The long-term effectiveness of the Family Check-Up on school-age conduct problems: Moderation by neighborhood deprivation

Abstract

Several studies suggest that neighborhood deprivation is a unique risk factor in child and adolescent development of problem behavior. We sought to examine whether previously established intervention effects of the Family Check-Up (FCU) on child conduct problems at age 7.5 would persist through age 9.5, and whether neighborhood deprivation would moderate these effects. In addition, we examined whether improvements in parent-child interaction during early childhood associated with the FCU would be related to later reductions in child aggression among families living in the highest-risk neighborhoods. Using a multisite cohort of at-risk children identified on the basis of family, child, and socioeconomic risk and randomly assigned to the FCU, intervention effects were found to be moderated by neighborhood deprivation, such that they were only directly present for those living at moderate versus extreme levels of neighborhood deprivation. Additionally, improvements in child aggression were evident for children living in extreme neighborhood deprivation when parents improved the quality of their parent-child interaction during the toddler period (i.e., moderated mediation). Implications of the findings are discussed in relation to the possibilities and possible limitations in prevention of early problem behavior for those children living in extreme and moderate levels of poverty.

What Doesn’t Work for Whom? Exploring Heterogeneity in Responsiveness to the Family Check-Up in Early Childhood Using a Mixture Model Approach

“…Gardner and colleagues identified teen parent status and single parenthood as family characteristics that limited intervention effectiveness, and lower parental education as a characteristic that enhanced intervention effectiveness. Second, Shaw et al (in press) examined the moderating effects of family’s neighborhood deprivation on FCU effects into late elementary school. Direct intervention effects were observed only for those two-thirds of the sample experiencing moderate levels of neighborhood deprivation, rather than extreme, although indirect intervention effects of the FCU were found on teacher-reported conduct problems by successfully improving parenting during early childhood even among those living in extreme neighborhood deprivation.…”

“…The present study applied this person-centered methodology to the Early Steps Multisite Trial, a large randomized, controlled trial of the FCU in early childhood (Dishion et al, 2014; Shaw et al, in press). A two-step mixture model was used to examine whether specific constellations of family characteristics at age 2 (baseline) could be identified and whether the effects of the FCU on parent-reported child conduct problems over time (ages 2, 3, 4, and 5) varied across these constellations.…”

New Directions and Challenges in Preventing Conduct Problems in Early Childhood

“…Consistent with previous work showing reduced intervention effects based on socioeconomic risk, intervention effects on teachers’ reports of children’s conduct problems at age 9½ were found only in the two thirds of families living in the relatively less deprived, albeit still low-income, neighborhoods, not for families living in the most deprived, primarily urban neighborhoods. However, and somewhat surprisingly, for families living in the most deprived, largely urban neighborhoods, the FCU indirectly reduced conduct problems at age 9½ by increasing positive parenting between 2 and 3 years (35). These findings suggest that instead of giving up on families of children with early-starting conduct problems that live in the most deprived neighborhoods, investing in the quality of their caregiving when they are toddlers (if not earlier) may prevent the emergence of long-term conduct problems and more serious forms of antisocial behavior.…”

Early Childhood Predictors of Low‐income Boys’ Pathways to Antisocial Behavior in Childhood, Adolescence, and Early Adulthood

“…Although both of these longitudinal studies did not measure parent–child conflict or family cohesion until middle childhood, they demonstrated the potential protective role that the quality of family relationships could play in attenuating risk of early starting AB. More recently, Shaw et al. (in press) noted that indirect effects of the Family Check‐Up intervention were found to reduce risk of teacher‐reported CP at age 9.5 years among those low‐income, urban families living in the highest risk neighborhoods when positive parenting was improved between child ages 2 and 3 years.…”