Parenting program does not prevent toddler behavior problems

A study of the first universal parenting programme, designed to prevent early child behaviour problems, shows that it has little impact on toddler behaviour.

The study, conducted at the Centre for Community Child Health (CCCH) in Melbourne, Australia, is published on bmj.com today.

Behaviour problems affect up to 20 per cent of children and have major personal, societal and economic ramifications. Left untreated, up to half of behaviour problems in preschool children develop into later mental health problems.

Prevention targeted to high-risk families can be effective, but has limited reach and may stigmatise. Universal programmes offered to all families could address these concerns, but their effectiveness is uncertain.

Researchers from the CCCH and the Parenting Research Centre, with input from maternal and child health nurses, designed a programme suitable for all parents to be delivered by trained health professionals in primary care. The programme aimed to prevent child behaviour problems, such as defiance and aggression, and improve parenting and maternal mental health.

Over 700 mothers of 8 month-old infants participated in the study and were randomised to either the programme (three sessions at age 8-15 months) or usual care from their local Maternal and Child Health centre. Mothers were surveyed throughout the study and their mental health was assessed when their children reached 18 and 24 months.

At 18 months, child behaviour and parenting scores were similar between the two groups. By age 24 months, parents on the programme were less likely to report harsh or abusive parenting and unreasonable expectations of child development, but there was no improvement in maternal distress or toddler behaviour.

This was the first trial to evaluate a universal parenting programme involving families from all social backgrounds, say the authors.

They conclude that the outcomes are insufficient to support widespread introduction of this programme to prevent toddler behaviour problems.