Prevention of Problem Behavior Through Annual Family Check-Ups in Early Childhood: Intervention Effects From Home to Early Elementary School

Abstract

Objective This randomized intervention trial examined the effects of yearly Family Check-Ups (FCUs) and tailored parent management training on parent report of problem behavior from age 2 to 5 years and teacher report of oppositional behavior at age 7.5. Method A multiethnic risk sample of 731 families in 3 distinct geographical settings who were receiving assistance from the Women, Infants, and Children Nutritional Supplement (WIC) program were randomly assigned to a yearly FCU. Intention to treat (ITT) analyses were used to examine overall intervention effects, and complier average causal effect (CACE) modeling was used to examine the effects of annual intervention engagement in the FCU on parent reports of child problem behavior from age 2 to 5, and teacher reports of problem behavior at age 7.5. Results ITT intervention effects were found regarding parent report at ages 2 to 5 and teacher report at age 7.5, indicating less growth in problem behavior for children in the intervention group than for those in the control group. CACE modeling of intervention engagement revealed that the effect sizes on parent- and teacher-reported problem behavior increased as a function of the number of yearly FCUs caregivers participated in. Conclusions Findings suggest that embedding yearly FCU services within the context of social, health, and educational services in early childhood can potentially prevent early-onset trajectories of antisocial behavior. The increases in effect size with successive FCU engagement underscores the importance of a motivational approach to parenting support among high-risk families.

Learning Better: Public Policy for Skills Development

“…One view is that parenting programs should be available for the population at risk of developmental delays. Ideally, health professionals should assess children for risk in regular screenings, just like dental screening (Dishion et al, 2014). Another view follows the old adage that more is better and argues that parenting programs should be promoted among large segments of the population.…”

The Family Check-Up and Service Use in High-Risk Families of Young Children: A Prevention Strategy with a Bridge to Community-Based Treatment

“…In two randomized studies of ethnically diverse, income-eligible families with toddlers enrolled in a national food supplement program, 75 to 92 % of the families randomized to the FCU engaged when the child was age 2 years (Dishion et al, 2008; Shaw et al, 2006). In the most recent and larger cohort of boys and girls from three distinct communities (i.e., rural, suburban, and urban), when followed from age 2 through 5 years, 50 % of the families randomized to the FCU engaged in the intervention at child ages 2, 3, and 4 (Dishion et al, 2014). …”

Childhood Psychosocial Determinants of Cardiovascular Health

“…Interventions following the "check-up" are tailored to the family's particular strengths and needs and may include more intensive parenting support designed to enhance parents' skills in positive behavior support, healthy limit-setting, and relationship-building. Follow up studies of children and adolescents whose families participated in FCU report increased school readiness, improved emotional and behavioral functioning and reduced substance use [33,34,35]. There is also preliminary evidence that FCU may have an indirect effect on later weight gain and obesity [36,37].…”