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The Effectiveness of Parent Training Programs for Child Maltreatment and Their Components: A Meta-Analysis.

ABSTRACT: This is the first meta-analytic review investigating what components and techniques of parent training programs for preventing or reducing child maltreatment are associated with program effectiveness. A literature search yielded 51 studies (N = 6670) examining the effectiveness of parent training programs for preventing or reducing child maltreatment. From these studies, 185 effect sizes were extracted and more than 40 program components and techniques were coded. A significant and small overall effect size was found (d = 0.416, 95% CI (0.334, 0.498), p < 0.001). No significant moderating effects were found for contextual factors and structural elements (i.e., program duration, delivery location, and delivery setting). Further, no significant moderating effects were found for most of the coded program components and techniques, indicating that these components are about equally effective. Only a few program components and techniques moderated program effectiveness, however these effects were negative. These results indicated that improving parental personal skills, improving problem solving skills, and stimulating children's prosocial behavior should not be the main focus of parental training programs for preventing and reducing child maltreatment. This also holds for practicing new skills by rehearsal and giving direct feedback in program sessions. Further clinical implications and directions for future research are discussed.

SUBMITTER: Gubbels J

PROVIDER: S-EPMC6651871 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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The Effectiveness of Parent Training Programs for Child Maltreatment and Their Components: A Meta-Analysis.

Gubbels Jeanne J van der Put Claudia E CE Assink Mark M

International journal of environmental research and public health 20190706 13

This is the first meta-analytic review investigating what components and techniques of parent training programs for preventing or reducing child maltreatment are associated with program effectiveness. A literature search yielded 51 studies (<i>N</i> = 6670) examining the effectiveness of parent training programs for preventing or reducing child maltreatment. From these studies, 185 effect sizes were extracted and more than 40 program components and techniques were coded. A significant and small ...[more]

PMID: 31284575

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Project description:ImportanceTraining parents to implement strategies to support child language development is crucial to support long-term outcomes, given that as many as 2 of 5 children younger than 5 years have difficulty learning language.ObjectiveTo examine the association between parent training and language and communication outcomes in young children.Data sourcesSearches of ERIC, Academic Search Complete, PsycINFO, and PsycARTICLES were conducted on August 11, 2014; August 18, 2016; January 23, 2018; and October 30, 2018.Study selectionStudies included in this review and meta-analysis were randomized or nonrandomized clinical trials that evaluated a language intervention that included parent training with children with a mean age of less than 6 years. Studies were excluded if the parent was not the primary implementer of the intervention, the study included fewer than 10 participants, or the study did not report outcomes related to language or communication.Data extraction and synthesisPreferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were applied to a total of 31 778 articles identified for screening, with the full text of 723 articles reviewed and 76 total studies ultimately included.Main outcomes and measuresMain outcomes included language and communication skills in children with primary or secondary language impairment and children at risk for language impairment.ResultsThis meta-analysis included 59 randomized clinical trials and 17 nonrandomized clinical trials including 5848 total participants (36.4 female [20.8%]; mean [SD] age, 3.5 [3.9] years). The intervention approach in 63 studies was a naturalistic teaching approach, and 16 studies used a primarily dialogic reading approach. There was a significant moderate association between parent training and child communication, engagement, and language outcomes (mean [SE] Hedges g, -0.33 [0.06]; P < .001). The association between parent training and parent use of language support strategies was large (mean [SE] Hedges g, 0.55 [0.11], P < .001). Children with developmental language disorder had the largest social communication outcomes (mean [SE] Hedges g, 0.37 [0.17]); large and significant associations were observed for receptive (mean [SE] Hedges g, 0.92 [0.30]) and expressive language (mean [SE] Hedges g, 0.83 [0.20]). Children at risk for language impairments had moderate effect sizes across receptive language (mean [SE] Hedges g, 0.28 [0.15]) and engagement outcomes (mean [SE] Hedges g, 0.36 [0.17]).Conclusions and relevanceThe findings suggest that training parents to implement language and communication intervention techniques is associated with improved outcomes for children and increased parent use of support strategies. These findings may have direct implications on intervention and prevention.

Project description:ObjectiveThe aim of this study is to perform the first meta-meta-analysis on the effectiveness of parent-based interventions for children with externalizing behavior problems. Even though parent-based interventions are considered as effective treatments the effects reported in meta-analyses are heterogeneous and the implementation in clinical practice is suboptimal. Recapitulative valid effect predictions are required to close the still existing gap between research findings and clinical practice. The meta-meta-analytic results on changes in child behavior shall result in a clear signal for clinical practice.MethodsThis meta-meta-analysis encompasses 26 meta-analyses identified via search in electronic databases (PsycINFO, Medline, PubMed). Meta-analyses had to report effects of parent-based interventions on child behavior and focus on children under the age of 13 years with externalizing behavior problems in a clinical setting. Analyses were based on random-effects models. To combine results, the effect estimates of the meta-analyses were transformed to SMD and weighted to correct for primary study overlap. The meta-meta-analysis is registered on PROSPERO, registration number CRD42016036486 and was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PRISMA).ResultsThe results indicate a significant moderate overall effect for child behavior (SMD = 0.46) as well as for parent reports (SMD = 0.51) and observational data (SMD = 0.62). Further analyses focusing on child externalizing behavior yielded significant and moderate effects (SMD = 0.45). All effects remained stable to follow-up. Considerable heterogeneity was observed within results.ConclusionParent-based interventions are shown to be effective in improving behavior in children with externalizing behavior problems, as assessed using parent reports and observational measures. The present results should encourage health care providers to apply evidence-based parent-based interventions.

Project description:School-based programs seem promising for child abuse prevention. However, research mainly focused on sexual child abuse and knowledge is lacking on how individual program components contribute to the effectiveness of school-based prevention programs for any form of child abuse. This study aimed to examine the overall effect of these school-based programs on (a) children's child abuse-related knowledge and (b) self-protection skills by conducting two three-level meta-analyses. Furthermore, moderator analyses were performed to identify how program components and delivery techniques were associated with effectiveness. A literature search yielded 34 studies (158 effect sizes; N = 11,798) examining knowledge of child abuse and 22 studies (99 effect sizes; N = 7804) examining self-protection skills. A significant overall effect was found of school-based programs on both knowledge (d = 0.572, 95% CI [0.408, 0.737], p < 0.001) and self-protection skills (d = 0.528, 95% CI [0.262, 0.794], p < 0.001). The results of the first meta-analysis on children's child abuse knowledge suggest that program effects were larger in programs addressing social-emotional skills of children (d = 0.909 for programs with this component versus d = 0.489 for programs without this component) and self-blame (d = 0.776 versus d = 0.412), and when puppets (d = 1.096 versus d = 0.500) and games or quizzes (d = 0.966 versus d = 0.494) were used. The second meta-analysis on children's self-protections skills revealed that no individual components or techniques were associated with increased effectiveness. Several other study and program characteristics did moderate the overall effects and are discussed. In general, school-based prevention programs show positive effects on both knowledge and self-protection skills, and the results imply that program effectiveness can be improved by implementing specific components and techniques.

Project description:Background It is essential to implement parent-targeted interventions to increase the use of child restraint systems (CRS) and thus reduce the injuries and deaths of children due to motor vehicle collisions. To optimize future intervention designs, this meta-analysis sought to quantify the effects of parent-targeted interventions and explore potential intervention moderators. Methods Studies met inclusion criteria if they included a parents-targeted intervention that focused on increasing CRS use for children, published from the inception of the databases to January 2022, were systematically retrieved from the PubMed, Embase, Cochrane library, Web of Science, Sinomed, Wanfang, and CNKI databases. Next, 2 researchers independently screened the retrieved articles, evaluated their quality according to the Cochrane Tool, and extracted the data. Finally, Stata12.0 was used for the meta-analysis. Heterogeneity was examined with I2, stratified analyses, and meta-regression. Results Of the 1,690 articles retrieved, 9 studies, comprising 22,329 parents of children aged 0–12 years, were ultimately included in the analysis. The results of the meta-analysis showed that the CRS use rate of the intervention group was 1.62 times higher than that of the control group [95% confidence interval (CI): 1.25–2.11, Z=3.616, P<0.001], indicating the positive effect of parent-targeted interventions on promoting the use of CRS. The subgroup analysis found that interventions guided by behavioral theories increased the use of CRS (odds ratio: 1.44, 95% CI: 1.27–1.63, n=5). The difference in the use of CRS between the groups in the studies that were not guided by theories was not statistically significant, indicating that interventions guided by behavioral theories may be the source of the heterogeneity. Risk of bias was low in most studies. Conclusions It is necessary to conduct interventions with parents to increase the use of CRS. The effects on CRS use appear to differ depending on whether the interventions are guided by behavioral theories. In-depth research needs to be conducted to explore the characteristics of the interventions, especially those guided by different behavioral theories, to reduce child vehicle injuries.

Project description:Parental cognitive functioning is thought to play a key role in parenting behavior and may inform response to behavioral intervention. This open-label pilot study examined the extent to which parent and child cognition impacted response to behavioral parent training for children with ADHD. Fifty-four participants (27 parent-child dyads; Mages?=?10.6 and 45.2 for children and parents, respectively) completed tasks assessing visuospatial and phonological working memory, inhibitory control, and choice-reaction speed at pre-treatment. Drift diffusion modeling decomposed choice-reaction time data into indicators of processing speed (drift rate) and response caution (boundary separation). Parents completed a 10-week manualized behavioral parent training program. Primary outcomes were pre- and post-treatment child ADHD and conduct problem severity, and parent-reported relational frustration and parenting confidence. Bayesian multiple regressions assessed parent and child cognitive processes as predictors of post-treatment outcomes, controlling for pre-treatment behavior. Better child visuospatial and phonological WM and higher parental response caution were associated with greater reductions in inattention. For conduct problems, better parental self-regulation (stronger inhibitory control and greater response caution) predicted fewer post-treatment conduct problems. Higher parental response caution also predicted lower post-treatment relational frustration and higher parental confidence. Bayesian evidence supported no relation between parent and child cognitive functions and treatment-related changes in hyperactivity. This pilot study demonstrates that cognitive processes central to etiologic theories of ADHD and models of parenting behavior can be successfully integrated into treatment outcome research to inform which families are most likely to benefit from behavioral interventions. This study demonstrates the feasibility of bridging the translational research gap between basic and applied clinical science and facilitates research on the role of cognition in psychosocial interventions.

Dataset Information

The Effectiveness of Parent Training Programs for Child Maltreatment and Their Components: A Meta-Analysis.

Publications

The Effectiveness of Parent Training Programs for Child Maltreatment and Their Components: A Meta-Analysis.

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