Reference Catalog

A Multi-Component Intervention to Prevent Child Maltreatment: Long-term Effects on Parenting and Child Functioning

Elizabeth M. Demeusy

• Other Models

The Building Healthy Children (BHC) home visiting program was designed to provide concrete support and evidence-based intervention to young mothers and their infants who were at heightened risk for child maltreatment and poor developmental outcomes. BHC flexibly delivers three evidence-based treatment models based on individual need in conjunction with continuous outreach support. These models addressed parenting (Parents as Teachers), attachment (Child-Parent Psychotherapy), and maternal depression (Interpersonal Psychotherapy for Depressed Adolescents). The current study utilized a longitudinal follow-up design to examine the long-term effects of BHC on parenting and child behavior in elementary school. In the current study, child maltreatment and parenting practices were assessed using the Conflict Tactics Scales: Parent–Child Version and Parenting Practices Interview. Child externalizing behavior and self-regulation were assessed using both parent and teacher report on the Child Behavior Checklist/Teacher Report Form (CBCL/TRF 6-18), the Behavior Rating Inventory of Executive Function (BRIEF-2), and the Emotion Regulation Checklist. Maternal social support and parent-child relationship quality were also examined as potential mechanisms of change. Data for these mediators was collected during the original study using the Parenting Stress Index, Attachment Q-sort, Maternal Behavior Qsort, and Social Support Behaviors Scale. Follow-up data was collected from 87 mothers/caregivers and 69 teachers. Main effects of the intervention on outcome variables of interest were analyzed using independent sample T-tests. Compared to the comparison condition, findings indicated that BHC intervention mothers exhibited less harsh and inconsistent parenting, and marginally less psychological aggression towards their children at follow-up. Interestingly, there were no significant intervention effects on positive parenting. BHC intervention children also exhibited less externalizing behavior and self-regulatory problems at follow-up, across parent and teacher report. Finally, there were no significant effects of the intervention on maternal social support or parent-child relationship quality, indicating that these were not the mechanisms responsible for change in this intervention. When delivered during infancy and early childhood, this program is effective in preventing negative parenting practices and the onset of child behavior problems in later childhood. Findings highlight the importance of an adaptive model of home visitation that addresses multiple determinants of parenting and child psychopathology. (author abstract)

Finished

• Participant, Family, and Program Outcomes