Teaching What Works for Children at Parenting University

POSTED BY: MARILEE COMFORT ON WED, SEPT. 10, 2014

Importance of Parenting & Evidence-Based Intervention

Children don’t come with instructions.  Yet, parenting quality effects a child’s overall welfare and influences vital outcomes such as social behavior, educational success and emotional well-being (Olds, et al., 2007). Characteristics of effective parenting include (a) interaction style with their child; (b) warmth and affection towards their child; and (c) parenting strategies used (Johnson, et al., 2008). Cultivating positive parent/child interaction is a cornerstone of most parenting programs and parenting curricula. 

Guest blog by

Kyla Liggett-Creel
University of Maryland School of Social Work

“Parent training is one of the most used prevention and intervention techniques to prevent or reduce child maltreatment or further child welfare services involvement. Parent training is identified in the general template of many case plans involving open child welfare cases (Barth et al., 2006) and many cases where there is not substantiation or an open case.  Yet, evidence based interventions remain very limited in the field of early childhood—especially for parents of children birth-3.” (Barth & Liggett-Creel, 2014)

Evidence-based models, such as SafeCare® and Triple P® 4, have been found effective for preventing child abuse and neglect within families with children birth to three years old. However, implementing evidence-based models can be challenging due to financial constraints, training requirements, and effort needed to maintain model fidelity (Barth & Liggett-Creel, 2014).  Due to these barriers, the University of Maryland, School of Social Work faculty and staff developed a parenting program using common components of evidence-based parenting models.  Common components include parent-child dyadic work focused on building responsive parenting skills, coaching, modeling, and group format.  (Learn more about the Common Components model).

Promise Heights Network of Community Services:  Parent University Program

The Promise Heights Initiative is a program through the University of Maryland with the mission to “create a comprehensive child, family and community building model in West Baltimore that provides children 0-21 with educational, social, physical, and economic opportunities and which allows them to thrive and succeed in work and family life” (Promise Heights, 2012). Promise Heights is fashioned after the Harlem Children’s Zone of New York.  The Parent University Program is embedded within the Promise Heights community. Over 50% of children in this community are living in poverty, 50% of adults do not have a high school diploma and 60% are unemployed (Promise Heights, 2012). The Promise Heights initiative has established a network of community services that includes churches, social service providers, schools and the University. The University of Maryland has developed a pipeline of programs to serve families from pregnancy to graduation from college. B’More for Healthy Babies is the first program in the pipeline and serves pregnant mothers until the babies are 18 months old. The Parent University Program is the second program in the pipeline. It was shaped to be more intensive and to have more interactive elements than the Baby College of Harlem Children’s Zone.

 PU parenting assessment

 Parent University Program Builds Responsive Parenting Skills

The Parent University Program (PUP) is a 10-week community-embedded parenting program for parents with children between birth and three years of age. Staff at the University of Maryland, School of Social Work developed and facilitated the initial PUP sessions with a focus on knowledge of child development, health and wellbeing. The goal of PUP is to increase positive joint interaction between parents and children through practicing dyadic activities, while receiving coaching and feedback from social workers, student interns and parent leaders. Because young children experience their worlds through early relationships, parent-child interaction is the highlighted form of communication throughout the PUP sessions.  PUP staff and faculty focus on addressing the needs of the parents so that they can focus on the needs of their children. Parents receive a lot of attention, praise and strengths-based support throughout the program to encourage passing these strategies forward to their children.

Parent University Program Builds Parent Leaders

After each program iteration since 2011, changes in PUP have been made based on feedback from family participants and staff.  The gradual passing of responsibilities from social workers to peer parent mentors, then to peer parent leaders is a striking distinction of the PUP, which translates into building confidence, competence and enjoyment for the families and the community.  In the current version of PUP, social work faculty take a back seat.  Parent leaders recruit family participants, facilitate the program sessions and lead intervention activities. The FED component was developed and implemented during the 4th iteration of the program, based on recommendations from the PUP graduates.  Parent/child dyads engage in reading and play activities, while participating parents are encouraged to Follow their child’s lead, Enjoy the interaction and Describe what their child is doing. The current role of social workers, students and volunteers is to support parent leaders and participating parents, and provide childcare during parent group.

Several components have remained the same through all four cohorts.  Sessions take place one morning a week from 9:00 am-11:30 am. Participants must be the primary caregiver (referred to as parents) for the identified child. Parents bring their children and are served breakfast. Parents, children and staff then join as a group to first sing songs, then read and then play with their children, establishing familiar routines with transitions during each session. Finally, parents attend a parent group where community service providers present on topics such as attachment, lead exposure and asthma. During each 10-week series, parents receive at least one home visit from program staff and weekly reminder calls. Case management is available if the parent expresses a specific need. Program facilitators give families two books and a small gift (eg. a tube of lotion or a CD) at the end of each group session.

Five cohorts of parents (n=60) have already graduated from PUP since 2011. We’re excited to announce that families with children three to five years old will be offered the Parent University Program II beginning in the fall of 2014. This program will be the next phase in the continuum of pipeline services offered in the Promise Heights community. 

Parenting Assessment: Will PUP Make a Difference?

For the evaluation, during the first four years families participated in five measures for the PUP research project: (a) Parent University Program Questionnaire, (b) Nursing Child Assessment Teaching Scale (NCATS: Sumner and Speitz, 1994), (c) Infant Intentionality Questionnaire-short form (Berlin, et al., 2013), (d) Safe Environment for Every Kid (SEEK) Parent Support Questionnaire (Dubowitz, et al., 2009) and e) the Ages and Stages Questionnaire (ASQ, Squires and Bricker, 2009).  Parents were given the ASQ as a screening tool for referral to early intervention services if needed. 

PUP added the KIPS assessment during the fifth cohort. The Keys to Interactive Parenting Scale (KIPS) allows the Promise Heights Initiative to assess parent-child interaction throughout the pipeline of services until entry into elementary school. KIPS also offers specific goals for intervention when working with parents through the various Promise Heights Programs for early childhood. We added KIPS because it is a strengths-based assessment tool that highlights positive interactions between the parent and child. The Parent University staff and parent leaders aim to support positive interactions by parents so they will nurture their children. KIPS is used as a program evaluation tool to allow program developers to assess whether PUP is effective in increasing responsive parenting skills in participants. KIPS is a wonderful fit for the PUP goal: to increase positive joint attention of parents and children.

References

Barth, R.B. & Liggett-Creel, K. (2014). Common components of parenting programs for children birth to eight years of age. Children and Youth Services Review, 40, 6-12.

Barth, R. P., Landsverk, J., Chamberlain, P., Reid, J., Rolls, J., Hurlburt, M., . . . Kohl, P. L. (2006). Parent-training in child welfare services: Planning for a more evidence-based approach to serving biological parents. Research on Social Work Practice, 15(5), 353-371.

Johnson, M.A., Stone, S., Lou, C., Ling, J., Claassen, & Austin, M.J. (2008). Assessing parent education programs for families involved with child welfare services: Evidence and implications. Journal of Evidence-Based Social Work, 5(1/2), 191-238.

Olds, D.L., Sadler, L., & Kitzman, H. (2007). Programs for parents of infants and toddlers: recent evidence from randomized trials. Journal of Child Psychology and Psychiatry, 48 (3/4), 355-391.

The proper measure of disadvantage is not necessarily family poverty or parental education. The available evidence suggests that the quality of parenting is the important scarce resource. So we need better measures of risky family environments in order to achieve more accurate targeting.

– James Heckman, page 35

When considering “measures of risky family environments” assessing parenting quality is among the most important.  Assessing parenting can be difficult for most family service providers.  When a family service provider is performing an assessment, it is important not to rely on personal feelings or rough impressions. This is difficult, because we all tend to make immediate gut-level judgments.  A family service provider needs a valid and empirical way to measure the quality of parenting. It is a delicate process that requires an organized conceptual model of parenting and attention to the complexities of parent-child interaction. An effective assessment tool needs to provide a balanced view that shows the full continuum of parenting quality from parenting that does not effectively nurture, and may harm the child, all they way through parenting quality that optimally promotes child development and well-being. Having the right parenting assessment tool can not only make the job easier and more effective, but can significantly improve the services provided to families.

“KIPS provides learning opportunities for parents, as well as a chance for educators to build stronger supportive relationships with parents . . . and for development of specific parent goals.”

Nohemi Ortega, Program Supervisor, Yuma Parents as Teachers, AZ

Parenting Assessment Tools

A useful parenting assessment tool will expand the range of behavior that a provider considers and will focus attention on specific meaningful behaviors.  The most meaningful behaviors to assess are those proven to support child development and that parents can change.  The goal is to provide actionable insights for improving the parent-child relationship.

Sometimes family service providers resort to checklists that rate individual behaviors as a yes/no.  Though better than having no tool at all, checklists don’t provide a continuum of information that can be used in supporting parental growth.  In contrast, on rating scales, like the Keys to Interactive Parenting Scale (KIPS), the observed behaviors are assessed on a continuum.  Using a continuum to observe more than once can monitor progress over time.  A rating scale is more sensitive in detecting changes, which is important in documenting changes in parenting for evaluation or research.

So what is the mark of a successful parenting assessment tool?  Our paper, Building a Strong Program for Families and Staff By Assessing What Matters to Children: Their Parents’ Behavior outlines the benefits of an effective observational parenting tool. At a minimum it should be reliable and valid.  Determination of validity needs to go beyond face validity. For an example of how an assessment was validated, see the KIPS validation studies.

Beyond validity, there are other questions to answer to see if a parenting assessment tool fits your needs:

1. Does the tool document outcomes that match your program goals?

2. Does it identify the parent’s individual strengths as well as the areas needing improvement? Are the assessed behaviors changeable?

3. Is it sensitive enough to note parents’ progress in your program.  Is the assessment information useful in planning services?

4. Is it designed so the assessment information can be used to reinforce a parent’s progress and build a parent’s confidence?

5. Does it cover and adapt to the age range of children you serve?

6. Does it highlight parent-child interaction?

7. Does it provide easy to understand language that can be shared with parents, staff, and programs alike?

8. Does the assessment information support reflective practice and reflective supervision?

9. Does it provide information and data that will be helpful in continuous improvement of both the staff and the program?

If the answer to any of these questions is “no”, it may be an indication that the tool itself may not be an ideal fit for your needs. The right tool will strike a balance between the amount of information it collects and its practical use.  Many tools first constructed for research, though comprehensive, are too cumbersome for use in daily services.

Family service providers, like any other professionals, need to have the right tool for the job.  Choosing the right tool to assess parent-child interaction will allow you to tailor your services to meet each family’s needs and prove the changes you are making in families’ lives.