Preventing enduring behavioural problems in young children through early psychological intervention (Healthy Start, Happy Start): study protocol for a randomized controlled trial.

BACKGROUND: Behavioural problems are common in early childhood, and can result in enduring costs to the individual and society, including an increased risk of mental and physical illness, criminality, educational failure and drug and alcohol misuse. Most previous research has examined the impact of interventions targeting older children when difficulties are more established and harder to change, and have rarely included fathers. We are conducting a trial of a psychological intervention delivered to families with very young children, engaging both parents where possible. METHODS: This study is a two-arm, parallel group, researcher-blind, randomized controlled trial, to test the clinical effectiveness and cost-effectiveness of a parenting intervention, Video Feedback Intervention to Promote Positive Parenting and Sensitive Discipline (VIPP-SD) for parents of young children (12-36 months) at risk of behavioural difficulties. VIPP-SD is an evidence-based parenting intervention developed at Leiden University in the Netherlands which uses a video-feedback approach to support parents, particularly by enhancing parental sensitivity and sensitive discipline in caring for children. The trial will involve 300 families, who will be randomly allocated into either an intervention group, who will receive the video-feedback intervention (n = 150), or a control group, who will receive treatment as usual (n = 150). The trial will evaluate whether VIPP-SD, compared to treatment as usual, leads to lower levels of behavioural problems in young children who are at high risk of developing these difficulties. Assessments will be conducted at baseline, and 5 and 24 months post-randomization. The primary outcome measure is a modified version of the Preschool Parental Account of Child Symptoms (Pre-PACS), a structured clinical interview of behavioural symptoms. Secondary outcomes include caregiver-reported behavioural difficulties, parenting behaviours, parental sensitivity, parental mood and anxiety and parental relationship adjustment. An economic evaluation will also be carried out to assess the cost-effectiveness of the intervention compared to treatment as usual. DISCUSSION: If shown to be effective, the intervention could be delivered widely to parents and caregivers of young children at risk of behavioural problems as part of community based services. TRIAL REGISTRATION: ISRCTN Registry: ISRCTN58327365 . Registered 19 March 2015.

Fathers, fathering and child psychopathology.

The last few years have seen a steady increase in research addressing the potential influence of fathers on their children's development. There has also been a clearer acknowledgement of the need to study families as a complex system, rather than just focusing on individual aspects of functioning in one or other parent. Increased father involvement and more engaged styles of father-infant interactions are associated with more positive outcomes for children. Studies of paternal depression and other psychopathology have begun to elucidate some of the key mechanisms by which fathers can influence their children's development. These lessons are now being incorporated into thinking about engaging both mothers and fathers in effective interventions to optimise their children's health and development.

Adapting and developing a video-feedback intervention for co-parents of infants at risk of externalising behaviour problems (VIPP-Co): A feasibility study.

BACKGROUND: Recent research on early interventions with parents of infants at risk of externalising behaviour problems indicates that focusing on co-parenting and involving fathers in treatment may enhance effectiveness. This article reports the development and preliminary evaluation of a brief intervention: video-feedback intervention to promote positive parenting and sensitive discipline for co-parents (VIPP-Co). METHODS: Families who reported to be struggling with their infant's behaviour were recruited from the community and received six home-based sessions of VIPP-Co. The primary outcome was feasibility of the adapted intervention, assessed using semi-structured questionnaires and interviews post-intervention. Preliminary clinical outcome measures were also recorded. RESULTS: In total, five families with infants between 10 and 24 months completed the intervention. Feedback data documented high rates of acceptability and feasibility. All fathers and mothers completing the intervention reported that it positively impacted their understanding of their child's thoughts and feelings, as well as their approach to individual parenting and co-parenting. Additional preliminary outcome data indicated positive changes in parent-chid interaction and a positive trend was found for infant behaviour, parental well-being and parent relationship adjustment across the intervention. CONCLUSIONS: The overall results of this study are encouraging, but VIPP-Co must be evaluated with larger samples to explore its efficacy.

Associations between postnatal maternal depression and psychological outcomes in adolescent offspring: a systematic review.

Postnatal depression (PND) affects approximately 10-20 % of new mothers in developed countries, with accumulating research documenting its adverse impact on not only the mother but also the wider family. Longitudinal studies assessing potential effects of maternal PND on offspring are mounting, and it is therefore timely to investigate the long-term psychological outcomes for adolescent offspring who were exposed to PND in infancy. PsycINFO, Medline, and Embase databases were searched with key terms for English language abstracts. Papers of 16 were identified that examined associations between PND and internalising problems, externalising problems, psychopathology, psychosocial, and cognitive outcomes of adolescent offspring. Impaired offspring cognitive outcomes reflected some of the most consistent findings. Conflicting evidence was found for an effect of PND on adolescent offspring internalising and externalising problems and overall psychopathology. Psychosocial outcomes in offspring adolescents indicated a specific adverse effect, although based on only two studies. Significant gender differences across outcomes were found. It was concluded that PND possibly increases risk vulnerability in the presence of recurrent, concurrent, and antenatal maternal depression but that these latter factors alone may be the stronger specific predictors. Limitations of the review are discussed as well as implications for future research and clinical practice.

An assessment of anxiety levels in dyslexic students in higher education.

BACKGROUND: It has long been hypothesized that children with learning disabilities, including dyslexia, may be highly vulnerable to emotional consequences such as anxiety. However, research has centred on school-aged children. AIMS: The present study aimed to clarify these findings with dyslexic students in higher education. SAMPLES: Sixteen students with dyslexia were compared with 16 students with no history of learning difficulties. METHODS: Students were asked to complete a written questionnaire concerning trait anxiety levels. They were then told that they would be given a timed reading test and their state anxiety levels were measured using the State-Trait Anxiety Inventory (STAI; Spielberger, Gorsuch, & Lushene, 1983). Finally, their reading was assessed using the Test of Word Reading Efficiency (TOWRE; Torgesen, Wagner, & Rashotte, 1999). RESULTS: Dyslexic students showed slower reading speeds than controls. They also had higher levels of state anxiety and elevated levels of academic and social, but not appearance, anxiety. CONCLUSIONS: Dyslexic students in higher education show anxiety levels that are well above what is shown by students without learning difficulties. This anxiety is not limited to academic tasks but extends to many social situations. It is proposed that assessment of emotional well-being should form part of the assessment of need for dyslexic students entering higher education.