Effects of parenting interventions for at-risk parents with infants: a systematic review and meta-analyses

Abstract

ObjectivesInfancy is a critical stage of life, and a secure relationship with caring and responsive caregivers is crucial for healthy infant development. Early parenting interventions aim to support families in which infants are at risk of developmental harm. Our objective is to systematically review the effects of parenting interventions on child development and on parent–child relationship for at-risk families with infants aged 0–12 months.DesignThis is a systematic review and meta-analyses. We extracted publications from 10 databases in June 2013, January 2015 and June 2016, and supplemented with grey literature and hand search. We assessed risk of bias, calculated effect sizes and conducted meta-analyses.Inclusion criteria(1) Randomised controlled trials of structured psychosocial interventions offered to at-risk families with infants aged 0–12 months in Western Organisation for Economic Co-operation and Development (OECD) countries, (2) interventions with a minimum of three sessions and at least half of these delivered postnatally and (3) outcomes reported for child development or parent–child relationship.ResultsSixteen studies were included. Meta-analyses were conducted on seven outcomes represented in 13 studies. Parenting interventions significantly improved child behaviour (d=0.14; 95% CI 0.03 to 0.26), parent–child relationship (d=0.44; 95% CI 0.09 to 0.80) and maternal sensitivity (d=0.46; 95% CI 0.26 to 0.65) postintervention. There were no significant effects on cognitive development (d=0.13; 95% CI −0.08 to 0.41), internalising behaviour (d=0.16; 95% CI −0.03 to 0.33) or externalising behaviour (d=0.16; 95% CI −0.01 to 0.30) post-intervention. At long-term follow-up we found no significant effect on child behaviour (d=0.15; 95% CI −0.03 to 0.31).ConclusionsInterventions offered to at-risk families in the first year of the child’s life appear to improve child behaviour, parent–child relationship and maternal sensitivity post-intervention, but not child cognitive development and internalising or externalising behaviour. Future studies should incorporate follow-up assessments to examine long-term effects of early interventions.

Newborn Behavioral Observation, maternal stress, depressive symptoms and the mother-infant relationship: Results from the Northern Babies Longitudinal Study (NorBaby).

“…Similar results were found in a meta-analysis showing that interventions to enhance parental sensitivity were in general more effective in clinical samples compared to non-clinical samples (62). Furthermore, a recent study of a video-based intervention to improve the parent-infant relationship did not find significant effects of the intervention for well-functioning parent-child dyads (63), despite positive effects for similar interventions within risk families (64). In line with this, the NBO may possibly have more significant effects on depressive symptoms, parenting stress and mother-infant relationship measures within a risk population.…”

Newborn Behavioral Observation, maternal stress, depressive symptoms and the mother-infant relationship: Results from the Northern Babies Longitudinal Study (NorBaby).

“…Similar results were found in a meta-analysis showing that interventions to enhance parental sensitivity were in general more effective in clinical samples compared to non-clinical samples (62). Furthermore, a recent study of a video-based intervention to improve the parent-infant relationship did not nd signi cant effects of the intervention for well-functioning parent-child dyads (63), despite positive effects for similar interventions within risk families (64). In line with this, the NBO may possibly have more signi cant effects on depressive symptoms, parenting stress and mother-infant relationship measures within a risk population.…”

Parental Beliefs, Investments, and Child Development: Evidence from a Large-Scale Experiment

“…In LMICs, a recent systematic meta-analysis, on the other hand, finds mean effect sizes in children's language and cognitive outcomes of 0.32 SD for home-based studies, and 0.59 SD for group visit studies (Aboud and Yousafzai 2015). The meta-analyses available in higher income settings are, on average, smaller for cognitive outcomes (with an average effect size of 0.3 SD (Rayce et al 2017), and suggestive evidence of a potential reduction of behavioral problems (Barlow et al 2016;Furlong et al 2012). 5 structured curriculum modeled after the Jamaica experience was added to an existing program delivering weekly group activities and a monthly home visit (Attanasio et al 2018).…”