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Connell, A., Bullock, B. M., Dishion, T. J., Shaw, D., Wilson, M., & Gardner, F. (2008). Family intervention effects on co-occurring early childhood behavioral and emotional problems: A latent transition analysis approach. Journal of Abnormal Child Psychology, 36(8), 1211-1225.

Model(s) Reviewed: Family Check-Up® For Children
Manuscript screening details
Screening decision Screening conclusion
Passes screens Eligible for review
Study design details
Rating Design Attrition Baseline equivalence Reassignment Confounding factors
High Randomized controlled trial Low Unknown, but relevant variables used as controls. None None
Notes:

footnote49

Submitted by user on Fri, 03/15/2019 - 14:29

Dishion, T. J., Shaw, D., Connell, A., Gardner, F., Weaver, C., & Wilson, M. (2008); Connell, A., Bullock, B. M., Dishion, T. J., Shaw, D., Wilson, M., & Gardner, F. (2008); and Shaw, D. S., Connell, A., Dishion, T. J., Wilson, M. N., & Gardner, F. (2009) use the same sample (Dishion et al., 2008; Shaw et al., 2009).

Study characteristics
Study participants The study included 731 families who participated in the Women,Infants and Children (WIC) program when their son or daughter was approximately 2 years old, and met the study’s criteria for being at risk for behavior problems—defined as one standard deviation or more above normative averages in at least two of three screening domains: (1) socioeconomic status; (2) family problems (e.g., maternal depression, substance abuse, teen parent status); and (3) child behavior problems (e.g., conduct problems, high-conflict relationships with adults). Screening was conducted in 2002 and 2003. Most children in the sample were European American (50%); the remaining participants were African American (28%), biracial (13%), or other races (9%), including Asian American, Native American, and Native Hawaiian. When asked about ethnicity, 13.4% reported being Hispanic American. More than two-thirds of the sample had an income below $20,000. Forty-one percent of the sample had a high school diploma or GED, and an additional 32% had one to two years of post-high school training.
Setting Families were recruited from WIC program sites in and around Pittsburgh, PA (37% of sample); Eugene, OR (37% of sample); and Charlottesville, VA (26% of sample). Note the percentage of the sample in Charlottesville differs slightly from other studies using the same sample.
Intervention services Family Check-Up typically involves three meetings (initial contact, assessment session, and feedback session). For the purposes of this study, the assessment was completed before random assignment, and thus the program group received the assessment (conducted by research staff), an interview session, a feedback session, and possible follow-ups. A trained parent consultant conducted the subsequent interview and feedback sessions. During the interview, the consultant explored parents’ concerns; in the feedback session, the consultant provided the results of the assessment and explored parents’ willingness to change in problem areas, reinforced parenting strengths, and identified services appropriate for the family. After the feedback session, families possibly also received up to six follow-up sessions focusing on parenting practices, family management issues, and contextual issues (such as child care resources and housing). Of the families assigned to the intervention, 78% participated in the interview and feedback sessions with the parent consultant, when the child was 2 years old and 65 percent participated when the child was 3 years old.
Comparison conditions Families in the comparison condition did not receive visits or intervention from parent consultants, but did receive an assessment session, conducted by research staff. Although this session typically is part of the Family Check-Up program, for the purposes of this study, the assessment was conducted before randomization.
Staff characteristics and training Parent consultants for this study had either a master’s or doctorate degree and had previous experience in carrying out family-based interventions. Consultants were trained for two-and-a-half to three months in strategies that included didactic instruction and role-playing, as well as ongoing videotaped supervision of intervention activity. Consultants were certified by lead parent consultants at each site; the lead parent consultants were certified by a member of the research team. Certification was repeated annually and was established by reviewing videotapes of feedback and follow-up sessions. Weekly conference calls were held to discuss cases, and annual consultant meetings were held to update training, discuss possible changes in the intervention, and address issues reflected by families’ needs.
Funding sources Funder(s) not listed.
Author affiliation Thomas Dishion, a study author, is a developer of this model.

Findings details

Child development and school readiness
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Remaining in “normal” (no externalizing or internalizing), age 2 to 3
FavorableUnfavorable or ambiguousNo Effect
Early Steps Multisite Study Sample Age 3 Not available Not available Not available OR = 3.75 Not available Not available
High Remaining in “normal” (no externalizing or internalizing), age 3 to 4
FavorableUnfavorable or ambiguousNo Effect
Early Steps Multisite Study Sample Age 4 Not available Not available Not available OR = 1.94 Not available Not available
High Transition from comorbid (externalizing and internalizing) at age 2 to “normal” at age 3
FavorableUnfavorable or ambiguousNo Effect
Early Steps Multisite Study Sample Age 3 Not available Not available Not available OR = 60.42 Not available Not available
High Transition from comorbid (externalizing and internalizing) at age 3 to “normal” at age 4
FavorableUnfavorable or ambiguousNo Effect
Early Steps Multisite Study Sample Age 4 Not available Not available Not available OR = 167.80 Not available Not available
High Transition from externalizing at age 2 to “normal” at age 3
FavorableUnfavorable or ambiguousNo Effect
Early Steps Multisite Study Sample Age 3 Not available Not available Not available OR = 0.89 Not available Not available
High Transition from externalizing at age 3 to “normal” at age 4
FavorableUnfavorable or ambiguousNo Effect
Early Steps Multisite Study Sample Age 4 Not available Not available Not available OR = 0.89 Not available Not available
High Transition from internalizing at age 2 to “normal” at age 3
FavorableUnfavorable or ambiguousNo Effect
Early Steps Multisite Study Sample Age 3 Not available Not available Not available OR = 1.01 Not available Not available
High Transition from internalizing at age 3 to “normal” at age 4
FavorableUnfavorable or ambiguousNo Effect
Early Steps Multisite Study Sample Age 4 Not available Not available Not available OR = 9.35 Not available Not available

Outcome measure summary

Child development and school readiness
Outcome measure Description of measure Data collection method Properties of measure

Remaining in “normal” (no externalizing or internalizing), age 2 to 3

The CBCL  assesses behavioral and emotional problems in young children. The CBCL Internalizing scale comprises four Subscales (Emotional Reactivity, Anxiety and Depression, Somatic Problems, and Social Withdrawal) and the Externalizing scale comprises two subscales (Aggression and Attention Problems). The researchers performed Latent Class Analyses (LCA) on the CBCL ’s subscales and developed four optimal classes at ages 2, 3, and 4: normative, externalizing, internalizing, and comorbid. Latent transition analyses were then conducted to examine transitions across classes from age 2 to 3 and from age 3 to 4. Parent/caregiver report

Cronbach’s α = 0.82 to 0.91 across ages 2, 3, and 4

Remaining in “normal” (no externalizing or internalizing), age 3 to 4

The CBCL  assesses behavioral and emotional problems in young children. The CBCL Internalizing scale comprises four Subscales (Emotional Reactivity, Anxiety and Depression, Somatic Problems, and Social Withdrawal) and the Externalizing scale comprises two subscales (Aggression and Attention Problems). The researchers performed Latent Class Analyses (LCA) on the CBCL ’s subscales and developed four optimal classes at ages 2, 3, and 4: normative, externalizing, internalizing, and comorbid. Latent transition analyses were then conducted to examine transitions across classes from age 2 to 3 and from age 3 to 4. Parent/caregiver report

Cronbach’s α = 0.82 to 0.91 across ages 2, 3, and 4

Transition from comorbid (externalizing and internalizing) at age 2 to “normal” at age 3

The CBCL  assesses behavioral and emotional problems in young children. The CBCL Internalizing scale comprises four Subscales (Emotional Reactivity, Anxiety and Depression, Somatic Problems, and Social Withdrawal) and the Externalizing scale comprises two subscales (Aggression and Attention Problems). The researchers performed Latent Class Analyses (LCA) on the CBCL ’s subscales and developed four optimal classes at ages 2, 3, and 4: normative, externalizing, internalizing, and comorbid. Latent transition analyses were then conducted to examine transitions across classes from age 2 to 3 and from age 3 to 4. Parent/caregiver report

Cronbach’s α = 0.82 to 0.91 across ages 2, 3, and 4

Transition from comorbid (externalizing and internalizing) at age 3 to “normal” at age 4

The CBCL  assesses behavioral and emotional problems in young children. The CBCL Internalizing scale comprises four Subscales (Emotional Reactivity, Anxiety and Depression, Somatic Problems, and Social Withdrawal) and the Externalizing scale comprises two subscales (Aggression and Attention Problems). The researchers performed Latent Class Analyses (LCA) on the CBCL ’s subscales and developed four optimal classes at ages 2, 3, and 4: normative, externalizing, internalizing, and comorbid. Latent transition analyses were then conducted to examine transitions across classes from age 2 to 3 and from age 3 to 4. Parent/caregiver report

Cronbach’s α = 0.82 to 0.91 across ages 2, 3, and 4

Transition from externalizing at age 2 to “normal” at age 3

The CBCL  assesses behavioral and emotional problems in young children. The CBCL Internalizing scale comprises four Subscales (Emotional Reactivity, Anxiety and Depression, Somatic Problems, and Social Withdrawal) and the Externalizing scale comprises two subscales (Aggression and Attention Problems). The researchers performed Latent Class Analyses (LCA) on the CBCL ’s subscales and developed four optimal classes at ages 2, 3, and 4: normative, externalizing, internalizing, and comorbid. Latent transition analyses were then conducted to examine transitions across classes from age 2 to 3 and from age 3 to 4. Parent/caregiver report

Cronbach’s α = 0.82 to 0.91 across ages 2, 3, and 4

Transition from externalizing at age 3 to “normal” at age 4

The CBCL  assesses behavioral and emotional problems in young children. The CBCL Internalizing scale comprises four Subscales (Emotional Reactivity, Anxiety and Depression, Somatic Problems, and Social Withdrawal) and the Externalizing scale comprises two subscales (Aggression and Attention Problems). The researchers performed Latent Class Analyses (LCA) on the CBCL’s subscales and developed four optimal classes at ages 2, 3, and 4: normative, externalizing, internalizing, and comorbid. Latent transition analyses were then conducted to examine transitions across classes from age 2 to 3 and from age 3 to 4. Parent/caregiver report

Cronbach’s α = 0.82 to 0.91 across ages 2, 3, and 4

Transition from internalizing at age 2 to “normal” at age 3

The CBCL  assesses behavioral and emotional problems in young children. The CBCL Internalizing scale comprises four Subscales (Emotional Reactivity, Anxiety and Depression, Somatic Problems, and Social Withdrawal) and the Externalizing scale comprises two subscales (Aggression and Attention Problems). The researchers performed Latent Class Analyses (LCA) on the CBCL’s subscales and developed four optimal classes at ages 2, 3, and 4: normative, externalizing, internalizing, and comorbid. Latent transition analyses were then conducted to examine transitions across classes from age 2 to 3 and from age 3 to 4. Parent/caregiver report

Cronbach’s α = 0.82 to 0.91 across ages 2, 3, and 4

Transition from internalizing at age 3 to “normal” at age 4

The CBCL  assesses behavioral and emotional problems in young children. The CBCL Internalizing scale comprises four Subscales (Emotional Reactivity, Anxiety and Depression, Somatic Problems, and Social Withdrawal) and the Externalizing scale comprises two subscales (Aggression and Attention Problems). The researchers performed Latent Class Analyses (LCA) on the CBCL’s subscales and developed four optimal classes at ages 2, 3, and 4: normative, externalizing, internalizing, and comorbid. Latent transition analyses were then conducted to examine transitions across classes from age 2 to 3 and from age 3 to 4. Parent/caregiver report

Cronbach’s α = 0.82 to 0.91 across ages 2, 3, and 4