TABLE 5

General Behavioral Development Interventions: Results and Levels of Evidence

Intervention, ReferenceStudy DesignSample Size, LocationAge, Specific PopulationLevels of EvidenceEffect
Child OutcomesParent Outcomes
IY, Reedtz et al35RCTN = 186, Tromso, Norway2–8 y1Decrease in behavior intensity (ECBI-IS) immediately after intervention, no difference at 12 mo postinterventionReduced use of harsh discipline (PPI), improved positive parenting (PPI), parent satisfaction at 12 mo postintervention
Mean age: 3.9 y
High behavioral intensity
No difference in parenting self-efficacy (PSOC)
IY, Perrin et al36RCT and direct assignmentN = 173, Greater Boston area, United States2–4 y1Reduced behavior problems and intensity (ECBI-IS) at 6 and 12 mo postinterventionReduced observed negative parent-child interaction–supportiveness/nurturing (DPICS-R) and reduced self-reported negative parenting (PS) at 12 mo
Poor social-emotional development
No difference in observed disruptive behavior (DPICS-R)No difference in observed negative parenting–parent negativity/hostility (DPICS-R) at 12 mo postintervention
Triple P level 2 & 3, McConnell et al37Quasi-experimentalN = 923, Alberta, CanadaBirth–11 y, mean age: 2.8 y2None reportedNo significant difference in personal distress or child rearing distress (PSI-SF), or family functioning (NLSCY) at 8–12 wk postintervention
Triple P level 3, Turner and Sanders38RCTN = 30, Brisbane, Australia2–6 y, mean age: 3.3 y1Reduced behavior problems (PDR, ECBI-PS, HCPC), intensity (ECBI-IS) at 6 mo postinterventionImproved discipline style (PS) and satisfaction (PSOC) at 6 mo postintervention
Family requesting adviceNo difference in child disruptive behavior (FOS)No difference in parent self-efficacy (PCOS), positive parenting (FOS), maternal depression, anxiety, or stress (DASS)
Triple P level 3, McCormick et al39RCTN = 101, Seattle, WA1.5–12 y1No difference in child behavior (CBCL) at 3 mo postintervention.No difference in discipline (CDS), parent satisfaction or self-efficacy (PCOS) at 3 mo postintervention
Mean age: 4.8 y
Triple P level 4, Leung et al40RCTN = 69, Hong Kong, China3–7 y1Improved behavior problems (PDR, ECBI-PS), intensity (ECBI-IS), conduct, emotion, hyperactivity, and peer interactions (SDQ) immediately after interventionImproved self-reported discipline style (PS), parent satisfaction, self-efficacy (PCOS), and marital health (RQI) immediately after intervention
Mean age: 4.2 y
Triple P level 4, Leung et al41Cohort studyN = 480, Hong Kong, China3 y old low income families, child behavior problem3Improved behavioral intensity (ECBI) immediately postinterventionImproved parental satisfaction, self-efficacy (PSOC), decreased parenting stress (PSI) and depression, anxiety or stress symptoms (DASS) immediately postintervention
Triple P level 4, Zubrick et al42Quasi-experimentalN = 1610, Western Australia36–48 mo2Improved behavior intensity (ECBI-IS) at 12 and 24 mo postinterventionImproved self-reported discipline style (PS), mental health (DASS), parental conflict due to parenting (PPC), and marital health (ADAS) at 12 and 24 mo postintervention
Mean age: 45 mo
Triple P level 4 and 5, Sanders et al43,444 arm RCT No control beyond 15 wkN = 305, Brisbane, Australia36–48 mo2Improved disruptive behavior (PDR) and behavioral intensity (ECBI) at 12 mo and 3 y postintervention. No difference between treatment groupsImproved parent competence (PCOS), discipline (PS), and marital conflict at 3 y. No difference at 12 mo postintervention
Mean age: 41 mo
Low income families, high behavioral intensityNo difference in depression, anxiety, or stress (DASS) for mothers or fathers at 12 mo postintervention
Triple P level 4 and 5, Cann et al45Cohort studyN = 589, Melbourne, Australia1–15 y, mean age: 4.5 y3Improved behavioral intensity and reduced behavior problems (ECBI) immediately postintervention.Reduction in dysfunctional parental styles (PS), improved parental satisfaction and self-efficacy (PCOS), improved depression, anxiety, and stress symptoms (DASS) immediately postintervention
Parent-child interaction theory, Berkovits et al46RCTN = 30, Gainesville, FL3–6 y1Improved behavior intensity (ECBI-IS) at 6 mo postinterventionImproved self-reported confidence (PLOC-SF) and discipline style (PS) at 6 mo postintervention.
Universal parenting program/toddlers without tears, Hiscock et al,47 Bayer et al48Cluster RCTN = 733, Melbourne, Australia8 mo1No difference in externalizing or internalizing behaviors (CBCL) at 10, 16, or 28 mo of ageDecreased unreasonable expectations (PBC) at 16 and 28 mo. Decreased harsh discipline (PBC) at 16 mo, but not at 28 mo of age
No difference in nurturing behaviors (PBC), maternal depression, anxiety, or stress (DASS)
Webster-Stratton, Patterson et al,49 Stewart-Brown et al50RCTN = 116, Oxford, England2–8 y1Decreased behavior and conduct problems (SDQ) at 6 mo, but not at 12 mo postintervention. No difference in behavior intensity (ECBI-IS), emotion, hyperactivity, or peer interactionReduction in depressive symptoms (GHQ) at 12 mo postintervention
Mean age: 4.6 y
Child behavior problemNo difference in total mental health scores (GHQ) or parenting stress (PSI)
Family Foundation, Feinberg et al51RCT Intention to TreatN = 399, United StatesBirth to 10 mo middle class, mostly white1Improved parent reported soothability, decreased night waking at 10 mo of ageImproved positive coparenting and communication (observed), and quality of marriage (QMI), decreased depression (CES-D) and anxiety symptoms (PSWQ) at 10 mo of age
ezParent, Breitenstein et al52RCTN = 79, Chicago, IL2–5 y low-income families, mostly African American or Latino1No difference in child behavior (ECBI) at 6 mo postinterventionNo difference in parenting behavior (PQ), self-efficacy (TCQ), or stress (PSI-SF) at 6 mo postintervention
PriCARE, Schilling et al53RCTN = 120, Philadelphia, PA2–6 y1Decreased behavior problems (ECBI) at 7 wk post interventionIncreased parental empathy (AAPI2) and decreased harsh discipline at 7 wk postintervention
Mean age: 4.3 y
Low income, child behavior problem
  • AAIP2, Adult Adolescent Parenting Inventory – 2; ADAS, Abbreviated Dyadic adjustment scale; CDS, Child Discipline Survey; CES-D, Center for Epidemiologic Studies-Depression Scale; DASS, Depression-Anxiety-Stress Scale; DPICS-R, Dyadic Parent-Child Interactive Coding System–Revised; ECBI-IS, Eyberg Child Behavior Inventory-Intensity Scale; ECBI-PS, Eyberg Child Behavior Inventory-Problem Scale; FOS, Family Observation Schedule; GHQ, General Health Questionnaire; HCPC, Home and Community Problem Checklist; NLSCY, National Longitudinal Survey of Children and Youth; PBC, Parent Behavior Checklist; PDR, Parent Daily Report; PLOC-SF, Parenting Locus of Control Short Form; PPC, Parent Problem Checklist; PPI, Parenting Practices Interview; PQ, Parenting Questionnaire; PS, Parenting Scale; PSI, Parenting Stress Index; PSI-SF, Parenting Stress Index Short Form; PSOC, Parenting Sense of Competence; PSWQ, Penn State Worry Questionnaire; QMI, Quality of Marriage Index; RQI, Relationship Quality Index; SDQ, Strength and Difficulty Scale; TCQ, Toddler Care Questionnaire.