tuning into kids

Doctorate in Educational and Child Psychology Dannika Osei

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Case Study 1 – An Evidence-Based Practice Review Report

Theme: Interventions Involving Parents

Does the ‘Tuning into Kids’ program enable parents to reduce emotional and behaviouraldifficulties in their children?

Summary

This systematic literature review aims to discover how effective the Tuning into Kids

programme is in enabling parents to reduce emotional and behavioural difficulties in their

children. Tuning into Kids and its variants (Tuning into Toddlers and Tuning into Teens) is

an emotion-focused parenting programme aimed at developing emotionally responsive

parenting with the aim of increasing emotion knowledge in children as well as reductions in

child behaviour problems. Six studies met the inclusion criteria and were reviewed using

the Weight of Evidence Framework (Gough, 2007) and the APA Task Force Coding

Protocol by Kratochwill (2003). The programme was effective in reducing emotional and

behavioural difficulties in children as indicated by small-medium effect sizes across the

majority of studies however was most effective for a clinical population as shown by large

effect sizes. Potential use and implications for future directions are discussed.

Introduction

What is Tuning into Kids?

The Tuning into Kids (TIK) program and its age-specific programs (Tuning into Toddlers;

Tuning into Teens) is a parenting intervention developed by Havighurst, Wilson, Harley and

Prior (2009) and is aimed at improving parent’s emotion coaching skills. According to

Gottman, Katz and Hooven (1996), emotion coaching parents are aware of low-intensity

emotions in themselves and their children, see negative emotions in their child as an


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opportunity for intimacy or teaching, validate their child’s emotions and help the child to

verbally label their emotions. Emotion coaching also involves problem solving with the

child, identifying goals for dealing with the problem situation and setting behavioural limits.

This contrasts with emotion dismissing parents who aim to quickly change a child’s negative

emotions, deny their feelings and convey to their children that negative emotions are

unimportant. The latter parenting style is believed to be related to poor child outcomes

(Havighurst et al, 2009).

The components of the program are outlined in Havighurst et al (2009) and have been

summarised in Table 1. TIK is a six-session, two-hour-per-week parenting program. TIK

hinges on teaching parents the five steps of emotion coaching outlined by Gottman (1997)

cited in Havighurst et al (2009). These five steps are similar to the above however also

emphasises communicating understanding and acceptance of the child’s emotion. The

steps are broken down into a series of exercises to be carried out throughout each session.

As the first four steps are thought to be most difficult to learn, they are prioritised, therefore

first three weeks of the program emphasise attending to the lower intensity emotions

exhibited by children, being able to reflect, label and empathise with the child’s negative

emotion. The fourth session focuses on anxiety and problem solving skills. The last two

weeks examine emotions such as anger and teach emotion regulation techniques. As the

importance of parents being aware of their own emotions was noted by Gottman et al

(1996), parents are taught how to understand and regulate their own emotions and reflect

on their experiences with emotion beliefs and responses deriving from their family of origin.

Sizes of parenting groups ranges from 7-15 and are carried out by two trained facilitators.

As the review focuses on Tuning into Kids, Toddlers and Teens, the program will be

referred to as “Tuning into” (TI).


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Table 1 – Summary of steps taught in ‘Tuning into Kids’

Steps taught in ‘Tuning into Kids’ Emphasis

1 To become aware of the child’s

emotion, especially if this emotion is at

a low intensity.

Becoming aware of emotions and

how they may present at a

physiological level.

Attending to the child’s lower

intensity behaviours. Reflecting,

labelling and empathising with the

emotion.

2 To view the child’s emotion as an

opportunity for intimacy and teaching.

3 To communicate to the child an

understanding and acceptance of their

emotion.

4 To help the child to be able to use

words to describe how they feel.

Focuses on anxiety and problem

solving. Also focuses on more

intense emotions such as anger.

5 To assist the child with problem solving

while setting limits.

Teaching emotion regulation

strategies involving slow, breathing,

relaxation, expressing anger in a

safe way and the turtle technique

which teaches self-control (PATHS;

Greenberg et al, 1995).

Throughout

program

Parents are taught to regulate and understand their own emotions


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Psychological Basis

The TI program draw on a number of psychological theories. A parent’s ability to respond

to their child’s emotions hinges on the parent’s emotional well-being. Therefore emotion

expression and regulation (Havighurst et al., 2009), meta-emotion (Gottman et al., 1996)

and Mindfulness is integrated into the program. This teaches parents to reflect on their

experiences of emotion socialisation as well as being able to “sit with” their emotions when

they need to respond to their child’s emotions.

However, Social learning Theory (Bandura, 1977) strongly underpins this program.

According to Bandura, humans learn through observing the attitudes, behaviour and the

consequences of behaviour that others in their environment display. Thus, most human

behaviour is learned through others such as parents, teachers, peers who model the

behaviour. Through this, people are able to form ideas on how to execute new actions

which later serves as a guide for how they should perform the behaviour. According to

Denham (1998), the emotional expression and regulation demonstrated by parents is an

important model for the child on how to go about managing and showing their emotions.

The TI program suggests children experience emotion socialisation through interacting with

caregivers, siblings and teachers and the emotional experiences they are exposed to

through these people. This plays a crucial role in how a child develops emotional

competence (Havighurst et al., 2009).

Attachment theory is another major concept in the development of the program. Bowlby

(1958) states attachment is an innate primary drive in an infant and results in the infant

maintaining proximity to their caregiver and looks at how infant’s emotions and behaviours

such as crying, smiling and clinging were received and responded to by parents. Ainsworth,

Blehar, Waters and Wall (1978) identified three categories of attachment: securely

attached, insecure-avoidant attachment and insecure resistant. Secure attachment is


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associated with positive interactions between parent and child whereas the others were

associated with negative interactions. Relating attachment to emotion socialisation,

Ainsworth, Bell and Stayton (1971, 1974) in Meins (2003) found mothers who responded

sensitively to their infants’ cues had securely attached infants while mothers who rejected

their infants’ cues had insecure-avoidant children and inconsistency in parenting was linked

to insecure-resistant attachment styles. According to Green and Goldwyn (2002),

ambivalent attachment styles are linked to anxiety and social withdrawal and avoidant

styles are linked to antisocial development. They also note attachment disorganisation

could lead to vulnerability in a child’s self-concept and emotion-regulation. Given the

research on and importance of early attachments, TI aims to develop supportive and

emotionally responsive parenting.

Rationale

In the new Special Educational Needs and Disabilities Code of Practice (SEND, 2014)

emotional and behavioural difficulties is referred to as Social, Emotional and Mental Health

(SEMH) Difficulties. This area of need is characterised by displaying withdrawn or isolated

behaviour, challenging, disruptive behaviour as well as disturbing behaviour. According to

the Department for Education (2014), in state-funded primary schools, 18.4% of pupils with

statements and those at school action plus had a primary need of Behaviour, Emotional

and Social difficulties (BESD) and in state-funded secondary schools this figure was 26.7%.

As well as supporting the inclusion of pupils with academic learning difficulties, Educational

Psychologists (EPs) must also work to support the inclusion of pupils whose SEMH pose

barriers to their learning. These pupils are overrepresented in UK exclusion figures


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(Sellman, 2009). Farrell et al. (2006) highlight the role EPs have in providing support and

intervention for children and young people who are experiencing BESD. However, early

intervention and prevention is another valuable aspect of EP practice (Farrell et al., 2006)

and resonates with frameworks such as Positive Educational Practices (PEPs; Noble and

McGrath, 2008) which states EPs must focus on promoting wellbeing such as through

teaching social and emotional competency. As emotion socialisation begins with the

primary caregivers of a child, promoting positive emotional learning opportunities from early

childhood could be particularly advantageous to pupils at-risk of SEMH, as well as to

Educational Psychology Services (EPSs) in the long run. Therefore the TI intervention

could potentially be important to EPs in empowering parents in being able to prevent the

development of behavioural difficulties in their children. Therefore this review aims to

answer the following question: Does the ‘Tuning into’ program enable parents to reduce

emotional and behavioural difficulties in their children?

Critical Review of the Evidence Base

Literature Search

Initial searches were carried out during December 2014 using electronic databases

PsychINFO, Medline and ERIC. Using a multi-field search, the following search terms were

entered into ‘all fields’ or ‘title’ to retrieve studies (see Table 2). As the research base for

this intervention is relatively new, the Principal researcher for the TI programme was

emailed to retrieve unpublished or ‘in press’ studies on the intervention.


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Table 2: Search terms used in PsychINFO, Medline and ERICSearchnumber

1 2 3 4

1 Tuning into(T)

Emotionsocial*

Behavio*

2 Tuning into(T)

Emotion Behavio* child OR toddlerOR Teen ORadolescent

3 Emotionfocusedparenting

Emotionsocial*

Behavio* child OR toddlerOR Teen ORadolescent

4 Tuning Emotioncoaching

Behavio* kids

5 Parenting Emotioncoaching

‘conduct’ or‘behavio’(T)

children

T = title only* = wildcard search term

Inclusion and exclusion criteria

Studies retrieved were included in the review if they met the criteria detailed in Table 3. As

shown in Figure I, 86 papers were found through the electronic databases: 65 from

PsychINFO, 14 from ERIC and 7 from Medline. Furthermore, 15 studies were received

from the principal researcher of the intervention, bringing the total amount of retrieved

papers to 101. 39 papers were excluded as duplicates and the remaining studies were

screened through their titles and abstracts and excluded based on the below criteria. 9

papers were eligible for a full review and a further 2 were excluded using the criteria in

Table 3 (see Appendix A). As shown in Appendix B, a total of 7 papers were suitable for

inclusion in the review.


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Table 3: Inclusion and exclusion criteriaInclusion criteria Exclusion criteria Rationale

1. Type ofpublication

a) Must be in a peerreviewed-journal orhave been submittedfor peer-review

a) Is not or hasnot beensubmitted forpeer reviewi.e. Bookschapters.

Peer reviewersassess the quality of astudy and thereforethe study in thesejournals is likely tomeet the requiredstandards.

2. Languageand setting

a) Must be written inEnglish. No restrictionson country in whichresearch has takenplace.

a) Study is notwritten inEnglish

Reviewer does nothave the resources toaccess otherlanguages.

3. Intervention a) The study must solelyimplement the TuningintoKids/Teens/Toddlersintervention.

b) Must include corecomponents ofteaching 5 steps ofemotion coachingskills (Gottman, 1997)and must beimplemented forstandard duration of 6weeks.

a) Study doesnot implementthe ‘Tuninginto’interventionor, studyimplements‘Tuninginto…’interventionalongsideanotherintervention.b) StudyimplementsTIK programfor longerthan 6sessions.

The review is basedon the ‘Tuning into’intervention.Reviewer will beunable to discern whateffects are due to the‘Tuning into’intervention. Ifinterventions lastlonger in somestudies, effect sizesmay differ accordingto this variable.

4. Type ofdesign

a) Must be a groupdesign that reportsbetween groupoutcomes (e.g. anRCT) or one thatreports pre and postmeasures.

a) The study is asingle-casedesign.

5. Outcomes a) The study reports onoutcomes of childbehaviour post-intervention

a) Childbehaviouroutcomes arenot reported

The review aims tofind out whether theparenting interventionimproves childbehaviour.

6. Participants a) Must involve parents ofchildren and youngpeople.

b) Sample is unique tothis paper

a) The studydoes notinvolveparents

b) Sample hasbeen used formultiplearticles

The review aims tofind out how aparenting programmecan improvebehavioural outcomefor children.If sample has beenused for more thanone study, findingsmay not be entirelyrepresentativetherefore the studythat most closely fitsinclusion criteria willbe used.


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Figure 1: Flowchart: Application of inclusion and exclusion criteria

Articles identified from electronic

databases

Psychinfo n= 65

ERIC n= 14

Medline n= 7

Total n= 86

Articles sent by author

N= 15

Papers for review

of title and abstract

N=101

Electronic database:

Papers excluded on basis of inclusion criteria 3a

N= 54 A

Papers excluded as duplicates

N=24

Total – 78

Sent by author:

Papers excluded on basis of inclusion criteria 1a,

3a, 3b, 4a, 3b, 5a

N = 6

Papers excluded as duplicates

N= 9

Total - 15

Papers for review of

full text

N =9

Papers excluded

Inclusion criteria 6b – n=2

Papers included

N = 7


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Critical appraisal for quality and relevance

The seven papers were summarised to capture the main aspects as well as the information

relevant to the review question (See Appendix C). The quality and relevance of each study

was appraised using the Weight of Evidence (WoE) framework (Gough, 2007). WoE

comprises four judgements. WoE A examines methodological quality in terms of the quality

of how well the study was executed. WoE A was judged using the APA Task Force Coding

Protocol by Kratochwill (2003) which was adapted according to the purpose of the review

question and to determine the methodological quality of the studies (See Appendix D).

Each study was examined using this protocol in order to systematically analyse each study

based on the same criteria. WoE B addresses the methodological relevance of the study -

the appropriateness of the study in relation to the review question. Finally WoE C appraises

the relevance of the focus of the study to the review question. Outcomes from the

aforementioned WoEs are averaged to calculate an overall WoE – termed WoE D (See

Table 4). For further information on how each study was appraised, see Appendix E.

Table 4- Overall Weight of Evidence (WoE D)

Studies WoE AQuality ofmethodology

WoE BRelevance ofMethodology

WoE CRelevance ofevidence tothe reviewquestion

WoE DOverallweight ofevidence

Havighurstet al (2009)andHavighurstet al (2010)

High2.5

Medium2

Medium2

Medium2.17

Havighurstet al (2011)

High3

High3

High3

High3

Kehoe et al(2014)

High2.5

Medium2

Medium2

Medium2.17

Lauw et al(2014)

Medium1.25

Low1

Low1

Low1.11

Wilson et al(2012)

High2.75

Medium2

Low1

Medium1.92


Medium2

Low1

Medium2

Medium1.27


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Participants

The number of participants in the studies ranged from 34-225 and were recruited from cities

such as Melbourne and Knox, Australia. The socioeconomic status (SES) of parents

across the sample varied as indicated by household incomes, however three studies

(Kehoe et al.; 2014; Lauw et al.; 2014; Wilson et al.; 2012) had a middle-upper class

majority. All included studies included only the primary caregiving parent of which the

majority were female (93.8%). Inclusion criteria for involvement in the study involved

parents being able to speak enough English to understand the intervention, having a child

within the target age for the study and not being committed to other research projects or

other parenting programmes. However, Havighurst et al. (2010) and Havighurst et al.

(2013) excluded parents if they had a child with a diagnosis of any communication disorders

or pervasive developmental disorders. Finally, Havighurst et al. (2013) only included

parents who had children who were above the clinical cut-off on the Eyberg Child Behaviour

Inventory (ECBI) to ascertain whether TIK could be used as an intervention for children with

behavioural difficulties therefore was rated highly on WoE C.

Samples were acquired using convenience sampling methods whereby parents in schools,

preschools, a kindergarten, a Maternal and Child Health centre, or behaviour clinics in

hospitals were asked to participate through distribution of information flyers and letters. In

Psychology research, this method of sampling is common however, non-random sampling

methods like convenience sampling are biased as not every member of the target

population has an equal chance of being selected (Barker, Pistrang and Elliot, 2002). As

the majority of participants opted into the study, particular characteristics in these parents

such as a motivation to improve parenting, an interest in socioemotional functioning or the

time available, may have influenced the decision to participate which may not be present


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in parents that did not opt-in. Therefore this may affect generalizability of results to the rest

of their target population.

Design

Randomised Controlled trials (RCTs) and prettest-posttest designs were included in this

review. Four of the studies were RCTs: Havighurst et al. (2009; 1a) and (2010; 1b),

Havighurst et al. (2013), Kehoe et al. (2014) and Wilson et al. (2012). Randomisation

methods varied from randomising schools into intervention/control groups to randomising

participants into groups (Havighurst et al., 2011) and was done using a random-number

generator. Havighurst et al. (2013) was given a high rating because it used an ‘active’

comparison group over a waitlist control group who received treatment as usual (Paediatric

treatment). This was rated highly as using an active comparison may show the intervention

is more effective than currently applied interventions for children presenting with

behavioural difficulties. Furthermore active comparisons are more ethical than a no

intervention group which withholds a potentially beneficial intervention from a group,

however this poses less risk if participants are not clinically distressed (Barker, Pistrang

and Elliot, 2002). The remaining studies using a waitlist intervention are deemed more

ethical than a no intervention group however, on WoE B, received a medium rating. This

is because one cannot conclude from these studies that the TI intervention is better than

alternative interventions in reducing emotional and behavioural difficulties in children. All

RCTs used objective methods to randomise participants into intervention and control

groups thus increasing the chances of equivalence between groups and reducing the risk

of error of bias in results (Evans, 2003).

Prettest-posttest designs used were in Lauw et al. (2014) and Havighurst et al. (2004) and

were both pilot studies. These studies were rated low on WOE B as it is problematic


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attributing changes in behaviour to the intervention alone without the presence of a control

group and poses threats to validity and reliability. Cook and Campbell (1979) cited in

Barker, Pistrang and Elliot (2002) note there are possible threats to internal validity when

using a prettest-posttest design including maturational trends whereby participants grow

out of their problem, a case especially relevant to children.

Studies varied on when measurements were taken. Some measured behaviour at pre-

intervention and post-intervention only (Lauw et al., 2014) pre-intervention, post-

intervention and follow-up (Havighurst et al., 2009;1a; 2010;1b; Havighurst et al., 2013; and

Havighurst et al., 2004) whereas others did pre-intervention and follow-up only (Kehoe et

al., 2014) and Wilson et al., 2012). Taking follow-up measures as well as pre-intervention

and post-intervention measures provides information on not only how effective an

intervention is but how long-lasting effects are. However if measures are only taken at two

time points pre-intervention and post-intervention then the study only provides information

on the immediate effect of the intervention. Conversely, it can be argued that, only taking

measures of behaviour at follow-up provides some evidence about the sustainability of

change after the intervention. However without immediate measures of change to compare

it to, it is possible that other factors may have contributed to improvement in behaviour over

the 3/6 month follow up period. Therefore studies measuring behaviour change pre-

intervention, post-intervention and follow-up were rated high on WoE B whereas those with

control groups that only took measures at two time-points were rated ‘medium’ and low

ratings were given to those without a control group that only took measures at two-time

points.


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Measures

The Eyberg Child Behaviour Inventory 6 (ECBI; Eyberg and Pincus, 1999) was used across

all studies but Kehoe et al. (2014) and Lauw et al. (2014). The ECBI has Cronbach’s alpha

reliability scores ranging from .90 to .94 across studies therefore has a high reliability.

These studies were also multi-source and multi-method thus receiving high ratings on WoE

A and C. The Sutter-Eyberg Student Behaviour Inventory – a teacher’s version of the ECBI

was used by Havighurst et al. (2009;1a and 2010;1b) and Havighurst et al. (2013) which

had Cronbach’s alpha’s of .97. As this was an additional measure of behaviour, in addition

to the ECBI as completed by parents, this moved data toward triangulation which led to

high weightings on WoE A and C. Other measures include the Social Competence and

Behaviour Evaluation (SCBE-30; LaFreniere and Dumas, 1996), a teacher report. In this

study (Wilson et al., 2012), they examined social competence and anger and aggression

scales thus was deemed a suitable measure of behaviour. Reliability coefficients ranged

from .88 - .92. Kehoe et al. (2014) sought to measure internalising behaviour difficulties

(anxiety and depression) in youth. Anxiety was measured using the Spence Children’s

anxiety scale (SCAS; Spence, 1998) and the parent-report version (SCAS-P, Nauta et al.,

2004) both of which had Cronbach’s alphas of .90 - .93. Depressive symptoms were

measured using the Child Depression Inventory (CDI; Beck, 1977) and the parent version,

CDI:P (Garber, 1984) and had reliability coefficients ranging from .84-.87. Consequently,

this study was rated highly on WOE A and C.

In Havighurst et al. (2004), the Strengths and Difficulties Questionnaire (SDQ: Goodman,

1997) was used which had reliability coefficients ranging from .57 to .77. Cronbach’s

alphas were not reported for the ECBI or the ERC, however studies reporting reliability

were cited, therefore on WOE A this received a medium rating. Lauw et al. (2014) also

received a medium rating for measures but only included the Brief Infant-Toddler Social


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and Emotional Assessment (Briggs-Gowan and Carter,2007) with no reliability coefficients

reported, this was given a medium weighting on WoE A and low on WoE C.

All child behavioural outcomes were measured using questionnaire data however using

self-report may be subjective which poses validity issues. Respondents may be less

truthful on questionnaires due to social desirability bias in that they may want to impress

researchers or may report outcomes suggesting improvements due to expectancy effects

(Barker, Pistrang and Elliot, 2002). Therefore validity could be improved if observational

measures of child behaviour were taken pre and post intervention in addition to self-report

measures. However, where parent self-report was supplemented by self-reports from other

perspectives (as specified on WoE A and C), this increases validity.

Findings

Parent-reported behaviour

Effect size data is briefly summarised in Table 6. A more in depth summary can be found

in Appendix F. The majority of effect size outcomes in studies using the ECBI were small-

medium however some large effect sizes were found. This suggests the TI programme

has moderate efficacy in reducing emotional and behavioural difficulties in children.

Havighurst et al. (2009; 2010) had a small-medium effect size for behaviour intensity at

posttest which was maintained at follow-up as well as a medium WoE D suggesting the

effect size is an accurate depiction of the study’s effectiveness. Wilson et al. (2012)

however had a small effect size as well as non-significant results for their time-condition

interaction effect. This may be due to the fact that post-intervention measures were only

taken 6 months after the intervention ceased. Therefore, immediate effects of the

intervention, which are valuable indicators of effectiveness, were not captured. Another

potential reason is that the programme facilitators were professionals from the local


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community, many of whom did not have Psychology degrees, experience in group

facilitation or parenting education. Although professionals were trained for two days and

provided with a manual, arguably as it is a specialised psychological intervention with a

range of components, the facilitator may need to have a background in Psychology to be

able to deliver this to full effect. This is reflected in a low WOE C rating.

Havighurst et al. (2013), was the only study with a large effect size on the ECBI and rated

high on WoE D making this a particularly impressive study. However effects for follow-up

measures were small for behaviour intensity and small-medium on behaviour problems.

This may suggest using the TI programme as an intervention with children at the clinical

level on the ECBI is where the intervention has the strongest effect, however long-term

effects are not as strong as immediate effects. The only drawback is that this study did not

have a sufficient sample size therefore may have been underpowered. If a sample does

not have enough power, the chances of the study detecting a significant effect is reduced,

therefore although a statistically significant effect was found for reduction in behaviour

intensity, a larger sample size may have found a smaller p-value. Despite having a medium

WoE D, Havighurst et al. (2004) also used the ECBI along with the ERC which both had

small effect sizes. This could be because in addition to having a small sample size, this

study was the pilot of TI programme and although the essential ‘emotion coaching’

components were present, the added benefit of helping parents to help children to regulate

anger and worry, and enhancing parental emotion awareness and regulation was only

added when the intervention formally became TIK.

Kehoe et al. (2014) had medium effect sizes when anxiety and depression was rated by

parents (SCAS-P, CDI-P) however small effect sizes when this was rated by youth (SCAS,

CDI). Potential reasons for this could be similar to the above in that there was an

expectancy bias present in parents. A small effect size was found on the Brief-ITSEA in


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Lauw et al. (2014). As this too was a pilot study without a control group, it was also rated

low on WOE D. Additionally, the study had approximately half the required sample size

and so may have lacked enough power to detect a more significant improvement in toddler

behaviour problems.

Teacher-reported behaviour

The SESBI was used in Havighurst et al. (2009; 2010) and Havighurst et al. (2013) as a

follow-up measure and showed small and medium effects respectively. However,

Havighurst et al. (2004) used an alternative teacher-report at posttest rather than follow up.

These outcomes showed a medium effect size. This may be as teacher-reported measures

were only taken at follow up thus immediate effects observed by parents may have

diminished with time as also shown by smaller parent-reported effect sizes at follow-up.

Similarly parent-reported behaviour change may reflect an expectancy bias as they were

the main change agents for the children and were aware of the purposes of the intervention,

therefore they may have anticipated a positive change in their child’s behaviour which may

be reflected in their ECBI scores. Conversely, teachers may be more objective as they

were not directly involved in the intervention. However as some effect was shown, it

supports the idea that moderate improvements were observed.


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Table 6 – Summary of effect sizes and overall quality ratingsa) Pre-post

Outcome Effect size Study Number ofParticipants

Overall Weightof Evidence

Behaviour Intensity(ECBI)

PPC SMD = -0.44(Small-medium)

Havighurst et al(2009)

218 Medium

PPC SMD= -0.76(Large)


54 High

PP SMD = -0.26(Small)


47 Medium

Behaviour Problem(ECBI/SESBI/BITSEA)

PPC SMD= -0.83(Large)


54 High


Lauw et al (2014) 34 Low



47 Medium

PP SMD= 0.49(Medium)


Lability/Negativity(ERC)



47 Medium


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b) Pre-follow-up

Note: Effect sizes were calculated from data given in the studies. For RCTs, Morris (2007) Prettest-Posttest Control (PPC) design Standardised Mean Difference (SMD) was used. This SMD was

Outcome Effect size Study Number ofParticipants

Overall Weightof Evidence

Behaviour Intensity(ECBI/SESBI)

PPC SMD= - 0.41(Small-medium)


216 Medium

PPC SMD = -0.2(Small)


216 Medium



54 High

PPC SMD= -0.58(Medium)


54 High

PPC SMD= -0.22(Small)

Wilson et al (2012) 128 Medium

PP SMD = -0.4(Small-medium)


47 Medium

Behaviour Problem(ECBI/SESBI) PPC SMD = -0.42

(Small)


54 High

PPC SMD= -0.5(Medium)


54 High



PP SMD = -0.42(Small-medium)


47 Medium

Anxiety(SCAS/SCAS-P)


Kehoe et al (2014) 225 Medium

PPC SMD = -0.48(Small-medium)


DepressionCDI:S/CDI:P)



PPC SMD =-0.46(Small-medium)


Anger/Aggression PPC SMD= 0.02(Small)


Lability/Negativity PP SMD = -0.41(Small-medium)


47 Medium


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used as opposed to Cohen’s d as it allows a computation of the difference in prettest-posttest scoresbetween the intervention and control groups whereas a Cohen’s d calculation would not factor inpre-intervention scores. This gives a more accurate measure of the effects of the intervention andtakes advantage of the strengths of an RCT design (Morris, 2007). Effect sizes using thiscalculation will be referred to as PPC SMD. For studies without a control group, Becker (1988)SMD was used as this calculation also examines prettest and posttest scores (referred to as PPSMD). Due to the absence of a control group, these effect sizes must be interpreted with cautionand cannot be directly compared to PPC SMDs. Cohen’s d (1988) effect size descriptors (high,medium, low) have been used to describe effect sizes at .02, .05 and .08 respectively.

Conclusions

This systematic literature review aimed to discover to what extent the TI intervention

enabled parents to reduce emotional and behavioural difficulties in their children. This

programme is efficacious in achieving this with small-medium effect both at posttest and

prettest. However, largest effects are clearly observed when implementing the

programme with a clinical population. This may be because children were displaying

above average behavioural difficulties thus had greater scope for improvement than

mainstream populations. According to Forgatch and DeGarno (1999), interventions have

been shown to have greatest effect on participants when they are in the clinical range.

This is because the clinical sample are usually close to homogeneity in terms of

diagnosed problems whereas prevention studies use samples that are heterogeneous in

type and intensity of their difficulties thus need a greater amount of power than clinical

trials.


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Limitations

All of the studies were carried out by the same research group and consistently involved

Havighurst, Wilson and/or Harley. This could potentially be a source of bias across

studies as researchers may have a particular interest in and investment in promoting how

effective the programme is. This may lead to results being analysed and reported in

similar ways, as well as a tendency to only report the most significant results and

downplay the significance of any non-significant results. For example only commenting

on the “main effect” significance instead of the interaction effect i.e. in Wilson et al.

(2012). However, the use of standardised measures of child outcomes could be deemed

to control for some of the bias.

Recommendations

In light of the above, although TI shows promising outcomes as a prevention programme

in terms of WoE, effect sizes and strong outcomes as an intervention programme for a

clinical sample, a more extensive, varied body of research is needed before this is

adopted as an intervention programme within EPSs. More research on its effect on

children at the clinical level of behavioural difficulties is needed to build on the idea that

this programme is best as an intervention. To reduce potential bias in the studies, the

programme may benefit from different research groups researching its effectiveness.

Subsequent studies may benefit from including an observational measure of behavioural

into the measures to triangulate questionnaire data obtained. Most studies incorporated a

follow-up measure into the design which shows how long the effects of the intervention

last therefore to further develop this, a longitudinal study could be conducted whereby

child behavioural outcomes are measured over the course of a few years.


37

The outcomes of this review show that the TI programme has potential benefits on the

emotional wellbeing of children and young people as both an intervention and prevention

programme. As studies where the programme was delivered by psychologists produced

better outcomes than the one that was delivered by other professionals who had received

training, it is recommended that this programme be delivered by EPs or other

psychologists of a similar background. After training, the programme could be delivered

by EPs to groups of parents identified as having children/young people with/at risk of

developing SEMH. The effectiveness of the programme should be evaluated by

measuring behaviour pre and post intervention and at follow up using the EBCI, SESBI,

SCAS, or CDI.

34

References

Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A

psychological study of the strange situation. Hillsdale, NJ: Erlbaum.

Bandura, A. (1977). Social learning theory. New Jersey: Prentice Hall.

Barker, C., Pistrang, N., & Elliott, R. (2002). Research methods in clinical psychology: An

introduction for students and practitioners. (2nd ed) Chichester: John Wiley &Sons LTD.

Bowlby, J. (1958). The nature of the child’s tie to his mother. International Journal of

Psychoanalysis, 39, 350-371.

Briggs-Gowan, M. J., & Carter, A. S. (2007). Applying the Infant-Toddler Social and Emotional

Assessment (ITSEA) and Brief-ITSEA in early intervention. Infant Mental Health Journal, 28, 564–

583.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Statistical Power Analysis

for the Behavioral Sciences.

Cohen, J. (1992). Quantitative Methods in Psychology. A Power Primer. Psychological Bulletin,

112(1), 155–159.

Dawson, J., & Singh-Desi, D. (2010). Educational psychology working to improve psychological

well-being: an example. Emotional and Behavioural Difficulties, 15, 295–310.

Denham, S.A. (1998). Emotional development in young children. New York: Guilford Press.

Department for Education. (2013). Statistical First Release: Special Educational Needs in England,

1–13.

Evans, D. (2003). Hierarchy of evidence: A framework for ranking evidence evaluating healthcare

interventions. Journal of Clinical Nursing, 12, 77–84.

35

Eyberg, S., & Robinson, E. A. (1983). Conduct problem behavior: Standardization of a behavioural

rating scale with adolescents. Journal of Clinical Child Psychology, 12, 347-354.

Eyberg, S., & Pincus, D. (1999). Eyberg Child Behavior Inventory and Sutter-Eyberg Student

Behavior Inventory_Revised: Professional manual. Odessa, FL: Psychological Assessment

Resources.

Farrell, P., Woods, K., Lewis, S., Rooney, S., Squires, G., & Connor, M. O. (2006). A Review of the

Functions and Contribution of Educational Psychologists in England and Wales in light of “ Every

Child Matters : Change for Children .”

Forgatch M. & S, DeGarmo D. S. (1999). Parenting through change: An effective prevention

program for single mothers. Journal of Consulting and Clinical Psychology. 67, 711–724.

Garber, J. (1984). The developmental progression of depression in female children. New

Directions for Child Development, 26, 29–58.

Gottman, J. M., Katz, L. F., & Hooven, C. (1996). Parental meta-emotion philosophy and the

emotional life of families: Theoretical models and preliminary data. Journal of Family Psychology,

10(3), 243–268.

Gough, D. (2007). Weight of evidence: a framework for the appraisal of the quality and relevance

of evidence, Research Papers in Education, 22(2), 213-228.

Green, J., & Goldwyn, R. (2002). Annotation: Attachment disorganization and psychopathology:

New findings in attachment research and their potential implications for developmental

psychopathology in childhood. Journal of Child Psychology and Psychiatry, 43, 835–846.

Greenberg, M.T., Kusche, C.A., Cook, E.T., & Quamma, J.P. (1995). Promoting emotional

competence in school-aged children: The effects of the PATHS curriculum. Development and

Psychopathology, 7, 117–136.

36

Havighurst, S. S., Harley, A., & Prior, M. (2004). Building Preschool Children’s Emotional

Competence: A Parenting Program. Early Education & Development, 15(4), 423–448.

Havighurst, S. S., Wilson, K. R., Harley, A. E., Kehoe, C., Efron, D., & Prior, M. R. (2013). “Tuning

into Kids”: reducing young children’s behavior problems using an emotion coaching parenting

program. Child Psychiatry and Human Development, 44(2), 247–64.

Havighurst, S. S., Wilson, K. R., Harley, A. E., & Prior, M. R. (2009). Tuning in to kids: an emotion-

focused parenting program-initial findings from a community trial. Journal of Community

Psychology, 37(8), 1008–1023.

Havighurst, S. S., Wilson, K. R., Harley, A. E., Prior, M. R., & Kehoe, C. (2010). Tuning in to Kids:

improving emotion socialization practices in parents of preschool children--findings from a

community trial. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 51(12), 1342–

50.

Kehoe, C. E., Havighurst, S. S., & Harley, A. E. (2014). Tuning in to Teens: Improving Parent

Emotion Socialization to Reduce Youth Internalizing Difficulties. Social Development, 23(2), 413–

431.

Kovács, M. (1981). Rating scales to assess depression in school-aged children. Acta

Paedopsychiatrica, 46 (5–6), 305–315.

Kovács, M., & Beck, A. (1977). An empirical clinical approach toward a definition of childhood

depression. In J. G. Schulterbrandt & A. Raskin (Eds.), Depression in children: Diagnosis,

treatment and conceptual models (pp. 1–25). New York: Raven Press.

Kratochwill, T. R. (2003). Evidence-Based Practice: Promoting Evidence-Based Interventions in

School Psychology. School Psychology Quarterly, 18(4), 389-408.

37

LaFreniere, P. J., & Dumas, J. E. (1995). Social competence and behaviour evaluation (preschool

edition). Los Angeles, CA: Western Psychological Services.

LaFreniere, P. J., & Dumas, J. E. (1996). Social Competence and Behavior Evaluation in children

ages 3 to 6 years: The Short Form (SCBE-30). Psychological Assessment, 8, 369–377.

Laible, D. J., & Thompson, R. A. (1998). Attachment and emotional understanding in preschool

children. Developmental Psychology, 34, 1038–1045.

Lauw, M. S. M., Havighurst, S. S., Wilson, K. R., Harley, A. E., & Northam, E. A. (2014). Improving

Parenting of Toddlers’ Emotions Using an Emotion Coaching Parenting Program: a Pilot Study of

Tuning in To Toddlers. Journal of Community Psychology, 42(2), 169–175.

Meins, E. (2003). Emotional Development and Early attachment relationships. In Slater,A., and

Bremner, G. Developmental psychology: An introduction. Oxford: Blackwell.

Morris, S. B. (2003). Estimating Effect Sizes From Pretest-Posttest-Control Group Designs.

Organizational Research Methods, 11, 364–386.

Nauta, M. H., Scholing, A., Rapee, R. M., Abbott, M., Spence, S. H., & Waters, A. (2004). A parent

report measure of children’s anxiety: Psychometric properties and comparison with child-report in a

clinic and normal sample. Behaviour Research and Therapy, 42, 813–839.

Noble, T., & McGrath, H. (2008). The positive educational practices framework: A tool for

facilitating the work of educational psychologists in promoting pupil wellbeing. Educational and

Child Psychology, 25, 119–134.

Sellman, E. (2009). Lessons learned: student voice at a school for pupils experiencing social,

emotional and behavioural difficulties. Emotional and Behavioural Difficulties, 14(January 2015),

33–48.

38

Shields, A., & Cicchetti, D. (1999). Emotion Regulation Checklist. Unpublished questionnaire, Mt.

Hope Family Center, University of Rochester, NY.

Spence, S. H. (1998). A measure of anxiety symptoms among children. Behaviour Research and

Therapy, 36, 545–566.

Wilson, K. R., Havighurst, S. S., & Harley, A. E. (2012). Tuning in to Kids: an effectiveness trial of a

parenting program targeting emotion socialization of preschoolers. Journal of Family Psychology :

JFP : Journal of the Division of Family Psychology of the American Psychological Association

(Division 43), 26(1), 56–65.

39

Appendices

Appendix A – Excluded studies

Excluded Studies – excluded at full text

Studies Reason for exclusionHavighurst, S. S., Kehoe, C. E., & Harley,

A. E. (Under review). Tuning in to Teens:Improving Parental Responses to Angerand Reducing Youth ExternalizingBehavior Problems. Development andPsychopathology.

6b – This study used the same sample asthe Tuning into Teens study by Kehoe etal (2014) which looked at internalizingbehaviour.

Kehoe, C. E., Havighurst, S. S., & Harley,A. E. (Early view). Somatic complaints inearly adolescence: The role of parents’emotion socialisation. Journal of EarlyAdolescence.

6b – This study also used the samesample as the Tuning into teems study byKehoe et al (2014).

40

Appendix B – Included studies

Included studiesHavighurst, S. S., Harley, A., & Prior, M. (2004). Building Preschool Children’s Emotional Competence:

A Parenting Program. Early Education & Development, 15(4), 423–448.doi:10.1207/s15566935eed1504_5

Havighurst, S. S., Wilson, K. R., Harley, A. E., Kehoe, C., Efron, D., & Prior, M. R. (2013). “Tuning intoKids”: reducing young children’s behavior problems using an emotion coaching parenting program.Child Psychiatry and Human Development, 44(2), 247–64.

Havighurst, S. S., Wilson, K. R., Harley, A. E., & Prior, M. R. (2009). Tuning in to kids: an emotion-focused parenting program-initial findings from a community trial. Journal of CommunityPsychology, 37(8), 1008–1023. doi:10.1002/jcop.20345

Havighurst, S. S., Wilson, K. R., Harley, A. E., Prior, M. R., & Kehoe, C. (2010). Tuning in to Kids:improving emotion socialization practices in parents of preschool children--findings from acommunity trial. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 51(12),1342–50.

Kehoe, C. E., Havighurst, S. S., & Harley, A. E. (2014). Tuning in to Teens: Improving Parent EmotionSocialization to Reduce Youth Internalizing Difficulties. Social Development, 23(2), 413–431.

Lauw, M. S. M., Havighurst, S. S., Wilson, K. R., Harley, A. E., & Northam, E. a. (2014). ImprovingParenting of Toddlers’ Emotions Using an Emotion Coaching Parenting Program: a Pilot Study ofTuning in To Toddlers. Journal of Community Psychology, 42(2), 169–175.

Wilson, K. R., Havighurst, S. S., & Harley, A. E. (2012). Tuning in to Kids: an effectiveness trial of aparenting program targeting emotion socialization of preschoolers. Journal of Family Psychology : JFP : Journal of the Division of Family Psychology of the American Psychological Association (Division 43), 26(1), 56–65.

41

Appendix C – Mapping the field

A - InformationAuthor and Aim (relevant to review) Sample size Sample Characteristics (age, gender, any

presenting difficulties)Country Intervention

1) A – Havighurst, Wilson, Harley and Prior (2009) –To report on an initial evaluation of a community-based parenting program teaching skills to parentsthat impact on children’s emotional competence andbehaviour

B – Havighurst, Wilson, Harley, Prior and Kehoe(2010) (Follow up study of Havighurst et al, 2009)- To consider whether the Tuning into Kids

(TIK) intervention resulted in children’semotion competence and behaviour

a) 218Intervention –106Control - 111

b) 216Intervention –106Control - 110

a) Primary caregivers - Mothers (n=209)and Fathers (n=9) (Mean age=36.52,SD=4.98) and their children (age = 4-5.11years)

b) Primary caregivers - Mothers (n=207)and Fathers (n=9) (Mean age=36.57,SD=4.97) and their children (mean age =56.28 months, SD= 4.59 months)

Community sample obtained from preschools.

A+B)Australia

A + B) Tuning into Kids intervention. Sixtwo-hours a week session delivered toparents (average – 10 parents per group)by trained facilitators.

Control group – waitlist control who wereoffered a 10-month delayed start for theintervention

2) Havighurst, Wilson, Harley, Kehoe, Efron andPrior (2013)

- Would emotion socialisation factors relatedto children’s emotion competence andbehaviour improve after parents participatedin the TIK program?

- Would the TIK program then improvechildren’s emotion knowledge and reducetheir behaviour problems?

54Intervention – 31Control - 23

Primary caregivers (all mothers, Mean age=35.66, SD =6.73) of children (mean age = 59.31months, SD= 7.38) attending a behaviour clinicas they presented with externalising behaviourdifficulties.

Australia Tuning into Kids intervention. Six two-hours a week session delivered toparents (8-14 parents per group) bytrained facilitators.Intervention groups consisted of part ofthe clinical sample alongside anothercommunity sample.

Control group – treatment as usual groupwho received paediatric treatmentinvolving guidance on behaviouralstrategies, speech and language,psychology and occupational therapywhere needed.

42

3) Kehoe, Havighurst and Harley (2014)- Does the Tuning into Teens program reduce

youth internalizing difficulties?

225

121(intervention)

104 (control)

Primary caregivers (200 mothers, 25 fathers,mean age=44.1, SD=5.13) of adolescents(mean age= 12.01, SD= .42)

Community sample obtained from schools

Australia Tuning into Teens (TINT) – an adaptedversion of TIK aimed at parents ofadolescents.

Control group – no intervention

4) Lauw, Havighurst, Wilson and Harley (2014)- To determine whether an emotion-coaching

intervention, with adaptations to address thetoddler developmental stage, would be worthinvestigating further

34Pre and postmeasures design

Primary caregivers (mothers, mean age=35.91,SD=3.36) and their toddlers (mean age= 25.37months, SD=6.15)

Sample obtained from Maternal and ChildHealth centres

Australia Tuning into Toddlers (TOTS) – anadapted version of TIK aimed at parentsof toddlers

5) Wilson, Havighurst and Harley (2012)- To evaluate the effectiveness of the Tuning

into Kids program under real-worldconditions.

128

62 (intervention)

66 (control)

Primary caregivers (118 mothers, 10 fathers,mean age= 36.3, SD=4.3) and their children(mean age=4.19, SD=.41)

Community sample obtained from preschools.

Australia Tuning into Kids program

Control group – waitlist control group

6) Havighurst, Harley and Prior (2004)- A program teaching parenting skills in

emotional awareness, acceptance andcoaching would lead to an improvement inemotion competence and reduction in childbehaviour problems

47

Pre and postmeasures design

Primary caregivers (43 mothers and 4 fathers)and their children (aged between 4 and 5 years).

Sample obtained from kindergarten classes.

Australia A parenting program delivered in six, two-hour sessions per week.

43

B - MethodsAuthor and Aim (relevant to review) Measures

(Child measures only)Analyses Outcomes

(child outcomes only)Follow up

1) A – Havighurst, Wilson, Harley andPrior (2009) – To report on an initialevaluation of a community-basedparenting program teaching skills toparents that impact on children’semotional competence and behaviour

B - Havighurst, Wilson, Harley, Prior andKehoe (2010) (Follow up study of Havighurstet al, 2009)

- To consider whether the Tuninginto Kids (TIK) interventionresulted in children’s emotioncompetence and behaviour

A) The Eyberg Child BehaviourInventory 6 (ECBI; Eyberg andPincus, 1999). This is a 36-itemparent report scale that measuresperceptions of children’s problembehaviours.

b) ECBI andSutter-Eyberg Student BehvaiourInventory – a teacher’s version ofthe ECBI.

a) A one way ANOVAwas used to comparepost-interventiondifferences between thecontrol group andintervention group.

b) General LinearModelling (GLM)repeated measures wasused to analyse conditioni.e. intervention vs.control across pre, postand follow-up.

a) Behaviour problems (intensity) –researchers found a significantimprovement in the intervention groupF(1, 181) = 18.39, p<.001

b) Behaviour problems (intensity) –Researchers found a significant interactionbetween condition and time on the EBCI,F(1, 169) = 11.14. p<.001

On the SESBI, there was also a significantinteraction between condition and timeF(1,150)=6.87, p=.02

Reported in 1b

2) Havighurst, Wilson, Harley, Kehoe,Efron and Prior (2013)

- Would emotion socialisationfactors related to children’semotion competence andbehaviour improve after parentsparticipated in the TIK program?

- Would the TIK program thenimprove children’s emotionknowledge and reduce theirbehaviour problems?

The Eyberg Child BehaviourInventory 6 (ECBI)

Sutter-Eyberg Student BehaviourInventory

n.b. -Post-intervention measurestaken immediately after programended. Follow-up measures taken6-month post-intervention

Data were analysed usingGrowth Curve Modelling(GCM) and an ANCOVA.

Behaviour Outcomes - No significantdifference found between intervention andcontrol group for rate of improvement inbehaviour intensity, F (1,34) = -2.031,p=.208 and behaviour problems, F(1,34) = -1.002, p=.098

ANCOVA at time 2 showed that parents inthe intervention condition reportedsignificantly lower child behaviour intensitythan the control group, F(1,34) = 6.32, p=.009

ANCOVAs of teacher reports on childbehaviour indicated that at follow-up,children in the intervention condition wereperceived to have lower behaviour intensity,F(1,26) = 4.87, p=.036, partial eta squared=.16, and fewer behaviour problems F(1,26)= 4.87, p=.036, partial eta squared = .16

Statistical dataprovided for 6-monthfollow-up is in theform of means andstandard deviationsand effect size.

For the interventiongroup, ECBIBehaviour intensityCohen’s d = .74 andfor behaviourproblem Cohen’s d=1.00.For the control group

Cohen’s d=.58 and.55 respectively.

For the interventiongroup, SESBIbehaviour intensity,Cohen’s d = .56 andfor behaviourproblem Cohen’s d=.46

44

3) Kehoe, Havighurst and Harley(2014)

- Does the Tuning into Teensprogram reduce youthinternalizing difficulties?

Spence children’s anxiety scale(SCAS; Spence, 1998). This is aself-report measure of youth anxietysymptoms.

Spence child anxiety scale forparents (SCAS-P; Nauta et al,2004). This a parent-report of youthanxiety symptoms.

Child Depression Inventory short-form child self-report (CDI:S;Kovacs, 1981; Kovacs and Beck,1977). This measured self-reportedyouth depressive symptoms.

Child depression Inventory parentreport (CDI:P; Garber,1984). Aparent report of youth depressivesymptoms.

Multi-level mixed effectmodels were used to analysedata.

Youth with parents in the interventioncondition reported significantly loweranxiety, F(1,217.36) = -2.17, p=0.31.

Parents in the intervention conditionreported significantly lower youth anxiety,F(1,215) = -4.92, p<.001.

No significant difference was found foryouth reported depressive symptoms,F(1,206.97) = -1.17, p=.244

Parent reported youth depression was alsosignificantly lower for the interventiongroup, F(1,215.46) = -4.06, p<.001

n.b. – postinterventionmeasures taken at 6-month follow up only

4) Lauw, Havighurst, Wilson andHarley (2014)

- To determine whether anemotion-coaching intervention,with adaptations to address thetoddler developmental stage,would be worth investigatingfurther

Brief Infant-Toddler Social andEmotional Assessment (Briggs-Gowan and Carter,2007) – an 11-item subscale measuring behaviourproblems.

n.b. pre-post intervention measuresonly

Paired samples t-tests wereused to analyse data.

Behaviour problemsParents reported significantly lower toddlerexternalising behaviour difficultiest(1,33)=-2.14, p<.05

None

5) Wilson, Havighurst and Harley(2012)

- To evaluate the effectiveness ofthe Tuning into Kids programunder real-world conditions.

The Eyberg Child BehaviourInventory 6 (ECBI)

The short form of the SocialCompetence and BehaviourEvaluation (SCBE-30; LaFreniereand Dumas, 1995,1996) is ateacher-report measure of socialcompetence, affective expressionand adjustment on 2.5-6 year oldchildren.

Mixed effects multilevelmodelling used to analysedata.

For interaction between time and condition,parent reported behaviour intensity werenon-significant, F(1,123.46) = 2.80, p = .97,as were parent reports of behaviourproblem frequency F(1,123.78) = 2.68,p=.104

No significant effects were found for teacherreports of anger and aggression,F(1,117.87) = 0.04, p=.843

n.b – post-interventionmeasures taken at 6-month follow-up only

45

6) Havighurst, Harley and Prior (2004)- A program teaching parenting

skills in emotional awareness,acceptance and coaching wouldlead to an improvement inemotion competence andreduction in child behaviourproblems

The Emotion Regulation Checklist(ERC; Shields and Cicchetti, 1999).This is a parent-report measure ofLability-Negativity and Emotionregulation.

The Eyberg Child BehaviourInventory (ECBI: Eyberg andRobinson,1983). This is a 36-itemparent repoprt measure ofperceptions of conduct problembehaviours in children.

A MANOVA was used toanalyse data.

ECBIA significant effect was found for Behaviourintensity, F(2,44) = 10.62, p <.001 andbehaviour problems, F(2,44) = 9.94, p<.001ERCA significant effect was found for emotionlability/negativity F(2,45)=8.06, p<.001.

No significant effects found on emotionaldifficulties and emotion regulation.

Univariate Repeated measures ANOVAshowed that for the group with lower scoreson the ECBI, there were no significantchanges in ECBI intensity post intervention,F(2,22) = 2.79, n.s.

For the group with higher scores on theECBI, significant improvements were foundpost-intervention, F(2,22) = 2.79=9.66,p<.001

Statistical dataprovided for 6-monthfollow-up is in theform of means andstandard deviationsonly

46

Appendix D

Coding protocols and items removed from APA Task Force Coding Protocol by Kratochwill (2003)

Coding Protocol: Group-Based Design

Domain: School- and community-based intervention programs for social and behavioral problems

Academic intervention programs

Family and parent intervention programs

School-wide and classroom-based programs

Comprehensive and coordinated school health services

Name of Coder(s): Date: 27/12/14

M / D / Y

Full Study Reference in APA format: Full Study Reference in proper format:__ Havighurst, S. S., Wilson, K. R., Harley, A. E.,Kehoe, C., Efron, D., & Prior, M. R. (2013). “Tuning into Kids”: reducing young children’s behavior problems using an emotioncoaching parenting program. Child Psychiatry and Human Development, 44(2), 247–64

Intervention Name (description from study): Tuning into Kids

Study ID Number (Unique Identifier): 03

Type of Publication: (Check one)

Book/Monograph

Journal article

Book chapter

Other (specify)

47

I. General Characteristics

A. General Design Characteristics

A1. Random assignment designs (if random assignment design, select one of the following)

A1.1 Completely randomized designA1.2 Randomized block design (between-subjects variation)A1.3 Randomized block design (within-subjects variation)A1.4 Randomized hierarchical design

A2. Nonrandomized designs (if nonrandom assignment design, select one of the following)

A2.1 Nonrandomized designA2.2 Nonrandomized block design (between-participants variation)A2.3 Nonrandomized block design (within-participants variation)A2.4 Nonrandomized hierarchical designA2.5 Optional coding of Quasi-experimental designs (see Appendix C)

A3. Overall confidence of judgment on how participants were assigned (select one of the following)

A3.1 Very low (little basis)A3.2 Low (guess)A3.3 Moderate (weak inference)A3.4 High (strong inference)A3.5 Very high (explicitly stated)A3.6 N/AA3.7 Unknown/unable to code

B. Statistical Treatment/Data Analysis (answer B1 through B6)

B1. Appropriate unit of analysis yes noB2. Familywise error rate controlled yes no N/AB3. Sufficiently large N yes no

Statistical Test:GrowthCurve Modelling andANCOVA_ level:

ES: .5N required: 64

B4. Total size of sample (start of the study): 54N

B5. Intervention group sample size: 31N

B6. Control group sample size: 23N

48

C. Type of Program (select one)

C1. Universal prevention programC2. Selective prevention programC3. Targeted prevention programC4. Intervention/TreatmentC5. Unknown

D. Stage of the Program (select one)

D1. Model/demonstration programsD2. Early stage programsD3. Established/institutionalized programsD4. Unknown

E. Concurrent or Historical Intervention Exposure (select one)

E1. Current exposureE2. Prior exposureE3. Unknown

II. Key Features for Coding Studies and Rating Level of Evidence/ Support

(3=Strong Evidence 2=Promising Evidence 1=Weak Evidence 0=No Evidence)

A. Measurement (answer A1 through A4)

A1. Use of outcome measures that produce reliable scores for the majority of primary outcomes. The table forPrimary/Secondary Outcomes Statistically Significant allows for listing separate outcomes and will facilitate decision makingregarding measurement (select one of the following)

1.1 Yes1.2A1.2 NoA1.3 Unknown/unable to code

A2. Multi-method (select one of the following)

A2.1 YesA2.2 NoA2.3 N/AA2.4 Unknown/unable to code

A3. Multi-source (select one of the following)

A3.1 YesA3.2 NoA3.3 N/AA3.4 Unknown/unable to code

49

A4. Validity of measures reported (select one of the following)

A5.1 Yes validated with specific target groupA5.2 In part, validated for general population onlyA5.3 NoA5.4 Unknown/unable to code

Rating for Measurement (select 0, 1, 2, or 3): 3 2 1 0

B. Comparison Group

B1. Type of Comparison Group (select one of the following)

B1.1 Typical contactB1.2 Typical contact (other) specify:B1.3 Attention placeboB1.4 Intervention elements placeboB1.5 Alternative interventionB1.6 PharmacotherapyB1.1B1.7 No interventionB1.8 Wait list/delayed interventionB1.9 Minimal contactB1.10 Unable to identify comparison group

B2. Overall confidence rating in judgment of type of comparison group (select one of the following)

B2.1 Very low (little basis)B2.2 Low (guess)B2.3 Moderate (weak inference)B2.4 High (strong inference)B2.5 Very high (explicitly stated)B2.6 Unknown/Unable to code

B3. Counterbalancing of Change Agents (answer B3.1 to B3.3)

B3.1 By change agentB3.2 StatisticalB3.3. Other

B4. Group Equivalence Established (select one of the following)

B4.1 Random assignmentB4.2 Posthoc matched setB4.3 Statistical matchingB4.4 Post hoc test for group equivalence

B5. Equivalent Mortality (answer B5.1 through B5.3)B5.1 Low Attrition (less than 20% for Post)B5.2 Low Attrition (less than 30% for follow-up) 24% attritionB5.3 Intent to intervene analysis carried out

Findings

Rating for Comparison Group (select 0, 1, 2, or 3): 3 2 1 0

50

B2. Overall confidence rating in judgment of type of comparison group (select one of the following)

B2.1 Very low (little basis)B2.2 Low (guess)B2.3 Moderate (weak inference)B2.4 High (strong inference)

B2.5 Very high (explicitly stated)

B2.6 Unknown/Unable to code

B3. Counterbalancing of Change Agents (answer B3.1 to B3.3)

B3.1 By change agentB3.2 StatisticalB3.3. Other

B4. Group Equivalence Established (select one of the following)

B4.1 Random assignmentB4.2 Posthoc matched setB4.3 Statistical matchingB4.4 Post hoc test for group equivalence

B5. Equivalent Mortality (answer B5.1 through B5.3)B5.1 Low Attrition (less than 20% for Post)B5.2 Low Attrition (less than 30% for follow-up) – 24% attritionB5.3 Intent to intervene analysis carried out

Findings

51

D. Educational/Clinical Significance

Outcome Variables: Pretest Posttest Follow Up

D1. Categorical DiagnosisData

Diagnostic information regardinginclusion into the study presented:

Yes No Unknown

Positive change indiagnostic criteria from preto posttest:

Yes No Unknown

Positive change indiagnostic criteria from posttest tofollow up:

Yes No Unknown

D2. Outcome Assessed viacontinuous Variables

Positive change in percentage ofparticipants showing clinicalimprovement from pre to posttest:

Yes No Unknown

Positive change in percentage ofparticipants showing clinicalimprovement from posttest to followup:

Yes No Unknown

D3. Subjective Evaluation:The importance of behaviorchange is evaluated byindividuals in direct contactwith the participant.

Importance of behavior change isevaluated:

Yes No Unknown

Importance of behavior changefrom pre to posttest is evaluatedpositively by individuals in directcontact with the participant:

Yes No Unknown

Importance of behavior changefrom posttest to follow up isevaluated positively by individualsin direct contact with the participant:

Yes No Unknown

D4. Social Comparison:Behavior of participant atpre, post, and follow up iscompared to normative data(e.g., a typical peer).

Participant’s behavior is comparedto normative data

Yes No Unknown

Participant’s behavior hasimproved from pre to posttestwhen compared to normative data:

Yes No Unknown

Participant’s behavior has improvedfrom posttest to follow up whencompared to normative data:

Yes No Unknown

Rating for Educational/Clinical Significance (select 0, 1, 2, or 3): 3 2 1 0

F. Implementation Fidelity

F1. Evidence of Acceptable Adherence (answer F1.1 throughF1.3)

F1.1 Ongoing supervision/consultationF1.2 Coding intervention sessions/lessons or proceduresF1.3 Audio/video tape implementation (select F1.3.1 or F1.3.2):

F1.3.1 Entire interventionF1.3.2 Part of intervention

F2. Manualization (select all that apply)

F2.1 Written material involving a detailed account of the exact procedures andthe sequence in which they are to be used

F2.2 Formal training session that includes a detailed account of theexact procedures and the sequence in which they are to be used

F2.3 Written material involving an overview of broad principles and a descriptionof the intervention phases

52

F2.4 Formal or informal training session involving an overview of broadprinciples and a description of the intervention phases

F3. Adaptation procedures are specified (select one) yes no unknown

Rating for Implementation Fidelity (select 0, 1, 2, or 3): 3 2 1 0

H. Site of ImplementationH1. School (if school is the site, select one of the followingoptions)

H1.1 Public

H1.2 PrivateH1.3 CharterH1.4 University AffiliatedH1.5 AlternativeH1.6 Not specified/unknown

H2. Non School Site (if it is a non school site, select one of the following options)

H2.1 HomeH2.2 University ClinicH2.3 Summer ProgramH2.4 Outpatient HospitalH2.5 Partial inpatient/day Intervention ProgramH2.6 Inpatient HospitalH2.7 Private PracticeH2.8 Mental Health CenterH2.9 Residential Treatment FacilityH2.10 Other (specify): community settingsH2.11 Unknown/insufficient information provided

I. Follow Up Assessment

Timing of follow up assessment: specify 6 months

Number of participants included in the follow up assessment: specify 41____

Consistency of assessment method used: specify Same method used

Rating for Follow Up Assessment (select 0, 1, 2, or 3): 3 2 1 0

III. Other Descriptive or Supplemental Criteria to Consider

A. External Validity Indicators

A1. Sampling procedures described in detail yes no

Specify rationale for selection: Participants chosen if children had elevated scores on ECBISpecify rationale for sample size:

A1.1Inclusion/exclusion criteria specified yes no

53

A1.2 Inclusion/exclusion criteria similar to school practice yes no

A1.3 Specified criteria related to concern yes no

A2. Participant Characteristics Specified for Treatment and Control Group

54

Participants fromTreatment Group

Grade/age Gender Ethnicityor Multi-ethnic

EthnicIdentity

Race(s) Acculturation Pri -maryLan-

guage

SES FamilyStruc-ture

Locale Disability FunctionalDescriptors

Child/StudentParent/caregiverTeacherSchool

35.66 Female Australian

White EnglishWorking/middleclass

unknown

Australia

Other

Child/StudentParent/caregiverTeacherSchoolOther



Participants fromControl Group

Grade/age Gender Ethnicityor Multi-ethnic

EthnicIdentity

Race(s) Acculturation Pri -maryLan-

guage

SES FamilyStruc-ture

Locale Disability FunctionalDescriptors


35.66 Female Australian

White EnglishWorking/middleclass

unknown

Australia

35.66


Child/StudentParent/caregiverTeacherSchoolOtherChild/StudentParent/caregiverTeacherSchoolOther

A3. Details are provided regarding variables that:

A3.1 Have differential relevance for intended outcomes yes no

Specify:

55

A3.2 Have relevance to inclusion criteria yes no

Specify: Participants excluded if they did not have sufficient English language skills

A5. Generalization of Effects:

A5.1 Generalization over time

A5.1.1 Evidence is provided regarding the sustainability of outcomes after intervention isterminated yes no

Specify: 6 month follow up measures reported

A5.1.2 Procedures for maintaining outcomes are specified yes no

Specify:

A5.2 Generalization across settings

A5.2.1 Evidence is provided regarding the extent to which outcomes are manifested in contextsthat are different from the intervention context yes no

Specify:

A5.2.2 Documentation of efforts to ensure application of intervention to other settingsyes no

56

Specify:

A5.2.3 Impact on implementers or context is sustained yes no

Specify:

A5.3 Generalization across persons

Evidence is provided regarding the degree to which outcomes are manifested with participants whoare different than the original group of participants for with the intervention was evaluated

yes no

Specify:

B. Length of Intervention (select B1 or B2)

B1. Unknown/insufficient information provided

B2. Information provided (if information is provided, specify one of the

following:)

B2.1 weeks 6N

B2.2 monthsN

B2.3 yearsN

B2.4 otherN

C. Intensity/dosage of Intervention (select C1 or

C2) C1. Unknown/insufficient information

provided

C2. Information provided (if information is provided, specify both of the following:)

C2.1 length of intervention session 2 hoursN

C2.2 frequency of intervention session weeklyN

D. Dosage Response (select D1 or D2)

D1. Unknown/insufficient information provided

D2. Information provided (if information is provided, answer D2.1)

57

D2.1 Describe positive outcomes associated with higher dosage:

58

E. Program Implementer (select all that apply)

E1. Research StaffE2. School Specialty StaffE3. TeachersE4. Educational AssistantsE5. ParentsE6. College StudentsE7. PeersE8. OtherE9. Unknown/insufficient information provided

F. Characteristics of the Intervener

F1. Highly similar to target participants on key variables (e.g., race, gender, SES)F2. Somewhat similar to target participants on key variablesF3. Different from target participants on key variables

G. Intervention Style or Orientation (select all that apply)

G1. BehavioralG2. Cognitive-behavioralG3. ExperientialG4. Humanistic/interpersonalG5. Psychodynamic/insight orientedG6. other (specify):G7. Unknown/insufficient information provided

H. Cost Analysis Data (select G1 or G2)

H1. Unknown/insufficient information providedH2. Information provided (if information is provided, answer H2.1)

H2.1 Estimated Cost of Implementation:

I. Training and Support Resources (select all that apply)

I1. Simple orientation given to change agentsI2. Training workshops conducted

# of Workshops provided

Average length of training

Who conducted training (select all that apply)

I2.1 Project DirectorI2.2 Graduate/project assistants

59

I2.3 Other (please specify):I2.3 Unknown

I3. Ongoing technical supportI4. Program materials obtainedI5. Special FacilitiesI6. Other (specify):

J. Feasibility

J1. Level of difficulty in training intervention agents (select one of the following)

J1.1 HighJ1.2 ModerateJ1.3 LowJ1.4 Unknown

J2. Cost to train intervention agents (specify if known):

J3. Rating of cost to train intervention agents (select one of the following)

J3.1 HighJ3.2 ModerateJ3.3 LowJ3.4 Unknown

59

Summary of Evidence for Group-Based Design Studies

Indicator

OverallEvidence Rating

NNR = Nonumerical rating

or

0 - 3

Description of Evidence

StrongPromising

WeakNo/limited evidence

or

Descriptive ratingsGeneral Characteristics

General Design Characteristics NNR

Statistical Treatment NNR

Type of Program NNR

Stage of Program NNR

Concurrent/Historical Intervention Exposure NNR

Key Features

Measurement 3 Strong

Comparison Group 3 Strong

Primary/Secondary Outcomes areStatistically Significant

N/A

Educational/clinical significance 3 Strong

Identifiable Components N/A

Implementation Fidelity 3 Strong

Replication N/A

Site of Implementation N/A

Follow Up Assessment Conducted 3 Strong

60

Appendix E

Weighting of studies

The APA Task Force Coding Protocol by Kratochwill (2003) coding protocol was used to codeeach of the studies in order to generate a ‘Weight of Evidence A’ rating for included studies. Thetable below shows the adaptations made to the protocol along with a rationale for theseamendments.

Items removed Rationale

Sections I.B.7 - B.8 Studies did not use qualitative research methods.

Section II.C The protocol was used to rate the methodological qualityof the included studies. Outcomes are examinedseparately in the review

Section II.D removed(with the exception ofHavighurst et al2013)

All studies being reviewed (apart from one) examined theprogramme as a prevention/universal program thereforethis section was not relevant for the type of studies in thereview.

Section II.E removed The intervention components are not separated.

Section II.G removed There was no within study replication.

Rating scale forsection II.H removed

As the review question was concerned with whether theprogram would enable parents to improve behaviouraloutcomes for their children, rating the site ofimplementation was irrelevant in ascertaining themethodological quality of each study. However forinformation purposes, details on site of implementationwas left in.

Table in section III.A4removed

Receptivity of intervention by target group was notdeemed necessary in determining methodological qualitynor was it reported in the studies.

61

Weight of Evidence A: Methodological Quality

This was assessed based on the guidance for methodological quality detailed in the Kratochwill(2003) coding protocol. Studies were weighted on ‘measures’, ‘comparison group’, ‘fidelity’, and‘follow-up’.

1. Measures

Weighting DescriptorsHigh - Studies used measures that produce reliable

scores of at least .70, for the majority ofprimary outcomes

- Data was collected using multiple methods,and collected from multiple sources

- Validity is reportedMedium - Studies used measures that produce reliable

scores of at least .70- Data was collected using multiple methods,

and/or collected from multiple sources- A case for validity does not need to be

presented.Low - Studies used measures that produce reliable

scores of at least .50- Data may have been collected either using

multiple methods and/or from multiple sourceshowever, this is not required.

- A case for validity does not need to bepresented.

2. Comparison group

Weighting DescriptorsHigh - Uses at least one type of "active"

comparison group- Initial group equivalency must be

established- Evidence that change agents

were counterbalanced- Equivalent mortality and low

attrition at post, and if applicable,at follow-up

Medium - Uses at least a "no interventiongroup" type of comparison

- There is evidence for at least twoof the following: counterbalancingof change agents, groupequivalence established, or

62

equivalent mortality with lowattrition.

- If equivalent mortality is notdemonstrated, an intent-tointervene analysis is conducted.

Low - The study uses a comparisongroup

- At least one of the following ispresent: counterbalancing ofchange agents, groupequivalence established, orequivalent mortality with lowattrition.

- If equivalent mortality is notdemonstrated, an intent-to-intervene analysis is conducted.

3. Fidelity

Weighting MeasuresHigh - The study demonstrates strong

evidence of acceptableadherence.

- Evidence of fidelity is measuredthrough at least two of thefollowing: ongoingsupervision/consultation, codingsessions, or audio/video tapes,and use of a manual.

- The “manual” is either writtenmaterials involving a detailedaccount of the exact proceduresand the sequence in which theyare to be used or formal trainingsession detailing exactprocedures and sequence.

Medium - The study demonstratesevidence of acceptableadherence.

- Evidence of fidelity is measuredthrough at least one of thefollowing: ongoingsupervision/consultation, codingsessions, or audio/video tapes,and use of a manual.

- The “manual” is either writtenmaterials involving an overviewof broad principles and a

63

description of the interventionphases, or formal/informaltraining session involving anoverview of broad principles anda description of the interventionphases.

Low - Demonstrates evidence ofacceptable adherence measuredthrough at least one of the abovecriteria or use of a manual

4. Follow-up

Weighting DescriptorsHigh - The study conducted follow up

assessments over multipleintervals with all participants thatwere included in the originalsample

- Uses similar measures used toanalyse data from primary orsecondary outcomes

Medium - The study conducted follow upassessments at least once withthe majority of participants thatwere included in the originalsample

- Similar measures used toanalyse data from primary orsecondary outcomes

Low - The study conducted follow upassessments at least once withsome participants from theoriginal sample.

Overall methodological quality

The following ratings were assigned to each weighting to calculate the overall methodologicalquality of the studies:

High weightings = 3

Medium weightings = 2

Low weightings = 1

No rating = 0

64

The scores were averaged:

Overall Methodological Quality Average scoresHigh >2.5Medium 1.5 - 2.4Low <1.4

Study Measures ComparisonGroup

Fidelity Follow-up OverallQuality ofMethodology

Havighurstet al (2009)andHavighurstet al (2010)

3 2 3 2 2.5


3 3 3 3 3

Kehoe et al(2014)

3 2 3 2 2.5

Lauw et al(2014)

2 0 3 0 1.25

Wilson et al(2012)

3 2 3 3 2.75


2 0 2 3 1.75

n.b. Havighurst et al (2009) and Havighurst et al (2010) have been weighted as one study (1a and 1b) as the

former reports preliminary post-intervention findings and the latter reports full post-intervention findings as well as

follow-up outcomes of the same sample.

65

Weight of Evidence B: Methodological relevance

This weighting is a review-specific judgement about the suitability of the evidence for answeringthe review question.

Weighting DescriptorsHigh An ‘active’ comparison group is used

Participants are randomly assigned togroupsPre, post and follow up measures aretaken for both groups.

Medium A waitlist/no intervention comparisongroup is usedParticipants are randomly assigned togroupsPre and post or pre and follow-upmeasures are taken for both groups

Low Pre and post measures are taken

As the TI programme is a relatively new intervention, the review question sought to review theefficacy of the studies. Therefore in WoE B, a classic evidence hierarchy (Evans, 2003) wasused to influence descriptors for the weighting of studies. Therefore, randomised controlledtrials (RCTs) are deemed as high quality evidence as results are at lower risk of error or biasthat a study that has no control group or a sample that was not randomised to conditions. The

addition of an ‘active comparison group’ to the ‘high’ category is due to the fact that the use ofan active comparison group can show that the intervention being researched is better than theusual/alternative form of intervention suggested for a presenting problem whereas a “nointervention/waitlist control” group just shows that the intervention is better than not interveningat all. Finally, pre, post and follow up measures are desirable as it shows not only the baselinemeasures or participants before intervention versus immediately post-intervention it also showsthe durability of the intervention effects which adds to the evaluation of the intervention’sefficacy.

66

Weight of Evidence C: Topic Relevance

This weighting is a review specific judgement about the relevance of the focus of the evidencefor review question

Weighting DescriptorsHigh The Tuning into Kids/Teens/Toddlers

programme is delivered by trainedpsychologists.

Includes only children that are at theclinical cut-off on the EBCI/otherbehavioural measures

Behavioural measures are gatheredfrom parents and teachers or parentsand child/young person

Medium The Tuning into Kids/Teens/Toddlersprogramme is delivered by trainedpsychologists.

Includes all children regardless ofbaseline scores on ECBI/otherbehavioural measures

Behavioural measures are gatheredfrom parents and teachers or parentsand child/young person.

Low The Tuning into Kids/Teens/Toddlersprogramme is delivered by trainedprofessionals

Includes all children regardless ofbaseline scores on ECBI/otherbehavioural measures

Behavioural measures are gatheredfrom parents

It is argued that TI is a specialised intervention that involves teaching parents how to emotioncoach their children using highly specialised psychological techniques as well as the ability toteach parents about their own emotions. Therefore it is argued that the person delivering theparent training would need to be a psychologist to be able to deliver this to the maximum effect,whereas, although a manual is used, training professionals outside of the field to deliver thisintervention may not be as effective. Studies including children that are at the clinical cut off onthe ECBI were weighted as highest as this demonstrates that the intervention’s effectiveness

as treatment for children at the clinical level of behavioural difficulties. Finally, the if measureswere multi-source e.g. derived from parents and teachers or parents and the child/young

67

person, then this shows evidence of triangulating data which provides a richer, more validreport of the outcomes of the intervention.

Weight of Evidence D: Overall Weight of Evidence

This is an overall assessment of the extent to which the evidence contributes to answering thereview question which is assessed by giving studies the following scores:

High weightings = 3

Medium weightings = 2

Low weightings = 1

The scores obtained were averaged to give an overall weight of evidence score

Overall Weight of Evidence Average scoresHigh >2.5Medium 1.5 - 2.4Low <1.4

Studies WoE AQuality ofmethodology

WoE BRelevanceofMethodology

WoE CRelevanceof evidenceto thereviewquestion

WoE DOverallweight ofevidence

Havighurstet al(2009) andHavighurstet al(2010)

High2.5

Medium2

Medium2

Medium2.17

Havighurstet al(2011)

High3

High3

High3

High3

Kehoe etal (2014)

High2.5

Medium2

Medium2

Medium2.17

Lauw et al(2014)

Medium1.25

Low1

Low1

Low1.08

Wilson etal (2012)

High2.75

Medium2

Low1

Medium1.92

Havighurstet al(2004)

Medium1.75

Low1

Medium2

Medium1.58

68

Appendix F

Full effect size table

Study Measures Number ofParticipants

Outcomes Effect SizeDescriptors

Pre andpostmeasures

Effect sizes

Pre and postmeasures

Effect sizedescriptors

Pre andfollow upmeasures

Effect sizes

Pre and followup measures

OverallWeight ofEvidence

1a.Havighurstet al (2009)– pre-post

1b.Havighurstet al (2010)– pre-followup data(Same studyas above)

The Eyberg ChildBehaviourInventory 6 (ECBI;Eyberg and Pincus,1999

218

216

1a. Behaviour problems(intensity) – researchersfound a significantimprovement in theintervention group F(1,181) = 18.39, p<.001

1b. Behaviour problems– Researchers found asignificant interactionbetween condition andtime on the EBCI, F(1,169) = 11.14. p<.001

On the SESBI, there wasalso a significantinteraction betweencondition and timeF(1,150)=6.87, p=.02

Small-medium

ECBIIntensity

PPC SMD = -0.44

Small-medium

Small

ECBIIntensity

PPC SMD= - 0.41

SESBIPPC SMD = -0.2

Medium


The Eyberg ChildBehaviourInventory 6 (ECBI)

Sutter-EybergStudent BehaviourInventory – a

54 ANCOVA at time 2showed that parents inthe interventioncondition reportedsignificantly lower childbehaviour intensity thanthe control group,F(1,34) = 6.32, p =.009,partial eta squared =.16

ANCOVAs of teacherreports on childbehaviour indicated that

Large

Large

ECBI

IntensityPPC SMD= -0.76

ProblemPPC SMD= -0.83

Small

Small-medium

ECBIIntensity

PPC SMD = -0.13

Problem

PPC SMD = -0.42

SESBI

High

69

teacher’s version ofthe ECBI.

at follow-up, children inthe interventioncondition wereperceived to have lowerbehaviour intensity,F(1,26) = 4.87, p=.036,partial eta squared =.16,and fewer behaviourproblems F(1,26) = 4.87,p=.036, partial etasquared = .16

Medium

Medium

BehaviourintensityPPC SMD= -0.58

BehaviourproblemPPC SMD= -0.5

Kehoe et al(2014)

Spence children’sanxiety scale(SCAS; Spence,1998).

Spence childanxiety scale forparents (SCAS-P;Nauta et al, 2004).

Child DepressionInventory short-form child self-report (CDI:S;Kovacs, 1981;Kovacs and Beck,1977).

Child depressionInventory parentreport (CDI:P;Garber,1984)

225 Youth with parents in theintervention conditionreported significantlylower anxiety,F(1,217.36) = -2.17,p<0.31.

Parents in theintervention conditionreported significantlylower youth anxiety,F(1,215) = -4.92,p<.001.

However no significantdifference was found foryouth reporteddepressive symptoms,F(1,206.97) = -1.17,p=.244

Parent reported youthdepression was alsosignificantly lower for theintervention group,F(1,215.46) = -4.06,p<.001

Small

Medium

Small

Medium

SCAS

PPC SMD = -0.19

SCAS-P

PPC SMD = -0.48

CDI:S

PPC SMD= -0.13

CDI:P

PPC SMD =-0.46

Medium

Lauw et al(2014)

Brief Infant-ToddlerSocial andEmotionalAssessment

34 Behaviour problemsParents reportedsignificantly lower

Toddlerbehaviourproblems

Low

70

(BITSEA; Briggs-Gowan andCarter,2007)

toddler externalisingbehaviour difficultiest(1,33)=-2.14, p<.05

SmallPP SMD = -0.26

Wilson et al(2012)

The Eyberg ChildBehaviourInventory 6 (ECBI)

The short form ofthe SocialCompetence andBehaviourEvaluation (SCBE-30; LaFreniere andDumas,1995,1996)

128 Compared to the waitlistcontrol, parents in theintervention groupreported significantlylower behaviourproblems shown by asignificant main effect forcondition, F(1,123.8) =4.99, p=.027

However for interactionbetween time andcondition, parentreported behaviourintensity were non-significant, F(1,123.46) =2.80, p = .97, as wereparent reports ofbehaviour problemfrequency F(1,123.78) =2.68, p=.104

No significant effectswere found for teacherreports of anger andaggression, F(1,117.87)= 0.04, p=.843

Small

Small

Small

ECBI

Behaviourintensity

PPC SMD= -0.22

BehaviourproblemPPC SMD= -0.26

SCBE-30

Anger/aggression

PPC SMD= 0.02

Medium

71


The EmotionRegulationChecklist (ERC;Shields andCicchetti, 1999)

The Eyberg ChildBehaviourInventory (ECBI:Eyberg andRobinson,1983).

47 A significant effect wasfound for Behaviourintensity, F(2,44) =10.62, p <.001 andbehaviour problems,F(2,44) = 9.94, p<.001

Another significant effectwas found forOppositional Defiantsymptoms, AttentionDeficit HyperactiveSymptoms, and ConductSymptoms combined,F(2,44) = 4.23, p<.01

Univariate Repeatedmeasures ANOVAshowed that for thegroup with lower scoreson the ECBI, there wereno significant changes inECBI intensity postintervention, F(2,22) =2.79, n.s. However forthe group with higherscores on the ECBI,significantimprovements werefound post-intervention,F(2,22) = 2.79=9.66,p<.001

Small

Small

Small

Medium

ECBI

BehaviourintensityPP SMD = -0.26

BehaviourproblemPP SMD = -0.31

ERCLability/negativity

PP SMD = -0.31

Teacher ratedbehaviour

PP SMD= 0.49

Small-medium

Small-medium

Small-medium

ECBI

BehaviourIntensity

PP SMD = -0.4

BehaviourProblem

PP SMD = -0.42

ERCLability/negativity

PP SMD = -0.41

Medium

tuning into kids

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