Can a brief intervention geared to caregivers help with early behavior problems?

March 24, 2021
Miranda Hester

Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.

Enduring behavior problems in very young children can lead to lifelong poor outcomes. Could a video-based intervention provided to parents in the home help with those problems?

Poor behavior in young children is not unusual, but consistent behavior problems can lead to poor health, social, and educational outcomes. An investigation published in JAMA Pediatrics looks at whether providing parents with a brief video-feedback intervention could lead to improved outcomes.1

Investigators ran a 2-group, parallel-group, researcher-blind, multisite randomized clinical trial that was run using health visiting services in 6 National Health Service trusts in England. They collected data at baseline and follow up at 5 months. Participants were caregivers of children who had scored in the top 20% for behavior problems in the Strengths and Difficulties Questionnaire. They were randomized to usual care or video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) program, which included 6 home-based video-feedback sessions that were of 1 to 2 hours’ duration provided every 2 weeks.

There were 300 caregiver and child pairs included. In the intervention group, 85% of the caregivers took part in 4 or more of the sessions and 80% of caregivers went through all 6 sessions. The investigators found that the average difference in the total Preschool Parental Account of Children’s Symptoms score between the intervention and control group was 2.03 (95% CI, 0.06-4.01; P = .04; Cohen d = 0.20 [95% CI, 0.01-0.40]). Children in the VIPP-SD group were found to have fewer behavior problems, in particular conduct symptoms mean difference, 1.61 [95% CI, 0.44-2.78]; P = .007; d = 0.30 [95% CI, 0.08-0.51]). Other outcomes appeared to favor VIPP-SD as well.

The investigators concluded that VIPP-SD appeared to be an effective way to reduce behavior problems in very young children. It seemed to be particularly effective in treating conduct problems. The study also showed that the intervention can be used effective in routine practice when administered by staff. Such an intervention offers a key way to treat behavior problems early before thy become chronic and have lasting, life-long impact.

Reference

1. O’Farrelly C, Watt H, Babalis D, et al. A brief home-based parenting intervention to reduce behavior problems in young children. JAMA Pediatr. March 15, 2021. Epub ahead of print. doi:10.1001/jamapediatrics.2020.6834