Group-based parent-training programmes for improving emotional and behavioural adjustment in children from birth to three years old.
BACKGROUND
Emotional and behavioural problems in children are common. Research suggests that parenting has an important role to play in helping children to become well-adjusted, and that the first few months and years are especially important. Parenting programmes may have a role to play in improving the emotional and behavioural adjustment of infants and toddlers. This review is applicable to parents and carers of children up to three years eleven months although some studies included children up to five years old.


OBJECTIVE
To:a) establish whether group-based parenting programmes are effective in improving the emotional and behavioural adjustment of children three years of age or less (i.e. maximum mean age of 3 years 11 months); b) assess the role of parenting programmes in the primary prevention of emotional and behavioural problems.


METHODS
We searched CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, Sociofile, Social Science Citation Index, ASSIA, National Research Register (NRR) and ERIC. The searches were originally run in 2000 and then updated in 2007/8.


METHODS
Randomised controlled trials of group-based parenting programmes that had used at least one standardised instrument to measure emotional and behavioural adjustment.


METHODS
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-effects model.


RESULTS
Eight studies were included in the review. There were sufficient data from six studies to combine the results in a meta-analysis for parent-reports and from three studies to combine the results for independent assessments of children's behaviour post-intervention. There was in addition, sufficient information from three studies to conduct a meta-analysis of both parent-report and independent follow-up data. Both parent-report (SMD -0.25; CI -0.45 to -0.06), and independent observations (SMD -0.54; CI -0.84 to -0.23) of children's behaviour produce significant results favouring the intervention group post-intervention. A meta-analysis of follow-up data indicates a significant result favouring the intervention group for parent-reports (SMD -0.28; CI -0.51 to -0.04) but a non-significant result favouring the intervention group for independent observations (SMD -0.19; CI -0.42, 0.05).


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 with a maximum mean age of three years eleven months. There is, insufficient evidence to reach firm conclusions regarding the role that such programmes might play in the primary prevention of such problems. There are also limited data available concerning the long-term effectiveness of these programmes. Further research is needed.
Health Sciences Research Unit, Warwick Medical School, University of Warwick, Gibbett Hill Road, Coventry, UK, CV4 7AL.
Jane
J
Barlow
Nadja
N
Smailagic
Michael
M
Ferriter
Cathy
C
Bennett
Hannah
H
Jones
D002653:Child Behavior Disorders / Q000517:prevention & control*; 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