Integrating equifinality and multifinality into the of prevention programs in early childhood: The conceptual case for use of tiered models.

Introduced in the context of developmental psychopathology by Cicchetti and Rogosh in the Journal, the current paper incorporates the principles of equifinality and multifinality to support the use of tiered models to prevent the development of emerging child psychopathology and promote school readiness in early childhood. We use the principles of equifinality and multifinality to describe the limitations of applying one intervention model to address all children presenting with different types of risk for early problem behavior. We then describe the potential benefits of applying a tiered model for having impacts at the population level and two initial applications of this approach during early childhood. The first of these tiered models, Smart Beginnings, integrates the use of two evidenced-based preventive interventions, Video Interaction Project, a universal parenting program, and Family Check-Up, a selective parenting program. Building on the strengths of Smart Beginnings, the second trial, The Pittsburgh Study includes Video Interaction Project and Family Check-Up, and other more and less-intensive programs to address the spectrum of challenges facing parents of young children. Findings from these two projects are discussed with their implications for developing tiered models to support children's early development and mental health.

The long-term indirect effect of the early Family Check-Up intervention on adolescent internalizing and externalizing symptoms via inhibitory control.

This study examined the long-term effects of a randomized controlled trial of the Family Check-Up (FCU) intervention initiated at age 2 on inhibitory control in middle childhood and adolescent internalizing and externalizing problems. We hypothesized that the FCU would promote higher inhibitory control in middle childhood relative to the control group, which in turn would be associated with lower internalizing and externalizing symptomology at age 14. Participants were 731 families, with half (n = 367) of the families assigned to the FCU intervention. Using an intent-to-treat design, results indicate that the FCU intervention was indirectly associated with both lower internalizing and externalizing symptoms at age 14 via its effect on increased inhibitory control in middle childhood (i.e., ages 8.5-10.5). Findings highlight the potential for interventions initiated in toddlerhood to have long-term impacts on self-regulation processes, which can further reduce the risk for behavioral and emotional difficulties in adolescence.

Child Birth Order as a Moderator of Intervention Effectiveness for the Early Childhood Version of the Family Check-Up.

Child birth order (CBO) in the family has received little attention in the field of prevention science. CBO is relevant to early interventionists from a public health perspective, as the most widely disseminated home-visiting program has traditionally targeted mothers and their first-born children. The current paper revisits a previous publication by Shaw et al. (2009) on the effectiveness of the Family Check-Up (FCU) to evaluate CBO (firstborn vs. middle vs. youngest) as a moderator of treatment effects of the FCU in relation to improvements in parenting, maternal depressive symptoms, and child outcomes from ages 2 to 4 in a sample of low-income, ethnically diverse families (N = 709) with multiple children. Results suggest that the FCU elicited improvements in observed parenting from ages 2 to 3 primarily for target children who were the youngest or middle children, but not for firstborns. Findings are discussed in the context of implications for prevention science research, dissemination, and public policy.

Indirect effects of the early childhood Family Check-Up on adolescent suicide risk: The mediating role of inhibitory control.

This study investigates suicide risk in late childhood and early adolescence in relation to a family-centered intervention, the Family Check-Up, for problem behavior delivered in early childhood. At age 2, 731 low-income families receiving nutritional services from Women, Infants, and Children programs were randomized to the Family Check-Up intervention or to a control group. Trend-level main effects were observed on endorsement of suicide risk by parents or teachers from ages 7.5 to 14, with higher rates of suicide risk endorsement in youth in the control versus intervention condition. A significant indirect effect of intervention was also observed, with treatment-related improvements in inhibitory control across childhood predicting reductions in suicide-related risk both at age 10.5, assessed via diagnostic interviews with parents and youth, and at age 14, assessed via parent and teacher reports. Results add to the emerging body of work demonstrating long-term reductions in suicide risk related to family-focused preventive interventions, and highlight improvements in youth self-regulatory skills as an important mechanism of such reductions in risk.

Extracurricular involvement in the school-age period and adolescent problem behavior among low-income youth.

OBJECTIVE: The present study tested the protective role of youth's school-age extracurricular involvement and multiple informants' reports of adolescent internalizing and externalizing problems in a sample of youth from low-income households. METHOD: Participating youth (n = 635, 49% female, 49% White, 28% Black/African American, 14% biracial, 8% other race, 13% Hispanic/Latinx) were drawn from the Early Steps Multisite Study. At ages 7.5, 8.5, and 9.5, primary caregivers reported the number of extracurricular activities for which youth participated (Parent Aftercare Survey). At ages 14 and 16, measures of internalizing and externalizing problems were collected from primary and alternate caregivers (Child Behavior Checklist) and target youth (Child Depression Inventory-Short Form, Multidimensional Anxiety Scale for Children, and Self-Report of Delinquency). At age 16, target youth also contributed measures of risky sexual behaviors and substance use (Youth Risk Behavior Survey). Teachers contributed measures of youth's internalizing and externalizing problems at age 14 (Teacher Report Form). RESULTS: After accounting for the effects of multiple sociodemographic factors, initial levels of child problem behavior, and intervention group status, structural equation models revealed that school-age extracurricular involvement was inversely associated with latent factors representing adolescent externalizing, but not internalizing, problems at ages 14 (ß = -.13, p < .01) and 16 (ß = -.12, p = .02). CONCLUSIONS: The present study suggests that low-income, school-age children's involvement in extracurricular activities serves a protective function in relation to adolescent externalizing problems. Future studies should assess underlying mechanisms and expand the scope of adolescent outcomes to include prosocial functioning. (PsycInfo Database Record (c) 2021 APA, all rights reserved).