Reducing conduct problems among children brought to women's shelters: Intervention effects 24 months following termination of services.

This study evaluated the long-term effects of Project SUPPORT, an intervention designed to reduce conduct problems among children in domestically violent families. Participating mothers had sought shelter because of domestic violence and had at least one child (4-9 years old) exhibiting clinical levels of conduct problems. Results indicated that at 2 years posttreatment, 15% of children in families in the Project SUPPORT condition exhibited clinical levels of conduct problems compared with 53% of those in the existing services condition. In addition, mothers of children in the Project SUPPORT condition reported their children to be happier, to have better social relationships, and to have lower levels of internalizing problems, relative to children in the comparison condition. Mothers in the Project SUPPORT condition were less likely to use aggressive child management strategies and were less likely to have returned to their partners during the follow-up period. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reducing conduct problems among children of battered women.

This study was an experimental evaluation of an intervention designed to reduce conduct problems among children of battered women. Participants were 36 families (mothers and children) in which the mother had sought shelter because of relationship violence and had at least 1 child (4-9 years old) with clinical levels of conduct problems. The intervention consisted of 2 primary components: (a) providing instrumental and emotional support and (b) teaching child management skills to mothers. Families were randomly assigned to either the intervention condition or the existing services comparison condition and were assessed on 5 occasions over 16 months after shelter departure. Compared with families receiving existing services, children in the intervention condition improved at a faster rate, the proportion of children displaying clinical levels of conduct problems was greatly diminished, and mothers displayed greater improvements in child management skills. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving parenting in families referred for child maltreatment: A randomized controlled trial examining effects of Project Support.

Project Support is an intervention designed to decrease coercive patterns of aggressive discipline and increase positive parenting. This research evaluates Project Support in a sample of families reported to Children's Protective Services (CPS) for allegations of physical abuse or neglect; 35 families with a child between 3- and 8-years-old participated. In all families, CPS allowed the children to remain in the family home while the family received services. Families were randomly assigned to receive either Project Support or services as usual, which were provided by CPS or CPS-contracted service providers. To evaluate intervention effects, a multimethod, multi-informant assessment strategy was used that included data from mothers' reports, direct observation of parents' behavior, and review of CPS records for re-referrals for child maltreatment. Families who received Project Support services showed greater decreases than families who received services as usual in the following areas: mothers' perceived inability to manage childrearing responsibilities, mothers' reports of harsh parenting, and observations of ineffective parenting practices. Only 5.9% of families in the Project Support condition had a subsequent referral to CPS for child maltreatment, compared with 27.7% of families in the comparison condition. The results suggest that Project Support may be a promising intervention for reducing child maltreatment among families in which it has occurred. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Political violence and child adjustment in Northern Ireland: Testing pathways in a social–ecological model including single-and two-parent families.

Moving beyond simply documenting that political violence negatively impacts children, we tested a social–ecological hypothesis for relations between political violence and child outcomes. Participants were 700 mother–child (M = 12.1 years, SD = 1.8) dyads from 18 working-class, socially deprived areas in Belfast, Northern Ireland, including single- and two-parent families. Sectarian community violence was associated with elevated family conflict and children's reduced security about multiple aspects of their social environment (i.e., family, parent–child relations, and community), with links to child adjustment problems and reductions in prosocial behavior. By comparison, and consistent with expectations, links with negative family processes, child regulatory problems, and child outcomes were less consistent for nonsectarian community violence. Support was found for a social–ecological model for relations between political violence and child outcomes among both single- and two-parent families, with evidence that emotional security and adjustment problems were more negatively affected in single-parent families. The implications for understanding social ecologies of political violence and children's functioning are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized trial of a family-centered approach to the prevention of early conduct problems: 2-year effects of the family check-up in early childhood.

Despite recent research indicating that 1 of the pivotal times for identifying pathways to early conduct problems is the toddler period, few family-based preventive interventions have been specifically designed to modify child disruptive behavior during this age period. This randomized trial tested the effectiveness of the Family Check-Up in sustaining maternal involvement and preventing the exacerbation of child conduct problems among 120 at-risk toddler-age boys, half of whom were randomly assigned to a treatment condition. The intervention was associated with reductions in disruptive behavior and greater maternal involvement and was particularly effective for children at greater risk for a persistent trajectory of conduct problems. The results are discussed in relation to other preventive interventions for young children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of an online cognitive-behavioral family intervention in improving child behavior and social competence following pediatric brain injury.

Objective: To examine whether an online cognitive-behavioral intervention could improve child adjustment following traumatic brain injury (TBI). Participants: Thirty-nine families of children with moderate to severe TBI. Intervention: Families were randomly assigned to the online family problem-solving (FPS) group or to the Internet resources comparison (IRC) group. Main Outcome Measures: Outcomes included child behavior problems, social competence, and self-management/compliance. Results: The FPS group reported better child self-management/compliance at follow-up than did the IRC group. The child's age and socioeconomic status (SES) moderated treatment effects, with older children and those of lower SES who received FPS showing greater improvements in self-management and behavior problems, respectively. Conclusions: Findings suggest that an online cognitive- behavioral approach can improve child adjustment after TBI, particularly in older children and children of lower SES. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief family intervention: Effectiveness and the importance of including the father.

A brief family intervention program consisting of training in conflict resolution and contingency management was given to 43 families reporting high rates of parent–child problems of long duration. Families were randomly assigned to a father-included treatment, father-not-included treatment, and a wait-control group. Children ranged in age from 5.9 to 10.9 yrs. Preintervention, postintervention, and 6-mo follow-up assessments were made by daily telephone calls and by interview. Families receiving the treatment procedures showed significantly greater reductions in rates of problem behaviors at postintervention than did the wait-control group, and these changes were maintained at follow-up. Improvement in mother–child problems was the same whether fathers were included or not. Families receiving a telephone monitoring procedure, designed to prevent relapses during the 6-mo follow-up period, were not significantly different at follow-up from families not receiving this procedure. The implications of these findings for a strong systems view of families and family therapy are discussed. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children of battered women: The relation of child behavior to family violence and maternal stress.

Evaluated behavior problems and social competence in 198 4–16 yr old children from violent and nonviolent families (47 females and 55 males from transition homes for abused women and 53 females and 43 males from the community). 142 mothers rated their child's or children's behavior on the Child Behavior Checklist and completed measures of family violence (the Conflict Tactics scale) and maternal stress (the Life Experiences Survey and the General Health Questionnaire). Results indicate that children of battered women were rated significantly higher in behavior problems and were rated lower in social competence than were those in the comparison group. Among the Ss from violent families, 34% of the boys and 20% of the girls fell within the clinical range of behavior problems. Multiple regression analyses revealed that the maternal stress and family violence variables combined accounted for 19% of the variance in child behavior problems and accounted for 16% of the variance in social competence. In accordance with theoretical predictions, the impact on the child of witnessing family violence may be partially mediated by factors associated with maternal stress. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal depression and maternal treatment of siblings as predictors of child psychopathology.

Maternal treatment of sibling pairs with affectively ill and well mothers was examined longitudinally in relation to child psychiatric status. Mothers and children in 77 families (34 unipolar, 16 bipolar, and 27 control mothers) were observed in interaction across early, middle, and late childhood and early adolescence. Interaction was assessed on dimensions of maternal engagement and critical-irritable behavior. The study examined the relative contributions of maternal depression, the quality of maternal treatment, and differential treatment of siblings to each child's psychiatric status. By maternal report, older siblings' symptoms were predicted by maternal bipolar or unipolar illness; younger siblings' symptoms were predicted by lower maternal engagement and higher maternal critical-irritable behavior in early childhood, in addition to maternal affective illness. For the younger sibling, persistent patterns of maternal treatment were also related to both maternal and child reports of problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treating children with early-onset conduct problems: A comparison of child and parent training interventions.

Families of 97 children with early-onset conduct problems, 4–8 yrs old, were randomly assigned to 1 of 4 conditions: a parent training treatment group (PT), a child training group (CT), a combined child and parent training group (CT?+?PT), or a waiting-list control group (CON). Posttreatment assessments indicated that all 3 conditions had resulted in significant improvements in comparison with controls. Comparisons of the 3 treatment conditions indicated that CT and CT?+?PT children showed significant improvements in problem solving as well as conflict management skills, as measured by observations of their interactions with a best friend; differences among treatments on these measures consistently favored the CT over the PT condition. As for parent and child behavior at home, PT and CT?+?PT parents and children had significantly more positive interactions, compared with CT parents and children. One-yr follow-up assessments indicated that all the significant changes noted immediately posttreatment had been maintained over time. Moreover, child conduct problems at home had lessened over time. Analyses of the clinical significance of the results suggested that the combined CT?+?PT condition produced the most significant improvements in child behavior at 1-yr follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mother and father connectedness and involvement during early adolescence.

The purpose of the current study was to explore how mother’s and father’s connectedness and involvement individually and collectively influence the lives of their children. Specifically, we asked how fathers’ and mothers’ parent–child connectedness and behavioral involvement influenced both problem behaviors (externalizing and internalizing behaviors) and positive outcomes (prosocial behaviors and hope) during early adolescence. Data for this study were taken from the Flourishing Families Project, from which 349 mothers and fathers were selected, along with their early adolescent child (mean age = 11.23 years, SD = .96). Hierarchical regression analyses revealed (even after controlling for child age, gender, and self-regulation) that mothers’ and fathers’ contributions differed, primarily as a function of child outcome. Namely, father (but not mother) connectedness and involvement were negatively related to adolescents’ internalizing and externalizing behaviors, whereas mother (but not father) connectedness and involvement were positively related to adolescents’ prosocial behaviors and hope. We also found that when one parent’s involvement was low (for whatever reason), the other parent’s involvement made a significant and important contribution to the child’s well-being, particularly in the area of internalizing behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Six month follow-up: the crucial test of multidisciplinary developmental assessment

Participation of parents in the developmental assessment process is thought to be beneficial in promoting understanding of their child's disability, and improving consensus between parents and professionals about appropriate intervention programmes. If costly multidisciplinary assessments are to be justified, it is necessary to establish long-term benefits for the child. This highlights a need for research identifying how families use services after diagnostic assessment and what they understand to be important for their child. Poor parent-professional agreement about diagnosis may be a factor contributing to low compliance with recommendations. The major purpose of the current study was to follow-up families 6 months after developmental assessment, in order to investigate use of recommended intervention services. In addition, mothers' opinions about diagnostic findings, recommendations and early intervention services were examined. Subjects were 40 pre-school children who presented for developmental assessment, and their mothers. The majority were diagnosed with developmental problems in multiple domains. Results indicated that most mothers recalled and agreed with their child's diagnosis, but underestimated the severity of developmental delay. Families had not accessed the range of multidisciplinary intervention programmes recommended, given the complexity of their children's disabilities. Speech therapy was considered the service of highest priority by mothers, and was the treatment most frequently received. Mothers recognized a need for more therapeutic interventions for their child. An unexpected finding was the high prevalence of families who organized nonprescribed therapies. Possible explanations of the findings and implications for service delivery are discussed.     

Families of children with attention deficit hyperactivity disorder: a review

OBJECTIVES: 1) To review the evidence of attention deficit hyperactivity disorder (ADHD) and other conditions in family members (siblings and parents) of children with ADHD and determine the importance of genetic and environmental factors in this condition. 2) To describe the prospective 10-year follow-up of 65 families with ADHD children and 43 families of matched normal controls. 3) To review various studies that have looked at parent-child interactions with ADHD children on and off stimulant medication, and such interactions over time. The paper thus provides an overview of family pathology and functioning of families of ADHD children over time. METHOD: The paper outlines twin, sibling, family and adoption studies with regard to possible genetic and environmental factors in ADHD. It also presents data of a prospective 10-year follow-up of 65 families with ADHD children and 43 families of normal controls. This family study evaluated sociocultural factors, child rearing practices, health of family members and relationships, as well as the parental view of the child's functioning over time. RESULTS: A review of the literature suggests that ADHD has a strong genetic component, but that environmental factors also play an important role. Families of children with ADHD have more problems than families of normal controls, but these problems improve as the child with ADHD grows up and leaves home. Families of ADHD subjects can appreciate positive as well as negative changes in their children over time. Generally, family interactions with children with ADHD are problematic but improve when the child is on medication and when the child becomes an adult. CONCLUSIONS: This condition has strong genetic underpinnings; therefore, diagnosing and treating family members (parents and siblings) as well as the child with ADHD is important in improving parent-child interactions and better long-term outcome for the child and his or her family.     

Family group cognitive–behavioral preventive intervention for families of depressed parents: 18- and 24-month outcomes.

Objective: In a long-term follow-up of a randomized controlled trial (Compas et al., 2009) to examine the effects at 18- and 24-month follow-ups of a family group cognitive–behavioral (FGCB) preventive intervention for mental health outcomes for children and parents from families (N = 111) of parents with a history of major depressive disorder (MDD). Method: Parents with a history of MDD and their 9- to 15-year-old children were randomly assigned to a FGCB intervention or a written information comparison condition. Children's internalizing, externalizing, anxiety/depression, and depressive symptoms; episodes of MDD and other psychiatric diagnoses; and parents' depressive symptoms and episodes of MDD were assessed at 18 and 24 months after randomization. Results: Children in the FGCB condition were significantly lower in self-reports of anxiety/depression and internalizing symptoms at 18 months and were significantly lower in self-reports of externalizing symptoms at 18 and 24 months. Rates of MDD were significantly lower for children in the FGCB intervention over the 24-month follow-up (odds ratio = 2.91). Marginal effects were found for parents' symptoms of depression at 18 and 24 months but not for episodes of MDD. Conclusions: Support was found for a FGCB preventive intervention for children of parents with a history of MDD significantly reducing children's episodes of MDD over a period of 2 years. Significant effects for the FGCB intervention were also found on internalizing and externalizing symptoms, with stronger effects at 18- than at 24-month follow-up. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Treatment effectiveness of parent management training in Norway: A randomized controlled trial of children with conduct problems.

This study was a randomized control trial (RCT) of Parent Management Training--The Oregon Model (PMTO) in Norway. A sample representing all health regions of Norway and consisting of 112 children with conduct problems and their families participated in the study. Families were randomly assigned to either PMTO or a regular services comparison group. PMTO was delivered via existing children's services, and families were recruited using the agencies' regular referral procedures, making this the first effectiveness study of PMTO and the first RCT of PMTO conducted outside of the United States. Using a multiagent-multimethod approach, results showed that PMTO was effective in reducing parent-reported child externalizing problems, improving teacher-reported social competence, and enhancing parental discipline. Age level and gender modified the effects of PMTO treatment on other outcomes. In a path model, participation in PMTO was associated with improved parental discipline, and effective discipline predicted greater child compliance, fewer child-initiated negative chains, and lower levels of child externalizing problems. Findings are presented along with a discussion of the implications for practice and research and the challenges accompanying effectiveness trials. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Can a Web-based family problem-solving intervention work for children with traumatic brain injury?

Objective: To examine the feasibility and efficacy of a Web-based intervention for children with traumatic brain injury (TBI). Participants: 6 families comprising 8 parents, 5 siblings, and 6 children with TBI (mean age=10.5 years). Intervention: Families received computers, Web cameras, and Internet access. Participants completed 7-11 online sessions and accompanying weekly videoconferences with the therapist. Main Outcome Measures: Outcomes included child behavior problems, social competence, executive function skills, and parent-child conflict. Results: Children with TBI rated Web site content as very to extremely helpful and reported high overall satisfaction. There was a trend for children with TBI to rate the videoconferences as less helpful than did other family members and relative to a face-to-face visit. Parents reported improvements in antisocial behaviors, and children with TBI reported reductions in conflict with parents regarding school. Conclusions: Web-based interventions hold promise for improving child outcomes following pediatric TBI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical aggression toward boys and girls in families characterized by the battering of women.

Forty-eight families (mothers and children) participated in a study on physical aggression toward boys and girls in households characterized by the battering of women. In each family, the mother had sought shelter because of relationship violence and had a son and daughter between 4 and 14 years. Mothers completed measures of physical marital violence directed at themselves, aggression toward children, and children's externalizing behavior problems. Older children completed measures of aggression directed at themselves. Results indicated that child gender moderates the relationship between the battering of women and aggression toward children. In families characterized by "more extreme" battering, boys were more often victims of aggression than girls, boys exhibited more externalizing problems than girls, and gender differences in externalizing problems helped account for the differential aggression directed at boys and girls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of the Incredible Years parent, child, and teacher training programs on children's co-occurring internalizing symptoms.

The Incredible Years (IY) Series includes separate group interventions to improve parenting interactions, teacher classroom management, and child social-emotional regulation. Although originally developed to treat early onset conduct problems, IY targets many of the proposed mechanisms and risk factors for internalizing distress in early childhood. Prior studies have demonstrated the effects of the IY parent intervention on co-occurring depressive symptoms. We attempted to extend these findings by examining the unique and combined effects of IY interventions on children's co-occurring internalizing symptoms. One-hundred and fifty-nine families with children ages 4- to 8-years-old were randomly assigned to parent training (PT); parent plus teacher training (PT + TT); child training (CT); child plus teacher training (CT + TT); parent, child, plus teacher training (PT + CT + TT); or a waiting list control group. Children who received any of the intervention components were more likely to have lower mother-rated internalizing symptoms at posttreatment compared to children in a wait-list control group. Implications for future research and for designing interventions and prevention strategies for children with internalizing symptoms are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Multimodal assessment of impulsiveness in abusing, neglecting, and nonmaltreating mothers and their preschool children.

Three groups of 12 mothers who had a history of child abuse (mean age 26.67 yrs), child neglect (mean age 25.75 yrs), or no known history of child maltreatment (mean age 29.08 yrs) and their 48–70 mo old children were compared on the nature and extent of their impulsiveness in a multimodal assessment procedure. Children were also rated by their mothers on the Revised Conners Parent Rating Scale and by their teachers on the Conners Teacher Rating Scale. Results indicate that comparison mothers performed better than did abusing mothers on 2 measures of motor inhibition, a modified Matching Familiar Figures Test and the Stroop Color and Word Test. Neglectful mothers rated their children as having more conduct problems than did comparison mothers. No significant differences were found on the other child measures of impulsiveness. Implications for assessing and treating child maltreatment are discussed. (48 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized controlled trial of a family cognitive-behavioral preventive intervention for children of depressed parents.

A family cognitive-behavioral preventive intervention for parents with a history of depression and their 9–15-year-old children was compared with a self-study written information condition in a randomized clinical trial (n = 111 families). Outcomes were assessed at postintervention (2 months), after completion of 4 monthly booster sessions (6 months), and at 12-month follow-up. Children were assessed by child reports on depressive symptoms, internalizing problems, and externalizing problems; by parent reports on internalizing and externalizing problems; and by child and parent reports on a standardized diagnostic interview. Parent depressive symptoms and parent episodes of major depression also were assessed. Evidence emerged for significant differences favoring the family group intervention on both child and parent outcomes; strongest effects for child outcomes were found at the 12-month assessment with medium effect sizes on most measures. Implications for the prevention of adverse outcomes in children of depressed parents are highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)