Effectiveness of a comprehensive,five-year family support program for low-income children and their families: findings from the comprehensive child development program

A randomized experiment was conducted to test the effects of the Comprehensive Child Development Program (CCDP), a two-generation program that employed case management and home visiting to ensure multi-risk, low-income children and their parents a range of education, health, and social services to meet the complex needs of disadvantaged families. The evaluation of 21 CCDP projects, which followed 4,410 families for five years, found no statistically significant impact on CCDP families when they were compared with control families in either child outcomes (cognitive and socio-emotional development, and health) on parent outcomes (parenting, family economic self-sufficiency, or maternal life course). Since the intervention failed to change parenting behavior or family economic status, the two hypothesized pathways to affecting the well-being of the children, not unexpectedly there were no significant impacts of CCDP on children. The study suggests that the combination of case management and parenting education, delivered through home visits, is not an effective means of improving developmental outcomes for low-income children.     

Common components of evidence-based parenting programs for preventing maltreatment of school-age children

Child maltreatment can lead to a variety of negative outcomes in childhood including physical and mental health problems that can extend into adulthood. Given the transactional nature of child maltreatment and the difficulties that many maltreating families experience, child protection services typically offer various kinds of programs to maltreated children, their parents, and/or their families. Although the specific difficulties experienced by these families may vary, sub-optimal parenting practices are typically part of the picture and may play a central role in maltreated children’s development. Hence, to deal with child maltreatment, programs that focus on parenting practices are essential, and identifying the common components of effective programs is of critical importance. The objectives of the present study were to: 1) describe the components of evidence-based parenting programs aimed at parents who have maltreated their elementary school-aged children or are at-risk for doing so and 2) identify the components that are common to these programs, using the approach proposed by Barth and Liggett-Creel (2014). Fourteen evidence-based parenting programs aimed at parents who had maltreated their elementary school-aged children (ages 6–12) or were at-risk for doing so were identified using both a review of relevant online databases of evidence-based programs (California Evidence-Based Clearinghouse for Child Welfare, Blueprints for Healthy Youth Development, Youth.gov, and the National Registry of Evidence-based Programs and Practices). Common components were identified (operationalized as components present in two thirds of programs) and discussed. The identification of common components of evidence-based programs may help clinicians choose the best intervention methods.     

Shared parenting: A new paradigm for the treatment of child abuse

The thesis of this article is that child abuse can be most effectively prevented by recasting it as a part of a larger problem of inadequately parented families. Services for these families may be offered for voluntary participation. They need not be thought of as treatments since they would be designed to prevent rather than treat injuries. The goal of the services would be to improve the childrearing experiences of children in two ways: by helping their parents to function more effectively and providing whatever elements of parental functioning (nurture, education, discipline, or protection) which the natural parents could not give. The proposed facilities would provide supplemental parenting and other services for children as necessary. Facilities would include outreach into the homes, family drop-in centers, family half-way houses for parents who can take care of their children only with onsite supervision, and residential facilities and foster homes at which natural parents would be encouraged to visit and participate. The majority of child abuses occur when there is stress on parents who are inadequate because they themselves have received deficient parenting. The proposed services would relieve stress on parents. This sharing of parental responsibilities between the natural parents and the sharing parents encountered in the proposed facilities would provide children with more adequate parenting than they could receive from their natural parents alone. This would give them a chance to grow into adequate, nonabusive parents and thus interrupt the generational cycle of abuse.(ABSTRACT TRUNCATED AT 250 WORDS)     

Efficacy of the Incredible Years group parent program with families in Head Start who self-reported a history of child maltreatment

Objective

A prevention form of the Incredible Years (IY) parenting program was offered to parents who had children enrolled in Head Start, regardless of whether they reported having a history of child maltreatment. This study compared whether parenting practices and child behavioral outcomes differed in families who self reported a history of child maltreatment relative to families who did not.

Methods

A site-randomized controlled trial of the IY parenting program was conducted in 64 classrooms in seven Head Start centers in Seattle, Washington. Families of 481 children took part in the study, with 335 in the IY condition and 146 in the control condition. Parenting practices and child behavior were measured by blinded raters through in-home observations and self-report questionnaires prior to the start of the IY program, in the spring after the IY program had concluded, and 12–18 months after study enrollment when children were in kindergarten. Analyses examine the impact of the IY program on parenting practices and children's behavior, exploring whether the program had differential impacts for parents with and without a self-reported history of child maltreatment.

Results

The IY program resulted in improvements along many parenting dimensions and on characteristics of observed child behavior. Program impacts were similar for parents who did and did not report a history of child maltreatment. However, parents with a reported history of prior maltreatment had greater initial room for improvement in areas such as harsh/critical parenting, nurturing/supportive parenting, and discipline competence than parents without such a history.

Conclusions

The IY parenting program has positive impacts for parents who self-reported a history of child maltreatment. While similar benefits were observed for both groups of parents in this study, results support delivering evidence-based parenting programs of longer duration and higher intensity than often used by agencies serving parents in contact with child welfare.

Practice

Agencies serving parents referred for child maltreatment should carefully examine the characteristics of the parenting programs they deliver. Use of a parenting program that has a sound base of empirical support, such as IY, and sufficient intensity and duration, is likely to make substantial changes in parents’ child-rearing practices.     

Promoting effective parenting practices and preventing child behavior problems in school among ethnically diverse families from underserved, urban communities

This study examines the efficacy of ParentCorps among 4-year-old children (N = 171) enrolled in prekindergarten in schools in a large urban school district. ParentCorps includes a series of 13 group sessions for parents and children held at the school during early evening hours and facilitated by teachers and mental health professionals. ParentCorps resulted in significant benefits on effective parenting practices and teacher ratings of child behavior problems in school. Intervention effects were of similar magnitude for families at different levels of risk and for Black and Latino families. The number of sessions attended was related to improvements in parenting. Study findings support investment in and further study of school-based family interventions for children from underserved, urban communities.     

Parental Socioeconomic Status,Communication, and Children's Vocabulary Development: A Third‐Generation Test of the Family Investment Model

This third‐generation, longitudinal study evaluated a family investment perspective on family socioeconomic status (SES), parental investments in children, and child development. The theoretical framework was tested for first‐generation parents (G1), their children (G2), and the children of the second generation (G3). G1 SES was expected to predict clear and responsive parental communication. Parental investments were expected to predict educational attainment and parenting for G2 and vocabulary development for G3. For the 139 families in the study, data were collected when G2 were adolescents and early adults and their oldest biological child (G3) was 3–4 years of age. The results demonstrate the importance of SES and parental investments for the development of children and adolescents across multiple generations.     

Web-based parenting skills to reduce behavior problems following abusive head trauma: A pilot study

Pediatric abusive head trauma causes significant cognitive and behavioral morbidity, yet very few post-acute interventions exist to facilitate long-term recovery. To meet the needs of this vulnerable population, we piloted a web-based intervention with live coaching designed to improve positive parenting and child behavior. The efficacy of this parenting skills intervention was compared with access to Internet resources on brain injury. Participants included seven families (four randomized to the parenting intervention and three randomized to receive Internet resources). Parenting skills were observed and child behavior was rated at baseline and intervention completion. At completion, parents who received the parenting skills intervention showed significantly more positive parenting behaviors and fewer undesirable behaviors during play than parents who received access to Internet resources. Additionally, during play, children in the parenting skills intervention group were more compliant following parent commands than children in the Internet resources group. Lastly, parents who received the parenting intervention reported less intense oppositional and conduct behavior problems in their children post-intervention than did parents in the Internet resources group. These findings provide preliminary evidence for the use of this web-based positive parenting skills intervention to improve parenting skills and child behavior following abusive head trauma.     

National survey of problems and competencies among four- to sixteen-year-olds: parents' reports for normative and clinical samples.

We compared parent-reported problems and competencies for national samples of 2,600 4-16-year-olds assessed at intake into mental health services and 2,600 demographically matched nonreferred children assessed in a home interview survey. Parents responded to the ACQ Behavior Checklist, which includes 23 competence items, three competence scales, 216 problem items, eight syndrome scales, Internalizing, Externalizing, and total competence and problem scores. Most items and scales discriminated significantly (p less than .01) between referred and nonreferred samples. There were important sex and age differences in problem patterns, but regional and ethnic differences were minimal. Somewhat more problems and fewer competencies were reported for lower- than upper-socioeconomic-status children. Referral rates were similar in the most urban and rural areas, but they were significantly higher in areas of intermediate urbanization. Correlations of problem scores with those obtained 10 years earlier in a regional survey and with surveys in other countries showed considerable consistency in the rank order of prevalence rates among specific problems. Apparently owing to its more differentiated response scales, the ACQ was susceptible to respondent characteristics that reduced its discriminative power below that of the Child Behavior Checklist. Comparisons of procedures for discriminating between the normal and the clinical range supported the value of a borderline category for children who are neither clearly normal nor clearly deviant. Interview data from the survey sample yielded significantly higher ACQ problem scores for children who had fewer related adults in their homes, those who had more unrelated adults in their homes, those whose biological parents were unmarried, separated, or divorced, those whose families received public assistance, and those whose household or family members had received mental health services. Children who scored higher on Externalizing than Internalizing problems tended to have unmarried, separated, or divorced parents and to come from families receiving public assistance. However, among children whose household or family members had received mental health services, there were greater proportions of both Externalizing and Internalizing patterns than among other children.     

Re-reporting of child maltreatment: does participation in other public sector services moderate the likelihood of a second maltreatment report?

OBJECTIVE: This study uses administrative data to track the first re-reports of maltreatment in a low-income, urban child welfare population (n=4957) while controlling for other public service involvement. Service system involvement is explored across the following sectors: Child Welfare, Income Maintenance, Special Education, Juvenile Court, and various forms of Medicaid-reimbursed medical or mental health care. This study builds knowledge by adding the services dimension to an ecological framework for analyses and by following recurrence for a longer period of time than prior investigations (7.5 years). METHOD: We model the re-reporting of a child for maltreatment as a function of child, caregiver, service, and neighborhood characteristics using data from birth records, child welfare, income maintenance, Medicaid, adult corrections, juvenile court, special education, law enforcement, and census sources. Bivariate and multivariate analyses are presented, the latter using Cox regression with a robust sandwich covariance matrix estimate to account for the intracluster dependence within tracts. RESULTS: Key results across bivariate and multivariate analyses included a lower rate of re-reporting among children with parents who were high school graduates and/or permanently exited from the first spell on AFDC (p<.0001); and for children in families that received less intensive in-home services compared to those not receiving services, receiving intensive in-home, or foster care services (p<.0001). Higher rates of re-reporting were found for children with Medicaid mental health/substance abuse treatment records (p<.0001) and special education eligibility for emotional disturbance (p<.005). CONCLUSIONS: Caretaker characteristics and non-child welfare service use patterns had a strong association with the likelihood of a child being re-reported to the child welfare agency and should be more heavily attended to by child welfare workers. High rates of service sector overlap suggest that interagency ties and cooperation should be strengthened. The lower risk associated with less intensive in-home services compared to un-served cases may indicate under-identification of in-home service eligibility following a first report of maltreatment.     

Parenting styles of mothers with deaf or hard-of-hearing children and hearing siblings

The present study aims to determine whether rearing a deaf or hard-of-hearing (d/hh) child would differentiate the parenting and disciplinary preference of parents between the d/hh and the hearing child. The parenting styles of 30 hearing mothers from Cyprus were assessed using the Greek version of the Parenting Styles & Dimensions Questionnaire. Additionally, mothers rated sibling interactions using the sibling inventory of behavior. The results indicated that the dominant parenting style for both the hearing and the d/hh children among the participating mothers was the authoritative type and the least prevalent parental types were the permissive and the strict. Moreover, mothers' perceptions of sibling relationship were found to be a significant factor in predicting mothers' reported parenting styles in this sample. The contribution of the present findings to our knowledge of the parenting characteristics and practices of families who have a d/hh child along with their possible implications for child and family services are discussed.     

Predictors of foster parents’ stress and associations to sensitivity in the first year after placement

In Germany, almost 70 000 children are living in foster families (Statistisches Bundesamt, 2016). Many foster children show mental health problems as they were exposed to an accumulation of risk factors. Hence, foster parents are often faced with challenging parenting situations. The current study focuses on the predictors of foster parents’ stress and examines longitudinally whether parenting stress is associated with foster parents’ sensitivity. The sample consisted of 55 children (aged from 1 to 6 years) and their foster caregivers. Foster parents’ sensitivity was observed during home visits. Caregiver reports were used to assess parenting stress (Parenting Stress Index) as well as foster children’s externalizing behavior problems (Child Behavior Checklist). For main caregivers’ stress at the beginning of placement, regression analyses revealed both, foster children’s externalizing problems as well as partners’ stress as predictive. For main caregivers’ stress one year after, only initial parenting stress and partners’ stress were predictive. Foster parents’ sensitivity was correlated with their parenting stress one year after placement. Regression analyses revealed no longitudinal effects of initial parenting stress on overall sensitivity. However, supportive presence was predicted by initial supportive presence and by the interaction between parenting stress and children’s externalizing problems at placement. The findings highlight the role of the partner in experiencing parenting stress when taking care of a foster child. Furthermore, they emphasize that foster parents who care for children with behavior problems need adequate support that can buffer initial parenting stress and thereby promote sensitive caregiving.     

Do Parents Benefit? Perspectives of Low-Income Parents Who Received a Free Early Readiness Program for Their Child

The purpose of this study was to discover the interpretations and perspectives of 4 low-income parents who received a free early readiness program for their child. Two interviewees were parents who had a child enrolled the year data was collected, and the other two interviewees were parents whose children had participated previously in the early readiness program. The results of this study show that the early readiness program offered benefits to the parents as well as the child, regardless of enrollment year. The benefits include, but were not limited to, social support for parents, financial assistance, greater understanding of their children, and practical parenting ideas. The findings of this study supported the value of free early readiness programs for low-income parents. The discussion substantiates the findings of this study with previous research and concludes there were several identifiable benefits for the parents.     

Parent stress and satisfaction with early intervention services for children with disabilities – a longitudinal study from Germany

This study assessed parent–child and family-related stress at two points of time and analysed relationships between stress, child and family characteristics and parent satisfaction with early intervention services. In Germany, 125 parents of young children with intellectual disabilities, hearing impairment or visual impairment responded to a questionnaire. Eighty-seven parents agreed to participate in the second survey. Results indicated that (a) perceived parenting competence is associated with general self-efficacy and satisfaction with professional support, (b) parent–child interactional stress increased with time, specifically in families with children with intellectual disability or visual impairment, (c) the level of satisfaction with amount and quality of family support was low in a considerable subgroup of parents, (d) regression analyses support predictive relationships among parent–child stress, family-related stress, perceived parenting competence and satisfaction with early intervention services.     

Direct and Indirect Effects of Parenting on the Academic Functioning of Young Homeless Children

Research Findings: Effects of parenting quality on the academic functioning of young homeless children were examined using data from 58 children ages 4 to 7 and their parents during their stay at an emergency homeless shelter. Parenting quality, child executive function, child intellectual functioning, and risk status were assessed in the shelter, and teacher reports of academic functioning were obtained when the children began kindergarten or 1st grade. As hypothesized, parenting quality was associated with children's academic success, and this effect was mediated by executive function skills in the child. Parenting quality also had a moderating effect on risk, consistent with a protective role of high-quality parenting among children with higher risk levels. Concomitantly, children with higher risk and lower parenting quality appeared to be more vulnerable to academic problems. Practice or Policy: In homeless families, parenting may play an especially important role in academic success through multiple pathways, including the development of executive function skills in their children. Policies and practices to support parents and foster the executive function skills of young children in homeless families may be important strategies to promote child academic success. Implications for intervention efforts with homeless parents and children are discussed.     

The role of mental health professionals contributes to mental health promotion and prevention: innovative programmes in Serbia

It has been estimated that 9 to 13% of children and adolescents have a mental disorder that causes significant functioning impairment and that only one fifth of those who need mental health services actually receive them. The majority of children and adolescents are enrolled in schools, where they spend a considerable amount of time, and this is followed by the increasing efforts to establish collaboration between mental health professionals and school personnel. The role of mental health professionals is crucial in improving children’s mental health, as well as for providing better response to parents, educational staff and other agencies. There are several ways for a child psychiatrist to reach children and adolescents in a school setting: through individual student consultations (case consultations), through consultations to schools on general mental issues (systems consultations) and through promotion of mental health by creating and demonstrating evidence-based programmes for children, parents, school staff and others who are involved in child’s care. In order to achieve these goals, we need to establish partnerships and to define roles among organisations and individuals in the wider school environment, such as schools and school management, municipal authorities and administration, media, police, social welfare centres, health centres, parents and youth associations.     

Impact of a statewide home visiting program on parenting and on child health and development

OBJECTIVES: To assess the impact of a voluntary, paraprofessional home visiting program on promoting child health and development and maternal parenting knowledge, attitudes, and behaviors. METHODS: This collaborative, experimental study of 6 Healthy Families Alaska (HFAK) programs enrolled 325 families from 1/00 to 7/01, randomly assigned them to HFAK and control groups, interviewed mothers at baseline, and followed families until children were 2 years old (85% follow-up). Child outcomes included health care use, development and behavior. Parent outcomes included knowledge of infant development, parenting attitudes, quality of the home environment, and parent-child interaction. HFAK records were reviewed to measure home visiting services. Home visitors were surveyed to measure knowledge, perceived effectiveness and perceived training adequacy. RESULTS: There was no overall impact on child health, but HFAK group children had more favorable developmental and behavioral outcomes. HFAK and control mothers had similar parenting outcomes except that HFAK mothers had greater parenting self-efficacy (35.1 vs. 34.6 based on the Teti Self-Efficacy Scale, p<.05). Fewer HFAK families had a poor home environment for learning (20% vs. 31%, p<.001). HFAK families were more likely to use center-based parenting services (48% vs. 39%, p<.05). The impact was greater for families with lower baseline risk (Family Stress Checklist scores<45). There was little evidence of efficacy for families with a higher dose of service. CONCLUSIONS: The program promoted child development and reduced problem behaviors at 2 years. Impact could be strengthened by improving home visitor effectiveness in promoting effective parenting. Future research is needed to determine whether short-term benefits are sustained.     

Fatal and non-fatal child maltreatment in the US: An analysis of child,caregiver, and service utilization with the National Child Abuse and Neglect Data Set

The purpose of this study was to compare children who are fatally and non-fatally maltreated in the United States. In this first national-comparison study, we used the Child Abuse and Neglect Data Set of children and families who encounter/receive support from child welfare services. We found that children who were fatally maltreated were younger, were more likely to live with both their parents, and that their families experienced more financial and housing instability compared to non-fatally maltreated children. Overall, families in which children die use/receive fewer social services, as compared to families in which children live. We discuss the results with regard to child welfare practice and research.     

Mothers in methadone treatment and their involvement with the child protection system: A replication and extension study

Objectives

Although a high level of involvement with the child protection system has been identified in families where parental substance use is a feature, not all such parents abuse or neglect their children or have contact with the child protection system. Identifying parents with substance-use histories who are able to care for their children without intervention by the child protection system, and being able to target interventions to the families who need them the most is important. This study interviewed a relatively large sample of mothers about their histories, their children and their involvement with the child protection system. We hypothesized that mothers in opioid pharmacological treatment who are involved with child protection services are different in characteristics to those mothers who are not involved.

Methods

One hundred and seventy-one women, with at least one child aged under 16 years, were interviewed at nine treatment clinics providing pharmacological treatment for opioid dependence across Sydney, Australia.

Results

Just over one-third of the women were involved with child protection services at the time of interview, mostly with children in out-of-home care. Logistic regression analyses revealed that factors which significantly increased the likelihood of the mother being involved with the child protection system were: (1) having a greater number of children, (2) being on psychiatric medication, and (3) having less than daily contact with her own parents.

Conclusions

This study replicates and extends the work of Grella, Hser, and Huang (2006) and the limited literature published to date examining the factors which contribute to some substance-using mothers becoming involved with the child protection system while others do not. The finding that mental health problems and parental supports (along with the number of children) were significantly associated with child protection system involvement in this study, indicates a need for improved interventions and the provision of treatment and support services if we are to reduce the involvement of the child protection system with these families.