Parenting Programs for the Prevention of Child Physical Abuse Recurrence: A Systematic Review and Meta-Analysis

Abstract

Child physical abuse is an issue of global concern. Conservative estimates set global prevalence of this type of maltreatment at 25%, its consequences and cost to society escalating with increasing frequency and severity of episodes. Syntheses of the evidence on parenting programs for reducing rates of physical abuse recidivism have, to date, not been able to establish effectiveness. Paucity of data and inconsistent inclusion criteria in past reviews made meta-analysis often impossible or uninformative. The current systematic review updates prior reviews and overcomes some of the methodological issues they encountered by pooling trial-level data from a well-defined scope of trials of parenting interventions aimed at preventing the re-abuse of children by parents with substantiated or suspected physical abuse history. Randomized controlled trials and rigorous non-randomized designs were sought via nine online databases, two trial registries, several clearinghouses and contact with experts. A total of fourteen studies of variable quality were included in this review, four of which had outcomes that enabled meta-analysis. Overall, this review presents evidence supporting the effectiveness of parenting behavioral programs based on social learning theory for reducing hard markers of child physical abuse recidivism. Meta-analysis found that the absolute risk reduction in risk of recidivism was 11 percentage points less for maltreating parents who undergo parenting programs (RD = −0.11, 95% CI [−0.22, −0.004], p = 0.043, I 2 = 28.9%). However, the pooled effect size was not statistically significant when calculated as a risk ratio (0.76, 95% CI [0.54, 1.07], I 2 = 38.4%). Policy makers and practitioners should be made aware that this intervention method is backed by promising evidence featuring modest yet significant reductions in hard markers of child physical abuse, even though the methodological robustness of these findings should be further explored in future research.

Mother-child interaction and the development status of children who have been accidentally poisoned

“…In our study, the degree of communication between parents and children was evaluated using the PICCOLO tool, as it provides concrete data on developmental guidance between parent and infant, helps determine and organize the potential needs of both the mother and children, and encourages the strengthening communication while identifying problems. [19][20][21][22] In our study, the PICCOLO scores were significantly higher among the poisoned group presented than among the control group. In particular, a high score within the domain of mother-child-teaching (≥9 points) was associated with a 3.3-fold increase in the risk of ingested medical drugs.…”

Family therapy and systemic interventions for child‐focused problems: the current evidence base

“…Systematic narrative reviews and meta-analyses concur that for physical child abuse and neglect, effective therapy is family-based, structured, extends over periods of at least six months, is often conducted on a home-visiting basis, and addresses specific problems in relevant subsystems including parenting skills deficits, children's posttraumatic adjustment problems, and the overall supportiveness of the family and social network (Henggeler and Schaeffer, 2016;Kennedy et al, 2016;Levey et al, 2017;Skowron and Reinemann, 2005;Timmer and Urquiza, 2014;Vlahovicova et al, 2017). Cognitive behavioural family therapy (Kolko et al, 2014;Kolko and Swenson, 2002;Rynyon and Deblinger, 2013), parent-child interaction therapy (Kennedy, 2016;McNeil and Hembree-Kigin, 2011), and multisystemic therapy for child abuse and neglect (Henggeler and Schaeffer, 2016;Swenson and Schaeffer, 2014) are manualized approaches to family-based treatment which have been shown in randomized controlled trials to reduce the risk of further physical child abuse.…”

What are the Optimal Combinations of Parenting Intervention Components to Reduce Physical Child Abuse Recurrence? Reanalysis of a Systematic Review using Qualitative Comparative Analysis

“…As with all systematic reviews, this review has strengths and limitations. In the original systematic review (Vlahovicova et al, ), the search was exhaustive, and included extensive grey literature searches alongside contact with authors to clarify study information and identify ongoing or missed trials. We undertook extensive efforts to find all relevant studies, though publication bias may mean that some relevant trials were not included.…”

“…These present findings may be useful for intervention developers and implementers when considering new interventions in their own settings. Previous reviews and meta‐analyses consistently show substantial heterogeneity in the effectiveness of parenting interventions for reducing child abuse (Barlow et al, ; Vlahovicova et al, ). This heterogeneity means that the extent of benefit from implementing programmes is uncertain.…”

“…We used standard systematic review methods to identify social learning theory‐based interventions for the prevention of physical child abuse, described extensively elsewhere (Vlahovicova et al, ). A summary is included in Appendix S1 (see the online Supporting Information).…”