The Impact of a Preventive Intervention on Persistent, Cross-Situational Early Onset Externalizing Problems
- 23 Downloads
The Nurse-Family Partnership (NFP) home visiting intervention for low-income first-time mothers was evaluated for its preventive impact on persistent, cross-situational early-onset externalizing problems (EXT). Seven hundred thirty-five women in the Denver, CO, area were randomly assigned into one of two active conditions (nurse or paraprofessional home visiting from pregnancy through child age 2) or a control group in which children were screened and referred for behavioral and developmental problems. Externalizing behavior was assessed by parent report when the children were 2, 4, 6, and 9 years old; teachers provided reports at ages 6 and 9. Latent profile analyses suggested the presence of persistent, cross-situational early onset EXT in approximately 6 to 7% of girls and boys. The intervention deflected girls away from these EXT and toward a pattern marked by a persistent moderate elevation of externalizing behavior that was evident at home and not at school. This finding should be interpreted cautiously given the small number of girls with the elevated EXT. Surprisingly, the intervention also moved girls away from stable low level externalizing behavior toward the moderately elevated pattern. Both of the significant effects on girls’ externalizing behavior were modest. No statistically significant effects were found for boys’ externalizing behaviors, which exhibited a somewhat different patterning across time and reporter. Effect sizes were generally similar for the nurse and paraprofessional-visited groups. The results are discussed in the context of prior efforts to prevent early EXT and emerging evidence on the normative development of externalizing behavior.
KeywordsPrevention Externalizing Infancy Toddlerhood RCT
The current phase of this research was supported by grants 99012, 99030, and 2001-049 from the Colorado Trust, 90PD0232 and 90XP0017 from the Administration for Children and Families, 2004-52854-CO-JS from the Office of Juvenile Justice and Delinquency Prevention, 2005-MU-MU-001 from the US Department of Justice, and 1R01MH069891, 1R01MH62485, and 1K05-MH01382 from the National Institute of Mental Health.
Compliance with Ethical Standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Colorado Multiple Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
Conflict of Interest
Michael Lorber and Nancy Donelan-McCall declare that they have no conflicts of interest. The Prevention Research Center for Family and Child Health (PRC), directed by David Olds, receives fees and travel expenses from governments and entities outside of the United States to implement the Nurse-Family Partnership©. Licensing fees are charged to international entities for implementing the program. The fees are used to support program implementation in international contexts and research on testing and improving the NFP and its implementation. In the US, the program is replicated by the NFP National Service Office, which provides funding to the PRC to conduct research aimed at improving the NFP model and its implementation. None of these fees are used to augment Dr. Olds’s university salary. Professor Olds does receive honoraria for writing and speaking about the NFP.
- Achenbach, T. M. (2009). Achenbach system of empirically based assessment (ASEBA): Development, findings, theory, and applications. Burlington, VT: Author.Google Scholar
- Alink, L. R. A., Mesman, J., Van Zeijl, J., Stolk, M. N., Juffer, F., Koot, H. M., et al. (2006). The early childhood aggression curve: Development of physical aggression in 10 to 50 month-old children. Child Development, 77, 954–966. https://doi.org/10.1111/j.1467-8624.2006.00912.x.CrossRefPubMedGoogle Scholar
- Crowne, S. S., Gonsalves, K., Burrell, L., McFarlane, E., & Duggan, A. (2012). Relationship between birth spacing, child maltreatment, and child behavior and development outcomes among at-risk families. Maternal and Child Health Journal, 16, 1413–1420. https://doi.org/10.1007/s10995-011-0909-3.CrossRefPubMedGoogle Scholar
- Eckenrode, J., Campa, M., Luckey, D. W., Henderson, C. R., Jr., Cole, R., Kitzman, H., et al. (2010). Long-term effects of prenatal and infancy nurse home visitation on the life course of youths: 19-year follow-up of a randomized trial. Archives of Pediatrics and Adolescent Medicine, 164, 9–15. https://doi.org/10.1001/archpediatrics.2009.240.CrossRefPubMedGoogle Scholar
- Kitzman, H. J., Olds, D. L., Cole, R. E., Hanks, C. A., Anson, E. A., Arcoleo, K. J., et al. (2010). Enduring effects of prenatal and infancy home visiting by nurses on children: Follow-up of a randomized trial among children at age 12 years. Archives of Pediatrics and Adolescent Medicine, 164, 412–418. https://doi.org/10.1001/archpediatrics.2010.76.CrossRefPubMedGoogle Scholar
- Loukas, A., Zucker, R. A., Fitzgerald, H. E., & Krull, J. L. (2003). Developmental trajectories of disruptive behavior problems among sons of alcoholics: Effects of parent psychopathology, family conflict, and child undercontrol. Journal of Abnormal Psychology, 112, 119–131. https://doi.org/10.1037/0021-843X.112.1.119.CrossRefPubMedGoogle Scholar
- Love, J. M., Kisker, E. E., Ross, C., Raikes, H., Constantine, J., Boller, K., et al. (2005). The effectiveness of Early Head Start for 3-year-old children and their parents: Lessons for policy and programs. Developmental Psychology, 41, 885–901. https://doi.org/10.1037/0012-16220.127.116.115.CrossRefPubMedGoogle Scholar
- Matjasko, J. L., Vivolo-Kantor, A. M., Massetti, G. M., Holland, K. M., Holt, M. K., & Dela Cruz, J. (2012). A systematic meta-review of evaluations of youth violence prevention programs: Common and divergent findings from 25 years of meta-analyses and systematic reviews. Aggression and Violent Behavior, 17, 540–552. https://doi.org/10.1016/j.avb.2012.06.006.CrossRefPubMedPubMedCentralGoogle Scholar
- Mesman, J., Stoel, R., Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., Juffer, F., Koot, H. M., & Alink, L. R. (2009). Predicting growth curves of early childhood externalizing problems: Differential susceptibility of children with difficult temperament. Journal of Abnormal Child Psychology, 37, 625–636. https://doi.org/10.1007/s10802-009-9298-0.CrossRefPubMedGoogle Scholar
- Moffitt, T. E., Caspi, A., Harrington, H., & Milne, B. J. (2002). Males on the life-course-persistent and adolescence-limited antisocial pathways: Follow-up at age 26 years. Development and Psychopathology, 14, 179–207 http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=100937.CrossRefGoogle Scholar
- Muthén, L. K., & Muthén, B. O. (1998-2017). Mplus user’s guide (8th ed.). Los Angeles, CA: Muthén & Muthén.Google Scholar
- NICHD Early Child Care Research Network, & Arsenio, W. F. (2004). Trajectories of physical aggression from toddlerhood to middle childhood: Predictors, correlates, and outcomes. Monographs of the Society for Research in Child Development, 69, 1–129. https://doi.org/10.1111/j.0037-976X.2004.00312.x.CrossRefGoogle Scholar
- NIMH National Advisory Mental Health Council Workgroup on Mental Disorders Prevention Research (2001). Prevention and Treatment, Volume 4, Article 17. Retrieved May 15, 2005 from http://www.journals.apa.org/prevention/volume4/pre0040027c.html
- Olds, D. L., Holmberg, J. R., Donelan-McCall, N., Luckey, D. W., Knudtson, M. D., & Robinson, J. (2014). Effects of home visits by paraprofessionals and by nurses on children: Follow-up of a randomized trial at ages 6 and 9 years. JAMA Pediatrics, 168, 114–121. https://doi.org/10.1001/jamapediatrics.2013.3817.CrossRefPubMedPubMedCentralGoogle Scholar
- Olds, D. L., Kitzman, H., Cole, R., Robinson, J., Sidora, K., Luckey, D. W., et al. (2004b). Effects of nurse home-visiting on maternal life course and child development: Age 6 follow-up results of a randomized trial. Pediatrics, 114, 1550–1559. https://doi.org/10.1542/peds.2004-0962.CrossRefPubMedGoogle Scholar
- Olds, D. L., Kitzman, H., Hanks, C., Cole, R., Anson, E., Sidora-Arcoleo, K., et al. (2007b). Effects of nurse home visiting on maternal and child functioning: Age-9 follow-up of a randomized trial. Pediatrics, 120, e832–e845. https://doi.org/10.1542/peds.2006-2111.CrossRefPubMedPubMedCentralGoogle Scholar
- Olds, D., Henderson, C. R., Jr., Cole, R., Eckenrode, J., Kitzman, H., Luckey, D., et al. (1998a). Long-term effects of nurse home visitation on children's criminal and antisocial behavior. Journal of the American Medical Association, 280, 1238–1244. https://doi.org/10.1001/jama.280.14.1238.CrossRefPubMedGoogle Scholar
- Olds, D., Henderson, C., Birmingham, M., et al. (1983). Final report to the Maternal and Child Health and Crippled Children’s Services Research Grants Program, Bureau of Community Health Services, Health Services Administration, Public Health Service, Department of Health and Human Services, grant MCJ-36040307. November, 1983.Google Scholar
- Olds, D. L., Henderson, C. R., Kitzman, H., Eckenrode, J., Tatelbaum, R., Robinson, et al. (1998). Prenatal and infancy home visitation by nurses: a program of research. In C. Rovee-Collier, L. P. Lipsitt, & H. Hayne (Eds.), Advances in infancy research (Vol. 12) (pp. 79–130). Stamford: Ablex Publishing Corp.Google Scholar
- Robins, L. N. (2006). Conduct disorder. Journal of Child Psychology and Psychiatry, 32, 193–212. https://doi.org/10.1111/j.1469-7610.1991.tb00008.x.CrossRefGoogle Scholar
- Sidora-Arcoleo, K., Anson, E., Lorber, M., Cole, R., Olds, D., & Kitzman, H. (2010). Differential effects of a nurse home-visiting intervention on physically aggressive behavior in children. Journal of Pediatric Nursing, 25, 35–45. https://doi.org/10.1016/j.pedn.2008.07.011.CrossRefPubMedGoogle Scholar
- St. Pierre, R. G., & Layzer, J. I. (1999). Using home visits for multiple purposes: The comprehensive child development program. Future of Children, 9, 134–151 http://futureofchildren.org/futureofchildren/publications/docs/09_01_06.pdf.CrossRefGoogle Scholar
- Streiner, D. L. (2003). Being inconsistent about consistency: Whencoefficient alpha does and doesn’t matter. Journal of Personality Assessment, 80, 217–222. https://doi.org/10.1207/s15327752jpa8003_01.
- Van Zeijl, J., Mesman, J., van IJzendoorn, M. H., Bakermans-Kranenburg, M. J., Juffer, F., Stolk, M. N., et al. (2006). Attachment-based intervention for enhancing sensitive discipline in mothers of 1- to 3-year-old children at risk for externalizing behavior problems: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 74, 994–1005. https://doi.org/10.1037/0022-006X.74.6.994.CrossRefPubMedGoogle Scholar
- Wakschlag, L. S., Pickett, K. E., Kasza, K. E., & Loeber, R. (2006). Is prenatal smoking associated with a developmental pattern of conduct problems in young boys? Journal of the American Academy of Child and Adolescent Psychiatry, 45, 461–467. https://doi.org/10.1097/01.chi.0000198597.53572.3e.CrossRefPubMedGoogle Scholar
- Ware, J. E., Veit, C. T., Donald, C. A. (1985). Refinements in the Measurement of Mental Health for Adults in the Health Insurance Study. Santa Monica, CA: RAND Corp.Google Scholar
- Whitley, E., Gale, C. R., Deary, I. J., Kivimaki, M., & Batty, G. D. (2011). Association of maternal and paternal IQ with offspring conduct, emotional, and attention problem scores: Transgenerational evidence from the 1958 British birth cohort study. Archives of General Psychiatry, 68, 1032–1038. https://doi.org/10.1001/archgenpsychiatry.2011.111.CrossRefPubMedPubMedCentralGoogle Scholar