Group-based parent-training programmes for improving emotional and behavioural adjustment in 0-3 year old children.
BACKGROUND
Emotional and behavioural problems in children are common. Research suggests that parenting has an important role to play in helping children to become adjusted, and that the first few months and years of a child's life are especially important in establishing patterns of emotional, cognitive and social functioning which will in turn influence the child's future development and in particular, their mental health. Parenting programmes may therefore have a role to play in improving the emotional and behavioural adjustment of infants and toddlers.


OBJECTIVE
The objectives of this review are as follows: a) To establish whether group-based parenting programmes are effective in improving the emotional and behavioural adjustment of children less than three years of age b) To assess the role of parenting programmes in the primary prevention of emotional and behavioural problems.


METHODS
A range of biomedical and social science databases were searched including MEDLINE, EMBASE, CINAHL, PsychLIT, Sociofile, Social Science Citation Index, ASSIA, the Cochrane Library including SPECTR, CENTRAL, National Research Register (NRR) and ERIC.


METHODS
Only randomised controlled trials of group based parenting programmes were included, and studies that had used at least one standardised instrument to measure emotional and behavioural adjustment.


METHODS
The treatment effect for each outcome in each study was standardised by dividing the mean difference in post-intervention scores for the intervention and treatment group by the pooled standard deviation, to obtain an effect size. The results for each outcome in each study have been presented, with 95% confidence intervals. Where appropriate the results have been combined in a meta-analysis using a random effect model.


RESULTS
Five studies were included in the review, and there was sufficient data from five studies to combine the results in a meta-analysis. Meta-analyses were conducted for both parent-reports and independent assessments of children's behaviour. The result for parent reports shows a non-significant result favouring the intervention group (ES -0.5, CI -1.06 to 0.08). The result for independent observations of children's behaviour shows a significant result favouring the intervention group (ES -0.54, CI -0.84 to -0.23). A meta-analysis of the limited follow-up data available shows a small non-significant result favouring the intervention group (ES -0.24, CI -0.56 to 0.09).


CONCLUSIONS
The findings of this review provide some support for the use of group-based parenting programmes to improve the emotional and behavioural adjustment of children under the age of 3 years. There is, however, insufficient evidence to reach any firm conclusions regarding the role that such programmes might play in the primary prevention of such problems. Furthermore, there is limited data available concerning the long-term effectiveness of these programmes, and the results from the two studies for which data was available produced borderline insignificant findings. Further research is required.
Barlow
J
J
Health Services Research Unit, University of Oxford, Institute of Health Sciences, Old Road, Headington, Oxford, UK, OX3 7LF. jane.barlow@dphpc.ox.ac.uk
Parsons
J
J
D002657:Child Development; D002668:Child Rearing; D002675:Child, Preschool; D004644:Emotions; D006801:Humans; D007223:Infant; D018730:Infant Behavior; D007231:Infant, Newborn; D008603:Mental Health; D016487:Parenting; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic