Program Goals
Family Check-Up (FCU) is a preventative, family-based intervention targeting families with young children who possess risk factors for child behavioral misconduct. The FCU program is a family assessment intervention that emphasizes motivation to change, and involves three sessions implemented in the home with optional follow-up parental training sessions. Primary goals include reductions in child problem behavior and prevention of delinquency later in life. Secondary goals include increased maternal involvement and improvements in positive behavior support and other family management practices. Specifically, the program targets disrupted and unskilled family management practices in early childhood to reduce and prevent future child problem behavior.
Target Population
The FCU intervention targets families with socioeconomic, family, and/or child risk factors for future behavioral problems. Two risk factors specifically examined include low child inhibition and maternal depression. Families with children between the ages of 2 and 11 years are eligible for FCU.
Program Activities
The FCU is a brief, three session intervention based on motivational interviewing. The three meetings are conducted by a professional therapist in the home. The sessions consist of a one-hour assessment session, an interview session, and a feedback session.
- The first session involves a staff member who reviews and discusses concerns with the caregiver, focusing on family issues that are most critical to the child’s well-being. Specifically, the interview covers the parent’s goals and concerns within the family.
- The assessment engages family in a variety of in-home videotaped tasks of parent-child interactions, while caregivers complete questionnaires about their own, their child’s, and their family’s functioning. During this session, staff completes ratings of parent involvement and supervision.
- The third meeting is a feedback session where the parent consultant can summarize results of the assessment and work with the parent to assess his/her motivation and willingness to change problematic behavior. This final session also includes an overview of the behaviors and/or practices that need additional attention. At that time, parents are offered a maximum of six follow-up sessions to continue improving their parenting practices and family management skills. Two annual follow-ups are conducted to assess progress over the long-term.
Key Personnel
Key personnel include the consultants and the Quality Assurance Implementation Team at Arizona State University (ASU) REACH Institute. Trainees are typically psychologists, family therapists, social workers, program developers, community mental health workers, and/or intervention scientists.
Program Theory
The FCU intervention is grounded on vulnerability theory, claiming that children who have a greater genetic risk for problem behavior are more susceptible to environmental influences, including punitive or neglectful parenting practices (Caspi et al., 2002). With this in mind, intervention strategies should strengthen parental use of positive behavior support strategies (Horner & Carr, 1997; Sugai, Horner, & Sprague, 1999). Thus, FCU includes motivation-to-change strategies based on the ecological approach to family intervention and treatment, otherwise known as the EcoFIT model. The EcoFIT approach was originally designed to improve children’s adjustment to various environments, seeking to motivate positive behavior support practices in these settings. FCU and EcoFIT interventions are tailored to the individualized needs of youth and families as revealed by assessments and other family observations. It stands to reason that preventing behavioral problems in early childhood will decrease one’s risk for substance abuse and criminal activity during adolescence.
Program Note
The FCU program examined in the study by Dishion and colleagues (2008) was implemented differently than the traditional FCU model. Normally, the FCU would consist of three ordinal sessions, consisting of an initial interview, comprehensive assessment, and a feedback session. However, in order to reduce differential attrition between groups, the researchers implemented the assessment prior to random assignment. Thus, the assessment was administered to all study participants (i.e. both groups), followed by the initial interview and feedback sessions for the intervention group only. The control group received the assessment followed by WIC services as usual. All participants received follow-up assessments at child age 3 and 4.
It should be noted that the actual FCU assessment protocol was also modified when applied to families of toddlers. Specifically, the assessment was expanded to focus on key development processes for families of toddlers, including those challenges that affect parenting and early child adjustment.
