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Interventions Supporting Mental Health and Positive Behavior in Children Ages Birth-5 Yr: A Systematic Review
Karrie Kingsley1, Grace Sagester2, Lindy L Weaver3
1Karrie Kingsley, OTD, OTR/L, is Associate Professor, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles.
Insights
Occupational therapy interventions like touch-based methods and parent-child interaction therapy (PCIT) show promise for improving young children's mental health and behavior. Parent training also supports positive outcomes for families.
Area of Science:
- Occupational therapy
- Child psychology
- Developmental pediatrics
Background:
- Addressing mental health and behavioral challenges in early childhood is crucial for occupational performance.
- Evidence-based interventions are needed to support young children (0-5 years) and their families.
Purpose of the Study:
- To identify occupational therapy interventions for improving mental health and behavior in children aged 0-5.
- To synthesize evidence on interventions for children and their families.
Main Methods:
- Systematic review of literature from 2010-2017 using multiple databases (PsycINFO, Cochrane, ERIC, MEDLINE, OTseeker).
- Adherence to PRISMA guidelines, with risk of bias assessment using AMSTAR or Cochrane method.
- Critical appraisal of 46 included articles.
Main Results:
- Forty-six articles yielded three intervention themes: touch-based (9), parent-child interaction therapy (PCIT; 4), and instruction-based (33).
- Touch-based interventions, PCIT, and parent training demonstrated statistically significant positive findings.
- Evidence supports touch-based interventions for infant self-regulation and social behavior, PCIT for child behavior, and parent training for parent and maternal-infant attachment outcomes.
Conclusions:
- Touch-based interventions show strong evidence for infant self-regulation and moderate evidence for social behavior and attachment.
- Parent-child interaction therapy (PCIT) has moderate evidence for improving child behavior.
- Parent training demonstrates strong evidence for maternal-infant attachment and moderate evidence for parent mental health and behavior.
Importance:
It is critical for providers to use evidence-based interventions to address mental health and behavioral barriers to occupational performance during early childhood.
Objective:
To identify evidence-based interventions within the scope of occupational therapy practice to improve mental health and positive behavior for children ages 0-5 yr and their families.
Data Sources:
PsycINFO, Cochrane, ERIC, MEDLINE, and OTseeker databases were searched for publications from 2010 through March 2017.
Study Selection And Data Collection:
This review was completed in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Risk of bias was assessed for each article using either A Measurement Tool to Assess Systematic Reviews (AMSTAR) or the Cochrane method. Articles meeting inclusion criteria were critically appraised.
Findings:
Forty-six articles met inclusion criteria and were organized into three themes: touch-based interventions (n = 9), parent-child interaction therapy (PCIT; n = 4), and instruction-based interventions (n = 33). Statistically significant findings and overall risk of bias supported the use of touch-based interventions, PCIT, and parent training.
Conclusions And Relevance:
The evidence indicates that touch-based interventions can improve infant self-regulation (strong), social behavior, and attachment (moderate) and reduce maternal stress, anxiety, and depression (low). Moderate-strength evidence supports PCIT to improve child behavior. The evidence indicates that parent training can improve parent behavior, maternal-infant attachment (strong), and parent mental health (moderate). Teacher training can improve mental health and behavior (moderate). Group-based parent training and sleep training have insufficient support (low).
What This Article Adds:
Occupational therapy professionals working with children younger than age 5 yr can use the results of this systematic review to guide clinical decision making related to mental health and behavioral outcomes.
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