The last few years have seen a steady increase in research addressing the potential influence of fathers on their children's development. There has also been a clearer acknowledgement of the need to study families as a complex system, rather than just focusing on individual aspects of functioning in one or other parent. Increased father involvement and more engaged styles of father-infant interactions are associated with more positive outcomes for children. Studies of paternal depression and other psychopathology have begun to elucidate some of the key mechanisms by which fathers can influence their children's development. These lessons are now being incorporated into thinking about engaging both mothers and fathers in effective interventions to optimise their children's health and development.

Behavior problems are one of the most common mental health disorders in childhood and can undermine children's health, education, and employment outcomes into adulthood. There are few effective interventions for early childhood. OBJECTIVE To test the clinical effectiveness of a brief parenting intervention, the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD), in reducing behavior problems in children aged 12 to 36 months. DESIGN, SETTING, AND PARTICIPANTS The Healthy Start, Happy Start study was a 2-group, parallel-group, researcher-blind, multisite randomized clinical trial conducted via health visiting services in 6 National Health Service trusts in England. Baseline and 5-month follow-up data were collected between July 30, 2015, and April 27, 2018. Of 818 eligible families, 227 declined to participate, and 300 were randomized into the trial. Target participants were caregivers of children who scored in the top 20% for behavior problems on the Strengths and Difficulties Questionnaire. Participants were randomly allocated on a 1:1 basis to receive either VIPP-SD (n = 151) or usual care (n = 149), stratified by site and number of participating caregivers. Analysis was performed on an intention-to-treat basis. Statistical analysis was performed from September 5, 2019, to January 17, 2020. INTERVENTIONS All families continued to access usual care. Families allocated to VIPP-SD were offered 6 home-based video-feedback sessions of 1 to 2 hours' duration every 2 weeks. MAIN OUTCOMES AND MEASURES The primary outcome was the score on an early childhood version of the Preschool Parental Account of Children's Symptoms, a semistructured interview of behavior symptoms, at 5 months after randomization. Secondary outcomes included caregiver-reported behavior problems on the Child Behavior Checklist and the Strengths and Difficulties Questionnaire. RESULTS Among 300 participating children (163 boys [54%]; mean [SD] age, 23.0 [6.7] months), primary outcome data were available for 140 of 151 VIPP-SD participants (93%) and 146 of 149 usual care participants (98%). There was a mean difference in the total Preschool Parental Account of Children's Symptoms score of 2.03 (95% CI, 0.06-4.01; P = .04; Cohen d = 0.20 [95% CI, 0.01-0.40]) between trial groups, with fewer behavior problems in the VIPP-SD group, particularly conduct symptoms (mean difference, 1.61 [95% CI, 0.44-2.78]; P = .007; d = 0.30 [95% CI, 0.08-0.51]). Other child behavior outcomes showed similar evidence favoring VIPP-SD. No treatment or trial-related adverse events were reported. CONCLUSIONS AND RELEVANCE This study found that VIPP-SD was effective in reducing symptoms of early behavior problems in young children when delivered in a routine health service context.

Young children in communities facing socioeconomic disadvantage are increasingly targeted by school readiness interventions. Interventions are stronger if they address stakeholders' priorities, yet children's priorities for early school adjustment are rarely accounted for in intervention design including selection of outcome measures. The Children's Thoughts about School Study (CTSS) examined young children's accounts of their early school experiences, and their descriptions of what a new school starter would need to know. Mixed-method interviews were conducted with 42 kindergarten children in a socioeconomically deprived suburb of Dublin, Ireland. First, inductive thematic analysis identified 25 priorities across four domains: feeling able and enthusiastic for school; navigating friendships and victimisation; supportive environments with opportunities to play; bridging school and family life. Second, deductive analysis compared children's priorities at item level against a school readiness outcome battery. Children's priorities were assigned to three groups: (1) assessed by outcome measures (core academic competencies, aspects of self-regulation); (2) partially assessed (self-efficacy, social skills for friendship formation and avoiding victimisation, creative thinking, play); and (3) not assessed by outcome measures (school liking, school environment, family-school involvement). This analysis derived from children's own perspectives suggests that readiness interventions aiming to support early school adjustment would benefit from considering factors children consider salient. It offers recommendations for advancing conceptual frameworks, improving assessment, and identifying new targets for supporting children and schools. In doing so we provide a platform for children's priorities to be integrated into the policies and practices that shape their early lives.

The psy-disciplines go to school: psychiatric, psychological and psychotherapeutic approaches to inclusion in one UK primary school.