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Although the evidence of parent training programmes for families of autistic children has continued to grow, little is known about the experiences and perceptions of key stakeholders, especially in low- and middle-income countries. This qualitative study was part of a larger real-world evaluation of a short-term intensive parent training programme in routine services delivered to caregivers of autistic children aged 3--6 years in China. It aimed to provide insights into programme acceptability, reasons for participant involvement, and factors related to programme implementation. Fourteen caregivers participated in the in-depth interviews, and two focus group discussions were conducted with eight practitioners. Data were analysed using a combination of data- and theory-driven approaches. Findings point to the needs in low autism resource settings for substantial practice and feedback; group support; individualised coaching; more autism-related knowledge, resources and activities for children and extended family members; and organisational support to practitioners. Further research is suggested to address the recommendations and assess their effectiveness empirically.

Purpose: This study examined the feasibility, acceptability, and preliminary effectiveness of Parenting for Lifelong Health for Parents and Adolescents program in reducing the risk of child maltreatment in Chinese families with adolescents. Methods: A pre-post single-arm pilot trial was conducted in July and August, 2023, and involved 16 parents and 13 teenagers with a mixed-methods design to collect both quantitative and qualitative data. Results: Parents reported enhanced positive parenting and reduced child behavioral problems. Adolescents reported decreased general child maltreatment and emotional maltreatment, along with perceived improvements in positive parenting and parent-child communication. Thematic analyses suggested of tangible benefits for participants, as well as for their family dynamics. Discussion: The program demonstrated promising feasibility, and it was significantly associated with reduced adolescent maltreatment. Further rigorous randomized controlled trials are needed. [ABSTRACT FROM AUTHOR]

Purpose: Parenting for Lifelong Health for Young Children (PLH-YC) is a program to prevent child maltreatment. This study aimed to examine the feasibility, acceptability and preliminary effects of the adapted program for Chinese parents. Methods: A pre–post single-arm pilot trial was conducted with 21 Chinese parents. A mixed-method design was utilized to collect questionnaire-based quantitative data and qualitative data of interviews and focus group discussions. Results: Program implementation was feasible, with overall high recruitment, enrollment, attendance, acceptability and fidelity. Quantitative results demonstrated reductions in general child maltreatment, physical and emotional abuse, child behavioral problems, and improvements in positive parenting. Thematic analyses identified reduced violent discipline, psychological aggression, and child behavioral problems, strengthened parent–child bonds, increased parenting confidence, and decreased family conflict. Conclusion: The adapted PLH-YC program for Chinese parents has shown good feasibility and acceptability, and exhibited a significant association with reduced child maltreatment. Further randomized controlled trials are required. [ABSTRACT FROM AUTHOR]

Global guidelines emphasize the critical role of responsive caregiving in terms of reducing violence against children and promoting early childhood development. However, there is an absence of global evidence synthesis on the effects of early childhood parenting programs for children with developmental disabilities. This systematic review and meta-analysis aims to investigate the effectiveness of parenting interventions delivered for preschool-age children with developmental disabilities in reducing violence against children, altering violence-related factors, and promoting child development. We searched for randomized controlled trials with inactive control. Estimates were pooled using robust variance estimations. Meta-regressions were conducted to explore sources of heterogeneity. In all, 33 studies met the inclusion criteria. The results showed that parenting programs improved child behavior, parental mental health, parenting practices, parental self-efficacy, parent–child interaction, child language skills, and child social skills post-intervention. No studies provided data on the actual occurrence of violence against children. Effects might vary by diagnosis, delivery modality, and world region. The findings supported the delivery of parenting programs to alter factors associated with violence against children and promote child language and social skills for families of young children with developmental disabilities, especially attention deficit hyperactivity disorder, autism, intellectual disability, and language disorders. More research using rigorous methods, long-term follow-ups, and transparent reporting is needed, particularly within more low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Children with autism are more likely to exhibit externalizing behaviors than children without autism. A cross‐sectional study was undertaken to investigate how parental mental health status and parenting practices contributed to the variance in externalizing behaviors among families of young children with autism in Chinese mainland, and whether parenting behaviors had any indirect effects on the relationship between parental mental health symptoms and externalizing behaviors. Data were drawn from the baseline assessment of a quasi‐experimental study of a parent training program delivered to Chinese caregivers of children with autism aged 3 to 6 from diverse backgrounds (N = 111). Results showed that parental mental health symptoms and parenting behaviors explained the variance in child externalizing behaviors. Parental mental health problems and parental over‐reactivity were linked to higher levels of child externalizing behaviors, whereas positive parenting was associated with less frequent externalizing behaviors. Positive parenting partially explained the relationship between parental mental health symptoms and externalizing behaviors. The findings of this study highlight the importance of actively attending to the psychological and parenting needs of caregivers in autism treatment programs. It points to the need for the development of culturally sensitive strategies to promote parental mental health and increase the use of positive parenting skills among parents of children with autism. [ABSTRACT FROM AUTHOR]

Background: There is a growing need for interventions that reduce both violence against children and intimate partner violence in low- and middle-income countries. However, few parenting interventions deliberately address this link. We tested the feasibility of a 16-session group-based parenting programme, Parenting for Respectability, in semi-rural Ugandan communities. Methods: This was a pre-post study with parents and their children (N = 484 parents; 212 children). Results: Pre-post comparisons found large effects for parent-reported reduced harsh parenting (Cohen's f2 = 0.41 overall; f2 = 0.47 (among session attendees); with an overall reduction of 26% for harsh parenting. Session attendees reported higher reductions than non-attendees (p = 0.014), and male caregivers reported higher reductions than female caregivers (p<0.001). Children also reported reduced harsh parenting by attending fathers (f2 = 0.64 overall; f2 = 0.60) and attending mothers (f2 = 0.56 overall; f2 = 0.51); with reduction in harsh parenting ranging between 27% to 29% in the various categories. Overall, spousal violence reduced by 27% (f2 = 0.19 overall; f2 = 0.26 (among session attendees). Both parents and children reported reduced dysfunctional parent relationships; parents: f2 = 0.19 overall; f2 = 0.26 (among session attendees); and children: f2 = 0.35 overall; f2 = 0.32 (for attending parents); with reductions ranging between 22% to 28%. Parents who attended more than 50% of the program reported greater effects on reduced dysfunctional relationships than those who attended less than half of the program (B = -0.74, p = 0.013). All secondary outcomes were improved with f2 ranging between 0.08 and 0.39; and improvements ranging between 6% and 28%. Conclusion: Results suggest the importance of more rigorous testing to determine program effectiveness. [ABSTRACT FROM AUTHOR]

Objective: This mixed-methods process evaluation examined the feasibility of a parenting program delivered by community facilitators to reduce the risk of child maltreatment in low-income families with children aged 3-8 years in Cape Town, South Africa (N = 68). Method: Quantitative measures included attendance registers, fidelity checklists, satisfaction surveys, and engagement in home practice activities. Qualitative data included parent interviews, facilitator focus groups, and transcripts from parent groups and facilitator supervision sessions. Results: Quantitative results show high levels of participant involvement, implementation, and acceptability. Thematic analyses identified seven themes related to program feasibility: (a) supporting participant involvement, (b) engagement in collaborative learning, (c) strengthening facilitator competency, (d) delivering nonviolent discipline skills, (e) contextualizing content, (f) receptivity to existing practices, and (g) resistance to new skills. Discussion: Findings suggest that parenting programs derived from evidence-based principles may be feasible in South Africa when situated within a culturally relevant context.

Purpose: Violence against children increases in adolescence, but there is a research and practice gap in research-supported child abuse prevention for the adolescent years. A pilot program for low-resource settings was developed in collaboration with nongovernmental organizations, government, and academics in South Africa, using research-supported principles. Method: This study used a pre-post design to test initial effects of a 10-session parenting program with 60 participants (30 caregiver-adolescent dyads) in high-poverty rural South Africa. Areas requiring further testing and adaptation were also identified. Results: Pre-post findings show medium to large program effects in reducing child abuse and adolescent problem behavior, as well as large effects in improvements of positive parenting, and perceived parent and adolescent social support. Discussion: There is potential to reduce child abuse, improve parenting, and reduce adolescent problem behavior in rural South Africa through parenting programs. Further development, testing and longer term follow-up are required to ascertain potential for scale-up.

Objective: The aim was to examine the relationship between caregiver's mental health (parental psychological distress, and parenting stress), dysfunctional parenting (lax or overreactive parenting), and the screen media use in understanding attention‐deficit/hyperactivity disorder (ADHD) symptoms of children within an integrated model framework. Background: Familial factors and screen use have shown to be significantly related to ADHD in children. However, theoretical models of the role of family environment, screen use, and ADHD have rarely been tested jointly, and little is known about these associations in southeastern European middle‐income countries (MICs). Method: Data from 835 primary caregivers (92% biological mother, 4% biological father, 3% grandmother or grandfather, 1% other) of children (2 to 9 years) from three MICs were analyzed using path analyses, and models were tested for generalizability across education levels and marital status using multigroup analyses. ADHD‐related symptoms were assessed with a structured clinical interview (Mini International Neuropsychiatric Interview for Children and Adolescents–Parent Version [MINI‐KID‐P]) and the Child Behavioral Checklist (CBCL). Results: Whereas screen use was directly associated with ADHD symptoms across measures, a significant indirect effect of lax parenting on attentional problems via screen use was found only for the CBCL parent report. The final models were tested using multigroup analyses across education levels and marital status with no significant differences. Conclusion: Investments in resource and capacity building for children's primary caregivers that target lax parenting and limiting of screen use may impact children's attentional problems across educational levels and married and nonmarried caregivers. [ABSTRACT FROM AUTHOR]

This study investigates the co-occurrence of intimate partner violence (IPV) against mothers and their risk of perpetrating child maltreatment (CM) in North Macedonia, the Republic of Moldova, and Romania. Risk factors for IPV, CM, and their co-occurrence were identified. Two samples (N 1= 112, N 2 = 701) of mothers with children with behavioral problems were assessed. IPV was reported by 64% of mothers, CM by 96%, and their co-occurrence by 63%. Mothers exposed to emotional IPV reported more physical and emotional CM. Mothers exposed to physical IPV reported more physical CM. Motheŕs own history of CM and offspring's behavior problems were associated with IPV and CM co-occurrence. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the psychometric properties of three versions of the Parenting Scale (PS; original PS, 13‐item version, and 10‐item version) in three European middle‐income countries. Background: The PS is one of the most frequently used questionnaires for measuring dysfunctional discipline strategies. Although its validity has been extensively investigated in American samples, there are mixed results regarding the recommended number of items and subscales, raising the question of replicability across European middle‐income countries. Method: Multigroup confirmatory factor analysis (MCFA) and item response theory (IRT) were applied to N = 835 parents from North Macedonia, Moldova, and Romania. Results: All three versions were significantly correlated with parental‐ and child‐related variables. Confirmatory factor analysis indicated the best model fit for the 10‐item version, and configural and partial metric invariance across countries could be established for this version. Item response theory analyses also supported this measure. Conclusions: Our findings show that the 10‐item version performed better than the 13‐item version and the original PS both overall and on the country level. Reliability values were somewhat lower than reported in studies from the United States. Implications: The 10‐item version constitutes a promising short measure for assessing dysfunctional parenting in European middle‐income countries for researchers and practitioners. [ABSTRACT FROM AUTHOR]

Background: The Parenting for Lifelong Health for Young Children (PLH‐YC) programme aims to reduce violence against children and child behaviour problems among families in low‐ and middle‐income countries (LMICs). Although the programme has been tested in four randomised controlled trials and delivered in over 25 countries, there are gaps in understanding regarding the programme's implementation fidelity and, more generally, concerning the implementation fidelity of parenting programmes in LMICs. Aims: This study aims to address these gaps by examining the psychometric properties of the PLH‐YC‐Facilitator Assessment Tool (FAT)—an observational tool used to measure the competent adherence of PLH‐YC facilitators. Examining the psychometric properties of the FAT is important in order to determine whether there is an association between facilitator competent adherence and programme outcomes and, if correlated, to improve facilitator performance. It is also important to develop the implementation literature among parenting interventions in LMICs. Methods: The study examined the content validity, intra‐rater reliability, and inter‐rater reliability of the FAT. Revision of the tool was based on consultation with programme trainers, experts, and assessors. A training curriculum and assessment manual was created. Assessors were trained in Southeastern Europe and their assessments of facilitator delivery were analysed as part of a large‐scale factorial experiment (N = 79 facilitators). Results: The content validity process with PLH‐YC trainers, experts, and assessors resulted in substantial improvements to the tool. Analyses of percentage agreements and intraclass correlations found that, even with practical challenges, assessments were completed with adequate yet not strong intra‐ and inter‐rater reliability. Conclusions: This study contributes to the literature on the implementation of parenting programmes in LMICs. The study found that the FAT appears to capture its intended constructs and can be used with an acceptable degree of consistency. Further research on the tool's reliability and validity—specifically, its internal consistency, construct validity, and predictive validity—is recommended. [ABSTRACT FROM AUTHOR]

We explore how organisations working on parenting programmes and other types of family support and violence prevention in low-resource settings experienced the pandemic. In August 2020–May 2021, we interviewed (1) staff from three community-based organisations delivering evidence-informed parenting interventions and other psychosocial services for families in Cape Town, South Africa, (2) staff from a parenting programme training organisation and (3) staff from two international organisations supporting psychosocial services in South Africa. Interviews (22) were thematically analysed, with findings in three areas. First, respondents noted changes in the context, including the job losses, food insecurity, and stress experienced by local communities, and reductions in organisational funding. Second, we found that in response to these context changes, the organisations shifted their focus to food provision and COVID prevention. Parenting and psychosocial programmes were adapted – e.g. by changing the physical delivery settings, reducing group sizes, and taking up digital and phone implementation. Participants reported improved perceptions of remote delivery as a feasible approach for working with families – but internet and phone access remained challenging. Third, the pandemic brought new responsibilities for staff, and both the challenges of working from home and the health risks of in-person work. [ABSTRACT FROM AUTHOR]

Background: Parenting was severely affected by lockdown, school closure, illness, movement restrictions and the many sudden changes wrought by the global emergence of COVID-19. Responding to the need for a rapid emergency response to support parents and caregivers, a consortium of providers developed a suite of COVID-19 parenting resources based on evidence-based parenting interventions. Launched in March 2020, these were adapted for online use, with versions in over 100 languages, and the possibility for downloading, radio, and oral provision. A rapid qualitative evaluation initiative was conducted from September 2020 to February 2021 to inform the procedure, understand the impact and to drive future provision. Methods: The evaluation collected openended responses surveys (n = 495 participants) and in-depth interviews with parents, providers, and adolescent children (n = 22) from 14 countries and one global source. Data were gathered on parenting challenges during COVID-19 and the utility of the COVID-19 parenting resources. In-depth, semi-structured interviews explored the same concepts and elaborated on challenges, utility of the resources, and recommendations for the future. Data were coded in a hierarchy from basic, organising and global theme generation.Results: The parenting resources equipped parents with information and practices transforming everyday lives, and interactions. The tips provided prompts and permissions related to children's behaviour, enabled communications, and offered ways to reduce stress, monitor behaviour and navigate discipline challenges. The timeliness of the resources as well as the clarity and ease of use were seen as advantages. Future direction and possible hurdles related to adaptations needed according to recipient, child age, local context, culture, and new challenges. Conclusions: Overall findings point to the value and utility of this unprecedented global response to theCOVID-19 pandemic. Results suggest that rapid provision of parenting resources at scale is feasible and of use and opens a pathway for providing evidence-based interventions under COVID-19 constraints. [ABSTRACT FROM AUTHOR]

Although the evidence of parent training programmes for families of autistic children has continued to grow, little is known about the experiences and perceptions of key stakeholders, especially in low- and middle-income countries. This qualitative study was part of a larger real-world evaluation of a short-term intensive parent training programme in routine services delivered to caregivers of autistic children aged 3–6 years in China. It aimed to provide insights into programme acceptability, reasons for participant involvement, and factors related to programme implementation. Fourteen caregivers participated in the in-depth interviews, and two focus group discussions were conducted with eight practitioners. Data were analysed using a combination of data- and theory-driven approaches. Findings point to the needs in low autism resource settings for substantial practice and feedback; group support; individualised coaching; more autism-related knowledge, resources and activities for children and extended family members; and organisational support to practitioners. Further research is suggested to address the recommendations and assess their effectiveness empirically. While much knowledge about autism derives from high-income countries, most people diagnosed with autism reside in low- and middle-income countries, where little is documented in terms of local interventions. This is also true for parent training programmes for families of autistic children. An evaluation was conducted to understand the effects of a short-term intensive parent training programme delivered in routine services for families of autistic children in China. This study reported results from the in-depth interviews with 14 participating caregivers and group discussions with eight group leaders. The interviews and discussions were aimed at learning (1) to what extent the programme components were deemed acceptable, (2) what affected caregivers' attendance and engagement in the programme and (3) what affected group leaders' delivery of the programme. Findings suggested that future parent training programmes provide adequate opportunities for caregivers to practice and receive feedback; group support; coaching experience tailored to individual challenges; more autism-related knowledge, resources and activities for children and extended family members; and organisational support to group leaders. This study highlights the value of qualitative research and points to the need for more empirical studies to address the recommendations, so that research findings can be better utilised to promote practices. [ABSTRACT FROM AUTHOR]

Copyright of Family Process is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Recent systematic reviews found limited rigorous research conducted to date of the effectiveness of parent training programs in reducing behavioral problems for autistic children in low- and middle-income countries. This study is aimed at evaluating the effectiveness of a short-term intensive parent training program for autistic children aged three to six in the context of routine service provision in China. A quasi-experiment was conducted involving the local implementing organization and using a waitlist control. Data were collected at baseline and immediate post-intervention. The primary outcome was child behavioral problems measured using the Child Behavior Checklist Externalizing scale. Between-group comparisons used a difference-in-differences design with propensity score weighting to reduce sources of bias. A process evaluation was undertaken in parallel to assess participant involvement, program acceptability, and delivery. The protocol was prospectively registered with ClinicalTrials.gov (NCT04257331). The final sample size was 111 (treatment: 63; comparison: 48). Results suggest that the program was associated with improvements in child externalizing behaviors (b = -2.71, 95% CI [-5.23, -0.18]), parental mental health symptoms (b = -5.96, 95% CI [-11.74, -0.17]), over-reactive parenting (b = -0.63, 95% CI [-0.98, -0.27]), and parental knowledge (b = 2.08, 95% CI [2.07, 2.17]). Exploratory analysis of factors related to implementation indicated that baseline parental mental health was related to participant engagement, and that satisfaction and engagement levels were potentially linked to positive treatment effects. Findings suggest that short-term intensive parent training programs that are provided by trained non-specialists, could potentially be used as an alternative to traditional prohibitively costly services that are delivered intensively for consecutive years in low-resource contexts. Follow-ups are needed to investigate its long-term benefits. [ABSTRACT FROM AUTHOR]

Copyright of Family Process is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: This study investigated process and outcomes of the Parenting for Lifelong Health (PLH) for Young Children and for Adolescents programs implemented as part of routine service delivery in postconflict settings. Methods: These group-based programs were delivered by trained facilitators to 97 caregivers (PLH for Young Children) and 108 caregiver–adolescent dyads (PLH for Adolescents) over 12 or 14 (respectively) weekly sessions. Routine monitoring data were collected by the implementing partners using standardized self-report measures. Reducing harsh discipline was specified as the primary outcome, with secondary outcomes including improvements in positive parenting and reductions in poor parental supervision and parental inefficacy. Results: Analyses were intention to treat. Both PLH programs retained effectiveness in routine conditions in a postwar setting, with moderate to large effect sizes. The programs also had high enrollment and attendance rates, indicating high acceptability. Conclusions: Findings suggest promising viability for the implementation of evidence-based parenting programs in challenging postconflict contexts. [ABSTRACT FROM AUTHOR]

Background: Parenting programs suitable for delivery at scale in low‐resource contexts are urgently needed. We conducted a randomized trial of Parenting for Lifelong Health (PLH) for Young Children, a low‐cost 12‐session program designed to increase positive parenting and reduce harsh parenting and conduct problems in children aged 2–9. Methods: Two hundred and ninety‐six caregivers, whose children showed clinical levels of conduct problems (Eyberg Child Behavior Inventory Problem Score, >15), were randomly assigned using a 1:1 ratio to intervention or control groups. At t0, and at 4–5 months (t1) and 17 months (t2) after randomization, research assistants blind to group assignment assessed (through caregiver self‐report and structured observation) 11 primary outcomes: positive parenting, harsh parenting, and child behavior; four secondary outcomes: parenting stress, caregiver depression, poor monitoring/supervision, and social support. Trial registration: ClinicalTrials.gov (NCT02165371); Pan African Clinical Trial Registry (PACTR201402000755243); Violence Prevention Trials Register (http://www.preventviolence.info/Trials?ID=24). Results: Caregivers attended on average 8.4 sessions. After adjustment for 30 comparisons, strongest results were as follows: at t1, frequency of self‐reported positive parenting strategies (10% higher in the intervention group, p =.003), observed positive parenting (39% higher in the intervention group, p =.003), and observed positive child behavior (11% higher in the intervention group, p =.003); at t2, both observed positive parenting and observed positive child behavior were higher in the intervention group (24%, p =.003; and 17%, p =.003, respectively). Results with p‐values <.05 prior to adjustment were as follows: At t1, the intervention group self‐reported 11% fewer child problem behaviors, 20% fewer problems with implementing positive parenting strategies, and less physical and psychological discipline (28% and 14% less, respectively). There were indications that caregivers reported 20% less depression but 7% more parenting stress at t1. Group differences were nonsignificant for observed negative child behavior, and caregiver‐reported child behavior, poor monitoring or supervision, and caregiver social support. Conclusions: PLH for Young Children shows promise for increasing positive parenting and reducing harsh parenting. Read the Commentary on this article at doi: 10.1111/jcpp.13172 [ABSTRACT FROM AUTHOR]