Family Check-Up ticks boxes at school

Trials of the Oregon's Child and Family Center [1] Family Check-Up (FCU) have been showing promising results in the US, particularly by curbing adolescent substance abuse and heightening parental involvement in young people's lives.

In their latest report to Prevention Science, Check-Up developers Elizabeth Stormshak and Tom Dishion describe an experiment among the families of 1,000 ethnically diverse early adolescents in a metropolitan area of the American North-West.

The premise, based on the ecological systems theory of Urie Bronfenbrenner, was simple and is well-established: “that children's experiences in one relationship context can affect development across settings”. So it was reasonable to expect that fruitful use of Family Check-up would have some impact on school performance.

Indeed it was puzzling, as Stormshak and Dishion explain, that so few programs tackling family management skills should have succeeded in demonstrating academic benefits.

They suggest it may often be too difficult to track school-related outcomes, since most intervention research depends on short-term funding. School data were always difficult and expensive to collect, and family-centered programs often too narrowly focused.

The Oregon team have a highly formulated technique for dealing with such hindrances. In each of the three participating schools they set up a "family resource center" providing some general services and a point of contact for preliminary interviews for the randomized controlled trial.

Community trials often struggle to overcome the social divisions that make families most in need the hardest to reach. In this case, teachers identified students they considered to be most "at risk" during the stressful transition between middle school and high school, and their parents were guided through a sequence of motivational interviews.

The result was that those who came to be most closely involved tended to be coping with a number of difficulties, such as single parenting and worse than average family conflict.

Changing schools was the focus of the comparison because it puts such demands on young people – a requirement for greater self regulation and autonomy, the onset of puberty and stronger peer group influences all coinciding.

Stormshak and Dishion argue that the inbuilt economy of the Check-Up – short sessions and sometimes not many of them – helped to keep dropout rates down (around 80% stayed on board) because it did not intrude sufficiently to conflict with childcare or work schedules.

The sample of around 1,000 adolescents and their families was distributed evenly between the Check-Up routine and a control group. Biological fathers, whose absence or presence turned out to be an important moderating factor, were part of just under 60% of the households. Across a wide ethnic range, 42% of the sample were Caucasian and 29% African American.

Based on measures including teacher report of sixth grade risk behavior, substance use, antisocial behavior, deviant peer involvement and family conflict, the researchers found that over time the activity had a positive impact on academic achievement and school attendance.

On both fronts, among members of the high-risk control group there was a marked decline.

Stormshak and Dishion conclude that an infusion of family centered approaches may turn out to be the most effective way to reduce problem behavior and increase school engagement.

Next on the research agenda, they say, should be studies paying closer attention to the role of family configuration in the treatment engagement process. The "family conflict" variable was too broad and was limited by having used only self-report as a measure.

They suggest that their findings are nevertheless relevant for policy decisions about the potential viability of delivering mental health services in the public school context, especially if they are family centered, brief, and focused on empowering parents to promote academic success,

• For more about Tom Dishion’s work at the Oregon Child and Family Center Family Check-up, see Bringing prevention services home to the family [2], Listening Before Doing! A commentary on the Bennett Lecture [3] and Putting brain science back on the streets of Los Angeles [4]

• For an alternative, southern hemisphere perspective on the relationship between young people’s behavior and context, see also: Wherever they're bad – it's bad [5]

See: Stormshak E A, Connell A and Dishion T J, “An Adaptive Approach to Family-Centered Intervention in Schools: Linking intervention engagement to academic outcomes in middle and high school,” Prevention Science (2009) 10:221–235
DOI 10.1007/s11121-009-0131-3