What Are the Effective Elements of Parenting Interventions for Reducing Disruptive Child Behavior?

Parenting interventions are among the key strategies to prevent and reduce disruptive child behavior. They comprise multiple potentially effective intervention elements (i.e., discrete parenting techniques taught to parents). Parenting interventions tend to be reasonably effective as a package of elements, but effect sizes remain small to moderate, and about a quarter to a third of the families do not benefit. Moreover, there is a need for smaller interventions that can be integrated with primary health care. Most evidence-based parenting interventions are too cumbersome for this in their current form.

Advancements in optimizing parenting interventions are limited by a dearth of knowledge about which elements of parenting interventions are essential. It is unlikely that all parenting techniques taught (e.g., typically a few dozen) contribute equally to intervention effectiveness. Which elements actually impact child behavior? Which elements may be superfluous in the light of others?

In Study 1, a multi-level meta-analysis, we test the individual empirical merit of five well-studied parenting intervention elements on child compliance: teaching parents to use play, praise positive behavior, ignore misbehavior, provide time-out for misbehavior, and give verbal reprimands for misbehavior. This is the first meta-analysis of causal effects of individual parenting intervention elements. We used data from 29 experiments that manipulated discrete parenting techniques in order to test their effects on child compliance. Only time-out (d=1.57, p<.001) and verbal reprimands (d=.80, p<.001) had a direct and causal impact child on child compliance, the other techniques did not (ds=-.46 to .51, ps>.23).

In Study 2, we meta-analyze the association between 25 parenting intervention elements and parenting intervention success. We include 140 randomized trials from all five continents with detailed coding of components based on intervention manuals. We are analyzing the results at the time of writing this abstract.

The contribution of our meta-analyses are threefold: First, insight into which parenting techniques are most successful at changing child behavior feeds back into theory about the development and maintenance of problematic child behavior. Second, the effectiveness and cost-effectiveness of parenting intervention programs will likely be optimized if evidence-based elements are used exclusively and less effective or superfluous elements are excluded. Third, dissemination of parenting interventions, and integration of interventions with primary health care, will likely be optimized if they can be reduced to a parsimonious set of evidence-based elements that address the core of healthy parenting practices.