Program Profile: Parenting Intervention to Prevent Early Conduct Problems and Improve Parenting Practices (New York City)

The program is a family-based, group preventive intervention for preschool children who are at high risk for antisocial behavior. The program is rated Promising. The intervention had statistically significant effects on observed child physical aggression, responsive parenting, and stimulation for learning, but had no statistically significant effects on parent-rated child physical aggression or harsh parenting practices.

A Promising rating implies that implementing the program may result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Goals/Target Population

This program is a family-based, group preventive intervention adapted from the Incredible Years Series (IYS). The program targets parenting practices and physical aggression in preschool children, who are at a high risk for antisocial behavior because of the family’s history of contact with the justice system (i.e., an older sibling had been in contact with the justice system in New York City). The goal of the program is to prevent children’s later conduct problems.

Program Components

The program targets several risk factors frequently experienced by families of delinquent adolescents such as limited parental education, high rates of parental depression, high levels of stressful life events, and socioeconomic disadvantage (Brotman et al. 2008). The program seeks to alter parents’ disciplinary practices by encouraging them to use non-harsh, consistent, and appropriate strategies. It also encourages parents to promote their child’s social competence by being less critical and using positive reinforcement. Program leaders also teach preschoolers social skills, reinforce positive behaviors, and use appropriate negative consequences for negative behaviors.

The program consists of 22 group sessions, separate for parents and preschoolers, over a 6- to 8-month period with a 3-month intervention booster that takes places 4 to 6 months after the intervention ends. Each group session lasts approximately 1.5 hours; there are also five 1.5-hour booster group sessions. After each parent group session, there is an additional 30-minute activity time (i.e., arts and crafts or free play), to allow parents to practice parenting strategies with their children.

Program staff also conduct 10 home visits during the intervention and provide additional contacts within the home or community as needed. The booster period also includes five 30-minute parent-child interaction sessions, two 1.5-hour home visits, and one 2-hour school visit. The goal of the booster sessions is to maintain the effects and skills learned during the intervention.

The home visits and contacts allow for flexibility in addressing potential barriers to change and to increase the adaption of learned skills to home life. Leaders from both the parent and child groups provide home visits that follow a curriculum that corresponds to the group lessons. Home visits allow for opportunities to implement skills learned during group sessions and to develop a behavior plan, such as placing a time-out chair in a crowded apartment or using existing resources in the home to create a stimulating learning environment.

Study

Brotman and colleagues (2008) conducted a randomized controlled trial that compares the intervention program to a no-treatment control condition. Ninety-two preschoolers (and parents) from the families of adolescents who had been adjudicated in family court in New York City participated in the study. Authors recruited participants, through youth records, who were younger than 16, had been adjudicated in two New York City boroughs between 1997 and 2001, and had preschool-aged siblings. The study authors defined a sibling as someone who is biologically related to the adjudicated youth or who lived with the adjudicated youth for at least a year, and who was also raised by the same caregiver. Families were eligible if siblings were between 33 months and 63 months, and the caregiver did not have a current substance abuse or psychotic disorder. Families in the intervention condition received 6 to 8 months of the prevention intervention and the 3-month booster. Families in the control condition received no intervention.

Ninety-two families agreed to participate in the trial. There were 47 families randomly assigned to the intervention condition, and 45 families randomly assigned to the control condition. Seven of the 92 families had more than one preschooler, so the child closest to 48 months was deemed the target child. Of the study sample, 68 percent of the 92 preschoolers were biological siblings (12 percent full; 56 percent half); 3 percent were adoptive siblings; and 28 percent were biological nieces, nephews, or cousins raised as siblings. Fifty-three percent of the preschoolers were girls, and 65 percent were African American, 27 percent were Latino/a, 1 percent were white, 1 percent were Asian, and 6 percent were mixed race/ethnicity. The average age of the children was 47.5 months, and 43 percent were not enrolled in a preschool or daycare program. Eighty-three percent of the caregivers were the biological mothers, 2 percent were the biological fathers, 10 percent were grandmothers, 3 percent were adoptive mothers, and 2 percent were other female relatives. The parents’ mean age was 36.3 years. Baseline comparison of the intervention and control groups did not produce any significant differences between the groups.

The primary outcome measured in the children was physical aggression, which was observed by blinded raters during the semistructured, parent-child interactions. Two parent-child interactions were measured, one at the home and one at the study center. At home, a 10-minute session was observed that included 5 minutes of child-directed free play and 5 minutes of a parent-directed puzzle task. At the study center, a 15-minute session was observed that included 7 minutes of child-directed free play, 5 minutes of a parent-directed puzzle task, and 3 minutes of clean up. The home assessments were coded at the time of the session, and the study center assessments were video recorded and coded at a later time. Different coders coded the home and study center sessions and were not involved in other aspects of the study. The Dyadic Parent-Child Interaction Coding System-Revised (DPICS-R) was used to assess aggressive behaviors, specifically using two codes: child physical negative and child destructive. The New York Parent Rating Scale (NYPRS-P) was filled out by parents to rate their children’s physical aggression. The scale, which was read aloud to parents, includes a five-item physical aggression scale. Parents were asked to rate their children’s behavior over the past 4 weeks.

Harsh parenting was measured by a composite of observations of parent-child interaction and parent report. The DPICS-R Critical Statements Scale and the Global Impressions of Parent-Child Interactions (GIPCI) Harsh Scale were used during observation of parent-child interaction, and two parent-report scales from the Parenting Practices Interview (PPI), the Harsh-C and Harsh-O scales, were used for the parent report. Responsive parenting was measured by observations of the parent-child interaction and coded using the DPICS-R Praise Scale and GIPCI Valence, Responsiveness, and Affection Scales.

Stimulation for learning was evaluated during the home visits with the Home Observation for the Measurement of the Environment-Early Childhood version (HOME-EC), in which raters used observation and interviews to determine the presence or absence of items. Three of the HOME subscales used were on learning, language, and academic stimulation. Stimulation for learning was only evaluated until time 3 (8 months), as the early childhood version of HOME is no longer age-appropriate at time 4 (16 months), and the elementary version differs significantly.

The effects of the intervention on children’s physical aggression and parenting practices were analyzed using the generalized estimating equation (GEE), which uses time-within-child as the unit of analysis with a regression model and accounts for the correlations of repeated measures. Follow-up measures were taken at 8 and 16 months after completion of the intervention. The study authors did not conduct subgroup analyses.

The parent groups used the published versions of the manuals from the Incredible Years Series. For this parenting intervention, the number of parent and child groups was increased from 12 to 22, to allow for more time to cover program content. Other components were also added to facilitate use of learned parenting skills in home settings, including guided parent-child interactions and home visits (Brotman et al. 2008).

A profile of the Incredible Years program can be found on CrimeSolutions: https://www.crimesolutions.ojp.gov/ratedprograms/194

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Following are CrimeSolutions-rated programs that are related to this practice:

Early Family/Parent Training Programs

This practice includes programs that seek to provide families and parents with training and skills to help promote their children’s physical, mental, and social skills. The practice is rated Effective for reducing child problem behaviors for children whose families participated in early family/parent training programs, compared with control group children whose families did not participate in programming.

Evidence Ratings for Outcomes

Juvenile Problem & At-Risk Behaviors - Multiple juvenile problem/at-risk behaviors

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?