Summary of findings for the main comparison. Group‐based parent training programmes compared to control for improving emotional and behavioural adjustment in young children at postintervention.
| Group‐based parent training programmes for improving emotional and behavioural adjustment in young children at postintervention | |||||
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Patient or population: young children
Settings: interventions were delivered in the community or at schools/preschools in Australia, Canada, Peru, the UK, and the USA
Intervention: group‐based parent training programmes Control: waiting list, no intervention, or treatment‐as‐usual | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI)** | Number of participants (studies) | Quality of the evidence (GRADE) | Comments |
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Emotional and behavioural problems (parent report) Scales used: BSI‐II, BSQ, CAPES, CBCL, CBQ postintervention |
The mean child emotional and behavioural problems, as reported by parents, in the intervention groups was 0.81 standard deviations lower (1.37 to 0.25 lower) compared to the control group representing a large difference favouring group‐based parent training programmes | SMD ‐0.81 (‐1.37 to ‐0.25) | 280 (5 studies) | ⊕⊕⊝⊝ Low1,2 | ‐ |
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Externalising problems (parent report) Scales used: CBCL, ECBI postintervention |
The mean child externalising problems, as reported by parents, in the intervention groups was 0.23 standard deviations lower (0.46 to 0.01 lower) compared to the control group representing a small difference favouring group‐based parent training programmes | SMD ‐0.23 (‐0.46 to ‐0.01) | 989 (8 studies) | ⊕⊕⊕⊝ Moderate2 | ‐ |
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Externalising problems ‐ hyperactivity‐inattention (parent report) Scales used: HSQ postintervention |
The mean child hyperactivity‐inattention externalising problems, as reported by parents, in the intervention groups was 1.34 standard deviations lower (2.37 to 0.31 lower) compared to the control group representinga moderate difference favouring group‐based parent training programmes | SMD ‐1.34 (‐2.37 to ‐0.31) | 19 (1 study) | ⊕⊝⊝⊝ Very low1,3 | ‐ |
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Internalising problems (parent report) Scale used: CAPES postintervention |
The mean child internalising problems, as reported by parents, in the intervention groups was 0.34 standard deviations higher (0.12 lower to 0.81 higher) compared to the control group representinglittle or no difference | SMD 0.34 (‐0.12 to 0.81) | 73 (1 study) | ⊕⊕⊝⊝ Low3 | ‐ |
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Social skills (parent report) Scale used: VABS postintervention |
The mean child social skills, as reported by parents, in the intervention groups was 3.59 standard deviations higher (2.42 to 4.76 higher) compared to the control group representing a large difference favouring group‐based parent training programmes | SMD 3.59 (2.42 to 4.76) | 32 (1 study) | ⊕⊝⊝⊝ Very low1,3 | ‐ |
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Parent‐child interaction ‐ negative behaviour (observer report) Scales used: DPICS, IBCS postintervention |
The mean child negative behaviour during parent‐child interaction, as reported by independent observers, in the intervention groups was 0.22 standard deviations lower (0.39 to 0.06 lower) compared to the control group representing a small difference favouring group‐based parent training programmes | SMD ‐0.22 (‐0.39 to ‐0.06) | 941 (7 studies) | ⊕⊕⊕⊝ Moderate1 | ‐ |
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Parent‐child interaction ‐ positive behaviour (observer report) Scales used: Attachment Q‐set, DPICS postintervention |
The mean child positive behaviour during parent‐child interaction, as reported by independent observers, in the intervention groups was 0.48 standard deviations higher (0.17 to 0.79 higher) compared to the control group representing a small difference favouring group‐based parent training programmes | SMD 0.48 (0.17 to 0.79) | 173 (4 studies) | ⊕⊕⊕⊝ Moderate4 | ‐ |
| * The effect sizes are differences in standard deviations. To facilitate interpretation we have used rules of thumb in interpretation of effect size (section 12.6.2 in Higgins 2011), where a standard deviation of 0.2 represents a small difference between groups, 0.5 represents a moderate difference, and 0.8 represents a large difference. ** Several different scales were used to measure outcomes, therefore, the effect sizes were estimated by calculating SMDs. BSI‐II: Bayley Scale of Infant Development II;BSQ: Behaviour Screening Questionnaire;CAPES: Child Adjustment and Parent Efficacy Scale;CBCL: Child Behaviour Checklist;CBQ: Child Behaviour Questionnaire;CI: Confidence interval; DPICS: Dyadic Parent‐Child Interaction Coding System; ECBI: Eyberg Child Behaviour Inventory;GRADE: Grades of Recommendation, Assessment, Development and Evaluation; HSQ: Home Situations Questionnaire;IBCS: Interpersonal Behaviour Construct Scale; SMD: Standard mean difference; VABS: Vineland Adaptive Behaviour Scale. | |||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | |||||
1 Downgraded one level for risk of bias; inadequate allocation concealment and/or randomisation. Three out of the five included studies did not adequately conceal participant allocation and two studies did not adequately carry out randomisation, and were judged to be at high risk of bias. 2 Downgraded one level for inconsistency; heterogeneity was considerable (I² > 50%). 3 Downgraded two levels for imprecision; only one study with small number of participants was included. 4 Downgraded one level for imprecision; four studies with only 173 participants were included.