of Security- Parenting™ or a waitlist control group. Key parenting capacity outcome variables will include positive and negative parenting, parenting sensitivity, parental sense of competence in managing negative toddler emotions, parent sense of caregiving helplessness, parent mentalizing about the child, parent emotion regulation, child abuse potential and parental stress. Key outcome variables for children will include child social-emotional functioning (initiative, relationship functioning, self-regulation), child emotion regulation, child attachment security, and child behavior. DISCUSSION Delivered in the early intervention period of toddlerhood, Parent Child Interaction Therapy - Toddler has the potential to bring about significant and lasting changes for children presenting with early onset behavioral issues. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR), 12618001554257 . Registered 24 September 2018 - retrospectively registered.
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Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, University of New South Wales, P.O. Box 241, Villawood, NSW, 2163, Australia.
- Karitane, Carramar, NSW, Australia.
- Ingham Institute for Medical Research, Liverpool, NSW, Australia.
| | - Sara Cibralic
- School of Psychiatry, University of New South Wales, P.O. Box 241, Villawood, NSW, 2163, Australia
- Karitane, Carramar, NSW, Australia
| | - Nancy Wallace
- School of Psychiatry, University of New South Wales, P.O. Box 241, Villawood, NSW, 2163, Australia
- Karitane, Carramar, NSW, Australia
| | | | | | | | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, P.O. Box 241, Villawood, NSW, 2163, Australia
- Ingham Institute for Medical Research, Liverpool, NSW, Australia
- South Western Sydney Local Health District, Liverpool, Australia
| | - Nancy Briggs
- Mark Wainwright Analytical Centre, University of New South Wales, Kensington, NSW, Australia
| | - Anna Huber
- Families In Mind Psychology, Canberra, Australia
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