Paper Sessions
A couples-based father involvement parenting intervention
Authors: Prof Emeritus Philip Cowan and Adjunct Prof Emerita Carolyn Pape Cowan
Background and objectives: Parenting programs are typically attended by mothers in the U.S. and abroad. Father involvement programs are almost always conducted in groups of men, led by male leaders. The Supporting Father Involvement (SFI) program is an intervention that addresses men’s central roles as partners, parents, and providers in groups attended by both parents, and led by clinically trained male-female teams. The goal of this presentation is to provide an overview of the findings from systematic evaluations of the program. Methods: The Supporting Father Involvement intervention involves 16 weekly meetings in groups of 5-8 couples/co-parenting teams. We focus on 5 broad family system risk and protective factors that affect the functioning of the individuals and relationships in the family: the physical and mental health of the individual parents, the quality of their relationship as partners and co-parents, each of their relationships with their child(ren), three generational patterns, and the balance of stressors and supports on each family. These 5 factors shape the curriculum and the evaluation protocols of the Supporting Father Involvement program, with assessments at intake and at one-year or 18-month follow-ups. To date there have been 9 systematic evaluation studies -- 6 of them RCTs, 3 with pre-post research designs. 5 of the studies targeted very low-income families from multiple ethnic groups (White, Black, Hispanic, Asian American, Native American). With government or Foundation funding, Supporting Father Involvement interventions have been conducted in the United States (California, Massachusetts, Oklahoma), Canada, England, and Malta. Findings: Participants in all studies show positive direct or indirect effects of intervention participation - on parents’ depression, communication and violence in the couple relationship, harsh parenting, and children’s behavior problems. Five of the studies with low-income participants show increases in employment status and income. Implications for policy, research, and practice: The findings of the Supporting Father Involvement approach demonstrate clear advantages of including both fathers and mothers in interventions designed to strengthen parents’ individual functioning, family relationship quality, and economic circumstances. On a policy level, these results raise questions about the currently siloed approach to family strengthening in which government and service agencies address the needs of mothers, fathers, and children in separate departments and programs. Biography Philip Cowan is a Professor of Psychology Emeritus at the University of California, Berkeley. He has headed the Clinical Program and the Institute of Human Development. He is the author, co-author, and co-editor of 5 books and more than 100 peer-reviewed research articles Originally presented as ‘A7 - Impact of Parenting Paper Session (90, 86, 224)’ at I-CEPS 2023.
A preliminary review of the Parenting Assessment and Skill Development Service: A 10-day residential service for families at risk of child maltreatment
Authors: Andi Jones, Dr Ali Fogarty and A/Prof Rebecca Giallo
Background and objectives: The Parenting Assessment and Skill Development Service (PASDS) is a 10-day residential program for families at risk of child maltreatment with current involvement with Child Protection Services. The service aims to build parenting capacity through skill development, and conduct a comprehensive parenting capacity assessment to inform case management and when required legal decisions. A preliminary review of PASDs was conducted to describe (a) the psychosocial functioning of parenting accessing PASDS, (b) key assessment outcomes of PASDS, and (c) explore parents’ experiences of taking part. Methods: A mixed methods study comprising a case study review and qualitative interviews with parents was conducted. Participants were 18 parents who participated in PASDS in Melbourne during 2020. Ethics approval was obtained from the Royal Children’s Hospital Human Research Ethics Committee. Parents attended Tweddle’s residential facility in Melbourne, Victoria to complete the 10-day PASDS. The service is comprised of three phases: (a) the initial observation phase (days 1-3), (b) the skill development phase (days 4-7) and (c) the post skill development phase (days 8-10). A final parenting capacity assessment is conducted by PASDS clinicians upon completion. Data relating to family demographics, referral information, mental health, clinician completing parenting capacity assessments were extracted from parent files. Parents also participated in semi-structured qualitative interviews to elicit their experiences of the program, including perceived benefits, and facilitators and barriers to taking part. Extracted data were analysed in SPSS using descriptive statistics. Qualitative interview data were analysed by two members of the research team using thematic analysis Findings: Approximately half of the parents who completed self-report questionnaires reported elevated symptoms of depression and/or anxiety, and a third reported low parenting self-efficacy. Most parents also reported a history of child protection involvement in their childhood, and/or adverse childhood experiences including abuse and neglect. Following participation in PASDS, 33% of families were assessed as not being able to provide independent care for their child, with 24-hour supervision or out-of-home care being recommended. Of parents whose child was in out-of-home care at the commencement of the admission, three (43%) were deemed able to provide independent care to their child and family reunification was recommended. Interviews with parents and clinician-based parenting assessments suggested that the potential perceived benefits of PASDS included improving parents’ knowledge and skills in recognising and responding to their child’s cues, fostering cognitive development, and providing a safe home environment. Implications for policy, research and practice: Families receiving PASDS have complex histories of intergenerational trauma and disadvantage, highlighting the importance of trauma-informed care and strengths-based approaches underpinning the service. An understanding of families’ experience of care and perceived benefits of PASDS also offers key information about what outcomes for parents should be assessed in a more rigorous service evaluation. There is a need to understand what works in building parenting capacity and assessing risk of child abuse and neglect to ensure the best outcomes for children’s health, wellbeing and development. Originally presented as 'G4 - Child Maltreatment and Adversity (219, 72, 175)' at I-CEPS 2023.
Are parents effectual child sexual abuse (CSA) prevention educators? Four studies and a new direction
Author: Dr Julia Rudolph
Background and objectives: Child sexual abuse (CSA) prevention has relied heavily on child education - teaching children about CSA risks and appropriate self-protection skills. Parental involvement has been limited, with parents’ roles restricted to that of educators. However, research suggests that many parents avoid giving their children accurate CSA messages, and questions remain about the effectiveness of this approach. The purpose of this body of work was to: 1. Add to available research on the rates and content of parent-led sexual abuse education (PLSAE) 2. Explore the reasons for parental reluctance to engage in PLSAE 3. Conduct preliminary research into the effectiveness of PLSAE Methods: The results of four studies with parents and young adults are presented. Data was gathered using qualitative, quantitative and mixed-methods methodologies. Samples included parents with relatively high levels of education and income, at-risk parents referred to a parenting program, and university students. Data was collected in 2018 and 2022 via online and pen-and-paper surveys, and face-to-face interviews. Results: This body of research supports previous literature demonstrating that most parents either did not educate their children about CSA or gave them incomplete message, avoiding discussion of sexual behaviours such as genital touch, or failing to mention that familiar adults may be perpetrators. For example, even parents who knew perpetrators are more likely to be familiar, tended to discuss strangers and abduction with their children. Findings also suggest that the variables most targeted by prevention campaigns to encourage parents to engage in PLSAE (i.e., increasing parental knowledge, risk appraisal and confidence) may be ineffectual, as these factors were not associated with increased rates of PLSAE. Retrospective reports from the university student sample also suggest PLSAE may be ineffective - as those participants who reported receiving PLSAE in their childhood were no less likely to experience CSA, and no more likely to disclose their abuse. In the first study of its kind, results suggest that protective parenting acted as a preventative factor, with those young adults who reported more parental involvement/care and monitoring/supervision also reporting less CSA. Implications for policy, research and practice: The presented body of research suggests that most parents are ineffectual CSA educators, that it may be difficult to increase rates of PLSAE by educating parents, that PLSAE may be ineffectual in preventing CSA, and that protective parenting may be a better avenue for the prevention of CSA. In view of this, new ways of involving parents in prevention are needed. One possible new direction is the Two Pathways model which proposes that parents can be protective via: 1) the creation of safer environments; and 2) fostering child well-being. Biography Julia Rudolph, PhD, is a research fellow in the Institute for Lifecourse Development (University of Greenwich). Julia has been instrumental in reconceptualising child sexual abuse prevention to include parents in novel ways (as protectors, rather than educators) developing the Two Pathways Model for the involvement of parents; via the creation of safe environments and positive parenting. Julia has also researched in the areas of adolescent symptomology (rejection sensitivity, appearance pre-occupation, anxiety, depressive symptoms), peer victimisation and parenting. Julia has worked in child protection both in Australia and the UK. Originally presented as ‘G9 - Child Maltreatment and Adversity Paper Session (2, 28, 205)’ at I-CEPS 2023.
Association of parental mental health, (parenting) stress and child mental health outcomes during the COVID-19 pandemic: A meta-analysis
Authors: Markus Stracke, Miriam Heinzl, Anne Dorothee Müller, Kristin Gilbert, Anne Thorup, Jean Paul, and Hanna Christiansen
Background and objectives: The COVID-19 pandemic as a multidimensional and universal stressor has negative effects on the mental health of children, adolescents and adults worldwide. Specifically, families faced numerous restrictions and challenges. From the literature it is well known that parental mental health problems and child mental health outcomes are associated and that children of parents with a mental illness have a higher risk to develop a mental disorder themselves. The aim of this review is to summarize the current research on the associations of parental mental health symptoms (mental illness, general stress, parenting stress) and child mental health outcomes during the COVID-19-pandemic. Methods: The review follows the PRISMA-guidelines and was registered at PROSPERO (#CRD42021273376). We conducted a systematic literature search in Web of Science (all databases) on May 25th, 2022. All original studies reporting on the association of parental mental health problems, parents’ general stress or parenting stress and child mental health outcomes during the COVID-19 pandemic were included. Abstract screening, full-text analysis, data extraction and risk of bias rating were performed by two authors (MS and MH) separately. Disagreements were resolved by discussion until a consensus was reached. For meta-analytic calculations, the Pearson’s product-moment-correlation r was used. Meta-analyses were computed with the free online meta-analysis tool Meta-Mar using the random effect model. Overall effects were interpreted according to Cohen (1992). Findings: Overall, 431 records were identified, of which 83 articles with data from over 80.000 families were included for meta-analysis. Research question 1: The association of parental mental health problems prior to the COVID-19 pandemic and child mental health outcomes during the COVID-19 pandemic was investigated in 8 studies. 9 meta-analyses resulted in overall small effects. Research question 2: The association of parental mental health problems and child outcomes during the COVID-19 pandemic was investigated in 54 studies. 18 meta-analyses revealed overall small to medium effects. Research question 3: The association of parents’ general stress and child outcomes during the COVID-19 pandemic was investigated in 39 studies. 6 meta-analyses resulted in overall small to medium effects. Research question 4: The association of parenting stress and child outcomes during the COVID-19 pandemic was investigated in 18 studies. 5 meta-analyses revealed overall medium to high effects. Implications for policy, research and practice: Similar to pre-COVID-19-pandemic results, small to moderate associations between parental mental health symptoms and child mental health outcomes were found. The largest effects (medium to high) were observed for the association of parenting stress and child mental health outcomes. As described in the developmental model of the transgenerational transmission of psychopathology (Hosman, van Doesum & van Santvoort, 2009), a dysfunctional parent-child interaction is a key mechanism for the transmission of mental disorders. Thus, specific parenting interventions are needed to foster healthy parent-child interactions, to promote the mental health of families and to reduce the negative impacts of the COVID-19-pandemic. Originally presented as 'A6 - Impact of Parenting Paper Session (99, 233, 8, 29)' at I-CEPS 2023.
Associations between parents’ job quality and adolescents’ academic outcomes: Findings from the Longitudinal Study of Australian Children
Authors: Kate McCredie, Dr Amanda Cooklin, Dr Stacey Hokke, and Dr Liana Leach
Background and objectives: Parents’ jobs can have a profound impact on child learning development. Early research in this area was largely limited to focusing on the effects of mothers’ employment status on child outcomes. Recent studies considering the quality of parents’ employment find that poor job quality and work-family conflict are adversely associated with children’s mental health and socio-emotional wellbeing. However, little research to date has examined the relationship between parent job quality and adolescent academic outcomes. This study aims to address these gaps using national cohort data to investigate the link between both mothers’ and fathers’ job quality and adolescents’ academic performance at two key stages of schooling. Methods: The study used cross-sectional data from two waves of the Longitudinal Study of Australian Children (LSAC), a nationally representative cohort study of Australian children and their families. Data are from wave 7 (collected in 2015) and wave 8 (collected in 2017) when adolescent children were in Year 7 and Year 9, respectively. Measures of parents’ job security, autonomy, flexibility, and access to paid family leave were used as indicators of parents’ job quality. NAPLAN reading and numeracy scores were used to measure adolescent academic outcomes. Analyses were stratified by parent gender at each wave (Year 7: n=1560 for mothers and n=1174 for fathers; Year 9: n=1407 for mothers and n=1027 for fathers). Multiple linear regressions were used to examine associations between parents’ job quality and child academic outcomes. Analyses were further stratified to explore whether the presence of a job quality indicator was protective in lower income households. Findings: Associations were observed between indicators of parents’ job quality and adolescent outcomes independent of household income, socio-economic status, parent education level, and occupation type, but are patterned differently by parent gender and schooling stage. For fathers, access to flexible work was associated with higher reading and numeracy scores for adolescents in Year 7, with effect sizes equivalent to approximately one year and half a year of learning respectively. However, no associations were found in Year 9. For mothers, unexpectedly, job security was associated with lower reading scores and job autonomy was associated with lower numeracy scores in Year 7. Mothers’ flexibility was associated with lower scores in both domains in Year 9. Additional analyses indicated the associations varied based on household income, however there was no clear patterning of these findings. Implications for policy, research and practice: This study is one of the first in Australia to establish a relationship between the distal influence of parents’ job features and adolescents’ academic performance. Findings motivate further research to better understand both the risk and protective factors parents’ job quality may present for children’s academic development. Additional research could also investigate the possible longitudinal effects of these associations and the pathways by which they operate. Findings suggest that different job features may be more or less important at different times throughout adolescent development, highlighting the complex and dynamic needs of working families – factors that should be taken into consideration in future research. Biography Kate McCredie is a PhD student at the Judith Lumley Centre, La Trobe University. Her PhD research examines the effects of parents' employment conditions on parenting, the home environment, and child academic outcomes. Originally presented as ‘A5 - Impact of Parenting Paper Session (43, 106, 100, 59)’ at I-CEPS 2023.
Benefits beyond disruptive behaviour: Reductions in problematic mealtime behaviour an additional positive outcome of Parent-Child Interaction Therapy
Authors: Dr Shawna Campbell, Dr Elia Edwards, Dr Haley Webb and Prof Melanie Zimmer-Gembeck
Background and objectives: Problematic mealtime behaviour (such as picky eating and tantrums at mealtimes) is common in young children and is associated with parental stress and family conflict, with many parents seeking support from allied health professionals. Parenting practices and parents’ responses to such behaviour have been shown to play a role in children’s problematic mealtime behaviour. In this study, we examined whether a manualised parenting program developed to improve children’s disruptive behaviour by coaching parenting skills that promote appropriate behaviour (Parent-Child Interaction Program; PCIT) may also have a side benefit of improving parents’ skills at managing their children’s problematic mealtime behaviour, as well as children’s eating-related behaviours. Methods: Standard (unmodified) PCIT was provided to 178 caregiver-child dyads presenting to a university clinic. All parents reported moderate to severe concerns about their young (aged 2 to 8 years) children’s behaviours. Caregivers were primarily biological mothers (93%) with the majority born in Australia (71%). In PCIT, caregivers practice relationship enhancement skills, such as positive attention and using attention to increase desired behaviour, using in-vivo live coaching. In the later sessions of PCIT, parents also practice behavioural management skills such as giving effective instructions. Caregivers completed questionnaires prior to joining the waitlist (pre-waitlist; lasting 10-17 weeks), after the waitlist (i.e., pre-PCIT) and 14 weeks after starting PCIT (described as post-PCIT, 65% had completed PCIT). Questionnaires included measures of parent and child eating-related outcomes (parent: aversion, positive mealtime environment, demandingness and responsiveness; child: resistance to eating, food refusal, manipulation of food, food aggression) and general parenting practices and internalising and externalising child behaviour. Findings: Paired samples t-tests were conducted to compare caregivers’ scores from pre-waitlist to pre-PCIT; only 1 of 12 study measures improved (positive mealtime environment). A final sample of 110 caregivers completed the post-PCIT measures. Comparing pre-PCIT to post-PCIT measures, 6 of 8 food-related outcomes improved (caregiver food-related outcomes: less aversion to mealtime, less food-related demandingness and more responsiveness; child food-related outcomes: less resistance to eating, less food refusal, less manipulation of food, less food aggression). For general outcomes, significant improvements included decreased negative, and increased positive, parenting practices, as well as significant reductions in both child internalising and externalising behaviour. Analyses were repeated using a multiple imputation to maintain all 178 participants; the results were similar. Implications for policy, research and practice: Our results show that an unmodified parent training program (PCIT) not designed to improve mealtime behaviour problems can be a worthwhile treatment for problematic mealtime behaviour. However, treatment may be enhanced by individualsing treatment to client need (such as providing psychoeducation about setting up the family eating environment in a positive way). Future research can consider weather an additional psychoeducation module around best practice for feeding young children enhances PCIT for families reporting mealtime behaviour concerns. The current study raises awareness of the potential positive impacts of PCIT beyond parenting practices and disruptive behaviour, and provides an evidence-based for PCIT as a treatment for problemtic mealtime behaviours. Originally presented as 'A9 -Impact of Parenting Paper Session (227, 190, 60)' at I-CEPS 2023.
Building parent (and service) capacity through coaching
Authors: Jackie Bateman and Vincent Lagioia
Background and objectives: The Victorian Government’s Roadmap for Reform shifts the child and family services system to intervene earlier to improve family functioning, safety, wellbeing and healthy development of children. Kids First (KFA) Integrated Family Service direct practice has traditionally involved case management. The journey to develop a new approach to ‘case management’ through a continuous practice improvement system started in 2021, with a partnership between KFA and the Parenting Research Centre (PRC). KFA has tested a new Coaching approach to practice. The way of working with families is premised on the idea that building the capacity of adults who care for children is the most powerful way of promoting a child’s development, wellbeing, and safety. Methods: A co-design process including both staff members and consumers was used to develop the outcomes and new practice framework for the Integrated Family Service in the first instance, with a view to rolling it out across the whole of family services. The project will realign with the agency practice principles and values. When designing the coaching model the vision was twofold: 1. Design a practice framework to maximise our impact by building consumer and practitioner capacity and capability. Achieved through the design, development, testing, documenting and implementation of a practice framework to ultimately be known as the ‘Family Services Coaching Practice Framework’. 2. Develop a fully operating and integrated continuous practice improvement system that uses data to build evidence, drive quality improvement in our practice and form the basis of an integrated learning system. Findings: The project has moved through three phases. • Exploration: clarifying the program’s theory of change and logic model; development of an outcomes chain, capturing existing guiding principles and good practice; and identifying practice challenges. • Design: identifying/evaluating existing and new coaching practices and testing them for relevance and fit with program principles, objectives and service ecology. • Piloting/testing: initial implementation, providing an opportunity to test the conceptual framework of the practice model, protocols, data collection and responses with staff and consumers. The diversity of skills and expertise ensure that current practice is captured, and input is received across Family Services at KFA. Implications for policy, research and practice: The new practice framework will be grounded in contemporary understandings of how to support adult self-regulation and improve capacity building, to guide professional practice and improve outcomes for families and children. Implementation of the model will support the adoption of the new practice with fidelity, including training, post-training support and data-based feedback loops. Continuous quality improvement will be supported via a learning system that is based on data and engages all levels of the organisation in monitoring and case progression. Practice models, such as the one envisaged here, lend themselves to being embedded within Continuous Quality Improvement (CQI) structures. Indicators and measures will be used to regularly assess whether the framework is effective in meeting outcomes, or whether adjustments need to be made. A data informed learning system can be responsive to research and practice developments and allows for innovation. Originally presented as ‘A5 - Impact of Parenting Paper Session (100) ’ at I-CEPS 2023.
Caregiving arrangements in Singapore:
Impacts on child outcomes
Authors: Dr Seok Hui Tan, Dr Charlene S. L. Fu, Qing Rong Chan, Rosie Lim, Grace Yap, John M. Elliott, Maria Shiu, and P. C. Khoo.
Background and objectives: With increasing levels of education and the rise of dual-income households, families face the challenge of deciding on the best caregiving arrangements for their infant. In Singapore, many families rely on grandparents, nannies, domestic helpers, and childcare centers to serve as primary caregivers. This longitudinal study therefore sought to examine the prevalence of the different types of caregiving arrangements, and the influence of such arrangements on mother-child attachment, and cognitive and social-emotional development. Methods: Face-to-face interviews were conducted with 439 first-time Singaporean mothers when their infant was 4, 18, and 36 months old. Findings: While approximately half the infants in our sample (56%) had mothers as their primary caregivers at 4 months, this number decreased at 18 months (20%) and 3 years (16%). At 18 months, primary caregivers were typically grandmothers (48%). At 3 years, most were cared for by grandmothers (30%) or childcare centers (37%). Only 11% of respondents reported no changes in primary caregiver for the duration of the study, while on average, children experienced 1.98 (SD = 1.31) changes in primary caregiver. Attachment security at 3 years, child’s cognitive outcomes, and child’s social-emotional outcomes were not predicted by the type of main caregiver, or the number of caregiving changes children experienced. Instead, attachment security at 3 years was predicted by attachment security at 18 months and child’s temperament at 3 years. Maternal factors such as maternal education and employment predicted cognitive (problem-solving skills) and social-emotional outcomes respectively. Implications: Overall, we found that within the Singaporean context, there is little evidence of a “best” caregiving type. These findings challenge traditional notions that mothers as main caregivers is the ideal care arrangement, and instead qualify that specific qualities in mothers are more important for child outcomes. The study findings also invite further research on caregiving practices on non-parental figures, and the impact of such practices on child outcomes. Biography Tan Seok Hui completed her doctoral thesis in infant language acquisition at the University of Reading, UK. She currently works as a speech therapist at a special education school. She is currently the Research Committee Chairperson of the Singapore Children’s Society. Originally presented as 'A3 - Impact of Parenting Paper Session (25, 232, 15, 64)' at I-CEPS 2023.
Contemporary parenting and its association with parents’ wellbeing in the face of COVID-19: The mediating role of guilt
Author: Dr Osnat Lavenda
Background and objectives: The outbreak of COVID-19, in the beginning of 2020, has brought about an abrupt, worldwide need to adjust constantly, rapidly, and more forcefully to changing circumstances. These intense changes in “normal” life circumstances have already been found to impact mental health. In particular, the effect of the pandemic was evident within the family, where the wellbeing of both parents and children has been impacted substantially. The presented study focuses on adjustment in the context of the family. Particularly, the focus of the study is on parental feelings of guilt as a mechanism underlying the association between parenting styles and difficulties to adjust to changing circumstances. Methods: The sample was recruited through social networks and included 382 Israeli parents, mostly educated mothers (ages 23–57, average education 16.4 years) who reported being the primary caregiver in a committed relationship. All participants filled out online self-report questionnaires that addressed their parenting style, parental guilt feelings, and difficulties to adjust in the face of COVID-19. To examine the study’s hypothesis, a mediation analysis was conducted using the PROCESS macro for SPSS. Findings: The analysis indicated a significant direct association between hostile/coercive parenting and adjustment difficulties, and an indirect significant association between engaged/supportive parenting and adjustment difficulties through parental guilt feelings. These findings are discussed in light of the Conservation of Resources Theory and in light of parental contemporary social imperatives. Implications: Social imperatives that shape contemporary parenting force parents to attempt to be the “perfect” parents by intensively meeting their children’s needs. This study emphasizes the toll that such parenting takes on its agents—the parents—as it can provoke feelings of guilt that are associated with poor wellbeing. Clinicians and other practitioners working with parents and families should be aware of the associations between parenting, guilt, and the difficulty to adjust to changing circumstances. Most importantly, understanding that guilt feelings might be inherent to the contemporary parenting role can assist professionals in preventing the escalation of adjustment problems, especially for parents with an engaged/supportive parenting style. Originally presented as A6 - Impact of Parenting Paper Session (8).
Cultural adaptation and contextual fit of evidence-based programs: A whole of community approach to family and child wellbeing
Authors: Arvind Ponnapalli, Lee-Ann Cliff, Michell Forster, and A/Prof Karen M.T. Turner
Background: The increasing over-representation of Aboriginal and Torres Strait Islander children in child protection services across Australia remains profoundly concerning. The shortage of culturally safe preventative and evidence-based parent support services in Indigenous communities perpetuates an inverse care representation: an under-representation of universal and targeted preventative interventions and an over-representation of statutory service systems. This research project was co-designed following extensive community consultations and a review of local protocols of a discrete Indigenous community in Queensland, Australia. This project discusses a whole-of-community approach to promoting family and child wellbeing, co-designing evidence-based parenting resources, and supporting local community organisations to implement Triple P. Methods: This project adopted a whole-of-community approach to promote family and child wellbeing by 1) incorporating training and accreditation for local community members, increasing the capacity of local Indigenous community-controlled family wellbeing services; 2) developing and implementing universal family and child wellbeing resources, and 3) a partnership approach to implementation of targeted parent support programs in a discrete Indigenous community. As part of collaborative partnerships, six community-controlled agency staff members were trained and accredited to deliver the Group Indigenous Triple P – Positive Parenting Program. In addition, a series of public service announcements (PSAs) were drafted from qualitative data on Indigenous parent wellbeing constructs from another study in this research series. These PSA drafts were reviewed and endorsed by community-based advisory group members. Production of PSAs involved local people’s voices, including Elders and parents, and creating an audio landscape involving sounds of the country and community. Findings: Between Jan 2021 to Sep 2022, six Indigenous Triple – group programs were implemented and co-facilitated by community staff. Thirty-nine participants have completed the groups and individual sessions. In addition, all participants completed pre- and post-program outcome measures, and the collection of three-month follow-up assessments is ongoing. Preliminary outcomes analysis indicates significant improvements in parent-child relationships, parents' positive encouragement of their children's desirable behaviours, and a significant reduction in coercive parenting and parental stress. Implications: Consistent with previous research on predicting factors of sustainment of evidence-based programs in disadvantaged communities, this study noted that the availability of mentoring and coaching by a program specialist was valuable. Having an Indigenous Implementation Consultant to support Indigenous practitioners and community-controlled agencies in identifying a contextual fit of the evidenced based parenting program, supporting practitioners through training and accreditations, and coaching in flexible delivery to ensure a fit with community circumstances was valuable in building confidence in their service delivery. This study offers crucial future policy, funding and practice considerations on the process and cultural factors associated with delivering evidence-based parenting programs in discrete Indigenous communities. The research team aims to assess the impact of universal and targeted evidence-based parenting support, tailored for the Cherbourg community, on parent wellbeing, parenting and child outcomes at a community level through a post-implementation community-wide survey in 2023. Biography Arvind Ponnapalli is a clinical psychologist at the Cherbourg Health Service, Queensland Health, Australia and a PhD candidate with the school of psychology, the University of Queensland. Arvind has 15 years of continuous experience as a psychologist working in the rural and remote areas, including a discrete Indigenous community. Originally presented as ‘E7 - Diverse Service Contexts Paper Session (181, 62, 37)’ at I-CEPS 2023.
Cursed or blessed: The rough road for teenage mothers from Narok County, Kenya
Author: Florence Maranga
Background and objectives: According to the Kenya National Bureau of Statistics (2014), approximately 18 percent of teenage girls aged between 15 to 19 years in Kenya are mothers. According to the county health department report. In Narok County, over 13,000 girls aged between 10 and 18 years in Narok got pregnant in 2021. As a consequence, they are forced to fall out of and end up not receiving very minimal psychosocial support from their peers and society at large. This study adopted a mixed method research approach to collect data. The respondents of the study included teenage mothers aged 19 years and below, parents, teachers/ principals, County Education directors, local chiefs and religious leaders. The county and sub county directors of education and county director of health services were purposively sampled to take part in this study. The overarching objective of this study was to explore the challenges of teenage mothers in Narok County and the Support interventions put in place for them. Methods: Qualitative data were collected through individual and group interviews while questionnaires were used to collect quantitative data. Individual interviews were conducted on parents, teachers /principles, religious leaders, local chiefs, county and sub county directors of education and county director of health services. Focus group discussions were conducted with 40 teenage mothers who were purposively selected through the help of headteachers of selected schools and local chiefs. Quantitative data were analyzed using SPSS while qualitative data were coded and analyzed according to themes. Findings: The study showed that teenage mothers grapple with a myriad of challenges including dropping out of school, lack of psychosocial support, lack of access to medical care, extreme poverty, stigma and inability to cope with their new parenting responsibilities. Further, young mothers lack professional counselling and suffer from stigma and discrimination, anxiety low self-esteem and guilt, Moreover, they are very ill prepared for their new role of parenthood. Teachers also are not well equipped on how to deal with students who become mothers. Worse still, the young mothers have no source of income to cater for their needs and those of their babies or even pay for their school fees should they want to go back to school. Implications: Findings of this paper are hoped to inform policy makers at national and County government levels in to come up with policies and intervention to leverage psychosocial and economic wellbeing and resilience among Kenyan teenage mothers and their children. The study findings mighty also be of help to other stakeholders including religious organizations, international and local NGOS and community-based organizations to formulate contextually responsive interventions to empower young mothers to be resilient. Thus becoming economically independent, able to be readmitted to school and reintegrate well to society. These findings also intend to contribute to research and practice in the fields of Population Studies and Child and Family Studies. Biography Florence is a trainer who has been lecturing in tertiary institutions in Kenya for the last 30 years. I hold a Phd degree in Peace and Conflict Studies and Masters in Counselling. My research interest is on vulnerable groups, especially women and Children in Emergency and Conflict Situations. Originally presented as 'A3 - Impact of Parenting Paper Session (25, 232, 15, 64)' at I-CEPS 2023.
Developing online parenting support programs for vulnerable families in Croatia
Authors: Martina Špaček and Dr Ninoslava Pecnik
Background and objectives: Parenting support program "Growing Up Together Online" was developed as a response to challenges in finding new ways of supporting vulnerable families that were brought about by pandemic and earthquakes in Croatia. It was developed through participative process of co-creation with parents of preschool children, users of social welfare and child protection services. Program objective is to create supportive environment for vulnerable parents in which they would exchange experiences and learn. Theory of change focused not only on parent-child interactions but also on parents as individuals, their strengths and resourcefulness, and their interpersonal relationships. Methods: During 2020 and 2021, 62 at-risk families participated in the "Growing Up Together Online" program. The program consists of 10 weekly, 90 minutes-long sessions and was implemented as a part of routine practice of public social services. Two sessions were conducted face-to-face (the first and the last workshop) and eight workshops were conducted via Zoom videoconferencing calls. Parents also had access to secure webpage where they could check on reading materials and write about their experiences. Parental self-reported cognitions (self-esteem, self-efficacy, parenting experience and parenting morale) and parental behaviors (positive involvement and reinforcement frequency, frequency of angry outbursts and physical and emotional harshness) were measured at pretest and posttest. Parental satisfaction with the program was measured at the end of the final session. Findings: We found significant improvements in parent-reported general self-esteem, parenting self-efficacy, parenting experience and morale and significant reductions in physical and verbal violence towards the child. Parents did not report increased attempts to understand children’s perspectives nor higher frequency of positive interactions. Reliable improvement was most common in parenting self-efficacy and least common in positive involvement and reinforcement. After the program, almost all parents reported that they had benefited greatly from participating in the program. There were few who considered participation a burden, mainly in terms of managing technology. Implications for policy, research, and practice: Implementing "Growing Up Together Online" was a new experience for practitioners (e.g., psychologists, social workers) in public social services since it is the first parenting support program in Croatia carried out almost entirely via videoconferencing calls. Outcome measures suggest potential of the program for improving parenting perceptions and practices and thus contributing to resilience of entire family. Program also showed its usefulness for at-risk parents who were unable to participate in in-person programs due to lack of transport in rural areas or lack of childcare during program hours. Successful implementation of "Growing Up Together Online" stimulated development of new online parenting support programs and web content for diverse caregiving contexts in Croatia (e.g., for adoptive families). These innovations in practices of Croatian public social services were enabled by their cooperation with the NGO Center for Parenting Support Growing Up Together and support from the Human Safety Net foundation. Originally presented as 'G3 - Child Maltreatment and Adversity Paper Session (212, 172, 211)' at I-CEPS 2023.
Dissecting the delivery of parenting interventions for child conduct problems: A Delphi study of core therapist competencies
Authors: Jessica Barker and Prof David Hawes
Background and objectives: The most effective interventions for conduct problems in early-to-middle childhood are social learning-based parenting interventions. Extensive research has tested the effectiveness of these interventions, and their contents (e.g., treatment components) have been a growing focus of meta-analyses and micro-trials. Little research, however, has investigated the clinical processes that are essential to their successful delivery. The aim of this study was to develop a core competency-based model for the delivery of parenting interventions for conduct problems, using a Delphi method. Of particular interest was the consensus of practitioners with expertise in the treatment of complex cases of child conduct problems. Methods: Participants were an international panel of 49 practitioners experienced in these interventions (average 18 years’ experience), 98% of whom currently worked with complex cases of conduct problems. Participants were sampled from the United States of America, Australia, Canada, New Zealand, England, Wales, Germany, Finland and the Netherlands. Data were collected using online survey and videoconference interviews, across three rounds, in order to achieve consensus. Participants rated and reported on a range of competencies derived from literature reviews and formal models of competencies from other fields of child and youth mental health. Conceptual content analysis was applied to key competency domains, and data re-presented to participants until consensus (agreement by at least 70% of participants) was reached. Findings: Data supported a model of core competencies consisting of three broad domains: generic therapeutic competencies; parenting intervention competencies, and specific parenting skills/techniques. These were further broken down into 15 subdomains of competencies to address shared processes. Examples from each include: building a therapeutic relationship; understanding relevant theory and research; and relationship enhancement; respectively. In the first survey, 88% of experts suggested at least one modification to the initial model. After revisions via conceptual content analysis, expert consensus was reached in the second survey, with 100% agreement between experts attained on 12 competencies, a minimum of 81% agreement on any one competency, and an 88% participant completion rate (43 of 49 original participants). Common themes raised as important by experts included: acknowledging culture and race and exploring implications thereof; using strengths-based practices; considering trauma experienced by the family and using trauma-informed practices as appropriate; and overcoming assumptions concerning traditional nuclear families. Implications for policy, research and practice: These findings have the potential to inform policy, practice and research concerning the evidence-based treatment of child conduct problems. They stand to inform clinical practice guidelines for the delivery of interventions to parents of children with conduct problems, particularly those cases with complex needs. They also have the potential to inform education, training, and professional development for practitioners in a range of postgraduate and community health settings, by identifying key priorities for such education. This includes applications related to the development of tools for clinical supervision and reflective practice in services for children with conduct problems and their families. Biography Jessica is a clinical psychology registrar and PhD candidate (University of Sydney). She completed her Master in Clinical Psychology (2022) and has clinical experience with disruptive behaviour problems and autism. Her PhD, supervised by Prof. David Hawes, investigates increasing efficacy and accessibility of parenting interventions through core therapist competency-based approaches. Originally presented as ‘D4 - Implementation Science Paper Session (183, 122, 163)’ at I-CEPS 2023.
Do neighbourhoods influence how parents and children interact? Direct observations of parent-child interactions within a large Australian study
Authors: Dr Shannon Bennetts, Jasmine Love, Dr Clair Bennett, Dr Fiona Burgemeister, A/Professor Elizabeth Westrupp, Dr Naomi Hackworth, Dr Fiona Mensah, Dr Penny Levickis, and Professor Jan Nicholson
Background and objectives: Neighbourhood-level factors can exert unique influence on parenting and child development, independent of individual parent, child, and family factors. Families living in neighbourhoods where there are high levels of poverty and crime and inadequate access to public services may be vulnerable to chronic stress that undermines parenting capacity. Mutually responsive parent-child interactions are well-established predictors of children’s socioemotional, behavioural, cognitive and language development in the early years, but how parent-child interactions vary as a function of neighbourhood is not well-understood. We therefore investigated the contribution of neighbourhood socioeconomic status (SES) to directly observed parent-child interactions. Methods: We conducted free play home-based observations with Australian parents and their 7-8-year-old children. Parents and children were provided with three toy sets: Lego, Jenga, and animal snap cards. They were asked to play together “however they wanted” for “around ten minutes”. Video-recorded observations were subsequently rated by trained researchers, according to an adapted version of the Coding of Attachment-Related Parenting framework. We rated the presence of 11 behaviours across two domains: (i) Parents’ Sensitive Responding (e.g., shows warmth, promotes child’s autonomy), and (ii) Parent-Child Positive Mutuality (e.g., turn-taking, fluid conversation). Neighbourhood SES was measured using the Australian Bureau of Statistics ‘Index for Relative Socio-economic Advantage and Disadvantage’, which categorises postcodes into five quintiles, from most disadvantaged to most advantaged. Adjusting for individual family characteristics, multilevel modelling was used to investigate the relationship between neighbourhood SES, the two overall domains, and the 11 specific behaviours. Findings: The 596 participating families were living across 148 postcodes of varying SES, including both metropolitan and regional areas of Victoria, Australia. We found that greater neighbourhood disadvantage was associated with less sensitive responding (β=.10, p=.004). There was no evidence of an association between neighbourhood SES and parent-child positive mutuality (β=-.01, p=.90). Parents living in the most disadvantaged neighbourhoods were the least likely to consistently demonstrate warmth towards their child, and the least likely to make efforts to promote their child’s autonomy. Implications for policy, research and practice: Our findings suggest that parents’ capacity to respond sensitively to their child might vary according to neighbourhood-level SES. Parents living in disadvantaged neighbourhoods may experience particular concerns related to a less safe environment, less access to services, or fewer green spaces, and these concerns can negatively impact parent mental health, causing spill-over effects for parent-child interactions. Therefore, tailored, evidence-based parenting supports according to local community need are warranted. Our findings also highlight the need for targeted government initiatives to reduce inequities experienced by those living in less advantaged areas. Originally presented as B5 Vulnerbale Families Paper (95) at I-CEPS 2023.
Emotion Socialisation Processes and Child Emotion Development
Authors: Gabriella King, Dr Jacqui Macdonald, Prof Sophie Havighurst, Dr Christiane Kehoe, Prof Julie Dunsmore, Dr Christopher Greenwood, Wendy Frogley, Xia Xin, Eliza Bate, George Youssef, Mr Tomer Berkowitz and A/Prof Elizabeth Westrupp
Background and objectives: Emotion regulation skills are foundational, and underpin lifelong wellbeing and mental health by determining our ability to form and maintain relationships, manage conflict, and navigate the challenges of daily life. The manner in which parents socialise their children’s emotion competence has long-term implications for child development. Emotion coaching parenting, i.e., sensitive, supportive parenting, is linked to prosocial behaviours, wellbeing, social competence, and academic achievement. On the other hand, emotion dismissing parenting, which is unsupportive and invalidates children’s emotions, is linked to higher levels of internalising and externalising problems, and peer problems. The four presentations in this symposium explore processes underlying parents’ emotion socialisation and their role in shaping child emotion regulation right from pregnancy to middle childhood. We test: (1) associations between parent emotion regulation in pregnancy and subsequent infant emotion regulation; (2) a latent profile analysis of parents’ emotion socialisation (beliefs, behaviours, emotion regulation); (3) associations between profiles of parents’ emotion socialisation and concurrent/long-term child emotional outcomes; and (4) associations between parents’ profiles of emotion socialisation and parental reflective functioning with long-term child emotional outcomes. Methods: Data were from the Child and Parent Emotion Study, an age-stratified longitudinal cohort study (N=2,336). Participants were parents of a child aged 0-9 years, or prospective (pregnant) parents, living in English-speaking countries. We present findings from four analyses using CAPES data: (1) a multiple linear regression that tested associations between parents’ emotion dysregulation and emotion socialisation during pregnancy and the transition to parenthood; (2) a latent profile analysis of parents’ emotion socialisation; (3) a multinomial logistic regression of associations between the profiles and child emotional outcomes; and (4) a multiple linear regression that assessed whether associations between the profiles and child outcomes remained when controlling for parental reflective functioning. Findings: (1) Parent emotion dysregulation during pregnancy was associated with higher distress reactive parenting and negative emotion expression in the family post-birth. (2) Three distinct profiles of parents’ emotion socialisation were found: ‘emotion coaching’; ‘emotion dismissing’; and ‘disengaged’. (3) Emotion dismissing and disengaged parenting (versus emotion coaching) were associated with child emotional problems concurrently and longitudinally. (4) Finally, when tested together, we found that both the parenting profiles and parental reflective functioning were independently associated with child outcomes. Conclusion and Implications: Our findings suggest that parents who find it difficult to manage their emotions would benefit from additional support and early intervention during the transition to parenthood and early childhood years. Identifying adults who experience heightened emotion dysregulation at pregnancy and offering them additional support during their first year of parenting could help prevent a negative home environment, and subsequent negative child outcomes. Further, our findings identified a middle group of parents reporting ‘disengaged’ parenting, showing low emotion and dismissing parenting. Clinicians and parenting interventions may be able to tailor their services for parents with a disengaged pattern of emotion socialisation, thus potentially improve treatment efficacy and retention rates of parents, and subsequent child development outcomes. Finally, findings suggest that parental reflective functioning and emotion socialisation are distinct parent constructs. Originally presented as A1 - Impact of Parenting Symposia (143) at I-CEPS 2023.
Examining parent-infant interaction trajectories in infants with and without an elevated likelihood for autism: A replication study
Authors: Eirini Papageorgopoulou, Dr Ming Wai Wan, Prof Mark Johnson, Prof Tony Charman, and Prof Emily Jones, and The Basis team
Background: It has been suggested that developmental antecedents of autism may bidirectionally affect parent-infant social interactions, amplifying social skills difficulties (Dawson, 2008; Elsabbagh & Johnson, 2007). Previous research using a sample from the British Autism Study of Infant Siblings (BASIS) found differences in several areas of parent-infant interaction for 7 and 14 months with lower ratings for infants with versus without elevated likelihood (EL) for autism (defined by having an older diagnosed sibling), and prediction of 3-year autism outcome based on 14-month interaction (in mutuality, positive affect and attentiveness; Wan et al., 2013). Objective: We sought to replicate previous work by Wan and colleagues in a more recent, larger sample to examine the consistency and predictive value of the parent-infant interaction aspects in relation to autism likelihood and later autism outcome (infants at EL with and with no autism outcome, EL-autism, EL-no autism; infants at typical likelihood, TL). Methods: Using the Manchester Assessment of Caregiver-Infant Interaction (MACI) global rating scales, we evaluated 6-minute videotaped laboratory-based unstructured parent-infant free-play interaction in a larger independent prospective cohort from the BASIS at 7-11 (100 infants at EL, 24 infants at TL) and 13-18 months (104 EL and 26 TL infants). Coding was blind to participant information. Assessment of autism outcome was conducted at 36 months. Findings: Linear mixed-effects models replicated previous findings showing significant differences in parent sensitive responsiveness, parent non-directiveness and dyadic mutuality (ps < 0.004) between the autism likelihood groups (EL-no autism, EL-autism, TL) with scores on these variables being lower in the EL-autism group compared to the other two groups. Additionally, an age-by-group interaction effect showed that infant attentiveness to parent decreased from 8 to 14 months in the EL-autism group compared to the other two groups (p=0.02). 14-month infant attentiveness to parent and mutuality predicted autism outcome; this also replicated previous effects. We failed to replicate the group effects in infant liveliness, positive affect and dyad engagement intensity. Furthermore, we found earlier (8m) predictive effects of autism outcome in infant positive affect and parent nondirectiveness (ps
Exploring Indigenous parent wellbeing: Implications for early intervention parenting programs in Indigenous communities
Authors: Arvind Ponnapalli, Tarita Fisher and A/Professor Karen M.T. Turner
Background: Little is known about subjective wellbeing indicators for Aboriginal and Torres Strait Islander parents and families. Despite increasing awareness of the models of Indigenous social and emotional wellbeing, applying such knowledge in clinical assessment and practice remains scarce as clinical practice continue to be driven by Western discourse. Methods: This community engagement project adopted a qualitative research design through focus group discussions and interviews to explore the subjective experiences of Indigenous parents’ wellbeing within an Indigenous community context. A participatory-action research methodology was utilised in collaboration with the community-based advisory group members to verify the Indigenous Parent Wellbeing (IPW) model and its domains and sub-themes. Participants’ cultural perspectives of wellbeing were collected through open-ended semi-structured questions during focus groups and interviews (n=20). NVivo (qualitative analysis software) was used to code and identify key themes. Thematic analysis was undertaken using a-priori coding based on Dudgeon and colleagues’ social and emotional wellbeing framework and an interpretative phenomenological analysis (IPA). The data was displayed to the advisory groups for collective data analysis. Subsequently, the Indigenous parent wellbeing themes were determined. Findings: To our knowledge, there is no prior study that explored domains of parent wellbeing specific to the Australian Indigenous parent or caregiver population. In this study, the findings were conceptualised into an IPW model with three super-ordinate domains, which include 1) the child wellbeing domain, 2) the primary parent wellbeing domain, and 3) the context domain. Within each domain, several sub-themes emerged. Noteworthy, three overlapping and intersecting wellbeing themes were noted in all three domains; these include the importance of parents, children and ecological context’s connections to a) culture; b) country; and c) spirituality. Implications for policy, research and practice: The influences of parent wellbeing on parenting and child development are well established. A clearer understanding of Indigenous parent wellbeing and its constructs will assist in the development of policy, research and clinical practice to better support Indigenous caregivers and their children. The findings of this study will potentially be of influence across many sectors including health, child welfare and education settings. Further studies in this research series will explore the impact of evidence-based parenting support, tailored for the Cherbourg community, on parent wellbeing, parenting and child outcomes at an individual family and community level. Originally presented as B5 - Vulnerable Families Paper Session (239, 95, 206, 54) at I-CEPS 2023.
Feasibility randomised controlled trial of Being a Parent-Enjoying Family Life: A novel, peer-led group parenting interventions for parents with significant emotional and interpersonal difficulties.
Authors: Ellie Baker, Dr Patrick Smith, Jordan Troup, and Professor Crispin Day.
Background and objective: Group-format parenting interventions are effective at reducing challenging child behavior and conduct problems. However, there is significantly less evidence about the performance of these interventions for parents with significant emotional and interpersonal difficulties, including personality disorder diagnoses. This poster presents the initial findings of a two-arm parallel group feasibility Randomised Controlled Trial and nested process evaluation of Being a Parent (BaP)-Enjoying Family Life, a novel peer-led intervention. Methods: 77 parents who experience significant emotional and interpersonal difficulties and who are concerned about their child’s, aged 2-11 years, behavior were recruited through clinical and community recruitment pathways. Of those 77 parents, 66 were randomised to received either BaP-Enjoying Family Life or the well-established Empowering Parents Empowering Communities-Being a Parent (EPEC-Being a Parent) group-format interventions. The primary outcomes were the feasibility (recruitment, retention and fidelity) and acceptability of BaP-Enjoying Family Life intervention and trial methods. Secondary clinical outcomes include child behavioral difficulties, parenting, parent wellbeing, reflective function, satisfaction and self-efficacy. An observational assessment of parent and index child was also used to assess changes in the home environment. Outcome measures were collected pre-intervention, post-intervention and at 6-month follow up. A parallel process evaluation will use qualitative data from interviews to assess parents’ experience of the intervention delivery and trial methods. Findings: Initial findings show sufficient participant identification (more than 60% of consenting participants eligible, 66 parents randomised) and retention (time 2 retention is over 65%) based on pre-determined feasibility criteria. Intervention acceptability, fidelity and evaluation of pre- post- clinical outcomes will also be presented. Implications for policy research and practice: The results of this feasibility trial will indicate the acceptability of low-intensity, group-based interventions for parents with significant emotional and interpersonal difficulties and indicate whether targeted and universal interventions are acceptable and beneficial to this population. The feasibility trial uses and evaluates a more inclusive recruitment approach through clinical and community pathways. The results will enable more reliable identification of the routes through which parents with significant emotional and interpersonal difficulties seek support. Originally presented as F4 - Future Directions Paper Session (141, 55, 222) at I-CEPS 2023.
Good Kombra na Glady Family: Promoting nurturing care and non-violence through parenting in Sierra Leone
Author: Emma Vincent
Background and objectives: Good Kombra na Glady Family (nurturing caring/caregiver and a happy family) is a positive parenting education program based on global evidence and adapted for Sierra Leone’s culture and context. The Ministry of Social Welfare and UNICEF Sierra Leone conducted research on children’s experience of violence in the home and parents’ and caregivers’ views on parenting, resulting in a commitment to promote parenting as an important and evidence-based response. The objectives were to develop and pilot a culturally relevant parenting program that addressed the high levels of all forms of violence, including harmful practices. The piloting process tested feasibility and acceptability. Methods: The parenting program was first designed on a review of the global evidence based on parenting. The Theory of Change reflected the global evidence base, national research findings and inputs from key actors in a Technical Working Group. The piloting assessment used a mixed-methods approach. Quantitative tools, applied during delivery of the pilot program, included pre- and post-program assessment questionnaires with parents and caregivers, session observation tools and supervisory reports. These were used to assess the curriculum, training, and delivery of Good Kombra na Glady Family. After completion of the pilot, Focus Group Discussions and Key Informant Interviews were conducted with supervisors, implementing staff, facilitators, participating caregivers, and community leaders, that gathered inputs on program delivery, acceptability and cultural acceptability. Initial recommendations were shared with national stakeholders with a focus on future sustainability and scale-up. Findings: The program was felt to be relevant and acceptable in all piloting sites, across three of the four regions in Sierra Leone and in peri-urban and rural settings. All participants reported being happy with the program (87% strongly agreed). Supervisors noted that the program was inclusive and highly engaging. There were positive changes for all parenting objectives, most significantly in the following areas: non-violent discipline (41% positive score difference); importance of self-care (18% positive score difference); promoting gender-equitable practices at home (20% positive score difference); and the importance of positive communication with other family members, including spouses (15% positive score difference). There are promising indications of culturally acceptable approaches to exploring gender-based violence and promoting positive gender norms, including greater male caregiving. These findings are based on a small sample, but the overall findings demonstrate the potential of the programme. Implications for policy, research and practice: The programme proves to be a popular and relevant intervention to promote positive parenting with a focus on violence prevention and male involvement. The positive reception by male caregivers to issues such as positive communication and non-violent discipline, and the willingness to discuss issues of child marriage and FGM within families/communities demonstrate its benefit. It would serve as an entry point for other interventions (WASH, Education, Social Protection, Innovation Health, Nutrition and peacekeeping during elections), complementing other social norms initiatives addressing gender and harmful practices. Future plans will explore potential for scaling up, including integration with other violence prevention initiatives. Originally presented as 'A7 - Impact of Parenting Paper Session (90, 86, 224)' at I-CEPS 2023.
Impact of training fathers in an early literacy intervention on child cognitive development and risk factors for violence
Authors: Kaathima Ebrahim, Prof Catherine Ward and Lauren Van Niekerk
Background: Violent behaviour in adolescence and adulthood can develop when children’s normal expression of aggression fails to follow the normal trajectory of emotion regulation. If this aggression becomes persistent and pervasive, it is a strong risk factor for later aggressive behaviour. This negative developmental pathway is predicted by three early parenting difficulties: unresponsive/insensitive parenting, leading to children’s insecure attachment; harsh/inconsistent parenting, leading to child behaviour problems; and poor cognitive stimulation, leading to child cognitive problems. An early positive parenting intervention called ‘dialogic book-sharing’ (DBS) has been shown in rigorous research to significantly improve the three problematic aspects of parenting with corresponding reductions in early childhood risks for later violent behaviour. DBS programmes have almost exclusively been attended by mothers. The current study adapted the DBS programme for delivery to fathers with the aim of increasing child secure attachment, prosocial-behaviour, and cognitive skills and thereby reducing risk factors for the development of violence. Methods: Mikhulu Trust partnered with Sonke Gender Justice and the University of Cape Town to adapt its DBS intervention for delivery to fathers and conduct a pilot study of delivering this intervention to fathers, with the aim of reducing both harsh parenting and early child risk factors for the development of aggressive behaviour and later violence (including violence against women). This was done by first running focus group discussions with fathers to adapt the existing DBS programme – making it more attractive for fathers. Once we had resolved on the adapted programme, it was delivered in the context of a pilot RCT with a wait-list control. A sample of 70 fathers of 12- to 24-month-old children from Gugulethu in the Western Cape were recruited. After a baseline assessment (of both mothers and fathers), fathers were randomly assigned to either the index group (n=35) or the waitlist control group (n=35). Two to four weeks after the 6-week intervention to the index group was completed, all participants were re-assessed. The waitlist control group then received the intervention. Findings: The study measured a number of outcomes for fathers and children. The data are still being analysed and the outcomes of the study will be available in early 2023. Outcomes that were measured include: • Fathering outcomes: How often fathers share books with their children each week (assessed using the Father Involvement Scale, completed by both mothers and fathers); Father observed sensitivity and reciprocity; Use of positive parenting (praise) and harsh parenting (hitting and yelling) in the past month; Gender equitable attitudes. • Child outcomes: Language assessed indirectly by father and mother report using the Child Development Index; Attention assessed with the Early Childhood Vigilance Task. Implications on policy, research and practice: This research project gives us an opportunity to identify a new mechanism to tackle gender-based violence, and more generally, violence prevention in South Africa. By focusing on the preventative measures in childhood, that are risk factors for violence in adulthood, we are developing a new approach that will be integral to the collective systemic approach to reducing violence against women. Originally presented as 'E8 - Diverse Service Contexts (186, 109, 171)' at I-CEPS 2023.
Improving early reading skills for low income Black and Latine children through cognitively stimulating parent-child Interactions: Findings from an RCT
Authors: Helena Wippick, Dr Caitlin Canfield, A/Prof Elizabeth B. Miller, Dr Erin Roby, Dr Daniel Shaw, Prof Alan Mendelsohn, and Prof Pamela Morris-Perez
Background and objectives: There is substantial evidence of disparities among low income and racial and ethnic minority children in school readiness and achievement, often called ‘opportunity gaps’ and attributable to structural inequalities. Positive parenting can be a strong buffer against said outcomes. Smart Beginnings (SB) is an evidence-based parenting intervention for children from birth to 3 years combining two interventions, a health care-based universal primary prevention program, Video Interaction Project (VIP) and a home-based targeted secondary prevention program, the Family Check-Up (FCU). Prior research has found that participation in SB increases parental support of cognitive stimulation from infancy through toddlerhood. The present research extends these impacts to later child academic achievement. Methods: The present study analyzes data from a single-blind randomized controlled trial (RCT) of the SB model with 403 families in New York City (NYC) and Pittsburgh, PA. Positive parenting practices are measured via coding of parent-child interactions for parental support of cognitive stimulation at child age 24 months. Child academic achievement is measured through early reading via children’s standardized scores on the Woodcock Johnson Battery of Achievement - Letter Word identification (WJ LW) assessed at child age 48 months. The WJ was administered in both English and Spanish for bilingual children (N=107 ) and the higher of the two scores was used for analysis. The primary analysis is to investigate if cognitive stimulation in parent-child interactions mediates the relationship between SB participation and child early reading. Findings: Due in part to the 48 month assessment occurring over the course of the COVID-19 pandemic, only 243/403 enrolled families have child WJ-LW scores available for analysis. The primary predictor is assignment to treatment, the mediator is observed cognitive stimulation in parent-child interactions (24mo), and the primary outcome is early reading skills (48mo), with site (NYC/Pittsburgh) included as a covariate. Analyses were conducted using the sem function for Stata. Analysis is still ongoing, but preliminary analyses reveal direct effects of intervention status on increases in observed cognitive stimulation in parent-child interactions ( β =.20, p
“In my own language”: Parental knowledge consuming in diverse groups in Israel
Authors: Dr Shulamit Pinchover and Rony Berger Raanan
Background and objectives: The Israeli society consists of many ethnic and cultural groups, which differ in various characteristics, which affect parental knowledge and knowledge consuming. It is important to understand the way parents from the Arab, ultra-Orthodox, and Ethiopian-Israeli groups consume knowledge, since often the knowledge disseminated to the general population is not culturally adapted. Understanding knowledge consuming in different cultural groups will inform cultural adaptation and contextual fit of parental programs and parental knowledge translation. The goal of the study is to learn about parental knowledge consuming in diverse groups in Israel. Methods: We conducted a two stage mixed method study in order to learn about parental knowledge consuming from the perspective of both parents and early childhood professionals. Data included: (1) A survey with 245 early-childhood professionals working with the Arab, ultra-Orthodox, and Ethiopian-Israeli population. The survey was followed by 3 focus groups, to gain deeper understanding of the survey findings. (2) Thirty semi-structured in-depth interviews with mothers from the Arab, ultra-Orthodox, and Ethiopian-Israeli population. Both groups were asked about parental knowledge and needs and the ways of parents in various group consume professional knowledge. Survey data was analyzing using descriptive statistics and focus groups and interviews were analyzed using qualitative-thematic analysis. Findings: Similar findings raised from the data of both mothers and early-childhood professionals. Discipline and education were found as a major challenge for parents in all groups. The necessity of parental knowledge and support was emphasis all across the data. In addition, tribal wisdom was found to be the most significant knowledge source for all groups. The ultra-orthodox and Arab communities are more traditional and collectivist communities, as reflected in the parental knowledge consuming. Parents from the Ethiopian-Israeli community are more integrated in the majority group in Israel, and express more ambivalence towards traditional knowledge and support. It is important to notice that high proportion of families in these groups are from low socioeconomic status which also affect parental knowledge and accessibility to professional help. Implications for policy, research and practice: The study’s findings have practical implications for parenthood and for children’s well-being. Parents are entitled to culturally and ethnically aware information, that is adapted and translated in a respectful way to the needs of their own group. Our study presents data on the view of parental knowledge consuming in terms of its societal diversity and its myriad sources. This understanding will inform knowledge translation in a beneficial and respectful way to diverse parents. Furthermore, in light of the insight that the primary source of parents' knowledge is the tribal wisdom, it seems that promoting parent training and dissemination through people within the community in crucial. Originally presented as E7 - Diverse Service Contexts Paper Session (181, 62, 37) at I-CEPS 2023
“Kind, sets limits sometimes, cares for one”: Children’s short descriptions about what constitutes a ‘good parent’
Author: Professor Anna Sarkadi
Background and objectives: Effective parenting practices have been the focus of research on children and families for several decades. Parenting programs based on social learning theory reach tens of thousands of parents every year and emphasize both boosting the quality of the relationship and providing assertive discipline. However, little research has explored what children themselves perceive as good or helpful parenting styles and practices. Our aim was to analyze children’s perceptions on what constitutes a “good parent”. Methods: Our research group had a stand at a science fair, presenting research to school classes (6th graders) during a weekday and families during a weekend day. The material constitutes responses to a single open-ended question: “What is a good parent?”. Children 4-14 years old, who came to the stand were informed that we do research on families and are interested to hear what children think about different things. They were then presented with the question and handed a post-it note to write their responses on. The youngest children were assisted, although most children preferred to write their own notes, judging from the ample presence of spelling mistakes. The responses (N=280) were then entered verbatim into an Excel file and a manifest content analysis was performed, resulting in N=29 codes. Findings: The most common characteristics of a ‘good parent’ were being kind (42%), caring (19%), and fun. According to the children, good parents listen (15%) and talk to their children, help them when they need it, respect them, like spending time with them, and provide for them. Children also had clear ideas about the value of limit setting (10%), often acknowledging the need for both being kind/caring and setting limits. A number of children explicitly said a good parent should not hit or hurt a child (3%) or should not be angry or shout (4%). Some children described a good parent as allowing the child to do whatever it wants (5%), especially regarding screen time. Finally, some children felt good parents should teach their children things, give them space, and be cool/good looking. In sum, children’s responses to a single open-ended question pinpointed characteristics of a good parent known from the parenting literature and advocated for in parenting programs. Implications for policy, research and practice: The majority of the codes identified in this analysis related to a warm and caring parent-child relationship, well in accordance with the general emphasis of parenting programs on spending ample quality time with the child to build the relationship. The fact that assertive discipline, along with quality time seems to be the optimal combination in effective parenting programs seems to resonate well with children. Finally, given that corporal punishment has been banned in Sweden since 1979 it is very interesting that 4% of children explicitly mentioned non-violent behavior as an important characteristic of a good parent. Parenting programs have been shown to reduce violence against children so even this aspect seems highly relevant from the children’s perspective. Originally presented as A5 - Impact of Parenting Paper Session (43, 106, 100, 59) at I-CEPS 2023.
Leticia's Journey: An evaluation of an audio-novella to strengthen habits of resilience in caregivers of young children
Authors: Prof Barbara Burns and Georgina Chavez
Background and objectives: Across a ten-year period, we have collaborated to implement a mindfulness-based, trauma-informed, community-led parent education program in San Jose, CA. Our community-led parent education program, called Safe, Secure and Loved: Resilient Families, provides parents with the knowledge and tools to enhance parental strengths related to stress management, goal setting and problem solving and the sensitive nurturing of young children. In this paper we share findings from a new Safe, Secure and Loved (SSL) parent support approach We have created a seven-episode audio-novela that elucidates the mission and vision of SSL using novel technology. This presentation shares what 45 families of young children remember and learn from listening to the audio-novela. Methods: The 7 episodes of Leticia’s Journey: Safe, Secure and Loved follow the Fernando family who is dealing with the many stressors that face families in communities with limited economic resources. In the telenovela, Leticia has two small children, food and housing insecurity, economic challenges and toxic stress from community violence and injustice. Leticia, enrolls in the SSL parent education program after a family crisis, and we follow her as she practices habits of resilience learned in each workshop. We witness Leticia as she launches herself on a hero’s journey as she faces crises, strikes out to solve new challenges using habits of resilience, and eventually decides to become trained as a facilitator in the SSL parent education to further support her community. Half of participants received all materials in English; half received all materials in Spanish. Findings: We recruited 45 caregivers of young children to participate in an evaluation of Leticia’s Journey. Half of caregivers received all materials in English; the other half in Spanish. Participants completed family wellness questionnaires and family strengths assessments and viewed seven 25 minute episodes across a 2-week period. Participants completed comprehension questions between each episode and after the last episode they completed short answer and reflective questions on their learning and reaction to the audio-novela. Comprehension of episode details was high ('more than' 80%) and participants demonstrated they learned about adversity and the need for practicing healthy stress management and sensitive caregiving to support family resilience. Implications for policy, research and practice: This audio-novela personifies the real struggles of parenting in a marginalized community and provides a relatable family to learn ways to promote child and family health and well being in the midst of adversity. The audio-novela depicts the journey of Leticia who faces these problems in community, and discovers in herself new ways to enhance her inner strengths. Leticia demonstrates what she has learned with family and friends and uses her voice to share what she has learned about resilience to uplift her own family and the larger community. This audio-novela project fits into larger goals to prevent child abuse and neglect and support resilience in children and families in under-resourced communities and demonstrates the potential for novel prevention approaches to support understanding of shared challenges and the need to support parental strengths of resilience. Biography Barbara M. Burns, Ph.D. is a developmental psychologist at Santa Clara University and long-time collaborator with Sacred Heart Community Service, a community agency in San Jose, CA. We have created a community-academic partnership to support discovery of ways to strengthen family resilience and preventing child abuse and neglect in families. Originally presented as ‘F4 - Future Directions Paper Session (141, 55, 222)’ at I-CEPS 2023.
Now and Next, an innovative parent-led program for building capacity in families of children with disability grounded within a system informed positive psychology perspective
Authors: Dr Anoo Bhopti, Dr Tim Moore, Yanchen Zhang, Katharine Lancaster, Ms Rachel Taylor, Sylvana Mahmic, Dr Annick Jansen, and A/Prof Margaret Kern
Background: The intersection of positive psychology and disability emphasises strengths-based approaches to support the wellbeing of people. However, existing disability services are primarily deficit-oriented, expert-led and insensitive to family needs. Such resource-intensive approaches place formidable pressure on families, who must provide care/support for their children without adequate wellbeing management. The Now & Next (NN) suite of programs are based on positive psychology principles, family-centred, peer-led, proactive support approaches that build capacity, empowering parents of children with disabilities to address their family’s needs, achieve goals, and build wellbeing. The programs run in 4 countries, uncovering parent empowerment principles at play across cultures. Methods: NN programs are codesigned with families and based on adult learning principles, fostering experiential learning through a ‘by families for families’ approach. Participants master positive psychology practices such as uncovering and harnessing their own and their children’s strengths, and unpacking long term goals into shorter, achievable ones. Participants use Pictability, a novel strength-based game-like tool that fosters transformational goal-setting. The programs also coach professionals to effectively use strengths-based tools in their practice. To evaluate the program, a quantitative study design was used, where participants (parents of children with disability who participated in the NN program), completed online standardised tools as well as pre-post surveys, reporting on impacts of the NN program on themselves and their children at pre and post program. Descriptive analysis and t-tests were used to look at patterns and changes over time, with multi-level regression used to evaluate program effectiveness. Findings: Initial external evaluation (N=154) showed that there were significant increases in parent empowerment, knowledge, attitudes, participation, hope, agency, strategies, and wellbeing, with 97% families reporting achieving their goals during the program. Further evaluation with an international sample (4 countries) of 561 parents nested within 58 groups, testing a-priori 3-level multilevel models for each outcome supported the effectiveness of the program on parents' wellbeing, hope, and empowerment, with treatment effects varying based on individual and group characteristics. Ongoing monitoring (N=899) follows these global trends. Findings also demonstrated that the program effectively engaged fathers and families from culturally and linguistically diverse backgrounds. Families reported enjoyable and powerful experiences, a growing sense of competence to assist their children through their development and having formed deep connections with peer families expanding beyond the program. The peer group environment provided families with the support to implement their vision by taking their goals into action. Implications: Future practice needs programs such as the NN program that demonstrate how parents can leverage systemic change, and be involved in service design and delivery. At the individual level, parents develop wellbeing literacy through peer contact, a sequenced structure of learning, focusing on short-term achievable goals. At the community level, families build support networks. Family leaders emerge to become co-facilitators. Future Policy needs to promote such programs to shape sustainable social change, disrupting current systemic bottlenecks potentially lowering dependency on the health system and disability care. Future research needs to evaluate this program using rigorous control studies, but current findings support the program’s value. Biography Anoo Bhopti is a Senior Lecturer and Researcher in the Faculty of Medicine, Nursing and Health Sciences at Monash University. Anoo’s research is embedded within the early childhood intervention/childhood disability sector. her research includes evaluating parent support programs with an aim to improve family well-being and family quality of life. Originally presented as ‘A8 - Impact of Parenting Paper Session (180, 108, 229)’ at I-CEPS 2023.
Online TEM - Transforming Everyday Moments - Workshop: A caregiver mediated intervention experience implemented in Argentina during the COVID-19 pandemic
Author: Alexia Rattazzi
Background and objectives: In many low and middle-income countries such as Argentina, parent-implemented interventions are sometimes the only available intervention for children with autism. One of such parent-implemented interventions existing in Argentina is called TEM - Transforming Everyday Moments - workshop, a free 2-day caregiver-oriented workshop intended for caregivers of children diagnosed with autism under the age of 6 and limited speaking abilities. This workshop offers tools to caregivers to promote play, engagement, shared enjoyment and communication skills. Since 2013 more than 200 TEM workshops have been done, reaching more than 2500 caregivers. In the midst of the COVID-19 pandemic in 2020, an online version of the TEM workshop was developed to give continued support to parents of recent diagnosed children. Methods: During 2020, PANAACEA, an NGO dedicated to autism awareness, training, research, intervention and public incidence, developed an online version of the 2013 in-person TEM workshop. In November 2020, the first virtual TEM workshop was piloted with 20 caregivers using a Zoom license. Adjustments in dynamics and length of the TEM workshop were made after the pilot testing, and since then, PANAACEA has offered the 2-day online TEM workshop on a monthly basis to the present day. Findings: More than 25 online workshops were done, reaching over 350 caregivers since November 2020. Caregivers were not only from different provinces in Argentina, but also from other countries, such as Uruguay, Chile, Peru, Mexico, Colombia, Paraguay, Bolivia, Ecuador. 346 caregivers completed a brief feedback survey at the end of the workshop. These were the overall results: 10% had a technical or connectivity problem during the workshop, 98% of the caregivers found the workshop extremely helpful (scored 8-10 in a 1 to 10 scale), 98% of the caregivers mentioned the workshop significantly changed their playing style (scored 8-10 in a 1 to 10 scale), 99.9% stated they would definitely recommend it to other caregivers. Implications for policy, research and practice: In countries like Argentina there are many barriers for families to access services for their young children with autism. In this context, parent mediated interventions can sometimes be the only source of tools and strategies to empower caregivers and improve the socio-communicative and play abilities of children with autism. Free online parent-training workshops are a feasible alternative to expand access to services and have a positive impact in caregivers, empowering them and improving joint engagement with their children. Biography MD, Child & Adolescent Psychiatrist, co-founder of PANAACEA (Argentine Program for Children, Adolescents and Adults with Autism Spectrum Conditions), TEM workshop coordinator, member of INSAR, REAL, AAPI, REDEA, AHORA. Clinician, researcher, professor, human rights activist, communicator. Originally presented as 'C4 - Global Perspectives Paper Session (185, 178, 230)' at I-CEPS 2023.
Parental behaviors before, during the COVID-19 first lockdown, a year and two years later: Lessons and challenges
Authors: Galia Meoded Karabanov and Professor Dorit Aram.
Background and objectives: The COVID-19 pandemic introduced changes in the daily lives of families of young children (Bornstein, 2021). Data confirm the negative impact of the prolonged pandemic on the mental health of parents and children, including deteriorated family cohesion, increased family conflicts, disorganized daily routines, and children's vulnerability (Fosco et al., 2021). We aimed to explore the stability and change in parenting behaviors of young children's parents at four-time points: Before the pandemic outbreak, during the first lockdown (March-April 2020), during the "new normal", and two years later. We study parenting using the Parenting Pentagon Model (PPM; Aram et al., 2021). The model comprises five beneficial parenting behaviors: Partnership between spouses; parent Leadership; Love expressions; supporting the child’s Independence; and adherence to Rules. Methods: The study integrated quantitative and qualitative research methods. Quantitative questionnaires were used to assess parenting behaviors during the first three periods. Qualitative interviews were used to evaluate parents' reflections on their parenting towards their young children during the two years of the pandemic. Participants were 577 Israeli parents, mostly educated from middle SES mothers, aged M=36.65 years (SD=3.94) to children aged M=4.72 years (SD=1.46). Data were collected before the COVID-19 outbreak (n=192), during the first lockdown in March-May, 2020 (n=190), one year later in April-May 2021 (n=180(, and two years later (n=15). Parents who participated in the first three assessments completed a 34-item online questionnaire rating the frequency of daily parenting behaviors with their young children. Parents also completed a socio-demographic questionnaire. Parents in the fourth assessment were interviewed regarding their daily parenting behaviors and changes during/since the COVID-19 outbreak. Findings: Results demonstrated changes in parental behaviors between the four periods. Post-hoc tests, controlling for parents' age and education, child’s age, and family size, revealed that during the first COVID-19 lockdown, parents reported significantly less beneficial parenting behaviors in the five measures of the PPM. A year later, there was a significant increase in Partnership between spouses, support for Independence, and Adherence to rules behaviors. Yet, their reports regarding Love expressions and parental Leadership behaviors remain significantly lower than before the pandemic. Qualitative data collected two years after the pandemic breakout supported these findings and deepened our understanding. Mothers described the first lockdown as "a tough time for our family", a time when "The family went through very big crises, losses, marital crisis… at the beginning, I was still in a kind of motivation, which slowly changed to despair. I was alone with them [children] all the time and I felt like I had no air". Implications for policy, research, and practice: The strength of this study lies in its broad view of parenting in times of prolonged crisis. The picture it presents can aid in supporting parents' coping skills during stressful times. Acknowledging parents as the central agents in their children’s lives can empower them. It can encourage parents to be aware of behaviors that need strengthening in the family. Parental guidance is essential during crises to support parents and children's well-being. Originally presented as 'A3 - Impact of Parenting Paper Session (25, 232, 15, 64)' at I-CEPS 2023.
Pilot implementation of the Incredible Years program with maltreating and at-risk families in Spain
Authors: A/Prof Ignacia Arruabarrena, Dr Gabriela Rivas, Dr Maria Cañas, and Dr Joaquín De Paúl
Background and objectives: Incredible Years is a parent training program designed to promote young children´s emotional and social competence, to prevent, reduce, and treat aggression and emotional problems, and to improve parental practices and the parent-child relationship. It consists of three group-based curricula for parents, teachers, and children, that can be used independently or in combination. The Parenting program has demonstrated extensive evidence of efficacy as a treatment and indicated prevention program with different samples. This paper presents the results of the first study carried out in Spain to evaluate the effectiveness of the Parenting and Child treatment curricula with at-risk and maltreating families. Methods: The study sample was made up of 111 families with 4- to 8-year-old children recruited from Child Welfare (CW) and Child Protection Services (CPS) of the region of Gipuzkoa (Spain). CW/CPS caseworkers recruited families where there was a substantiated report or significant risk for child maltreatment, children displayed significant behavior problems, and parents had significant difficulties managing their children´s behavior. After agreeing to participate, families were randomly assigned to the IY program—where they received 19 parent and child group sessions, plus four home visits—or to a control group that received standard services (e.g., psychoeducational services for parents and children, CW/CPS follow-up). Parenting practices, parenting stress, parents´ depressive symptomatology, child abuse potential, and parental perception of child behavior problems were measured at baseline, and six and twelve months later. Findings: Compared to the control group, the IY intervention made a significant positive difference in parents´ observed and reported use of praise, and a significant reduction in inconsistent discipline, parenting stress, depressive symptomatology, and perception of child behavior problems. A full serial mediation effect was found between participation in IY, changes in parenting practices, subsequent parenting stress reduction, and both child abuse potential reduction and perception of child behavior problems. No moderating influence on IY effects was found. Parents also expressed high satisfaction with the IY program and a high degree of adherence. Implications for policy, research and practice: Results provide evidence that transporting IY with fidelity to CW/CPS in Spain was feasible, that it was a well-accepted approach by practitioners and families, that it promoted positive outcomes similar to those found in other Western countries, and that its benefits were greater than those of current standard services. The implementation of the Incredible Years program in a real-world setting was a challenging experience. It required previous adaption and training processes, as well as ongoing support and monitorization of program fidelity. The results obtained clearly indicate that the group-based Incredible Years approach merits the attention of policymakers, agencies, and practitioners as a particularly relevant preventive and rehabilitative evidence-based approach in the field of child welfare and child protection. Biography Ignacia Arruabarrena, Ph.D. in Psychology. Associate Professor at the Department of Social Psychology, University of the Basque Country UPV/EHU, Spain. Originally presented as ‘G4 - Child Maltreatment and Adversity Paper Session (219, 72, 175)’ at I-CEPS 2023.
Preventing Child Recruitment and Supporting Reintegration through Parenting
Authors: Alexandra Blackwell and Yvonne Agengo
Background: The number of children living in conflict zones has increased almost three times since 1990, with one in five conflict-affected children living in an area with child recruitment by armed forces and armed groups in 2020. The increasing complexity of factors that puts adolescents at higher risk of recruitment makes traditional interventions focused on the release and reintegration of children associated with armed forces and armed groups insufficient. In response to this gap, the International Rescue Committee (IRC) undertook a research initiative to better understand how to support families in conflict-affected communities and developed the Growing Strong Together programme, an evidence-based, family-centred intervention to support caregivers and equip adolescents with the protection to not engage with armed forces and armed groups and to reintegrate successfully into their families and communities. This presentation will highlight key findings from each stage of the intervention development process: 1) formative research, 2) development and adaptation, 3) feasibility and acceptability, and 3) implementation quality. Methods and findings: To gain greater understanding of protection risks and barriers and facilitators for reintegration, the IRC conducted in-depth interviews with adolescents and caregivers in Democratic Republic of Congo (DRC) and Central African Republic (CAR). Based on the formative research and a desk review, the intervention was then developed and adapted to incorporate learning from feasibility studies conducted in four distinct conflict settings: Democratic of Congo, Central African Republic, Nigeria, and Iraq. An ongoing, mixed-methods implementation study examining implementation quality and participant engagement is being conducted to assess implementation across contexts. The formative research revealed the unique perspectives of adolescents and demonstrated how conflict experiences and factors at the institutional, community, and interpersonal levels influence adolescents’ engagement with armed groups and reintegration with their families. The findings from the formative research informed the intervention’s family-based approach, and using this as a framework, the IRC developed and piloted a parenting intervention specifically aimed at supporting caregivers to prevent child recruitment and facilitate reintegration. During the feasibility study, the IRC found high acceptability of the intervention by staff and participants and identified areas for improvement and adaptation that strengthened the final intervention package. Preliminary findings from the implementation study show positive improvements in parent-child relationship quality and knowledge of child recruitment, and mixed findings relating to mental health and caregiver needs. Implications for policy, research, practice: This project has engaged stakeholders throughout the research and intervention development which has enabled its uptake across different conflict settings since its launch. Its implementation in multiple contexts will enable a systematic understanding of the moderators of caregiver needs. While parenting programmes show positive results when transferred across contexts, this programme has demonstrated that an intervention tailored for a specific at-risk group in humanitarian contexts can result in targeted outcomes specific to the rights violations that children face. By better understanding the experiences of adolescents and their caregivers in humanitarian settings from a socio-ecological perspective, comprehensive programming models can be better designed to adequately prevent voluntary recruitment and enable young people to reach their full potential. Originally presented as 'G3 - Child Maltreatment and Adversity Paper Session (212, 172, 211)' at I-CEPS 2023.
Psychological flexibility training: Acceptance and Commitment Therapy (ACT) in the context of intellectual disability and neurodevelopmental problems
Authors: Professor David Lobato Casado and Dr Francisco Montesinos Marín
Background and objectives: Families of children with intellectual disabilities and other neurodevelopmental disorders face psychological challenges due to the chronicity of their children. These challenges are experienced with stress, health problems and can sometimes generate aversive interaction dynamics. A group ACT-based intervention programme was applied to increase psychological flexibility and functional responses to stressful experiences, as well as to observe changes in interaction styles. Methods: A randomised clinical trial was conducted. Relatives of children with neurodevelopmental disorders were randomly assigned to the psychological acceptance programme condition (n=8) or to the control group (n=6). The intervention programme focused on the psychological flexibility: values, defusion, mindfulness, committed action and psychological acceptance through 3 weekly 3-hour sessions. Treatment effect was measured using the standardised questionnaires GHQ-12, PSS, 6-PAQ and WBSI. Changes in interactions were assessed through self-monitoring, including baseline. Measures were taken before and after the implementation of the intervention programme, and 3 months later. Subsequently, the control group was switched to the psychological flexibility programme condition. Findings: Following the intervention programme, results suggest that psychological flexibility (6-PAQ) and the tendency to suppress unwanted private events (WBSI) improved significantly after the intervention and at follow-up. Perceived stress (PSS) improved significantly at follow-up. Additionally, punitive-hostile behaviours decreased, and supportive-accompanying behaviours increased in the interactions with the children, reducing family hostility. In the control condition, no statistically significant changes were observed in any of the variables studied or in family interactions. Implications for policy, research and practice: The study supports the importance of psychological flexibility processes in families with children with neurodevelopmental problems, reducing stress and improving the family's quality of life. Furthermore, behavioural interaction repertoires could be changed by increasing the frequency of supportive-accompanying behaviours and decreasing the frequency of punitive-hostile behaviours. A shift towards psychological care for family members would lead to an improvement of the diagnosed child and allow them to reach higher levels of personal development and community integration. Originally presented as B7 - Vulnerable Families Paper Session (18, 21, 6) at I-CEPS 2023.
Responsive adaptation of Multisystemic Therapy to support telehealth delivery
Authors: Prof Suzanne Kerns, Ruth Berhanu, A/Prof Dana Hollinshead, Dana Garofalini, and Julia Wagenaar
Background: Evidence-based parenting supports (EBPS) have the potential to move the needle on key indicators of child wellbeing, however high-quality implementation is critical. In times of rapid change, such as the COVID-19 pandemic, established methods for delivery of EBPS may be compromised and maintaining treatment fidelity may be challenging. This presentation describes an approach to enhancing the flexibility of a treatment to be responsive to a changing implementation climate. Multisystemic Therapy (MST) is a family-based intervention for adolescents who engage in antisocial behaviors and/or have substance use issues. It is typically delivered in person in the family home. We describe the development and pilot results of a telehealth-enhanced supplement to MST (MST-TE) to support service delivery when in-person sessions are not possible (due to public health mandates, weather, other circumstances). Methods: Based on a prior survey of therapists and supervisors regarding program aspects that were challenging to implement via telehealth platforms during the COVID-19 pandemic, we collaborated with model developers to develop a telehealth-enhancement to MST. The associated training module includes a decision tree for determining if sessions should be held in person or via telehealth and guidance for effective treatment delivery. Therapists across 5 sites in Colorado, USA were trained to implement MST-TE in their practice. Pilot results focus on implementation outcomes and are based on a mixed-methods approach to describe therapist, supervisor, and agency administrator satisfaction, acceptability, and feasibility of the pilot model. Ethical approval was obtained from the University of Colorado-Anschutz. Participants include MST therapists (n=5) and their supervisor (n=4 supervisors; one supervises two of the MST therapists), and one administrator per agency (n=4). 100% of MST-TE therapists and supervisors are female, hold a Masters (or equivalent) degree, and have up to 5 years’ experience. Participants completed 1) a baseline survey, 2) after MST-TE training, brief monthly surveys, and 3) a 6-month follow-up survey. Findings: Currently, all therapists have been able to use MST-TE with at least one family. Baseline surveys indicate that therapists and supervisors had a positive perception of the model, though they anticipated concerns regarding technology and family comfort levels. Few participants anticipated issues with clinical fidelity. Monthly surveys administered to therapists and supervisors post-training indicate a high degree of satisfaction with MST-TE and low overall barriers. However, the most significant barrier remains use of technology by therapists and supervisors while conducting telehealth sessions and caregiver responsibility for technology for MST-TE treatment. The six-month surveys will be distributed in February 2023, results will be available for the presentation. Implications: This study provides preliminary indicators for how one EBPS was able to adjust to dramatic implementation challenges and create a more sustainable model for future delivery. This study illustrates how responsive adaptation decisions can align with practice and maintain clinical fidelity. Long-term and large-scale implementation efforts require a degree of flexibility in service delivery to ensure match to local contexts and to address emerging implementation challenges. Future policy and funding opportunities should support adequate investments in development of flexible treatment delivery mechanisms. Biography Suzanne Kerns is a clinical psychologist, Professor of Pediatrics at the University of Colorado, and Director of Transformative Research at the Kempe Center. Her academic focus is on ways to improve the quality and effectiveness of child and family mental health services through implementation science. Originally presented as ‘E4 - Diverse Service Contexts Paper Session (85, 110, 234)’ at I-CEPS 2023.
Supporting families online: Exploring the experiences of service users and practitioners and the development of a best practice framework for digital social care
Authors: Siobhan Greene and Dr Gráinne Hickey
Background: Digital technology has become an increasingly prominent feature of healthcare delivery, yet social care has remained less digitised than other systems. The use of digital services to support families, however, accelerated greatly during Covid19 yet there remains much that we need to learn regarding the implementation, appropriateness and acceptability of digital interventions for parents and children. We explore the service user and practitioner experiences of working together online during the pandemic and outline the development of a digital practice framework. This work was conducted in the Republic of Ireland as part of an internal evaluation of online work with families delivered by Barnardos Ireland in response to the Covid-19 pandemic. Barnardos Ireland are a children's charity and provide a range of evidence-based interventions for children and parents including one-to-one and group-based supports and services. Methods: A mixed-methods study combining survey and qualitative research was conducted. In total, 139 parent/adult service users and 102 social care practitioners working in the Republic of Ireland who respectively received and delivered a range of digital social care supports, took part in online surveys. Nineteen focus groups with 106 staff members working directly with children and families were also conducted. The findings informed the development of a best practice framework that includes guidance documents, protocols, and assessment tools to support staff and service users working in an online space. Findings: The service user survey results indicated that majority of participating service users enjoyed engaging in online services, whilst more than half of participating parents identified a blended approach of online and face-to-face meetings as their preferred option for receiving services. Results from the survey and focus groups with practitioners indicted they generally felt confident and comfortable engaging in digital service delivery. Benefits of digital practice included perceived positive impacts on participation rates, ease of access and removal of barriers to engagement. Challenges included lack of access to technology and/or WiFi, inadequate spaces to engage in digital intervention, concerns regarding privacy and safeguarding. Implications: These findings shed light on both service user and practitioners’ experiences of digital social care services during the Covid-19 pandemic. Both benefits and challenges within the delivery of digital social care supports, as well as conflicting findings were identified. The digital practice framework developed by Barnardos Ireland in response to these findings provides guidance and outlines activities to support high quality online service delivery and achieve outcomes in the following areas: session planning guidance; safeguarding and risk assessments; maintaining programme fidelity; delivering online supports; building therapeutic relationships online; and evaluation and reflection following service delivery. Originally presented as 'F7 - Future Directions (199, 198, 48)' at I-CEPS 2023.
Supporting parents in caring for their high-risk children during hospitalisation and at home
Authors: Beatrice Niyonshaba, Cornety Nakiganda, Hilda Namakula, Georgia Carter, and Brooke Magnusson
Development Uganda to help sick and small babies survive and thrive. These babies experience a higher burden of morbidity and mortality than their healthy peers. The H2H programme was designed to improve health outcomes through parent education, interventions to improve growth and development—including Kangaroo Mother Care (KMC) and cue-based feeding—and by reducing barriers to follow-up care. H2H provides education and care during hospitalisation and at home after discharge. The programme is delivered by nursing staff during the infant’s hospital stay, and by trained Community Health Workers (CHWs) at home. Methods: The hospital component of the H2H programme is delivered by nursing staff who are specially trained in the care of sick and small newborns. The nurses receive additional training in educating family members in the care of newborns during hospitalisation and at home, covering topics such as lactation and breastfeeding, danger signs, and newborn development. Once discharged, the families are referred to local CHWs who provide regular follow-up support to babies and their families for up to 12 months. We evaluated the acceptability of the caregiver education component of the H2H programme using qualitative, in-depth interviews with staff, CHWs, and caregivers. The interviews elicited caregivers’ reflections on their stay in the hospital, the education they received, and their visits from the CHWs. Two rounds of interviews—in 2019 and 2020—allowed us to assess parents’ perspectives of their neonatal unit stay before and after implementation of the programme. Findings: The comprehensive education that caregivers receive during their hospital stay increased their understanding of the importance of early health care interventions and enabled them to build positive, health-informed relationships with their children. Parent education was found to be a continuous process rather than a singular activity. We saw increased caregiver confidence in asking questions about their children, likely due to increased interactions with hospital staff and ongoing relationships with local CHWs. Caregiver education was also found to be more systematic after the introduction of the H2H programme. The home component increased the number of families receiving follow-up care. It helped eliminate barriers such as lack of services and high transportation costs by providing flexible delivery through the CHWs. Visiting the families in the community allows the CHWs to engage with and educate more family members; it is an inclusive approach to providing care. Implications/Conclusion: Discharge and follow-up programmes are critically important to ensure sick and small babies survive and thrive. Both components of the H2H programme focus on family-centred care and equip the parents with the skills and knowledge to look after their babies. The hospital component is the foundation for caregivers to learn how to care for their high-risk newborns. Providing continued support and education to the parents in a flexible environment grants parents the confidence, skills, and knowledge to look after their babies. The H2H programme helps to ensure sick and small babies receive the best continuity of care at the most critical time of their development. Originally presented as 'D7 - Implementation Science Paper Session (118, 144, 114)' at I-CEPS 2023.
The development, reliability, and validity of the Responsive Care Indicator Tool
Authors: Elizabeth Hentschel, Saima Siyal, Dr Frances Aboud, Dr Dana McCoy, Dr Henning Tiemeier, and Dr Aisha Yousafzai.
Background and objectives: The Nurturing Care Framework (NCF) provides a roadmap to strengthen public policies and promote good health, adequate nutrition, safety and security, opportunities for early learning, and responsive caregiving for all children under the age of 5. Despite global action to promote the NCF, no tools exist that measure responsive caregiving as a distinct concept that are suitable for low- and middle-income settings and are open access. The present study provides reliability and validity evidence for an indicator tool developed to quantify responsive care in a rural, low-income setting in Sindh, Pakistan. Methods: Two hundred households were randomly selected and data was collected on responsive caregiving, early learning, socio-demographic characteristics, maternal depression, and child development outcomes. Exploratory factor analysis and structural equation models were used to test the reliability and validity of the responsive care tool in this setting. Findings: The responsive care tool reliably loads onto two distinct factors, responsive caregiving and caregiver-initiated interactions, accounting for 96.01% of the underlying variation. Internal consistency reliability was high within each factor, with Cronbach’s alphas of 0.93 and 0.83, respectively. Factor loadings of individual items were all above 0.7 within factors. Concurrent validity was found as the responsive care factor was strongly and positively correlated with measures of the home environment quantified by the Home Observation Measurement of the Environment-Infant Toddler version (HOME-IT). Predictive validity was found as the responsive care factor was strongly and positively associated with child development outcomes measured by the Bayley Scales of Infant and Toddler Development, Fourth Edition (BSID-4). The caregiver-initiated interactions domain was significantly and negatively associated with both the home environment and child development outcomes. Implications for policy, research and practice: Overall, the results indicated that the responsive care indicator tool is a reliable and valid measure of responsive caregiving and can easily be administered in less than 5-minutes in a low-income and low-resource setting. Biography Elizabeth Hentschel is a PhD Candidate in Global Health and Population at Harvard University. She holds a MSc from Harvard and a BS from the University of Michigan. With a specific focus on ECD in LMICs, Elizabeth utilizes quantitative and qualitative methods to better understand measurement pathways that influence ECD. Originally presented as 'I9 - Implementation Science Brief Paper Session (193, 111, 187, 5)' at I-CEPS 2023.
The Family Preservation and Reunification Response: Providing evidence-informed parenting support to vulnerable families in Victoria, Australia.
Author: Dr Heather Morris
Background and objectives: The Family Preservation and Reunification Response (FPRR) was borne out of a statewide reform of the child welfare sector in Victoria, Australia. There is a focus on early intervention to prevent children entering out-of-home-care (OOHC) through a short, intensive program with a key worker and evidence-informed programs and/or practices. The most vulnerable families with complex needs and risks are connected with the program by the Child Protection department. A Child Protection Navigator is an intermediary within the system, enabling collaborative partnerships. The aim of this presentation is to provide preliminary data on the efficacy of the program as delivered by one Community Service Organisation. Methods: This program began in July 2020 as a pilot that was tendered by the Victorian state government. At the time, it was not known that Victoria would experience the harshest lockdowns in the world due to the Covid-19 pandemic. It was in this context that the largest reform initiatives began, which had an emphasis on both implementation and outcomes. A university was engaged to evaluate the program. Validated measures such as the North Carolina Family Assessment Scale-General-Reunification (NCFAS-GR; three timepoints) and the Parent Empowerment and Efficacy Measure (PEEM; two time points) are used by practitioners to determine change in family functioning and parental efficacy. Other outcomes including adverse childhood experiences (ACE) survey and child development measures are collected. Implementation factors such as time to first visit, hours used, connection and closure information and other important data is being gathered. Implementation teams facilitate the program’s sustainability and enable a forum where barriers and enablers are discussed. Findings: Seventy-seven percent of parents who completed the ACE survey had experienced four or more ACEs during their childhood. This represents a highly traumatic upbringing that is likely to have contributed to their current parenting practices. Significant improvements in the NCFAS and PEEM data were seen across timepoints indicating that the program is able to generate positive outcomes for families. While there are 10 domains of the NCFAS-GR, one example of the parental capabilities domain showed significant difference across all three timepoints: F = 12.02, p
The Impact Parent Support Network to improve the well-being of vulnerable families of children with disabilities during the pandemic
Authors: Ami Tango-Limketkai and Grace Torres
Background and objectives: The global response to COVID-19 changed daily life for many people. In the Philippines, stay-at-home orders went into effect nationwide and schools remain closed for 30 months. Struggles faced by already vulnerable families of children with disabilities were amplified. Supporting the bond between parents or caregivers of these children is as important as ever. This paper aims to explore how parents of children with disabilities, across the Philippines, support each other as they learn to adapt and meet their children's needs as well as maintain their own mental health and relationships. Methods: Qualitative methods were used to examine the experiences of members of 1 parent-run support group in the Philippines. Thirty parents were interviewed about the benefits and limitations of participation in the support group. Information was collected by observing support group meetings, activities, and reviewing group documents. Interview, observation, and document data was analyzed to identify emerging themes. All meetings and interviews took place remotely on Zoom. Findings: Results of the study indicated that the effects of belonging to a parent-led parent support group were substantial. Through the group, parents gained increased skills, an increased sense of power and a sense of belonging. The support group built advocacy skills and self-efficacy skills among parents as they coped with the impacts of the Covid-19 Pandemic. Activities that the support group organized during the lockdown allowed families to regularly engage with each other and become present supporters of their children’s development as they helped them thrive and learn during the pandemic. Participants were able to connect with each other and provide support and skills to deal with the day-to-day issues of raising a child with disabilities, contributing to the well-being of both parents and children. Implications: The findings of this case study demonstrate the potential of parent support groups to contribute to the well-being of families of children with developmental disabilities. The recommendations and suggestions as shared by this support group in the Philippines can be leveraged by parents in other areas to form similar groups of support for vulnerable families of children with disabilities. Originally presented as B7 Vulnerbale Families Paper Session (21) at I-CEPS 2023.
The influence of You Are Enough online peer support groups on family well-being
Authors: Katariina Leivo, Nina Vaaranen-Valkonen, and Valeriia Soloveva
Background and objectives: One in five children in Europe falls victim to some form of sexual violence. Parents/guardians, who have experienced sexual violence against their child, are often burdened by challenging emotions, duration of criminal proceedings and lack of awareness on how to help the child to recover. Protect Children has piloted You Are Enough online peer support groups since January 2021 to support parents/guardians whose children have become victims of sexual violence. Protect Children performed an evaluation of surveys completed by participants in order to define the influence of the You Are Enough peer support group model on family well-being. Methods: The You Are Enough peer support groups are held online. The groups are formed based on the proximity of the offender (close one/outsider) or type of the offence (online/contact). Participants get a chance to discuss their thoughts, feelings and experiences with those in a similar situation, in discussions facilitated by expert clinicians. Protect Children created surveys that participants were offered to fill out during and after the peer support group in order to trace and evaluate general effects of the group on family’s, parents’, and children’s well-being, as well as the impact of particular methods used by clinicians. The surveys were anonymous and consisted of questions aimed at collecting both quantitative and qualitative data. Findings: Protect Children’s research-based evaluation of the surveys received from peer support group participants revealed that 75% of parents/guardians feel that joining the You Are Enough groups had a positive effect on their child’s well-being. Participation increased participants’ knowledge and skills on noticing and addressing their child’s trauma symptoms or seeking additional support, if needed. Parents and guardians shared that they learnt how to deal with conflicting emotions and respond to their child’s challenging needs. All participants signified that their own mental well-being improved. Finally, all participants responded feeling significantly more optimistic about the future at the end of the group compared to the beginning. The improvement of a parent’s/guardian’s well-being appeared to correlate with their child’s healing from the traumatic experience, likely due to the child restoring the sense of safety as the whole family gradually heals. Implications for policy, research and practice: Support received from parents is the most significant factor for the child's recovery. As the whole family is affected by the traumatic experience, the peer support group model has proven to be effective in promoting parent's coping, indirectly facilitating the child’s recovery. The peer support groups are arranged online which does not require substantial resources allowing people, especially those in more vulnerable positions, to access the service with their privacy respected even from hard-to-reach locations. Further spread of You Are Enough peer support group model and its adaptation to cultural dimensions would allow effective help for affected families globally, preventing long-term negative effects of traumatic experiences of sexual violence in childhood. Originally presented as 'C7 - Global Perspectives Paper Session (148, 132, 133)' at I-CEPS 2023.
“Their happiness, not neurotypical success”: Autistic adults reflect on their experiences of being parented in childhood.
Jia Ying Sarah Lee, Dr Koa Whittingham and Dr Amy Mitchell
Background and objectives: Parenting has implications for psychosocial adjustment well into adulthood. While much is known about the parenting behaviours that influence adjustment in autistic children, little is known about how the effects of parenting persist in autistic adults. Further, autistic adults’ perspectives on how they were parented have not been investigated to date. This study aimed to examine autistic adults’ perspectives on their experiences of being parented in childhood and the advice they would like to offer to all parents of autistic children in the context of their own lived experience. Methods: Ninety-six Australian autistic adults recruited via convenience sampling provided their responses to open-ended questions in a larger online survey assessing childhood experiences of parental care, overprotection, adult attachment, psychological flexibility, and adult adjustment. Findings: A total of 10 themes were identified. Autistic adults emphasized the importance of parents embracing early diagnosis, and that the goal of parents should be their child’s happiness rather than “neurotypical success”. They also highlighted the importance of unconditional love and understanding of their autistic child, and of recognizing that autistic children have the same fundamental needs as other children. Autistic adults also discussed the importance of parents creating structure and predictability in the home to create feelings of comfort and safety. Parents were encouraged to find creative ways into their child; to meet them halfway. Finally, autistic adults reflected on the role of parents in advocacy as well as the importance of parental well-being. Parental neurodivergence was discussed as a possible bane or boon. Implications for policy, research and practice: Autistic adults emphasized the importance of unconditional acceptance and understanding from their parents, with the goal being their child’s happiness over and above everything else. Findings from this study will inform the future development of parenting support programs for families of autistic children. Originally presented as A3 - Impact of Parenting Paper Session (25, 232, 15, 64) at I-CEPS 2023.