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Family Check-Up - Toddler

Blueprints Program Rating: Promising

The toddler version of the Family Check-Up (FCU) aims to prevent conduct problems among at-risk toddlers by improving the quality of parenting and increasing and maintaining parents' use of Positive Behavior Support.

Program Outcomes

  • Conduct Problems
  • Externalizing
  • Internalizing
  • Reciprocal Parent-Child Warmth

Program Type

  • Parent Training

Program Setting

  • Community (e.g., religious, recreation)
  • Home
  • Hospital/Medical Center
  • School

Continuum of Intervention

  • Universal Prevention (Entire Population)
  • Selective Prevention (Elevated Risk)

Age

  • Infant (0-2)

Gender

  • Male and Female

Race/Ethnicity

  • All Race/Ethnicity

Endorsements

  • Blueprints: Promising
  • Crime Solutions: Promising
  • OJJDP Model Programs: Promising
  • SAMHSA: 3.0 - 3.1

Program Information Contact

Anne Marie Mauricio, Ph.D.
REACH Institute
Arizona State University
P.O. Box 876005
Tempe, AZ 85287-6005
Phone: (480) 965-7420
Fax: (480) 965-5430
Email: thefamilycheckup@asu.edu
Website: reachinstitute.asu.edu/family-check-up

Program Developer/Owner

  • Anne Marie Mauricio, Ph.D.
  • The REACH institute

Brief Description of the Program

The Family Check-Up (Toddler version) is a strengths-based, family-centered intervention that motivates parents to use parenting practices in support of child competence, mental health, and reducing risks for substance use. The intervention has two phases: 1) initial interview, assessment, and feedback; and 2) Everyday Parenting as a follow-up service that builds parents' skills in positive behavior support, healthy limit-setting, and relationship-building. Phase 1 involves three 1-hour sessions (interview, assessment, and feedback). As a health promotion and prevention strategy, Phase 2 of the FCU can be limited to 1 to 3 Everyday Parenting sessions; as a treatment approach, Phase 2 can range from 3 to 15 Everyday Parenting sessions. The FCU is appropriate for families with toddlers 17 months through 2 years of age and has been evaluated with samples including people of African American, White, Latino or Hispanic, and other race/ethnicities. FCU providers should have a master’s degree in education, social work, counseling, or related areas.

See: Full Description

Outcomes

The Family Check-Up toddler program resulted in significant improvements relative to controls in:

  • observer-rated Positive Behavior Support provided by parents
  • parent-reported child problem behaviors
  • parent reported child externalizing
  • parent and teacher-reported oppositional defiant behavior at the 5.5-year follow-up, particularly among those that engaged most in the program (Dishion et al., 2014)
  • BMI (indirect effect related to improvements in caregivers' Positive Behavior Supports in toddlerhood, which was related to the nutritional quality of the meals served at the in-home assessments)
  • Reports of child depressed/withdrawn symptoms at ages 7.5-8.5 via decreased maternal depression

Significant effects on risk and protective factors included:

  • decreases in maternal depression
  • increases in maternal involvement and positive parenting

Race/Ethnicity/Gender Details

The sample in the first study (Shaw et al., 2006) consisted only of boys, but Study 2 (Dishion et al., 2008, 2014), which also had a much larger sample size, evaluated program effects for both genders, and drew from an ethnically and geographically diverse population. There were no gender or ethnicity differences found for intervention effects.

Risk and Protective Factors

Risk Factors
  • Individual: Antisocial/aggressive behavior, Early initiation of antisocial behavior*
  • Family: Family conflict/violence, Family history of problem behavior, Neglectful parenting, Parent history of mental health difficulties*, Parent stress, Poor family management*, Violent discipline
Protective Factors
  • Individual: Clear standards for behavior, Prosocial behavior
  • Family: Attachment to parents, Non-violent discipline, Opportunities for prosocial involvement with parents*, Parent social support*, Parental involvement in education
  • School: Opportunities for prosocial involvement in education

*Risk/Protective Factor was significantly impacted by the program.

See also: Family Check-Up - Toddler Logic Model (PDF)

Training and Technical Assistance

We currently offer in-person training workshops, but soon will also offer online training as early as October 2015. Our four-day, in-person workshops incorporate active learning such as role-play, discussion, and case study. Two days focus on the Family Check-Up (Interview, Assessment, and Feedback) and two days focus on the Everyday Parenting Curriculum. The workshops are at Arizona State University or on-site for a contracting organization, and can accommodate up to 25 participants. Trainees earn up to 22 Continuing Education (CE) credit hours.

The online training program will contain two courses: Family Check-Up and Everyday Parenting. Each course will consist of a series of learning modules designed to offer a comprehensive training. After completing the online training, trainees will be able to participate in a brief in-person workshop that offers opportunities to practice delivery of the Family Check-Up and Everyday Parenting Curriculum. Trainees who complete the online training will be able to earn up to 8 CEs.

Providers who participate in Family Check-Up training also have access to all training and implementation support resources, which are available through the ASU REACH Institute. These materials include:

  • intervention manuals for the Family Check-Up and the Everyday Parenting Curriculum
  • videos of (real-world and mock-session) providers demonstrating delivery of each component of the Family Check-Up and modules from Everyday Parenting,
  • all materials needed for administration, scoring and interpretation of the ecological child and family assessment
  • all forms and documents needed to support delivery of the initial interview and feedback sessions of the Family Check-Up 
  • Family Check-Up and Everyday Parenting Curriculum COACH fidelity assessment forms and manuals
  • online support for monitoring implementation and clinical outcomes

Training Certification Process

Providers who have completed either the online or in-person training program may then work towards certification in the model. The certification process includes further direct experience implementing the model and consultation related to intervention activity through case conferences and review of videotaped intervention sessions. Certification is established when the provider demonstrates reliable delivery of the model with fidelity. Trained providers participate in twice-monthly group consultation sessions and approximately 10 hours of individualized consultation towards certification. Providers are recertified every three years to reduce drift from the intervention model.

Certified Family Check-Up Consultants provide training and consultation. However, there is a model for providers on-site to train and certify as Family Check-Up trainers and supervisors. Providers certified as Family Check-Up trainers and supervisors can train, supervise, and certify providers at their own site. Certification as a Family Check-Up trainer and supervisor requires certification as a Family Check-Up provider, reliability using the COACH fidelity assessments, and adherence to our training and supervision model as demonstrated by observation and rating of training and supervision. On average, certification as a Family Check-Up trainer and supervisor requires 25-30 hours of consultation.

Brief Evaluation Methodology

Two studies used random assignment of families to treatment or control conditions. Outcomes were evaluated using parental reports and behavioral observations conducted through home-visit assessments, with Dishion et al. (2014) also collecting teacher-reported measures. Initial assessments were conducted prior to randomization, and were conducted again 1, 2, 3, and 5.5 years after the program was initiated. Later assessments followed 7.5 and 8.5 years from baseline.

References

Connell, A., Bullock, B. M., Dishion, T. J., Shaw, D., Wilson, M., & Gardner, F. (2008). Family intervention effects on co-occurring early childhood behavioral and emotional problems: A latent transition analysis approach. Journal of Abnormal Child Psychology, 36, 1211-1225.

Dishion, T. J., Brennan, L. M., Shaw, D. S., McEachern, A. D., Wilson, M. N., & Jo, B. (2014). Prevention of problem behavior through annual check-ups in early childhood: Intervention effects from home to elementary school. Journal of Abnormal Child Psychology, 42, 343-354.

Dishion, T. J., Shaw, D., Connell, A., Gardner, F., Weaver, C., & Wilson, M. (2008). The Family Check-Up with high-risk indigent families: Preventing problem behavior by increasing parents' positive behavior support in early childhood. Child Development, 79, 1395-1414.

Gardner, F., Connell, A., Trentacosta, C. J., Shaw, D. S., Dishion, T. J., & Wilson, M. N. (2009).Moderators of outcomes in a brief family-centered intervention for preventing early problem behavior. Journal of Consulting and Clinical Psychology, 77, 543-553.

Lunkenheimer, E. S., Dishion, T. J., Shaw, D. S., Connell, A. M., Gardner, F., Wilson, M. N., & Skuban, E. M. (2008). Collateral benefits of the Family Check-Up on early childhood school readiness: Indirect effects of parents' positive behavior support. Developmental Psychology, 44, 1737-1752.

Reuben, J. D., Shaw, D. S., Brennan, L. M., Dishion, T. J., & Wilson, M. N. (2015). A family-based intervention for improving children’s emotional problems through effects on maternal depressive symptoms. Journal of Consulting and Clinical Psychology, 83 (6), 1142-1148.

Shaw, D. S., Connell, A., Dishion, T. J., Wilson, M. N., & Gardner, F. (2009). Improvements in maternal depression as a mediator of intervention effects on early childhood problem behavior. Development and Psychopathology, 21, 417-439.

Shaw, D. S., Dishion, T. J., Supplee, L., Gardner, F., & Arnds, K. (2006). Randomized trial of a family-centered approach to the prevention of early conduct problems: 2-year effects of the Family Check-Up in early childhood. Journal of Consulting and Clinical Psychology, 74, 1-9.