The Family Check-Up in Early Childhood: A Case Study of Intervention Process and Change

Abstract

This article describes a case study in the use of the Family Check-Up (FCU), a family-based and ecological preventive intervention for children at risk for problem behavior. The FCU is an assessment-driven intervention that utilizes a health maintenance model; emphasizes motivation for change; and offers an adaptive, tailored approach to intervention. This case study follows one Caucasian family through their initial assessment and subsequent treatment for their toddler daughter's conduct problems over a 2-year period. Clinically meaningful improvements in child and family functioning were found despite the presence of child, parent, and neighborhood risk factors. The case is discussed with respect to the findings from a current multisite randomized control trial of the FCU and its application to other populations.There is growing interest in identifying young children at risk for early and persistent trajectories of antisocial behavior (Shaw & Gross, 2008), motivated by several studies of earlystarting antisocial youth (Moffitt, 1993). Several researchers have documented that compared to late starters (who begin delinquent activity in mid-to late adolescence), early starters (who typically initiate antisocial activities before age 10) show a more persistent and chronic trajectory of antisocial behavior extending from middle childhood to adulthood (Moffitt & Caspi, 2001;Patterson & Yoeger, 1993). Early starters represent approximately 6% to 7% of the general population of youth yet are responsible for almost half of all adolescent crime and three fourths of violent crimes (Offord, Boyle, & Racine, 1991). During the past 2 decades, Copyright © Taylor & Francis Group, LLC Correspondence should be addressed to Anne Gill, 210 South Bouquet Street, 4419 SENSQ, Pittsburgh, PA 15260. E-mail: E-mail: amgst35@pitt.edu. Full terms and conditions of use: http://www.informaworld.com/terms-and-conditions-of-access.pdf This article may be used for research, teaching and private study purposes. Any substantial or systematic reproduction, re-distribution, re-selling, loan or sub-licensing, systematic supply or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material. (Shaw & Bell, 1993). NIH Public AccessThe Family Check-Up (FCU) is a preventive intervention that has been adapted specifically to address the normative challenges parents face during the terrible 2s, particularly in high-risk environments where these normative challenges are more likely to lead to negative outcomes (Dishion et al., in press;Shaw, Dishion, Supplee, Gardner...

The Promise of Motivational Interviewing in School Mental Health

“…Shaw et al (2006) detailed the first in a series of notable studies of the FCU program in early childhood. These studies demonstrated the positive longitudinal effects of the program on very young children who were identified as at-risk for early conduct problems Dishion et al, 2008;Gill, Hyde, Shaw, Dishion, & Wilson, 2008;Lunkenheimer et al, 2008;Moilanen, Shaw, Dishion, Gardner, & Wilson, 2010;. Those children of low-income families, who were randomly assigned to the FCU condition, demonstrated improvements in school readiness (inhibitory control and language development) through the effects of the FCU on parents' provision of increased positive behavioral support.…”

Moderators of outcome in a brief family-centered intervention for preventing early problem behavior.

“…The parent was also offered follow-up sessions that focused on parenting practices, other family management concerns (e.g., co-parenting), and contextual issues (e.g., day care, partner relationship, housing). The MI approach is especially prominent in the initial interview and feedback sessions and pervades later sessions as needed, depending on parent motivation and engagement (Gill et al, 2008). …”

Adaptive Interventions and SMART Designs

“…The meeting would provide feedback on the child's behavior (e.g., your child is in the 99 th percentile for their age in disruptive behaviors) gathered by teacher ratings on the standardized measure (i.e., the CBCL/TRF). This meeting would also include motivational strategies to encourage parents to engage with community supports or to consider approaches to change child behavior (for a case study example of feedback see Gill et al, 2008). Children whose parents that would not receive feedback would be monitored meaning that their teachers would continue to fill out questionnaires on the child's behavior at each assessment point.…”