Search

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.

Background: Parents were at the forefront of responding to the needs of children during the COVID-19 pandemic. This study used the RE-AIM framework to examine the Reach, Effectiveness, Adoption, Implementation, and Maintenance of a global inter-agency initiative that adapted evidence-based parenting programs to provide immediate support to parents. Methods: Data were collected via short surveys sent via email, online surveys, and analysis of social media metrics and Google Analytics. Retrospective surveys with 1,303 parents and caregivers in 11 countries examined impacts of the resources on child maltreatment, positive relationship building, parenting efficacy, and parenting stress. Results: The parenting resources were translated into over 135 languages and dialects; reached an estimated minimum 212.4 million people by June 2022; were adopted by 697 agencies, organizations, and individuals; and were included in 43 national government COVID-19 responses. Dissemination via social media had the highest reach (n = 144,202,170, 67.9%), followed by radio broadcasts (n = 32,298,525, 15.2%), text messages (n = 13,565,780, 6.4%), and caseworker phone calls or visits (n = 8,074,787, 3.8%). Retrospective surveys showed increased parental engagement and play, parenting self-efficacy, confidence in protecting children from sexual abuse, and capacity to cope with stress, as well as decreased physical and emotional abuse. Forty-four organizations who responded to follow-up surveys in April 2021 reported sustained use of the resources as part of existing services and other crisis responses. Conclusion: This study highlights the importance of a) establishing an international collaboration to rapidly adapt and disseminate evidence-based content into easily accessible resources that are relevant to the needs of parents; b) creating open-source and agile delivery models that are responsive to local contexts and receptive to further adaptation; and c) using the best methods available to evaluate a rapidly deployed global emergency response in real-time. Further research is recommended to empirically establish the evidence of effectiveness and maintenance of these parenting innovations. [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]

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]

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]

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]

Millions of children in China are diagnosed with developmental disabilities (DD), many of whom are subject to physical abuse. While a significant body of research suggests that parenting interventions can reduce the incidence and risk of such abuse, there is currently limited evidence of their effectiveness for this population or from non-English-speaking countries. This review involved searches in both English and Chinese databases to identify randomized controlled trials and quasi-experimental studies of parenting interventions for families of children with DD in mainland China. Multilevel meta-analyses were undertaken to examine the effectiveness of parenting programs. Subgroup analyses and meta-regression were conducted to investigate heterogeneity and identify potential moderators with a focus on intervention and delivery components. Risk of bias was assessed for each study. Thirty-one studies were included. The results showed that parenting interventions could reduce child emotional and behavioral problems (CEBP) and improve the parent–child relationship, although only one study directly measured the actual incidence of abuse. Programs for autism and epilepsy had stronger treatment effects. Teaching knowledge about CEBP, skills to improve parental mental health, and techniques to cultivate empathy were associated with program success; however, positive reinforcement was associated with more problems. The results also supported the delivery of programs with longer duration, a combination of group and individual sessions, efforts to build rapport, ongoing communication outside the programs, and delivery in hospitals or service agencies. Further research is needed, however, in addition to improvements in the quality of research and reporting. [ABSTRACT FROM AUTHOR]

Evidence shows that parenting interventions are an effective method of reducing caregiver-perpetrated child maltreatment. The recent COVID-19 pandemic has changed the provision of parenting interventions worldwide, with many interventions adapting to continue providing services during the crisis. This global systematic review examined how parenting interventions targeting child maltreatment and its risk and protective factors were adapted during the COVID-19 pandemic. We searched for studies published between 2020 and 2022 and identified 31 eligible studies. The data on the rationale, process, feasibility, acceptability, and impacts of adaptations were narratively synthesized in accordance with the Framework for Reporting Adaptations and Modifications to Evidence-Based Interventions. Results showed that most adaptations were proactive and focused on delivery methods, predominantly digitalization. While feasibility and acceptability were generally observed, the impacts of adapted programs were inconclusive. Inadequate reporting, especially regarding rationale, fidelity, facilitator capacity building, stakeholder involvement, and decision-making processes, was noted. The review recommends enhanced planning, documentation, and reporting of program adaptations using established guidelines, as well as process and impact evaluations., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: ZF and YS were involved in one of the included studies. ZF, MM, and YS have worked on Parenting for Lifelong Health program evaluations. There is no other conflict of interest.