Review question

We wanted to know whether group-based parent training programmes are effective in improving emotional and behavioural adjustment in young children.

Background

Emotional and behavioural problems are common among infants and toddlers and, for many children, these problems persist into school age and adolescence. Parenting practices play a significant role in the development of emotional and behavioural problems in children. Programmes targeting parents of infants and toddlers have the potential to prevent the occurrence of such problems.

Study characteristics

We searched the scientific literature for all randomised controlled trials (RCTs, in which participants are randomly allocated to one of two or more treatment groups) and quasi-RCTs (where participants are allocated to a treatment group using methods that are not strictly random e.g. date of birth), published up to July 2015; we found 24 trials (22 RCTs and two quasi-RCTs) to include in the review. The total number of participants in the studies were 3161 parents and their young children. Eight studies were conducted in the USA, five in the UK, four in Canada, five in Australia, one in Mexico, and one in Peru. All of the included studies were of behavioural, cognitive-behavioural or videotape modelling parenting programmes.

Key results and quality of the evidence

Overall, we found low quality evidence from the included populations of universal and at-risk (targeted) children and parents, that group-based parenting programmes can improve the overall emotional and behavioural development of young children. However, this finding was no longer significant when we removed two studies that used quasi-methods of randomisation. Data from subscales showed moderate quality evidence of an improvement in externalising problems (negative behaviours directed towards the external environment such as aggression or delinquency). On the whole, results from single studies were of poor quality and showed no effect on internalising problems (e.g. depression and anxiety), but showed an improvement on one subscale measure of hyperactivity-inattention and in social skills. There was moderate quality evidence from subscales that group-based parenting programmes also improve parent-child interaction in terms of a reduction in negative behaviours, and an increase in positive behaviours. Our methodological concerns about these studies included inconsistency (different studies yielded different results), unclear risk of bias, and small sample sizes. More research is needed to assess whether the identified benefits continue over time and whether they can prevent the occurrence of such problems.