Family Check-Up
Category
Family Support
Child's Age
2-3 years, 3-4 years, 4-5 years
Participant
Children, Parents/Guardian
Languages
English, Spanish
Brief Description
The Family Check-Up (FCU) model is a brief, family-centered & strengths-based approach to mindful parenting. It combines empirically-validated assessment with motivational interviewing to engage families in identifying strengths and areas for improvement in parenting. It also provides parents with simple, practical parenting strategies to promote positive child development. Improvement in parenting skills and family relationships leads to reductions in child behavioral and mental health problems over time.
Expected Impact
- General decrease in problem behaviors (both destructive and oppositional behaviors)
- General increase in positive parenting practices
- Better outcomes with more engagement
- Increased use of positive parenting practices
- Strengthened parent-child relationships
- Reduced family conflict
- Reduced parent depression
- Improved school readiness
- Reduced child problem behaviors
- Improved child emotional regulation
- Improved academic achievement
- Improved school attendance
Core Components for Model Fidelity
- FCU Providers: Providers are evaluated on model fidelity, competence and regularly certified.
- Phase 1- Assessment and Feedback: 60-minute interview. Child and family assessment that includes videotaped observations, questionnaires, and data from the parent, child, and teacher. 60-minute assessment feedback session with goal setting.
- Phase 2- Parent Management Training via Everyday Parenting: Individual sessions regarding positive behavior support strategies, how to set limits/monitoring skills, parent-child relationship building skills. Utilizing a selection of up to 12 parent training modules. The average family completes 4 sessions but may complete as many sessions as necessary.
Languages Materials are Available in
English, Spanish
Delivery Mode
In-person at participant’s home, early childhood education classroom, or medical office or virtually.
Dosage
Phase 1: Three 60-minute sessions; one every 1-2 weeks.
Phase 2: 1-hour long session every 2 weeks up to 12 sessions (intensity varies).
Infrastructure for Implementation
Materials: Devices with the following HIPPA-compliant capabilities: video recording, storage, and review; internet access; potential to be used for caregivers' completion of on-line assessments. A computer/tablet can be useful for reducing time spent completing and scoring the PARYC assessment. Copies of EDP manual for each staff person: Everyday Parenting: A Professional’s Guide to Building Family Management Skills. Toys to be used for family interaction tasks. Space in which staff can meet with families privately (in the family's home, in an office, or via a virtual platform). Northwest Prevention Science provides training, consulting services, and a digital delivery platform to assist with implementation.
Staffing Requirements
Certified Supervisor: Master’s degree with clinical experience and experience in Motivational Interviewing and parent skills training.
Trained provider: Bachelor's degree with relevant experience, including experience or training in Motivational Interviewing. Master's degrees are preferred.
FTEs, caseloads, staff ratios, and recommended salaries are tailored to each agency/site implementing FCU.
NCPC strongly recommends staff receive training in the Standards of Quality for Family Support and Strengthening. Contact Prevent Child Abuse North Carolina | PCANC (preventchildabusenc.org) or National Family Support Network for more information, training and certification.
Training for Model Fidelity
There are multiple levels of training that entail different roles and abilities in the FCU model. For more information, visit Family Check-Up Training. Levels 1-3 are eligible for Smart Start funding.
Level 1- Knowledge Base Training E-Learning Course:
- Virtual, asynchronous e-learning modules general introduction
- E-learning consists of two courses, one for the FCU component (15 hours) and one for the Everyday Parenting component (15 hours)
- NOTE: Level 1 training by itself is not sufficient for implementing the FCU model.
Level 2- Implementation Training and Support:
- Approximately 15 hours
- Interactive webinar sessions for small groups, individualized or small group consultations
- Access to the FCU Portal (includes assessment tools, handouts, example videos, and more)
Level 3- Sustainability Training and Support:
- Any site implementing FCU must train a Certified Supervisor/Trainer. Supervisors/Trainers are qualified to train and supervise new providers.
- Approximately 20-25 hours
- Certification is associated with the individual, not the implementation site, and remains valid if the Supervisor/Trainer changes their place of employment.
- NOTE: Level 2 training is not sufficient to sustain model fidelity over time.
- Supervisor/Trainers must be recertified within 2 years of the last date of Certification.
Certification of a Supervisor/Trainer is not mandatory. However, it is highly recommended for model fidelity maintenance that at least two staff achieve Certification. If 3rd party verification is required or expected, the purveyor would require the implementation site to maintain Certification in good standing of at least one staff. Northwest Science will work with the implementation sites to identify the best candidates for Certification.
Contact Information
https://www.nwpreventionscience.org/
Lisa Reiter: Clinical Director; 843-819-7057, lisa@nwpreventionscience.org
Cost Estimates
Typical implementation costs are $30,000-$50,000 per agency for start-up during the first year, including Certification of two Supervisor/Trainers and all necessary materials and training. Typical implementation costs in subsequent years are approximately $7,000 per year per agency, including recertification of two Supervisor-Trainers. Costs vary depending on the number of staff implementing the FCU model.
Purpose Service Code (PSC)
5505 – Parent Education
Program Identifier (PID)
Family Check-Up
Minimal Outputs for NCPC Reporting
FY 23-24:
- Number of children participating
- Number of parents/guardians participating†
FY 24-25:
- Number of children participating
- Number of parents/guardians participating†
†Select Family Support Programs data collection will include basic demographic data for parent/guardian participants including Race, Ethnicity. Data on interpretation and transportation will be collected when appropriate.
Minimal Outcomes for NCPC Reporting
FY 23-24:
- Increase in positive parenting practices
FY 24-25:
- Increase in positive parenting practices
Minimal Measures for NCPC Reporting
FY 23-24:
- Family Check-Up Parent Assessment
FY 24-25:
- Family Check-Up Parent Assessment
NCPC Evidence Categorization
Evidence Based- 2 randomized control trials and 1 additional study using the same data set as one of the randomized control trials.
Research Summary
Three of the most relevant studies on FCU include two separate randomized controlled studies and an additional study based on one of the RCT’s data sets. Outcomes of Shaw et al. (2006)1 showed that at age 3 FCU children showed a significant decrease in destructive behavior (moderate significance, still evident at age 4). Mothers in FCU saw an increase in maternal involvement from age 2 to 3 (stable at age 4) compared to control mothers. FCU was also significantly effective for reducing destructive behaviors in children that originally scored higher on inhibition scales and had mothers with depression. In Dishion et al. (2008),2 problem behavior grew significantly more in control group and significant improvements in positive behavior support from caregivers were found. Results depicted a significant model showing that the Family Check-Up intervention led to more positive parenting behaviors, which led to less growth in behavior issues. In 2014, Dishion et al.3 continued the research using this data set and found that parents reported a significant decrease in child oppositional-defiant behaviors between ages 2 and 5 for the intervention group. Greater engagement increased the effects of FCU as well. Results support that parenting support in early childhood may have long-term positive effects on children’s behaviors.
- ^ See Shaw et al. (2006). Completed as a randomized controlled trial where FCU was offered as a home-based family intervention. Population included 120 mothers and sons (between 17 and 27 months old) recruited through WIC in a metropolitan area with socioeconomic, family, and/or child risk factors for problem behaviors in the future. Data was collected via a demographics questionnaire, the Beck Depression Inventory, coded observations for child inhibition, Child Behavior Check List, and the Home Observation for Measurement of the Environment. Population limited to urban male children that were generally Caucasian or African American.
- ^ See Dishion et al. (2008). Completed as a randomized controlled trial that was conducted through home visitation. The study population was recruited in metropolitan areas and recruited through WIC. Participants included 731 mothers with 2-year-old children with socioeconomic, family, and/or child risk factors for problem behaviors in the future. Data was collected through a demographics questionnaire, the Center for Epidemiological Studies on Depression Scale, and the Child Behavior Checklist. Results showed small to moderate effect sizes but authors believe that they are significant and practical.
- ^ See Dishion et al. (2014). This study continued to analyze data collected from Dishion et al. (2008) and as such has the same methodology and population. Data was collected using parent reports of child problem behaviors for ages 2-5 and teacher reports of behaviors at 7.5 years of age, a demographic questionnaire, the Center for Epidemiological Studies on Depression Scale, Adult Substance Use (short version), Adult-Child Relationship Scale adapted from Student-Teacher Relationship Scale, Confusion, Hubbub, and Order Scale, Me and My Neighbor Questionnaire (exposure to violence factor), and videotaped interactions coded using the Relationship Process Code.
Researched Population
- Families with children ages 17 months to 5 years and identified as having socioeconomic, family, and/or child risk factors for future problem behaviors
Clearinghouse and Compendium References
California Evidence Based Clearinghouse- rated “1 - Well Supported by Evidence”
Blueprints Programs- rated “Certified Promising Program”
Title IV-E Prevention Services Clearinghouse- rated “Well Supported”
Dishion, T. J., Brennan, L. M., McEachern, A., Shaw, D. S., Wilson, M. N., & Weaver, C. M. (2014). Prevention of problem behavior through annual Family Check-Ups in early childhood: Intervention effects from the home to the beginning of elementary school. Journal of Abnormal Child Psychology, 42(3), 343-354. https://www.doi.org/10.1007/s10802-013-9768-2
Dishion, T. J., Connell, A., Weaver, C., Shaw, D., Gardner, F., & Wilson, M. (2008). The Family Check-Up with high-risk indigent families: Preventing problem behavior by increasing parents’ positive behavior support in early childhood. Child Development, 79(5), 1395-1414. https://www.doi.org/10.1111/j.1467-8624.2008.01195.x
Shaw, D. S., Dishion, T. J., Supplee, L., Gardner, F., & Arnds, K. (2006). Randomized trial of a family-centered approach to the prevention of early conduct problems: 2-year effects of the Family Check-Up in early childhood. Journal of Consulting and Clinical Psychology, 74(1), 1-9. https://www.doi.org/10.1037/0022-006X.74.1.1
Local Partnerships Currently Implementing
Local Partnerships in purple have adopted Family Check-Up. Local Partnership contact information can be found here.