Group-based parent-training programmes for improving emotional and behavioural adjustment in children from birth to three years old

 

Abstract

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.

Objectives

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.

Search 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.

Selection criteria

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

Data collection and analysis

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.

Main 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).

Authors' 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.

 

Plain language summary

Group-based parent-training programmes for improving emotional and behavioural adjustment in children age three and under

Parenting practices play a significant role in the development of emotional and behavioural problems in children, and parenting programmes aimed at the parents of infants and toddlers have the potential to prevent the occurrence of such problems. 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. The evidence concerning the long-term effects of improvements is inconclusive. It may be that during this period of rapid development, input at a later date is required. More research is needed to address this question.

 

摘要

背景

增進0至3歲孩童情緒及行為適應之團體為基礎的父母訓練計畫

孩童的情緒與行為問題是常見的。研究顯示，父母的教導對幫助孩子適應扮演了重要的角色，而在孩子生命當中最早的幾個月和幾年，在建立情緒、認知以及社會功能的模式上又是特別重要，因為其將會影響孩子未來的發展，特別是他們的心智健康。親職教養計畫因此在增進嬰孩與幼兒的情緒及行為適應上扮演了重要的角色。

目標

這個回顧文獻的目標如下：第一，証實以團體為基礎的親職教育計畫，對於增進三歲以下孩童的情緒及行為適應是否有效。第二：評估親職教養計畫在初級預防情緒與行為問題上的角色。

搜尋策略

我們搜尋了關於生物醫學及社會科學的資料庫，包括了MEDLINE, EMBASE, CINAHL, PsychLIT, Sociofile, Social Science Citation Index, ASSIA, the Cochrane Library包括了 SPECTR, CENTRAL, National Research Register (NRR), ERIC。

選擇標準

我們只納入以團體為基礎的親職教育計畫的隨機控制試驗研究，而研究中至少使用一種標準化的工具去評估情緒及行為的適應。

資料收集與分析

每個研究中的結果以95% 的信賴區間方式報告。適當的結果以隨機效果的模式結合在統合分析當中。

主要結論

此回顧文獻包含了五個研究，而這五個研究在統合分析中有足夠的資料可以結合其結果。統合分析的執行包括父母的報告以及獨立評估孩子的行為。父母報告的結果顯示出沒有統計顯著的結果認為接受治療介入的組較佳 (ES −0.29, CI −0.55 to 0.02) 。對於獨立觀察孩子行為方面的結果顯示接受治療介入的組有較好的結果 (ES −0.54, CI −0.84 to −0.23) 。有限而可得的追蹤資料的統合分析顯示出小的但無顯著的差異認為接受治療介入的組有較好的結果 (ES −0.24, CI −0.56 to 0.09) 。

作者結論

本回顧的發現支持以團體為基礎的親職教養計畫可以增進三歲以下孩童的情緒及行為適應。然而，關於這個計畫或許扮演了預防這些問題的角色上，仍沒有足夠的証據可以下結論。此外，關於這些計畫課程長期的有效性方面，可得的資料是有限的，而從兩個可得的研究中所得到的結果表現出在邊緣而未有顯著結果。需要更進一步的研究。

翻譯人

本摘要由成功大學附設醫院謝佩君翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

親職的教養在孩子的情緒及行為問題上的發展扮演了相當重要的角色，因此目標放在那些嬰幼兒的父母身上的親職計畫也可預防這些問題的發生。這個回顧文獻的結果發現，使用以團體為基礎的親職訓練計畫，對於增進三歲以下孩童的情緒及行為適應是有效的。然而，關於這個結果可延申的部份可得的証據有限，而且是無定論的，可能是由於在這一段時期內嬰孩的發展變化是快速的，需要更進一步的資料。在這個本質的問題能被回答之前需要的是更多的研究。