Effects of early parenting interventions on parents and infants
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Parenting interventions conducted during pregnancy or before a child’s first birthday significantly improve parental responsiveness and prevent infant sleep problems, according to a recent systematic review published in the Journal of Child and Family Studies.
Comprehensive searches across a number of electronic databases identified 36 English language studies, occurring over the last 35 years, that evaluated parenting interventions that included an educational component. Studies were included if they were:
- randomised controlled trials (RCTs);
- the parenting intervention began during pregnancy or the first 12 months after birth; and
- assessed parental responsiveness, confidence or competence, or baby sleep and crying behaviours.
21 of the 36 studies focused on families with specific vulnerabilities, including low education or income, or psychosocial or mental health issues, while the remaining studies included families with no known vulnerabilities. Parenting interventions were run across a few different formats including one-on-one consultations, group based sessions and self-directed study, and were held either in parents’ homes or in hospital.
The review showed that parents who received parenting interventions were significantly more responsive to their baby compared to those who did not. All studies included in the review assessed for parental responsiveness using observation measures, with researchers looking for responsiveness and sensitivity to infant distress and social signals, and parents’ anticipation of their infant’s needs.
Infants whose parents received the interventions also had significantly better sleep behaviours than those whose parents did not receive the intervention. The impact of the interventions on infant sleep, however, was not as strong as the impact on parental responsiveness. Sleep behaviours were mostly assessed through the use of behavior diaries, filled out by parents.
Interventions assessing levels of infant crying did not show significant effects, although the authors suggest this is likely due the small number of studies measuring infant crying and the reliance on parents to self-report levels of crying through methods such as baby-diaries.
The authors suggest the stronger impact of parenting interventions on parental responsiveness compared to infant sleep and crying may be attributable to the style of the intervention. Parenting interventions focusing on responsiveness used attachment-based approaches with more active practice components such as facilitator modelling, video feedback and active encouragement of responsiveness towards the baby. Interventions focusing on sleep and crying by comparison used mostly information-based behavioural approaches that did not provide much facilitator support or opportunities to practice within the session. The authors suggest the practice strategies of attachment-based interventions may be the active ingredient in producing higher levels of change.
There were a number of limitations to the review, including the small number of studies identified for each variable (i.e. the number of studies on infant sleep or parenting confidence and competence was small) and the lack of data following up participants over the longer term. The authors suggest future trials of parenting interventions should consider more direct methods of assessing impact (e.g. observation) than relying on parents to self-report (e.g. through diary keeping), because information gathered through self-report could be less reliable as it may be influenced by parents’ sleep deprivation or poor memory recollection.
Mihelic, M., Morawska, A., Filus, A. (2017). Effects of Early Parenting Interventions on Parents and Infants: A Meta-Analytic Review, Journal of Child and Family Studies, 26, 1507-1526.
Feature image is by Andrew Branch, CC0 1.0.