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

Evidence Rating: Promising - One study Promising - One study

Date: This profile was posted on June 17, 2019

Program Summary

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.

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

Program Description

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.

Evaluation Outcomes

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Study 1
Overall, Brotman and colleagues (2008) found that the parenting intervention had statistically significant effects on observed child physical aggression, responsive parenting, and stimulation for learning, although the effects were small. The intervention did not have a statistically significant effect on parent-rated child physical aggression or harsh parenting practices. Overall, the preponderance of evidence suggests the program did have the intended effects on parents and preschool children.

Observed Child Physical Aggression
The intervention had a statistically significant effect on observed child physical aggression at the 16-month follow up. The intervention group showed a statistically significant decrease in observed aggression over time, whereas the control group showed an increase in observed aggression over time.

Parent-Rated Child Physical Aggression
At the 16-month follow up, there was no statistically significant effect on the parent-rated child physical aggression.

Responsive Parenting
There was a statistically significant effect on measures of responsive parenting practices at the 16-month follow up. Parents in the intervention group were more likely to show responsive parenting practices, compared with parents in the control group.

Harsh Parenting
There was no statistically significant effect on measures of harsh parenting at the 16-month follow up.

Stimulation for Learning
There was a statistically significant effect on measures of stimulation for learning at the 8-month follow up. There were more items in the homes of intervention group families that could stimulate learning, compared with those in the homes of control group families.
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Evaluation Methodology

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Study 1
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.
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Cost

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There is no cost information available for this program.
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Implementation Information

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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.gov: https://www.crimesolutions.gov/ProgramDetails.aspx?ID=194
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Evidence-Base (Studies Reviewed)

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

Study 1
Brotman, Laurie Miller, Kathleen Kiely Gouley, Keng-Yen Huang, Amanda Rosenfelt, Colleen O’Neal, Rachel G. Klein, and Patrick Shrout. 2008. “Preventive Intervention for Preschoolers at High Risk for Antisocial Behavior: Long-Term Effects on Child Physical Aggression and Parenting Practices.” Journal of Clinical Child & Adolescent Psychology 37(2):386–96.
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Additional References

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

Brotman, Laurie Miller, Kathleen Kiely Gouley, Daniel Chesir-Teran, Tracy Dennis, Rachel G. Klein, and Patrick Shrout. 2005. “Prevention for Preschoolers at High Risk for Conduct Problems: Immediate Outcomes on Parenting Practices and Child Social Competence.” Journal of Clinical Child and Adolescent Psychology 34(4):724–34.

Brotman, Laurie Miller, Spring Dawson-McClure, Kathleen Kiely Gouley, Kristina McGuire, Bert Burraston, and Lew Bank. 2005. “Older Siblings Benefit from a Family-Based Preventive Intervention for Preschoolers at Risk for Conduct Problems.” Journal of Family Psychology 19(4):581–91. (This study was reviewed but did not meet CrimeSolutions.gov criteria for inclusion in the overall program rating.)

Ehrensaft, Miriam K., Heather Knous Westfall, Phyllis Holditch Niolon, Thailyn Lopez, Dimitra Kamboukos, Keng-Yen Huang, and Laurie Miller Brotman. 2018. “Can Parenting Intervention to Prevent Early Conduct Problems Interrupt Girls’ Risk for Intimate Partner Violence 10 Years Later?” Prevention Science 19:449–59. (This study was reviewed but did not meet CrimeSolutions.gov criteria for inclusion in the overall program rating.)
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Program Snapshot

Age: 2 - 5, 26 - 46

Gender: Both

Race/Ethnicity: Black, Asian/Pacific Islander, Hispanic, White, Other

Geography: Urban

Setting (Delivery): Home, Other Community Setting

Program Type: Cognitive Behavioral Treatment, Conflict Resolution/Interpersonal Skills, Family Therapy, Group Therapy, Parent Training

Targeted Population: Families

Current Program Status: Active

Listed by Other Directories: Model Programs Guide