Lyhytkestoinen vanhemmuusohjelma ja käytöshäiriöoireet

Sauli Hyvärinen

Näytön aste: D

Varhaislapsuudessa annettu käytöshäiriön syntymisen riskiryhmässä olevien lasten vanhemmille annettu lyhytkestoinen vanhemmuusohjelma saattaa vähentää myöhäisempiä lasten käytöshäiriöoireita, mutta luotettava näyttö puuttuu.

A randomized controlled trial «Macdonald G, Turner W. An Experiment In Helping Fo...»1 was implemented with groups of foster-carers (N = 117 foster parentis) in Britain to test the effectiveness of group based, short term cognitive-behavioural parent training in the management of difficult behavior of children. Because of the geographical distribution of foster-carers it was not possible to randomly allocate participants from one pool. Instead, six geographically based groups of carers were randomized within intervention and control groups, using a random numbers table. The training sought to familiarize carers with an understanding of social learning theory, in terms of both how patterns of behaviour develop and how behaviour can be influenced using interventions derived from learning theory. The groups met in four, weekly, five-hour sessions. No statistically significant differences were found between the groups with regard to behaviour management skills, the frequency and/or severity of behavioural problems (CBCL), and placement stability in six month follow up.

  • Study quality: High
  • Applicability to Finnish population: Good

A randomized intervention trial «Dishion TJ, Brennan LM, Shaw DS ym. Prevention of ...»2 of Dishion et al (2014) examined the effects of yearly and tailored Family Check-Ups parent management training on parent report of problem behavior from age 2 to 5 years and teacher report of oppositional behavior at age 7.5 years.

Participants included 731 mother-child dyads, recruited between 2002 and 2003. Families were invited to participate if they had a child between age 2 years and 2 years 11 months, following a screen to ensure they met the study criteria by having socioeconomic, family, and/or child risk factors for future behavior problems. Of the families who initially participated 566 (77 %) participated in the 5.5-year follow-up when children were between 7 years 4 months and 8 years 5 months. For teacher ratings of child oppositional problems at age 7, only 314 reports were available.

The intervention had two phases. The first phase was the actual intervention, which was a brief, three-session intervention to guide and motivate support for specific family management practices. The second phase of the intervention model was a structured curriculum with 12 unique and self-contained modules that address three domains of the caregiving environment: positive behavior support, limit setting and monitoring, and relationship quality. Control intervention was not described.

The study found that the intervention has effect on parent report of oppositional-defiant behavior (effect size -0,46; p < 0,05), but no effect at all on the teacher report (effect size 0,00; p < 0,05).

  • Study quality: Low
  • Applicability to Finnish population: Good
  • Comment: Control intervention was not described and there was a significant loss of participating families during the study process.


  1. Macdonald G, Turner W. An Experiment In Helping Fostercarers Manage Challenging Behaviour. Br J Social Work 2005;35:1265-82
  2. Dishion TJ, Brennan LM, Shaw DS ym. Prevention of problem behavior through annual family check-ups in early childhood: intervention effects from home to early elementary school. J Abnorm Child Psychol 2014;42:343-54 «PMID: 24022677»PubMed