Prevention of problem behavior through annual family check-ups in early childhood: intervention effects from home to early elementary school.
- Authors
- Dishion, Thomas J; Brennan, Lauretta M; Shaw, Daniel S; McEachern, Amber D; Wilson, Melvin N; Jo, Booil
- Year
- 2014
- Journal
- Journal of abnormal child psychology
- PMID
- 24022677
- DOI
- 10.1007/s10802-013-9768-2
- PMCID
- PMC3952033
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 5ย years and teacher report of oppositional behavior at age 7.5. 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. 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. 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.
An overview of recruitment, assessment, randomization, and participation.
LLM interpretation
This is a flow diagram illustrating the recruitment and retention process of study participants. It shows a progression from 1,666 screened candidates to 879 qualified candidates, with 731 ultimately participating. Participants were then split into control and treatment conditions, with sample sizes tracked across assessments from age 2 (N=364 control, N=367 treatment) through age 5 (N=316 control, N=305 treatment).
Latent growth model of intervention effects on early-childhood problem behavior and teacher ratings of oppositional behavior.
LLM interpretation
This figure is a path diagram of a latent growth model illustrating the effects of an intervention on oppositional behavior from age 2 to 5 and its relationship to teacher ratings at age 7. The model includes latent variables for "Intercept" and "Slope," with fixed loadings (0, 1, 2) connecting the slope to behavioral measures across the four age points. Significant paths are indicated, including the intervention's effect on the intercept (-.196**) and slope (.136*), and the slope's positive effect on TRF Oppositional Defiant Problems at age 7 (.439***).
CACE results for the effect of the intervention on changes in child oppositional-defiant behavior for 3 FCU engagers and nonengagers.
LLM interpretation
This line graph shows the mean child oppositional-defiant behavior across ages 2 to 5 for three groups: Nonengagers, Engagers (control), and Engagers (intervention). All three groups show a downward trend in behavior means over time, with the Engagers (control) group maintaining the highest mean scores from age 3 onwards. The Nonengagers and Engagers (intervention) groups follow a similar, lower trajectory, with the intervention group ending with the lowest mean at age 5.
| Name | Type |
|---|---|
| 2-year-old children local | phenotype |
| 731 toddlers local | cohort |
| Above poverty line local | phenotype |
| adolescent conduct problems | phenotype |
| Adolescent crime local | phenotype |
| adolescent parent at birth of first child local | phenotype |
| adolescents | cohort |
| adult caregivers local | cohort |
| Adult population local | cohort |
| aggression | phenotype |
| antisocial personality disorder | phenotype |
| behavioral disorders | phenotype |
| CACE local | drug |
| Caregiver depression local | phenotype |
| Center for Epidemiological Studies on Depression Scale local | phenotype |
| CHAOS local | phenotype |
| Chaotic home environment local | phenotype |
| Charlottesville local | cohort |
| Charlottesville cohort local | cohort |
| Charlottesville, Virginia local | cohort |
| Child Behavior Checklist local | cohort |
| Child Behavior Checklist | drug |
| child conduct problems local | phenotype |
| Child Disruptive Behaviors local | phenotype |
| child problem behavior local | phenotype |
| children | cohort |
| cocaine | phenotype |
| Coercive behaviors local | phenotype |
| conduct disorder | phenotype |
| control | cohort |
| control group | cohort |
| daily parenting challenges local | phenotype |
| defiance | phenotype |
| depression | phenotype |
| direct observations local | phenotype |
| disruptive problem behavior local | phenotype |
| drinks per week | phenotype |
| early-child disruptive behavior local | phenotype |
| early child problem behavior local | phenotype |
| early conduct problems | phenotype |
| Early Head Start local | cohort |
| early mental health problems local | phenotype |
| Early starters local | cohort |
| emerging adulthood | cohort |
| engaged families local | cohort |
| Engagement in all three FCUs local | phenotype |
| Engagement status local | phenotype |
| Engagers local | cohort |
| Eugene local | cohort |
| Eugene cohort local | cohort |
| Eugene, Oregon local | cohort |
| Exposure to violence factor local | phenotype |
| families | cohort |
| families most in need of caregiving support local | cohort |
| family challenges local | phenotype |
| Family Check-Up local | cohort |
| Family Check-Up local | drug |
| Family Check-Up (FCU) local | drug |
| family intervention local | drug |
| family management practices local | phenotype |
| family strengths local | phenotype |
| FCU local | drug |
| FCU assignment local | cohort |
| Forgatch & Patterson program local | cohort |
| hashish | drug |
| Head Start local | cohort |
| Health Maintenance Framework local | drug |
| high-conflict relationships with adults local | phenotype |
| High-risk populations | cohort |
| Indigent families local | cohort |
| intervention | cohort |
| intervention group | cohort |
| Intervention Nonengager Group local | cohort |
| ITT local | drug |
| latent class of engagers local | cohort |
| low education achievement local | phenotype |
| lower risk local | phenotype |
| low family income local | phenotype |
| marijuana | phenotype |
| maternal psychopathology | phenotype |
| Me and My Neighborhood Questionnaire local | cohort |
| methamphetamine | drug |
| Minority families local | cohort |
| Minority racial group local | phenotype |
| mood disorders | phenotype |
| motherโchild dyads local | cohort |
| Mplus local | drug |
| Neighborhood dangerousness local | phenotype |
| Nonengagers local | cohort |
| Nonengagers local | phenotype |
| One-FCU Engagers local | cohort |
| Opposition local | phenotype |
| oppositional behavior local | phenotype |
| Oppositional Behavior local | phenotype |
| Oppositional behaviors local | phenotype |
| oppositional child local | phenotype |
| Oppositional-defiant behavior local | phenotype |
| Oppositional-Defiant Behavior local | phenotype |
| oppositional defiant disorder | phenotype |
| oppositional defiant problems local | phenotype |
| Oppositional-defiant problems local | phenotype |
| Oppositional Defiant Problems local | phenotype |
| oppositional problems local | phenotype |
| Oppositional problems local | phenotype |
| Pain killers local | drug |
| Parenting services local | drug |
| parent management training local | drug |
| parent motivation local | phenotype |
| Parent support check-up local | drug |
| parents who decline the FCU local | cohort |
| parents who engage the FCU local | cohort |
| participants | cohort |
| Pittsburgh local | cohort |
| Pittsburgh cohort local | cohort |
| Pittsburgh, Pennsylvania local | cohort |
| positive behavior support local | phenotype |
| Positive Relationship Score local | phenotype |
| Potential Engagers local | cohort |
| poverty | phenotype |
| Primary caregiver age at target child's birth local | phenotype |
| primary caregivers local | cohort |
| Primary caregivers local | cohort |
| Problematic children local | cohort |
| problem behavior | phenotype |
| Project site local | cohort |
| Public school environments local | cohort |
| public school setting local | anatomy |
| Risk community sample local | cohort |
| risk factor | phenotype |
| school districts local | cohort |
| Serious problem behavior in adolescence local | phenotype |
| sex | phenotype |
| Site 1 local | cohort |
| Site 2 local | cohort |
| Site 3 local | cohort |
| substance or mental health diagnosis local | phenotype |
| substance use | phenotype |
| Teacher ratings local | phenotype |
| teacher report local | phenotype |
| Teacher-reported oppositional behavior local | phenotype |
| Teacher-Reported Oppositional Behavior local | phenotype |
| Teacher Report Form local | cohort |
| teenage parenthood | phenotype |
| Teen parent local | phenotype |
| three-FCU engagers local | cohort |
| two-FCU engagers local | cohort |
| Violent crimes local | phenotype |
| WIC local | cohort |
| WIC cohort local | cohort |
| WIC programs local | cohort |
| young families local | cohort |
| Young maternal age local | phenotype |
| Youths | cohort |
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| Resilience in Children: Developmental Perspectives. | Masten AS et al. | โ | 2018 | โ |
| The Family Check-Up 4 Health (FCU4Health): Applying Implementation Science Frameworks to the Process of Adapting an Evidence-Based Parenting Program for Prevention of Pediatric Obesity and Excess Weight Gain in Primary Care. | Smith JD et al. | โ | 2018 | โ |
| Transactional Associations Among Maternal Depression, Parent-Child Coercion, and Child Conduct Problems During Early Childhood. | Hails KA et al. | โ | 2018 | โ |
| EARLY CHILDHOOD PREDICTORS OF LOW-INCOME BOYS' PATHWAYS TO ANTISOCIAL BEHAVIOR IN CHILDHOOD, ADOLESCENCE, AND EARLY ADULTHOOD. | Shaw DS et al. | โ | 2017 | โ |
| Early Childhood Predictors of Severe Youth Violence in Low-Income Male Adolescents. | Sitnick SL et al. | โ | 2017 | โ |
| Ethnic differences in mothering qualities and relations to academic achievement. | Caughy MO et al. | โ | 2017 | โ |
| New Directions and Challenges in Preventing Conduct Problems in Early Childhood. | Shaw DS et al. | โ | 2017 | โ |
| Outcomes for adolescents who comply with long-term psychosocial treatment for ADHD. | Schultz BK et al. | โ | 2017 | โ |
| The Long-Term Effectiveness of the Family Check-up on Peer Preference: Parent-Child Interaction and Child Effortful Control as Sequential Mediators. | Chang H et al. | โ | 2017 | โ |
| The Validation of Macro and Micro Observations of Parent-Child Dynamics Using the Relationship Affect Coding System in Early Childhood. | Dishion TJ et al. | โ | 2017 | โ |
| What Doesn't Work for Whom? Exploring Heterogeneity in Responsiveness to the Family Check-Up in Early Childhood Using a Mixture Model Approach. | Pelham WE et al. | โ | 2017 | โ |
| Adaptive Interventions in Child and Adolescent Mental Health. | Almirall D et al. | โ | 2016 | โ |
| A Review of the Key Considerations in Mental Health Services Research: A Focus on Low-Income Children and Families. | Jones DJ et al. | โ | 2016 | โ |
| Can Targeted Intervention Mitigate Early Emotional and Behavioral Problems?: Generating Robust Evidence within Randomized Controlled Trials. | Doyle O et al. | โ | 2016 | โ |
| Maltreatment in Infancy: A Developmental Perspective on Prevention and Intervention. | Harden BJ et al. | โ | 2016 | โ |
| The long-term effectiveness of the Family Check-Up on school-age conduct problems: Moderation by neighborhood deprivation. | Shaw DS et al. | โ | 2016 | โ |
| The Oregon Model of Behavior Family Therapy: From Intervention Design to Promoting Large-Scale System Change. | Dishion T et al. | โ | 2016 | โ |
| The Role of Language Skill in Child Psychopathology: Implications for Intervention in the Early Years. | Salmon K et al. | โ | 2016 | โ |
| Transactional relations between caregiving stress, executive functioning, and problem behavior from early childhood to early adolescence. | Lagasse LL et al. | โ | 2016 | โ |
| A transactional approach to preventing early childhood neglect: The Family Check-Up as a public health strategy. | Dishion TJ et al. | โ | 2015 | โ |
| Early Parental Positive Behavior Support and Childhood Adjustment: Addressing Enduring Questions with New Methods. | Waller R et al. | โ | 2015 | โ |
| Feasibility of intensive parent-child interaction therapy (I-PCIT): Results from an open trial. | Graziano PA et al. | โ | 2015 | โ |
| Longitudinal relations between observed parenting behaviors and dietary quality of meals from ages 2 to 5. | Montaรฑo Z et al. | โ | 2015 | โ |
| Negative relational schemas predict the trajectory of coercive dynamics during early childhood. | Smith JD et al. | โ | 2015 | โ |
| Parenting and the Family Check-Up: Changes in Observed Parent-Child Interaction Following Early Childhood Intervention. | Sitnick SL et al. | โ | 2015 | โ |
| Results of a pragmatic effectiveness-implementation hybrid trial of the Family Check-up in community mental health agencies. | Smith JD et al. | โ | 2015 | โ |
| The family check-up and service use in high-risk families of young children: a prevention strategy with a bridge to community-based treatment. | Leijten P et al. | โ | 2015 | โ |
| The Predictive Utility of Early Childhood Disruptive Behaviors for School-Age Social Functioning. | Brennan LM et al. | โ | 2015 | โ |
| The trajectory of fidelity in a multiyear trial of the family check-up predicts change in child problem behavior. | Chiapa A et al. | โ | 2015 | โ |
| An application of the Complier Average Causal Effect analysis to examine the effects of a family intervention in reducing illicit drug use among high-risk Hispanic adolescents. | Huang S et al. | โ | 2014 | โ |
| Coercive family process and early-onset conduct problems from age 2 to school entry. | Smith JD et al. | โ | 2014 | โ |
| Direct and indirect effects of the family check-up on self-regulation from toddlerhood to early school-age. | Chang H et al. | โ | 2014 | โ |
| Early-starting conduct problems: intersection of conduct problems and poverty. | Shaw DS et al. | โ | 2014 | โ |
| Inhibitory control as a mediator of bidirectional effects between early oppositional behavior and maternal depression. | Choe DE et al. | โ | 2014 | โ |
| Introduction to the special series on booster sessions and long-term maintenance of treatment gains. | Kolko DJ et al. | โ | 2014 | โ |
| More than afterthoughts and details: maintenance and booster effects as critical elements of intervention research. | Tolan PH | โ | 2014 | โ |
| Effects of video feedback on early coercive parent-child interactions: the intervening role of caregivers' relational schemas. | Smith JD et al. | โ | 2013 | โ |
| Indirect effects of fidelity to the family check-up on changes in parenting and early childhood problem behaviors. | Smith JD et al. | โ | 2013 | โ |
| Indirect Effects of the Family Check-Up on School-Age Academic Achievement Through Improvements in Parenting in Early Childhood. | Brennan LM et al. | โ | 2013 | โ |