Abstract
Based on evidence that early antisocial behavior is a key risk factor for delinquency and crime throughout the life course, early family/parent training, among its many functions, has been advanced as an important intervention/prevention effort. There are several theories concerning why early family/parent training may cause a reduction in child behavior problems including antisocial behavior and delinquency (and have other ancillary benefits in non-crime domains over the life course). The prevention of behavior problems is one of the many objectives of early family/parent training, and it comprises the main focus of this review. Results indicate that early family/parent training is an effective intervention for reducing behavior problems among young children, and the weighted effect size was 0.35. The results from a series of analog to the analysis of variance (ANOVA) and weighted least squares regression models (with random effects) demonstrated that there were significant differences in the effect sizes of studies conducted in the USA versus those conducted in other countries and that studies that were based on samples smaller than 100 children had larger effect sizes. Sample size was also the strongest predictor of the variation in the effect sizes. Additional evidence indicated that early family/parent training was also effective in reducing delinquency and crime in later adolescence and adulthood. Overall, the findings lend support for the continued use of early family/parent training to prevent behavior problems. Future research should test the main theories of early family/parent training and detail more explicitly the causal mechanisms by which early family/parent training reduces delinquency and crime, and future evaluations should employ high quality designs with long-term follow-ups, including repeated measures of antisocial behavior, delinquency, and crime over the life course.
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Notes
It is useful to define what parent training is and is not. There are two general subcategories that deal with prevention programs for early childhood, based on their general approach (Greenwood 2006: 52). The first, home visitation, includes those programs for mothers with infants, with or without additional services. According to Greenwood (2006: 52), these programs “work with at-risk mothers to improve their prenatal health status, reduce birth complications, and provide guidance and support in caring for the infant and improving the quality of their own lives. Programs differ in how they identify at-risk mothers, when the home visits begin and end, who the visitors are, what the visits cover, and what other services are provided.” The main goal of home visiting programs centers on educating parents to improve the life chances of infants and children. According to Farrington and Welsh (2007: 123), “Some of the main goals include the prevention of preterm or low-weight births, the promotion of healthy child development or school readiness, and the prevention of child abuse and neglect. Home visits very often also serve to improve parental well-being, linking parents to community resources to help with employment, educational, or addiction recovery.” The second subcategory includes those programs that combine parent training, daycare, and preschool for parents with preschool children. According to Greenwood (2006: 54), these programs “attempt to advance cognitive and social development of the children, as well as the parenting skills of their caregivers, so that participants will be better prepared and more successful when they enter regular school. Some programs include home visits as well.” According to Farrington and Welsh (2007: 125), “[D]aycare programs are distinguished from preschool programs, in that the daycare programs are not focused on the child’s intellectual enrichment or necessarily on readying the child for kindergarten and elementary school, but serve largely as an organized form of daycare to allow for parents (especially mothers) to return to work. Daycare also provides children with a number of important benefits, including social interaction with other children and stimulation of their cognitive, sensory, and motor control skills.” Another set of programs within this subcategory include parent management training programs, which refer to treatment procedures in which parents are trained to alter their child’s behavior at home (Farrington and Welsh 2007: 126). Many are based on the behavioral parent management training theory of Patterson (1982).
Those authors did not conduct an exhaustive review, as they did not search major abstracting services such as PSYCHINFO, which would have, using general search terms, identified a great many more studies than they likely identified through their process.
Specifically, the family and family factors were the focus of the intervention, and programs that targeted only the child were excluded from their review.
Several reasons could account for these findings, including the heterogeneity in the definition of parent training, the absence of evidence regarding which components of parent training were most effective, the small number of findings, the lack of consistency in outcomes (delinquency) assessed, which intervention components were most important, which parents were more likely to benefit from the intervention, how long it should last, and whether parent training should be combined with other interventions (pp. 28-29).
Greenwood also reviewed programs for elementary-school-age children, two of which included young children aged 5-10 years (FAST TRACK, which adopts social skills and parent training, home visits, tutoring, and behavior management) and 3-8 years (The Incredible Years, which adopts parent training and behavior management), respectively. Greenwood identifies each as a program that ‘works’
Greenwood (2006: 82) notes that, while the positive effects do not appear when the nurses are absent from the program implementation, NFP is being replicated in more than 60 sites and has been evaluated in three randomized trials. Expansion of the program must follow a very strict set of guidelines and protocols. Further, a competitor of NFP, Healthy Families America (HFA) is seeking to expand home visitation services in the USA.
The majority of the studies included in this meta-analysis utilized some type of parent training program, which typically involved either individual or group-based parent training sessions that were conducted in a clinic, the school, or some other type of community-based site, and the main parenting intervention programs were the Incredible Years Parenting Program, the Triple P-Positive Parenting Program, and parent–child interaction therapy. Comparatively, the home visitation studies typically involved health professionals, such as nurses or doctors, or paraprofessionals that visited the mothers and gave them advice about how to manage their child’s behavior effectively. All the early family/parent training interventions (as defined) in these studies had begun prior to childbirth or early in infancy.
We certainly recognize that studies are likely to vary in how they operationalize and report child behavior problems; however, in order to provide a more general portrait of the totality of the effects, we opted to rely on self-report measures from a variety of psychometric indexes that are commonly used in studies such as these [e.g., child behavior checklist (CBCL) and Eyberg child behavior inventory (ECBI)]. Yet, a note of caution is needed here. We also acknowledge that particular indexes are often reported as a total behavioral measure (e.g., include internalizing and externalizing behaviors) and that less frequently do the studies themselves disaggregate their child behavior construct (i.e., report separate effects for externalizing, internalizing, aggression, hostility, etc.). Ultimately, we decided to utilize the overall behavioral measure, since we were primarily concerned with the totality of the effects. Nevertheless, we call for future research on this issue in order to partial out the possible variation in the effects of early family/parent training programs on certain dimensions and subscales within the larger construct of child behavior problems, including delinquency and antisocial behavior.
The key words included: “parent training” and “childhood” or “pre-school” and “delinquency” or “conduct disorder” or “antisocial behavior” or “aggression” or “physical aggression” or “behavior problems”, and “family training” and “childhood” or “pre-school” and “delinquency” or “conduct disorder” or “antisocial behavior” or “aggression” or “physical aggression” or “behavior problems”.
The databases included: Criminal Justice Periodical Index, Criminal Justice Abstracts, National Criminal Justice Reference Services (NCJRS) Abstracts, Sociological Abstracts, Social Science Abstracts (SocialSciAbs), Social Science Citation Index, Dissertation Abstracts, Government Publications Office, Monthly Catalog (GPO Monthly), PsychINFO, C2 SPECTR (The Campbell Collaboration Social, Psychological, Educational and Criminological Trials Register), Australian Criminology Database (CINCH), MEDLINE, Web of Knowledge, IBSS (International Bibliography of the Social Sciences, and Future of Children (publications).
These journals included: Criminology, Criminology and Public Policy, Justice Quarterly, Journal of Research in Crime and Delinquency, Journal of Criminal Justice, Police Quarterly, Policing, Police Practice and Research, British Journal of Criminology, Journal of Quantitative Criminology, Crime and Delinquency, Journal of Criminal Law and Criminology, Policing and Society, as well as psychology/psychiatry journals, including, among others, Child Development.
The groups and agencies included: Washington State Institute for Public Policy, Institute for Law and Justice, Vera Institute for Justice, Rand Corporation, The Home Office (UK), Australian Institute of Criminology, Swedish National Council for Crime Prevention, Cochrane Library, Substance Abuse and Mental Health Services Administration (SAMSHA), Institute of Medicine, American Psychiatric Association, Office of Juvenile Justice and Delinquency Prevention (OJJDP), Youth Justice Board, Department of Health and Department of Children, Schools, and Families (UK), National Institute for Health and Clinical Excellence (NICE), UK, and National Children’s Bureau (which publishes ‘Child Data Abstracts’).
Another possible way to pool ESs across interventions that use multiple groups who receive variations of the treatment is to average the mean and variance pooled across the treatment groups and compare this pooled mean and variance with the control group, as opposed to generating independent ESs for each treatment group compared with the control group and then averaging these effect sizes. We recalculated the single study ESs using this alternative procedure, and the results were substantively similar to those presented in the text.
While studies do not always report actual percentages of dropouts and the specific reasons for attrition (e.g., death, dropout, loss of contact), we still estimated the correlation between dropout rates and ES, based on subtracting the sample size that provided data after assessment from the original sample size reported at the onset of the program and divided this difference by the original sample size. According to estimates derived from Lipsey and Wilson’s (2001) meta-analysis regression macro, the correlation between dropout rates and ES was positive (r = 0.12), indicating that studies having larger attrition tended to have larger ESs; however, the correlation was non-significant (P = 0.31).
The sample sizes of the studies in this review ranged from a low of 11 (Zangwill 1983) to a high of 870 (McCarton et al. 1997). On average, the sample size was 137 [standard deviation ((SD) = 184.15], and a little over a third of the studies had sample sizes of fewer than 50, and 10% of the studies had samples > n = 25.
The one study with the worst effect size (−0.97) was by Helfenbaum-Kun and Ortiz (2007), but it is worth noting that this effect was only based on the fathers’ reports, because there was not enough information on how many mothers had participated in providing data for the child outcome measures.
In order to determine if any outliers were having a substantial impact on the mean ES, we removed the three outliers that had individual ESs greater than two standard deviations from the mean ES and re-estimated the mean ES with the remaining 52 studies. Since the mean ES after we had removed the outliers was reduced to 0.32 (ci = 0.24–0.40), we retained the outliers, since they did not appear to have had a large effect on the mean ES.
The correlations were based on the regression coefficient estimated with Lipsey and Wilson’s SPSS meta-analysis regression macro using a single predictor.
It is important to note here that, while our overall ES generated per study was based on one ES per study, in this particular portion of the analysis we performed a moderator analysis of source (reports by parents, teachers, and direct observers) and included only one effect size per dataset in each category of the moderator variable (that is, only one effect based on parents’ report, etc.) but allowed a study to provide an ES to more than one category when available (that is, we included both a parent and teacher report from the same study). Performing the analysis in this fashion estimates the bias in the test of the difference across the mean ESs in a known direction, e.g., the P value will be somewhat too big. Thus, if a statistically significant effect is found, then there is confidence that a ‘correctly’ estimated model would have also been significant.
Separate weighted least squares regression models (with random effects) were also estimated for the small and large sample studies. These findings failed to reveal anything different from what had already been demonstrated in the full sample model (i.e., the marginal significance of being a US-based study).
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Support for this project was made possible by the Campbell Collaboration and the Swedish National Council for Crime Prevention (BRA).
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Piquero, A.R., Farrington, D.P., Welsh, B.C. et al. Effects of early family/parent training programs on antisocial behavior and delinquency. J Exp Criminol 5, 83–120 (2009). https://doi.org/10.1007/s11292-009-9072-x
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DOI: https://doi.org/10.1007/s11292-009-9072-x