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Ahun MN, Ali NB, Hentschel E, Jeong J, Franchett E, Yousafzai AK. A meta-analytic review of the implementation characteristics in parenting interventions to promote early child development. Ann N Y Acad Sci 2024; 1533:99-144. [PMID: 38354095 DOI: 10.1111/nyas.15110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
This review summarizes the implementation characteristics of parenting interventions to promote early child development (ECD) outcomes from birth to 3 years. We included 134 articles representing 123 parenting trials (PROSPERO record CRD42022285998). Studies were conducted across high-income (62%) and low-and-middle-income (38%) countries. The most frequently used interventions were Reach Up and Learn, Nurse Family Partnership, and Head Start. Half of the interventions were delivered as home visits. The other half used mixed settings and modalities (27%), clinic visits (12%), and community-based group sessions (11%). Due to the lack of data, we were only able to test the moderating role of a few implementation characteristics in intervention impacts on parenting and cognitive outcomes (by country income level) in the meta-analysis. None of the implementation characteristics moderated intervention impacts on cognitive or parenting outcomes in low- and middle-income or high-income countries. There is a significant need in the field of parenting interventions for ECD to consistently collect and report data on key implementation characteristics. These data are needed to advance our understanding of how parenting interventions are implemented and how implementation factors impact outcomes to help inform the scale-up of effective interventions to improve child development.
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Affiliation(s)
- Marilyn N Ahun
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Nazia Binte Ali
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Elizabeth Hentschel
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
| | - Joshua Jeong
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Emily Franchett
- Department of Applied Psychology, New York University Steinhardt School of Culture, Education, and Human Development, New York, New York, USA
| | - Aisha K Yousafzai
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Okitundu-Luwa D, Imbula Essam B, Sombo Ayanne MT, Ndjukendi Omba A, Otete Djamba F, Kayembe Kalula T, Kamanga Mbuyi T, Guedeney A, Kashala-Abotnes E. Sustained social withdrawal behavior and 'difficult' temperament among infants, in relation to maternal affectivity in a low-income area of Kinshasa, Democratic Republic of Congo. Eur Child Adolesc Psychiatry 2023; 32:427-437. [PMID: 34536147 DOI: 10.1007/s00787-021-01873-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 09/08/2021] [Indexed: 10/20/2022]
Abstract
Little is known about the relationship between maternal affectivity, social withdrawal and temperament in infants in low-income countries. The goal of the study was to assess the prevalence of social withdrawal behavior in infants aged 8 ± 2.3 months and to explore associations between maternal affectivity during pregnancy and postpartum, infant social withdrawal (as a sign of stress) and 'difficult' temperament as assessed by the mothers. 458 mother-infant dyads were recruited in the city's public mother and child health-care centers. The eight items of the Alarm Distress Baby scale (8-ADBB) and the five-item M (modified) ADBB (M-ADBB) were used to assess sustained withdrawal behavior (ISSWB). The Goldberg Depression and Anxiety Scales were used to assess maternal affectivity and mental well-being. A specially designed questionnaire was used to identify stressful events faced by the mother during pregnancy. The ELDEQ-QCB was used to assess the degree of difficulty in managing the baby. Using the M-ADBB, we found a striking figure of 69.2% for ISSWB with 8-ABB (range 0-29) and 72.7% with the M-ADBB (range 0-10). ISSWB was linked to negative maternal affectivity and to high incidence of stressful events for the mothers, and to the child being viewed as 'difficult' by the mother. Positive prenatal affectivity was a protective factor of ISSWB (OR 0.46). Results are compared with previous studies in Africa. Early screening for ISSWB and identification of factors affecting maternal mental well-being could help in early intervention and increase the chances of better child development.
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Affiliation(s)
- Daniel Okitundu-Luwa
- Unités de Neurologie Pédiatrique et de Neuropsychologie, Département de Neurologie, Centre Neuro Psycho Pathologique du Mont-Amba, Faculté de Médecine, Université de Kinshasa, B.P.825, Kinshasa, Democratic Republic of the Congo.
| | - Brigitte Imbula Essam
- Service de Psychiatrie Femme et Enfants, Département de psychiatrie, Centre Neuro Psycho Pathologique du Mont-Amba, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Marie-Thérèse Sombo Ayanne
- Unité de Neuropsychologie, Département de Neurologie, Centre Neuro Psycho Pathologique du Mont-Amba, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Ally Ndjukendi Omba
- Service de Psychiatrie Femme et Enfants, Département de psychiatrie, Centre Neuro Psycho Pathologique du Mont-Amba, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Franck Otete Djamba
- Médecin Chargé de la Recherche et la Documentation Scientifique à la Fondation pour la Promotion et la Protection de la sante mentale de l'enfant «FOPPROSAME Asbl», Kinshasa, Democratic Republic of the Congo
| | - Tharcisse Kayembe Kalula
- Service de Neurodiagnostic, Département de Neurologie, Centre Neuro Psycho Pathologique du Mont-Amba, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Timothée Kamanga Mbuyi
- Département de Psychologie Clinique, Faculté de Psychologie et Sciences de l'Education Département et, Consultant au Département de Neurologie, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Antoine Guedeney
- Service de Psychiatrie de l'enfant et de l'adolescent, Hôpital Bichat, APHP, Paris et Université de Paris, Paris, France
| | - Espérance Kashala-Abotnes
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
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Burtchen N, Alvarez-Segura M, Urben S, Giovanelli C, Mendelsohn AL, Guedeney A, Schechter DS. Effects of maternal trauma and associated psychopathology on atypical maternal behavior and infant social withdrawal six months postpartum. Attach Hum Dev 2022; 24:1-27. [PMID: 36371796 DOI: 10.1080/14616734.2022.2142894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/29/2022] [Indexed: 11/15/2022]
Abstract
Maternal psychopathology given a history of maltreatment and domestic violence exposure increases the risk for child psychopathology. Infant social withdrawal is one warning sign of adverse developmental outcomes including child anxiety and depression. It remains unclear how maternal trauma-related psychopathology might affect infant social withdrawal six-months postpartum. METHODS One-hundred ninety-five women and their six-month-old infants were studied in an at-risk community sample. Maternal trauma history, posttraumatic stress (PTSD) and major depressive (MDD) disorders were assessed. Maternal and infant behaviors were coded from videotaped interactions. RESULTS Maternal trauma was correlated with atypical maternal behavior (AMB) and infant social withdrawal (p ≤ .001). PTSD and MDD, and comorbid PTSD/MDD predicted increased AMB (p ≤ .001) but only maternal MDD was predictive of infant social withdrawal (p ≤ .001). Effects of maternal MDD on infant withdrawal were mediated by AMB. CONCLUSIONS At six-months postpartum, maternal MDD was associated with infant withdrawal. AMB is an important target for early intervention.
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Affiliation(s)
- Nina Burtchen
- Clinic for Psychosomatic Medicine and Psychotherapy, Freiburg University Medical Center, Freiburg, Germany
- Department of Pediatrics, New York University, New York University Grossman School of Medicine, New York, NY, USA
| | - Mar Alvarez-Segura
- Child and Adolescent Psychiatry Service, Department of Psychiatry, Abat Oliba CEU University, Barcelona, Spain
- Department of Child & Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Sébastien Urben
- Child & Adolescent Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Alan L Mendelsohn
- Department of Pediatrics, New York University, New York University Grossman School of Medicine, New York, NY, USA
| | - Antoine Guedeney
- Child & Adolescent Psychiatry Service, Hôpital Bichat-Claude
- Bernard Faculty of Medicine, University of Paris Diderot, Paris, France
| | - Daniel S Schechter
- Department of Child & Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
- Child & Adolescent Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and Faculty of Biology and Medicine, Lausanne, Switzerland
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Jeong J, Franchett EE, Ramos de Oliveira CV, Rehmani K, Yousafzai AK. Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. PLoS Med 2021; 18:e1003602. [PMID: 33970913 PMCID: PMC8109838 DOI: 10.1371/journal.pmed.1003602] [Citation(s) in RCA: 197] [Impact Index Per Article: 65.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/01/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Parents are the primary caregivers of young children. Responsive parent-child relationships and parental support for learning during the earliest years of life are crucial for promoting early child development (ECD). We conducted a global systematic review and meta-analysis to evaluate the effectiveness of parenting interventions on ECD and parenting outcomes. METHODS AND FINDINGS We searched MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and Global Health Library for peer-reviewed, published articles from database inception until November 15, 2020. We included randomized controlled trials (RCTs) of parenting interventions delivered during the first 3 years of life that evaluated at least 1 ECD outcome. At least 2 reviewers independently screened, extracted data, and assessed study quality from eligible studies. ECD outcomes included cognitive, language, motor, and socioemotional development, behavior problems, and attachment. Parenting outcomes included parenting knowledge, parenting practices, parent-child interactions, and parental depressive symptoms. We calculated intervention effect sizes as the standardized mean difference (SMD) and estimated pooled effect sizes for each outcome separately using robust variance estimation meta-analytic approaches. We used random-effects meta-regression models to assess potential effect modification by country-income level, child age, intervention content, duration, delivery, setting, and study quality. This review was registered with PROSPERO (CRD42018092458 and CRD42018092461). Of the 11,920 articles identified, we included 111 articles representing 102 unique RCTs. Pooled effect sizes indicated positive benefits of parenting interventions on child cognitive development (SMD = 0.32, 95% CI [confidence interval]: 0.23, 0.40, P < 0.001), language development (SMD = 0.28, 95% CI: 0.18 to 0.37, P < 0.001), motor development (SMD = 0.24, 95% CI: 0.15 to 0.32, P < 0.001), socioemotional development (SMD = 0.19, 95% CI: 0.10 to 0.28, P < 0.001), and attachment (SMD = 0.29, 95% CI: 0.18 to 0.40, P < 0.001) and reductions in behavior problems (SMD = -0.13, 95% CI: -0.18 to -0.08, P < 0.001). Positive benefits were also found on parenting knowledge (SMD = 0.56, 95% CI: 0.33 to 0.79, P < 0.001), parenting practices (SMD = 0.33, 95% CI: 0.22 to 0.44, P < 0.001), and parent-child interactions (SMD = 0.39, 95% CI: 0.24 to 0.53, P < 0.001). However, there was no significant reduction in parental depressive symptoms (SMD = -0.07, 95% CI: -0.16 to 0.02, P = 0.08). Subgroup analyses revealed significantly greater effects on child cognitive, language, and motor development, and parenting practices in low- and middle-income countries compared to high-income countries; and significantly greater effects on child cognitive development, parenting knowledge, parenting practices, and parent-child interactions for programs that focused on responsive caregiving compared to those that did not. On the other hand, there was no clear evidence of effect modification by child age, intervention duration, delivery, setting, or study risk of bias. Study limitations include considerable unexplained heterogeneity, inadequate reporting of intervention content and implementation, and varying quality of evidence in terms of the conduct of trials and robustness of outcome measures used across studies. CONCLUSIONS Parenting interventions for children during the first 3 years of life are effective for improving ECD outcomes and enhancing parenting outcomes across low-, middle-, and high-income countries. Increasing implementation of effective and high-quality parenting interventions is needed globally and at scale in order to support parents and enable young children to achieve their full developmental potential.
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Affiliation(s)
- Joshua Jeong
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Emily E. Franchett
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Clariana V. Ramos de Oliveira
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Karima Rehmani
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Aisha K. Yousafzai
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Abstract
PURPOSE OF REVIEW Quality of attachment relationships is believed to be an important early indicator of infant mental health as it is considered a vital component of social and emotional development in the early years. As a result, there has been a growing call for the development of early intervention attachment research programs. In this brief overview, we summarize what we consider to be the state-of-the-art of intervention programs targeted to increase the prevalence of secure attachment and to reduce the level of disorganized attachment among infants with a wide range of psychological risks. RECENT FINDINGS The themes in the literature covered by the article are as follows: recent results of the main preventive parent-young child interaction interventions to promote optimal attachment; recent metaanalysis on efficiency of these early attachment-based programs; intermediate variables on intervention effects; and benefits of specific therapeutic approaches focused on maternal psychopathology. Globally, early attachment-informed interventions show positive effects, both for mothers and infants. SUMMARY Our revision stresses the importance of formally assessing the underlying mechanisms of change within interventions in research programs to open the path to improve and target these preventive approaches and consequently promote optimal attachment.
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McLuckie A, Landers AL, Curran JA, Cann R, Carrese DH, Nolan A, Corrigan K, Carrey NJ. A scoping review of mental health prevention and intervention initiatives for infants and preschoolers at risk for socio-emotional difficulties. Syst Rev 2019; 8:183. [PMID: 31337424 PMCID: PMC6651971 DOI: 10.1186/s13643-019-1043-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 05/13/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Infant mental health has emerged as a unique area of practice and research distinguished from child and youth sub-specialties by its advocacy for a relational practice framework with an emphasis on parents/caregivers being integral to assessment, treatment, and prevention initiatives. A diverse array of initiatives offered across a broad spectrum of delivery methods is available to clinicians. However, to date, a large-scale mapping of the research evidence regarding these interventions has yet to be completed to help inform clinician's decisions regarding the best approaches for their clients. To address this knowledge gap, this study aimed to report on the landscape of research pertaining to mental health interventions for infants and preschoolers (0-5 years), and their families at risk for socio-emotional difficulties and negative developmental outcomes. METHOD A scoping review methodology was used to conduct a large-scale mapping of the intervention research pertaining to infants and preschoolers (0-5) at risk for socio-emotional difficulties. We searched MEDLINE, PsycINFO, EMBASE, Web of Science, The Cochrane Library, CINAHL, LILACS, ProQuest Nursing & Allied Health Source, World Cat, and ClinicalTrials.gov , from inception to December 31, 2012. We extracted information regarding publication date, geographical location, study design, level of risk, population, key intervention mechanism, and outcome measures. RESULTS We identified 533 potential studies from 1233 title and abstracts after the first round of screening. Full text article review in the second round of screening resulted in a total of 162 included articles for the final analysis. Results indicated that over 50% of interventions evaluated were randomized controlled trials conducted in Westernized countries. Most studies could be subdivided by level of risk within a preventative public health framework including universal, selected, indicated, and direct treatment for children formally diagnosed with a mental disorder. Risk factors experienced by children and their families were heterogeneously defined and numerous outcome measures across included studies. The results of this study are limited to the last search date of 2012. CONCLUSIONS Key intervention mechanisms spanned a range of approaches including parenting groups, dyadic, in-home, cognitive-behavioral therapy, and day care-based interventions. The findings are discussed in terms of implications for broad trends and gaps in research and policy for this population.
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Affiliation(s)
| | - Ashley L Landers
- Department of Human Development, Virginia Polytechnic Institute & State University, 7054 Haycock Road, Falls Church, VA, 22043, USA.
| | | | | | - Domenica H Carrese
- Department of Human Development, Virginia Polytechnic Institute & State University, 7054 Haycock Road, Falls Church, VA, 22043, USA
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Væver MS, Smith-Nielsen J, Lange T. Copenhagen infant mental health project: study protocol for a randomized controlled trial comparing circle of security -parenting and care as usual as interventions targeting infant mental health risks. BMC Psychol 2016; 4:57. [PMID: 27876079 PMCID: PMC5120549 DOI: 10.1186/s40359-016-0166-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 11/10/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Infant mental health is a significant public health issue as early adversity and exposure to early childhood stress are significant risk factors that may have detrimental long-term developmental consequences for the affected children. Negative outcomes are seen on a range of areas such as physical and mental health, educational and labor market success, social network and establishing of family. Secure attachment is associated with optimal outcomes in all developmental domains in childhood, and both insecure and disorganized attachment are associated with a range of later problems and psychopathologies. In disadvantaged populations insecure and disorganized attachment are common, which points to the need of identifying early risk and effective methods of addressing such problems. This protocol describes an experimental evaluation of an indicated group-based parental educational program, Circle of Security-Parenting (COS-P), currently being conducted in Denmark. METHODS/DESIGN In a parallel randomized controlled trial of two intervention groups this study tests the efficacy of COS-P compared to Care as Usual (CAU) in enhancing maternal sensitivity and child attachment in a community sample in the City of Copenhagen, Denmark. During the project a general population of an estimated 17.600 families with an infant aged 2-12 months are screened for two known infant mental health risks, maternal postnatal depression and infant social withdrawal. Eligible families (N = 314), who agree to participate, will be randomly allocated with a ratio of 2:1 into the COS-P intervention arm and into CAU. Data will be obtained at inclusion (baseline) and at follow-up when the child is 12-16 months. The primary outcome is maternal sensitivity. Secondary outcomes include quality of infant attachment, language, cognitive and socioemotional development, family functioning, parental stress, parental mentalizing and maternal mental wellbeing. DISCUSSION The potential implications of the experimental evaluation of an indicated brief group-based parenting educational program to enhance parental sensitivity and attachment are discussed. TRIAL REGISTRATION ClinicalTrials.govID: NCT02497677 . Registered July 15 2015.
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Affiliation(s)
- Mette Skovgaard Væver
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark
| | - Johanne Smith-Nielsen
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark
| | - Theis Lange
- Section of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark
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Deans C, Reay R, Buist A. Addressing the mother–baby relationship in interpersonal psychotherapy for depression: an overview and case study. J Reprod Infant Psychol 2016. [DOI: 10.1080/02646838.2016.1221502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Foulon S, Greacen T, Pasquet B, Dugravier R, Saïas T, Guedeney N, Guedeney A, Tubach F. Predictors of Study Attrition in a Randomized Controlled Trial Evaluating a Perinatal Home-Visiting Program with Mothers with Psychosocial Vulnerabilities. PLoS One 2015; 10:e0142495. [PMID: 26554839 PMCID: PMC4640666 DOI: 10.1371/journal.pone.0142495] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 10/22/2015] [Indexed: 11/29/2022] Open
Abstract
Objective Randomised controlled trials evaluating perinatal home-visiting programs are frequently confronted with the problem of high attrition rates. The aim of the present study is to identify predictors of study attrition in a trial evaluating a perinatal home-visiting program in France. Materials and Methods CAPEDP is a French randomized trial comparing a perinatal home-visiting program using psychologists versus usual care (N = 440). The first assessment was at inclusion into the trial at the 27th week of pregnancy and the final assessment when the child reached the age of two. Attrition rates were calculated at 3 and 24 months postpartum. Stepwise logistic regression was used to identify predictors of early (between inclusion and 3 months postpartum) and later (between 3 and 24 months postpartum) attrition among social, psychological and parenting factors. Results Attrition rates were 17% and 63% at 3 and 24 months respectively. At 24 months, there was significantly more attrition in the control arm (70.6%) compared to the intervention arm (55.2%). Five independent predictors of early attrition were identified: having already had an abortion; having greater attachment insecurity as measured with the Vulnerable Attachment Style Questionnaire (VASQ); having lower global severity of psychiatric symptoms as assessed with the Symptom Check-List (SCL-90) at inclusion, being neither currently employed nor studying; and declaring no tobacco consumption during pregnancy. Being randomized into the control arm, having undergone early parental loss before age 11 and having lower global severity of psychiatric symptoms (SCL-90) at 3 months postpartum were the only variables associated with later attrition. Conclusion This study provides key information for identifying mothers who may require specific support to avoid study attrition in trials evaluating a home-visiting program.
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Affiliation(s)
- Stéphanie Foulon
- Département d’Epidémiologie et Recherche Clinique, AP-HP Hôpital Bichat, Paris, France
- * E-mail:
| | - Tim Greacen
- Laboratoire de recherche, Etablissement Public de Santé Maison Blanche, Paris, France
| | - Blandine Pasquet
- Département d’Epidémiologie et Recherche Clinique, CIC-EC 1425, AP-HP Hôpital Bichat, Paris, France
| | - Romain Dugravier
- Service de Pédopsychiatrie, AP-HP Hôpital Bichat, Paris, France
- U669 PSIGIAM, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Thomas Saïas
- Laboratoire de recherche, Etablissement Public de Santé Maison Blanche, Paris, France
- Institut National de Prévention et d’Education pour la Santé, Saint-Denis, France
- Département de Psychologie, Université du Québec à Montréal, Montréal, Canada
| | | | - Antoine Guedeney
- Service de Pédopsychiatrie, AP-HP Hôpital Bichat, Paris, France
- U669 PSIGIAM, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Florence Tubach
- Département d’Epidémiologie et Recherche Clinique, CIC-EC 1425, AP-HP Hôpital Bichat, Paris, France
- INSERM, ECEVE, UMR 1123, CIC-EC 11425, Paris, France
- Université Paris Diderot, ECEVE, UMR 1123, Sorbonne Paris Cité, Paris, France
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Le Foll J. [Supporting parenting in families with multiple problems]. SOINS. PÉDIATRIE, PUÉRICULTURE 2015:12-4. [PMID: 26145294 DOI: 10.1016/j.spp.2015.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Supporting parenthood in families with multiple problems is a major early prevention challenge. Indeed, the factors of vulnerability, especially if they mount up, expose the child to an increased risk of a somatic pathology, developmental delays, learning difficulties and maltreatment. In order to limit the impact of these vulnerabilities on the health of mothers and infants, it is essential to act early, to adapt the working framework and to collaborate within a network.
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Affiliation(s)
- Julie Le Foll
- Service de psychiatrie infanto-juvénile, Hôpital Bichat, AP-HP, Université Denis Diderot, 124 boulevard Ney, 75018 Paris, France.
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Social withdrawal at 1 year is associated with emotional and behavioural problems at 3 and 5 years: the Eden mother-child cohort study. Eur Child Adolesc Psychiatry 2014; 23:1181-8. [PMID: 24464247 DOI: 10.1007/s00787-013-0513-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 12/24/2013] [Indexed: 10/25/2022]
Abstract
The objective of the study was to examine how social withdrawal in infants aged 12 months predicted emotional and behavioural problems at ages 3 and 5 years. The sample included 1,586 infants from the French Eden Mother-Child Cohort Study who had a measure of social withdrawal with the Alarm Distress BaBy scale at age 1 year; among these children, emotional and behavioural difficulties were rated by mothers using the Strength and Difficulty Questionnaire (SDQ) at 3 years for 1,257 (79 %) children and at 5 years for 1,123 (72 %) children. Social withdrawal behaviour at age 1 year was significantly associated with the SDQ behavioural disorder scale at 3 years, independently of a host of familial and child temperament confounders. The association with the relational disorder, prosocial and total difficulty scales was close to significance at 3 years after taking into account familial and temperament confounders. Social withdrawal significantly predicted the three aforementioned scales when measured at 5 years. No significant predictivity of the emotional scale and hyperactivity scale was detected at any age. This study made with a large longitudinal sample confirms the negative effects on development of social withdrawal behaviour, shedding light on the unfolding of behavioural disorders and relational difficulties in children; this calls for early detection of sustained social withdrawal behaviour, as it seems to hamper emotional development.
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