© 2013 American Psychological Association 0022-0663/13/$12.00 DOI: 10.1037/a0032096

Joumal of Educational Psychology 2013. Vol. 105. No. 3. 762.-773

Indirect Effects of the Family Check-Up on School-Age Academic Achievement Through Improvements in Parenting in Early Childhood Frances Gardner

Lauretta M. Brennan, Elizabeth C. Shelleby, and Daniel S. Shaw

University of Oxford

University of Pittsburgh

Thomas J. Dishion

Melvin Wilson

Arizona State University

University of Virginia

This project examined the hypothesis that the impact of the Family Check-Up on parent use of positive behavior support would indirectly improve academic achievement scores at school age. The study included a sample of 731 high-risk families recruited from Women, Infant, and Children Supplemental Nutrition Program settings in 3 geographically distinct areas. The results demonstrated that changes in positive parenting between the child ages of 2 and 3 were associated with higher scores on children's school-age academic achievement, as measured by the Woodcock-Johnson III (W-J) Academic Skills composite. Moreover, stmctural equation modeling revealed that random assignment to the intervention was associated with higher levels of children's academic achievement at age 5 and age 7.5 indirectly, through greater increases in parents' use of positive behavior support in intervention families than in control families. Results are discussed with respect to the potential of a brief parenting intervention for improving parenting practices that promote academic achievement up to 5 years later. The results have promising implications for efforts to promote child adaptation in the school environment. Keywords: parenting, prevention, intervention, academic achievement, risk factors

& Hayduk, 1988) and lower levels of antisocial behavior (Màguin & Loeber, 1996; Moiknen & Shaw, 2010). Furthermore, higher levels of academic achievement in elementary school predict positive outcomes in adulthood such as low levels of drug use (Fothergill et al., 2008) and emotional problems (Masten et al., 2005), as well as high occupational status (Dubow, Huesmann, Boxer, Pulkkinen, & Kokko, 2006). Research has demonstrated that child characteristics at school entry (i.e., between 4 and 6 years of age) such as cognitive ability and regulatory behaviors, are important determinants of early success in the academic setting (Bierman, Torres, Domitrovich, Welsh, & Gest, 2009; Howse, Calkins, Anastopoulos, Keane, & Shelton, 2003). For example, a growing body of literature has shown that the academic skills children demonstrate at school entry are robust predictors of academic achievement into middle school (Duncan et al., 2007). It is likely that children who are lacking in these requisite skills at school entry would be more likely to struggle in acquiring academic skills and to subsequently fall behind on foundational material. Thus, research aiming to understand mechanisms related to increased academic success would logically look to early childhood factors that could promote school readiness.

Academic achievement during the school-age period is a crucial stepping-stone toward success in our society. Higher academic performance in second- through fourth-graders has been concurrently linked with numerous positive features during the same age period, ranging from increased levels of self-efflcacy (Bandura, 1997; Helmke & van Aken, 1995) and peer acceptance (Green, Forehand, Beck, & Vosk, 1980) to fewer behavior problems (Hinshaw, 1992). Theoretically, children who are successful in the academic setting are reinforced for their efforts with positive attention and feedback and, therefore, are more likely to seek out and continue engaging positively within their academic and social environments. Longitudinal research supports this notion, linking flrst- through third-grade academic achievement to positive academic and social outcomes in adolescence including continued academic success (Alexander, Entwisle, & Horsey, 1997; Entwisle

This article was published Online First March 18, 2013. Lauretta M. Brennan, Elizabeth C. Shelleby, and Daniel S. Shaw, Department of Psychology, University of Pittsburgh; Frances Gardner, Department of Social Policy and Intervention, University of Oxford, Oxford, England; Thomas J. Dishion, Department of Psychology, Arizona State University; Melvin Wilson, Department of Psychology, University of Virginia. Correspondence conceming this article should be addressed to Lauretta M. Brennan, Department of Psychology, University of Pittsburgh, 210 South Bouquet Street, 4427 Sennott Square, Pittsburgh, PA 15260. E-mail: [email protected]

Contextual and proxumal factors in early childhood (i.e., from birth to age 5) have been shown to be vital in the development of both cognitive and regulatory skills (Campbell & von Stauffenberg, 2008; Ladd, 1989; Lemelin et al., 2007). For example, family income and socioeconomic status (Brooks-Gunn & Duncan, 1997; Evans, 2004), neighborhood quality (Leventhal & Brooks-Gunn, 762

INTERVENTION, PARENTING, AND ACADEMIC ACHIEVEMENT 2000), enrollment in childcare (Votruba-Drzal, Coley, & ChaseLansdale, 2004), and aspects of parenting (Campbell & von Stauffenberg, 2008; Lunkenheimer et al., 2008) during early childhood have each been shown to be positively related to early language development, academic skills, and school readiness. Moreover, parenting has been shown to be one of the most robust early childhood predictors of school readiness (Brooks-Gunn, Rouse, & McLanahan, 2007) and to be a mechanism through which many contextual factors (e.g., socioeconomic strain) infiuence child development (Raver, Gershoff, & Aber, 2007).

Parenting and Academic Achievement Parenting quality during early childhood, in particular, has been a focus of attention for basic and prevention science because of its strong theoretical and empirical ties to current and later adaptive child functioning. Theoretically, parenting practices during the early childhood period, when child regulatory strategies and problem-solving approaches are being established (Cole, Michel, & Teti, 1994; Kochanska, Coy, & Murray, 2001), have been found to be critical in setting up the cognitive and behavioral foundations with which children enter school. Researchers have suggested that early regulatory abilities develop from contingent processes in early childhood and become more independently directed later (Calkins, 1994; Cole et al., 1994; Kopp, 1989), making proximal extrinsic factors such as parenting especially important to consider during very early development. As Englund, Luckner, Whaley, and Egeland (2004) note, early experiences, such as scaffolding, may play an important role in facilitating the development of child problem-solving techniques and provide them with resources to draw from in later independent leaming situations. In hne with theory positing a crucial role of parenting during early childhood for later academic achievement, empirical evidence suggests there are numerous pathways through which early parenting has the potential to influence achievement, including cognitive stimulation (Brooks-Gunn & Duncan, 1997; Hart & Risley, 1995), transmission of beliefs and attitudes toward school (Pomerantz, Grolnick, & Price, 2005; Taylor, Clayton, & Rowley, 2004), investment of valuable resources such as time and money (Conger & Dogan, 2007), modeling and scaffolding of effective regulatory and problem-solving approaches (Englund et al., 2004; Putnam, Spritz, & Stifter, 2002), and the use of positive reinforcement and warmth to promote self-efficacy and autonomy (Fulton & Tumer, 2008; Ryan, Martin, & Brooks-Gunn, 2006). Work fi-om the field of educational psychology has emphasized the specific importance of positive parenting bebaviors such as warmth, praise, responsivity, scaffolding, and involvement for child academic development (e.g.. Homer, Sugai, & Anderson, 2010; Sugai & Homer, 2009). This literature uses the term positive behavior support (PBS) to refer to responsive strategies that would be expected to promote development and competence in the academic setting (Carr et al., 2002). Examples of strategies that would be expected to provide an optimal context for leaming are the provision of clear expectations for child behavior, proactive structuring of the environment to prevent problematic situations and promote positive behavior, the use of positive reinforcement, and interactively engaging with children (Lunkenheimer et al., 2008). Children whose parents use PBS techniques might be better equipped to understand adult expectations, behave appropriately in

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a structured environment, and respond to positive reinforcement for adaptive behavior. Thus, it would be expected that parents who demonstrate PBS behaviors with their children during early childhood would better prepare their children to perform successfully in the school context. Consistent with this expectation, longitudinal work has shown that dimensions of positive behavior support such as proactive structuring and engagement (Englund et al., 2004; Supplee, Shaw, Hailstones, & Hartman, 2004), as well as positivity (NICHD Early Child Care Research Network, 2005) during the toddler-age and pre-school period, are linked with higher levels of academic achievement at fn-st and third grade. However, relatively few studies have directly examined global constructs of positive parenting during early childhood in relation to academic achievement at elementary school, much less in the context of an experimental design. Studies demonstrating links between PBS practices in early childhood and later academic achievement would likely have important implications for poUcy, prevention, and intervention work. In prior work with the current sample, it was demonstrated that improvements in positive behavior support from ages 2 to 3 were associated with higher levels of child self-regulation and language skills at age 4, two important components of school readiness (Lunkenheimer et al., 2008). Thus, taking into account theoretical and empirical Unks between PBS and pre-school academic development, in combination with the finding that increases in PBS during early childhood were associated with improved school readiness, it would be expected that increases in PBS from ages 2 to 3 would also be hnked to higher levels of academic achievement at formal school entry and during the early school-age period, at ages 5 and 7.5, respectively.

Parenting Intervention, Positive Behavior Support, and Academic Achievement Based on the critical role of early parenting for later child outcomes, including academic achievement, numerous prevention and intervention programs (e.g.. Incredible Years, Family CheckUp, Nurse-Family Partnership) have attempted to improve parenting skills as a mechanism to promote children's success (Kazdin, 1985; Olds et al., 2004; Persampieri, Gortmaker, Daly, Sheridan, & McCurdy, 2006; Sanders, Tumer, & Markie-Dadds, 2002; Shaw, Dishion, Supplée, Gardner, & Amds, 2006; WebsterStratton, Reid, & Stoolmiller, 2008). Such projects have been successful at increasing positive parenting (Gardner, Burton, & Klimes, 2006; Gardner, Shaw, Dishion, Burton, & Supplée, 2007) and decreasing negative parenting practices (Dishion, Patterson, & Kavanagh, 1992), as well as at improving child problem behavior through changes in parenting (Dishion et al., 2008; WebsterStratton, 1998). For example, Beauchaine, Webster-Stratton, and Reid (2005) found that improvements in critical, harsh, and ineffective parenting behaviors mediated their intervention effect on child disruptive behavior. Moreover, in the current sample, random assignment to a brief, parenting-focused intervention that uses aspects of parent management training and motivational interviewing techniques, the Family Check-Up (FCU), predicted primary caregivers' greater use of PBS and reduced growth in child conduct problems from ages 2 to 4 (Dishion et al., 2008). However, there is a dearth of literature examining whether parenting inter-

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ventions initiated during early childhood aimed at reducing child conduct problems have a collateral benefit on academic performance at school entry and the early elementary school period (Bierman, Nix, & Makin-Byrd, 2008). Thus, the primary goal of the current study was to examine whether increases in PBS associated with the FCU would also benefit children's later academic achievement. In addition, much of the academic intervention literature focuses on comprehensive school-based interventions carried out over multiple years (e.g.. Fast Track, Head Start Research-Based Developmental Informed [REDI], Abecedarian Project). Such programs have been successful at producing improvements in child academic achievement and conduct problems at preschool age (Bierman, Domitrovich, et al., 2008; Conduct Problems Prevention Research Group, 2007) and school age (Luiselli, Putnam, Handler, & Feinberg, 2005), as well as during adolescence (Muscott, Mann, & LeBrun, 2008). Although the comprehensive nature of these interventions may be ideal, they are also expensive and timeintensive; therefore, it would be theoretically and practically important if a brief, parent-focused intervention already shown to reduce preschool-age conduct problems was also associated with increased academic achievement at school age.

Method Participants Participants included 731 children and primary caregivers recruited between 2002 and 2003 from Women, Infants, and Children Nutrition Programs (WIC) in the metropolitan areas of Pittsburgh, PA, and Eugene, OR, and in and outside the town of Charlottesville, VA. Primary caregivers were contacted at WIC sites and invited to participate if they had a son or daughter between age 2 years 0 months and 2 years 11 months, following a screen to ensure that they met the study criteria by having socioeconomic, family, and/or child risk factors for future behavior problems (Dishion et al., 2008). Recruitment risk criteria were defined as one standard deviation above normative averages on screening measures in at least two of the following three domains: (a) child behavior problems (conduct problems—Eyberg Child Behavior Inventory; Robinson, Eyberg, & Ross, 1980; or highconfiict relationships with adults—Adult Child Relationship Scale; adapted from Pianta, 1995), (b) primary caregiver problems (matemal depression—Center for Epidemiological Studies on Depression Scale; Radloff, 1977; or daily parenting challenges—Parenting Daily Hassles; Cmic & Greenberg, 1990; or self-report of substance or mental health diagnosis, or adolescent parent at birth of first child), and (c) sociodemographic risk (low education achievement—less than or equal to a mean of 2 years of post-highschool education between parents and low family income using WIC criterion; Trentacosta et al., 2008). In the case of children not qualifying on the criterion of child conduct problems, all participants were required to have at least above-average scores to increase parent motivation to reduce child problem behavior. Of the 1,666 primary caregivers who had children in the appropriate age range and who were contacted at WIC sites across the three study sites, 879 met the eligibility requirements (52% in Pittsburgh, 57% in Eugene, and 49% in Charlottesville), and 731 (83.2%) agreed to participate (88% in Pittsburgh, 84% in Eugene,

and 76% in Charlottesville). The children in the sample had a mean age of 29.9 months (SD = 3.2) at the time of the age 2 assessment. Of the 731 (49% female), 272 (37%) were recruited in Pittsburgh, 271 (37%) were recruited in Eugene, and 188 (26%) were recruited in Charlottesville. Across sites, primary caregivers self-identified as belonging to the following ethnic groups at the study outset: 28% African American, 50% European American, 13% biracial, and 9% other groups (e.g., American Indian, Native Hawaiian). Thirteen percent of the sample reported being Hispanic American. During the 2002-2003 screening period, more than two thirds of those families enrolled in the project had an annual income of less than $20,000, and the average number of fatnily members per household was 4.5 (SD = L63). Forty-one percent of the sample had a high school diploma or general education diploma (GED), and an additional 32% had 1 to 2 years of post-high school training. Of the 731 primary caregiver-child dyads who initially participated, 659 (90%) were available at the age-3 follow-up, 619 (85%) participated at the age-4 follow-up, 621 (85%) participated at the age-5 follow-up, and 578 (79%) participated at the age 7.5 followup. Selective attrition analyses comparing age-2 study variables for participants retained versus attrited at ages 3, 4, 5, and 7.5 have revealed no significant differences with respect to project site, children's race, ethnicity, income, or gender, children's conduct problems, or intervention status. However, primary caregivers who participated at age 7.5 reported having a higher education level at age 2 than primary caregivers who dropped out of the study; this differential attrition was only evident in the control group. Thus, the ensuing analyses included an age 2 primary caregiver education by intervention group interaction term to account for possible group differences in the results that were due to selective attrition effects.

Procedure At child ages 2, 3, 4, 5, and 7.5, the target child (TC), primary caregiver (PC), and when available, the altemate caregiver (AC) participated in annual 2-3 hr assessments at the family's home. These assessments consisted of a battery of self-report measures, observational interaction tasks and a child testing session. This study used a subset of the collected data, which are described below. Families who participated in the ages 2, 3, 4, 5, and 7.5 assessments were reimbursed $100, $120, $140, $160, and $180, respectively. Assessment protocol. Age 2 assessments began by having an adult stranger (i.e., undergraduate videographer) approach the child, introduce him/her to an assortment of age-appropriate toys, and then allow him/her to play for 15 min while the primary caregivers completed questionnaires. After the free play (15 min), each primary caregiver and child participated in a cleanup task (5 min), followed by a delay of gratification task (5 rtiin), four teaching tasks (3 min each, with the last task being completed by altemate caregiver and child), a second free play (4 min), a second cleanup task (4 min), the presentation of two inhibition-inducing toys (2 min each), and a meal preparation and lunch task (20 min). Similar procedures were used to assess child behavior and parentchild interaction at ages 3, 4, and 5, with minor modifications made to adjust for the developmental status of the child (e.g., wait task lasting 5 vs. 3 min at age 5). Although the age 7.5 assessments

INTERVENTION, PARENTING, AND ACADEMIC ACHIEVEMENT also included similar parent-child interactive tasks, only data from the Woodcock-Johnson test were used in the current study, which was administered at the end of the assessment. Intervention protocol: The Family Check-Up (FCU). The FCU is a brief, typically three-session, intervention based on motivational interviewing techniques (also see Dishion et al., 2008; Gill, Hyde, Shaw, Dishion, & Wilson, 2008). The FCU model differs from traditional clinical models and practice in three important ways: It (a) utilizes a health maintenance model, (b) derives much of its power from a comprehensive assessment, and (c) emphasizes motivating change. In contrast to the standard clinical model, the health maintenance approach of the FCU explicitly promotes periodic contact with families (yearly at a minimum). Whereas traditional clinical models are activated in response to clinical pathology, the health maintenance model involves regular periodic contact between client and provider to proactively prevent problems (analogous to the use of semiannual cleanings in dentistry). Another key difference from traditional clinical practice is the FCU's explicit focus on providing a comprehensive assessment of child and family functioning. Assessment results are shared with caregivers in feedback sessions to enhance motivation for change (Miller & RoUnick, 2002). The ecological assessment covers a range of domains including the family context and climate, the child's behavior and emotional adjustment, and parenting practices. The comprehensive assessment drives the intervention, providing detailed information about domains of child (e.g., negative emotionality, behavior problems), family (e.g., parental depression, marital quality), and community-level (e.g., neighborhood dangerousness) risk factors that past research has shown to be related to the development of maladaptive outcomes (e.g., conduct problems). The FCU is also ecological in its emphasis on improving children's adjustment across settings by motivating positive parenting practices and involvement in those settings. Moreover, the comprehensive assessment allows tailoring and adaptation, in that the intervention is fit to the family's circumstances and their desires for more, less, or different forms of intervention. The FCU is the initial phase of a general parenting intervention strategy referred to as the ecological approach to family intervention and treatment (EcoHT) described in detail by Dishion and Stormshak (2007). The EcoFIT utilizes two main components to facilitate change: motivational interviewing and direct training in family management practices using a stmctured curriculum (Dishion, Stormshak, & Kavanagh, 2011). The motivational interviewing component is based on Miller and RoUnick's (2002) work using the Drinker's Check-Up. In working with families of young children, the FCU feedback session is designed to elicit motivation for the parent(s) to change problematic behavior in their child, which is often achieved by modifying parenting behavior (Forgatch, Patterson, & DeGarmo, 2005) or aspects of the caregiving context that compromise parenting quality. The FCU model integrates motivational interviewing into a general framework for supporting caregivers to evaluate strengths and weaknesses in parenting practices, and to motivate change in those that need attention. The EcoHT is an adaptive and tailored intervention in that services are provided that fit the family's assessment and level of motivation to change. Following the FCU, the parent consultant may provide referrals for help with problems outside of parenting

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(e.g., language development) or work with caregivers themselves on these issues depending on expertise (e.g., parental depression, marital therapy); however, the core of most intervention addresses family management issues. Family management includes a collective set of parenting skills within three broad domains: Positive Behavior Support, Monitoring and Limit Setting, and Relationship Quality, which have been empirically established as critical to the development of problem behavior in childhood and adolescence (Patterson, Reid, & Dishion, 1992). The Everyday Parenting curriculum is used (Dishion et al., 2011), based on a well-established social leaming parent management training intervention which has shown positive effects on both parenting practices and child behavior (e.g., Dishion & Andrews, 1995; Forgatch & Patterson, 2010). Everyday Parenting focuses on four main skill sets for the parents of young children: limit setting, proactive parenting, positive reinforcement, and relationship building. Using Everyday Parenting typically involves providing parents with a rationale to stimulate interest, careful explanation of new skills, and in-session practice using role plays and in vivo practice with the child. Based on the FCU, sessions within the Everyday Parenting intervention are applied to specific domains of parenting highlighted as needing attention in the assessment. The FCU in the early steps multisite study. Following the initial assessment at age 2, primary caregivers and the target child were randomly assigned to the intervention condition (n = 367, 50.2%). Primary caregivers assigned to the FCU were scheduled to meet with a parent consultant for two or more sessions, depending on the family's preference. Primary caregivers could also identify an altemate caregiver that helps care for the target child to participate in both the assessment and the FCU. The three meetings in which the primary caregiver and/or altemate caregiver were typically involved include an assessment meeting, an initial contact meeting, and a feedback session (Dishion & Kavanagh, 2003). For research purposes, the sequence of contacts at age 2 was assessment, randomization, initial interview, and feedback session, with the option for follow-up treatment sessions. Families assigned to the FCU received a $25 gift certificate for completing the feedback session. After the first meeting (the assessment described above), the second visit called the "get to know you" (GTKY) meeting consisted of the parent consultant meeting with the caregiver(s) and discussing their concems, with a focus on current family issues that were most critical to their child's and family's functioning. For the third meeting, the feedback session, parent consultants utilized motivational interviewing to summarize the results of the assessment and highlight areas of strength and areas in need of attention. The caregiver was given the choice to participate in additional follow-up sessions that were focused on parenting practices as well as other family management and contextual issues (e.g., co-parenting, child care resources, or housing). Parent consultants were also able to recommend community service organizations that may be of assistance to the family. Caregivers in the intervention group received the FCU after each year's assessment at child ages 2, 3, 4, and 5. Rates of participation varied, with 276 (75.0%) completing at least the 1-1.5 hr feedback session at age 2, 242 caregivers (65.9%) completing at least a feedback at age 3, 231 (62.9%) at age 4, and 202 (55.0%) at age 5. In addition, caregivers completed an average of 3.12 (SD = 4.56) post-

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feedback treatment sessions at age 2, 2.64 {SD = 4.54) sessions at age 3, 2.78 (SD = 5.17) sessions at age 4, and 3.58 {SD = 8.24) sessions at age 5. Analyses of intervention participation by demographic characteristics at each assessment wave revealed no differences in the mean number of post-feedback intervention sessions based on child gender, poverty status, or baseline extemalizing problems. However, at ages 3 and 5, primary caregivers who reported having more than a high school education engaged in more treatment sessions than did caregivers who reported having 12 or fewer years of education (M = 3.46 and 2.22, respectively, at age 3 and M — 5.07 and 2.81, respectively, at age 5; ps < .05). Importantly, number of treatment sessions was not related to child outcomes at ages 5 or 7.5. ]VIeasures Demographics questionnaire. A demographics questionnaire was administered to the primary caregivers during the ages 2, 3, 4, 5, and 7.5 visits. This measure included questions about family stmcture, parental education and income, parent criminality, and areas of family stress. Positive behavior support (PBS). Coding of videotaped parent-child interactions. A team of undergraduates coded the videotaped family interaction tasks by using the Relationship Process Code (RPC; Jabson, Dishion, Gardner, & Burton, 2004). The average team RPC percent agreement = .87, K = .86. The RPC is a third-generation code derived from the Family Process Code (Dishion, Gardner, Patterson, Reid, & Thibodeaux, 1983), used extensively in previous research. After coding each family interaction, coders completed a coder impressions inventory regarding proactive and positive behavior support practices. All family interaction tasks were evaluated in the scoring of positive behavior support practices. In addition, the home visitors' ratings of primary caregiver involvement with the young child were used as another indicator of the positive behavior support construct. Although coders were predominantly European American (90%), protocols developed by using examples of culturally diverse coding categories and by extensive training ensured that coding of family interactions was culturally sensitive. Our previous research revealed that cultural biases in coding of African American family interactions existed when coders were untrained in the coding system and that coder training resulted in eliminations of coding differences between European American and African American coders (Yasui & Dishion, 2007). In detail, the following items were entered into the positive behavior support scores: 1. Parent Involvement. This measure is based on the home visitor's rating of the primary caregivers' involvement, which includes three items from the Home Observation for Measurement of the Environment inventory (HOME; Caldwell & Bradley, 1984) assessing whether the parent looks at the child, talks to the child, and/or stmctures the child's play. 2.

Positive Reinforcement. This measure is based on videotape coding (durations) of caregivers prompting and reinforcing young children's positive behavior as captured

in the following RPC codes: positive reinforcement (verbal and physical), prompts and suggestions of positive activities, and positive stmcture (e.g., providing choices in a request for behavior change). 3.

Engaged Parent-Child Interaction Time. This measure reflects the average length of parent-child sequences that involve talking or physical interactions such as tum taking or playing a game. Thus, the average duration of episodes that included consecutive parent-child exchanges involving RPC codes such as Talk and Neutral Physical Contact were used to define these episodes.

4.

Proactive Parenting. Videotape coders rated caregivers on the tendency to anticipate problems and provide prompts or structural changes to avoid children becoming upset or involved in problem behavior on the six items: parent gives child choices for behavior change whenever possible; parent communicates to the child in calm, simple, and clear terms; parent gives understandable, ageappropriate reasons for behavior change; parent adjusts/ defines the situation to ensure the child's interest, success, and comfort; parent redirects the child to more appropriate behavior if the child is off task or misbehaves; parent uses verbal stmcturing to make the task manageable (a = .835).

Child Behavior Checklist IV2-S (CBCL). The CBCL (Achenbach & Rescorla, 2000) for ages l'/2-5 is a 99-item questionnaire that assesses behavioral problems in preschool-age children. Primary caregivers completed the CBCL l'/2-5 at the ages 2 and 3 visits. The CBCL has two broad-band factors, intemalizing and extemalizing. Individual items from the extemalizing factor were combined with items from the Eyberg Child Behavior Inventory to create a continuous scale of ages 2-3 aggressive behavior (see description below). Eyherg Child Behavior Inventory (ECBI). The ECBI is a 36-item parent-report behavior checklist administered to primary caregivers at the ages 2 and 3 assessments (Robinson et al., 1980). The ECBI assesses conduct problems in children between 2 and 16 years of age via two factors, one that focuses on the perceived intensity of behavior and another on the degree the behavior is a problem for caregivers. As the intensity factor is similar in stmcture, and complementary in content, to the CBCL extemalizing factor, items from the ECBI were used to supplement items from the CBCL in creating a Diagnostic and Statistical Manual of Mental Disorders {DSM) based scale of aggressive behavior at ages 2 and 3 (see the following description). Externalizing behavior scales. To create an aggressive behavior composite, ECBI items were initially rescaled from a 7-point Likert scale to match the 3-point scale of the CBCL. Scores were recoded so that values reflecting conceptually similar behavior frequencies were equated (i.e., 1, or Never, on the ECBI was equal to 0, or Not True, on the CBCL; 2-4, or Sometimes, on the ECBI was equal to 1, or Somewhat or Sometimes True, on the CBCL; and 5-7, or Always, on the ECBI was equal to 2, or Very True or Often True, on the CBCL). Individual items from the extemalizing factor of the CBCL were then averaged with rescaled items from the ECBI and matched with DSM-IV criteria for the

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aggressive items from the Conduct Disorder diagnosis to create a scale of aggressive behavior (i.e., items that assessed a specific DSM symptom for a disorder were included on that disorder's scale; 6 CBCL, 4 ECBI items). The age 2 and age 3 scales were then averaged to obtain a more stable indicator of child aggressive behavior. Intemal consistency for the aggression composite at ages 2-3 was .82. Academic achievement. Academic abilities were assessed at the age 5 and age 7.5 home assessments by administering the Academic Skills Cluster of the Woodcock-Johnson Tests of Achievement HI (W-J), which consists of an aggregate, agestandardized composite of the subtests Letter-Word Identification, Math Calculation, and Spelling (Woodcock, McGrew, & Mather, 2001). It uses a standard score scale based on a mean of 100 and standard deviation of 15 and has a median reliability of .95. For this study, tbe Academic Skills composite of all three subscales was used to best capture the target child's overall academic achievement at school age.

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To carry out the study's objectives, structural equation modeling (SEM) was utilized. Analyses were conducted in MPlus 6.11 (Muthén & Muthén, 2010) using full information maximum likelihood estimation. Based on the project's preventive nature, this study used an intent-to-treat design in all analyses. Thus, all participants randomly assigned to either the treatment (n = 367) or control group (n = 364), regardless of their level of participation in the intervention, were included in the analyses. However, the final sample size was N = 725, with six cases excluded due to missing data. Covariates used in the analysis were child gender (female = 1), child race and ethnicity (minority status = 1), project site (Eugene, OR, served as the reference group), and primary caregiver education level at age 2 because of gender, ethnic, and socioeconomic differences associated with parenting in early childhood and academic achievement at school age (BrooksGunn & Duncan, 1997; Brooks-Gunn et al., 2007). In addition, a measure of primary caregiver-reported child aggression at ages 2-3 was included as a covariate to account for possible thirdvariable associations between aggressive child behavior, parenting, and school-age academic achievement (Brennan, Shaw, Dishion, & Wilson, 2012). Lastly, an age 2 primary caregiver education by intervention group interaction term was included to account for differential attrition of lower educated caregivers within the control group.

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oocsesp--—i^No-->voosorVOON^OONO'—>e .20, ps < .01). In addition, in support of the use of the academic achievement composite, all subtests were highly interrelated at age 5 (all rs > .47, ps < .01) and age 7.5 (all rs > .56, ps < .01). Correlations between parenting variables at age 2 and age 3 and academic achievement variables at age 5 and age 7.5 revealed that age 2 proactive parenting and parent involvement at ages 2 and 3 were most consistently associated with academic achievement variables at school age (rs = .10 to .17, ps < .05-.01). In sum, univariate associations demonstrated moderate associations among parenting factors at ages 2 and 3 as well as modest associations between parenting factors and academic achievement measures at ages 5 and 7.5.

Changes in Positive Behavior Support and School-Age Academic Achievement Figure 1 illustrates the findings from the full SEM model used to analyze this study's main hypothesis, that the FCU would lead

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Academic Skills Age 7.5

Pittsburgh Charlottesville Figure 1. Indirect effect of FCU assignment on child academic achievement through changes in Positive Behavior Support. Model estimates are standardized and provided for significant pathways only. Nonsignificant modeled pathways are illustrated by gray dotted lines. Indirect effect pathways are shown in bold. Effect sizes were ds = .06, ps < .05. FCU = Family Check-Up; PC = primary caregiver. ' p < .05. " p < .01.

INTERVENTION, PARENTING, AND ACADEMIC ACHIEVEMENT to increases in PBS from age 2 to age 3 and increases in PBS, in tum, would be related to higher levels of academic achievement at age 5 and age 7.5. As shown in the full model in Figure 1, direct paths between FCU group assignment and academic achievement at ages 5 and 7.5 were not significant (ß = .01 and ß = .21, ps > .10, respectively). However, consistent with previously reported findings from this sample (Dishion et al., 2008), results indicated that random assignment to the FCU was associated with greater increases in PBS from age 2 to age 3 for intervetition families than for controls (ß = .17, p < .05; Cohen's d = .33). In addition, changes in primary caregivers' use of PBS from age 2 to age 3 were associated with higher scores on the W-J Academic Skills composite at age 5 (ß = .19, p < .05) and age 7.5 (ß = .20, p < .05). Moreover, indirect effects of the FCU on academic achievement at age 5 and age 7.5, through changes in PBS from age 2 to age 3, were significant, according to the Sobel (1982) test (ßs = .03, ps < .05; pathways shown in bold in Figure 1), with all fit indices, except the chi-square statistic, indicating the model is a good fit to the data (x^(85) = 132.5, p < .05; CFI = .96, TLI = .94, RMSEA = .03). Cohen's d effect sizes were both ds = .06 (Cohen, 1988). Because the chi-square statistic is sensitive to sample size and this sample contains over 700 individuals, it is possible for the chi-square to indicate a significant difference between the model-implied covariance matrix and empirical covariance matrix when the magnitude of the difference is very small (Bentler & Bonett, 1980). Thus, as suggested by Hu and Bentler (1999), we rely on multiple fit indices to evaluate the model. In sum, as expected, random assignment to the FCU was associated with improvements in PBS during early childhood and, in tum, improvements in PBS were positively associated with academic achievement at age 5 and age 7.5. Moreover, as expected, the indirect pathway linking FCU group assignment to academic achievement through improved parenting was significant.

Discussion Based upon literature and theory linking parenting during early childhood to subsequent academic achievement (e.g., Englund et al., 2004; Supplee et al., 2004; Taylor et al., 2004), it was expected that higher levels of a global parenting construct, positive behavior support, would be associated with higher academic achievement scores at school age. Furthermore, based on prior findings that random assignment to a brief, parenting-focused intervention (FCU) was associated with increases in parents' use of PBS from age 2 to age 3, it was expected that intervention would be indirectly associated with higher levels of academic achievement at school age. The results from univariate analysis demonstrated that positive parenting techniques when children were age 2 and age 3 were positively associated with academic achievement at age 5 and age 7.5. Moreover, SEM analysis revealed that random assignment to the FCU was associated with higher levels of overall academic achievement at age 5 and age 7.5 through greater increases in parents' use of PBS for intervention group members than for controls.

Parenting Intervention, Positive Behavior Support, and Academic Achievement The study's findings are in line with what would be expected based on theory and evidence that parenting during early child-

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hood plays a crucial role in emerging child self-regulatory and problem solving strategies as well as early "academic" skills (e.g., language ability; Cole et al., 1994; Hart & Risley, 1995; Kochanska et al., 2001). The results supported the study's hypotheses that parents' use of PBS when children were 2 and 3 years of age would be positively associated with child academic achievement at age 5 and age 7.5 and that the FCU would have an indirect effect on school-age academic achievement through improvements in PBS from age 2 to age 3. These results are also consistent with prior findings linking parenting during early childhood to developing child academic and socioemotional skills (Lunkenheimer et al., 2008; NICHD Early Child Care Research Network, 2005; Supplée et al., 2004). However, this study is one of only a few to link the same intervention to improvements in both child behavior problems and academic achievement (Bierman, Nix, & MakinByrd, 2008; Luiselli et al., 2005). Moreover, in contrast with other interventions shown to improve child academic and socioemotional functioning, which involve years of investment in the school in addition to working with parents and children (e.g., Bierman, Domitrovich, et al., 2008; Conduct Problems Prevention Research Group, 2007), the FCU is brief (averaging 3 sessions) and parenting-focused. Further, the FCU intervention achieved these effects working solely with caregivers, none of whom were actively seeking treatment, in a sample known to be at high risk for child conduct problems and low academic achievement based on the presence of sociodemographic, family, and/or child risk when children were age 2 (Brooks-Gunn & Duncan, 1997). Thus, the findings demonstrate that a brief, parenting-focused intervention during early childhood may be a viable strategy to prevent at-risk children from developing behavior problems (Dishion et al., 2012; 2008) and low academic achievement at school age.

Limitations In addition to this project's numerous methodological strengths, which included a longitudinal prospective randomized controlled design following a high-risk, low-socioeconomic status sample from early childhood, the study also had several limitations. First, academic achievement was measured through a standardized achievement test administered by project examiners. While the W-J is a well-validated assessment of academic achievement (McGrew & Woodcock, 2001), it is possible that a child's performance on this measure would not translate to the classroom or to other standardized achievement tests administered in the school setting. Indeed, it was somewhat surprising that based on the level of cross-domain risk factors needed to be eligible to participate in the study that children's W-J scores were in line with normative averages at age 5 and age 7.5. Despite these normative scores, we fear that based on the level of contextual adversity many of the children in the sample will face at home and school in the coming years, their achievement at school may not match their current test scores. To corroborate the relationship between W-J performance and actual school performance, it would be important to also examine grades, absences, and standardized test scores administered at school. Such information tnight elucidate mechanisms that could be interfering with child functioning, particularly for children who apparently possess adequate academic skills but do not carry them over to the school setting.

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Second, the sample used in this study was recmited for being at an elevated risk of developing conduct problems based upon parent-report questionnaires when the children were 2 years old. Although it is cmcial to study the relationship between parenting behaviors during early childhood and school-age academic achievement in samples of children at high risk for experiencing difficulties in both domains, in part because it is a population likely to benefit from intervention (Brooks-Gunn & Duncan, 1997), it is also important to note that these findings may not generalize to other lower-risk samples. For example, the relationships between early dimensions of parenting and later academic achievement could play out differently for children whose families have greater economic and psychosocial resources to draw upon. However, longitudinal research with community samples from mostly middle-class families has revealed similar associations between positive parenting during early childhood and school-age academic achievement (Burchinal, Peisner-Feinberg, Pianta, & Howes, 2002; NICHD Early Child Care Research Network, 2004), suggesting that these results could apply to the broader population. Third, the magnitude of the effects of the FCU on PBS and academic achievement were small (ds = .33 and .06, respectively; Cohen, 1988). However, based on the sample's high risk nature and the preventive design of the study (i.e., none of the intervention families were actively seeking treatment for their children for conduct problems), not to mention the use of an intent-to-treat analysis (i.e., 55 to 75% engaged in the intervention at individual waves), the effect size is quite respectable compared to other prevention studies of this type. For example, the Fast Track program, which consisted of school- and home-based services aimed at preventing conduct problems in high-risk children over a 10year period demonstrated no intent-to-treat effects on conduct problems at grades 3, 6, and 9 (Conduct Problems Prevention Research Group, 2007), while another parenting-focused prevention trial with divorcing mothers was associated with indirect effects on behavior problems in school-age boys at 1-year follow-up only after accounting for intervention dosage (Forgatch & DeGarmo, 1999). In addition, more modest effect sizes would be expected than for a clinical sample, in which all families were seeking assistance for their child's dismptive behavior or academic difficulties. Moreover, academic achievement was not a direct target of the intervention. Therefore, despite the critical role of parenting in promoting academic success, the relative contribution of a parenting intervention in the current study was modest in size. Given the brief nature of the FCU (the average number of yearly sessions was between 2.64 and 3.58 across the four waves of the study) and the preventive design of the study, the detection of a significant effect on academic outcomes, albeit small, is promising. Furthermore, work from this sample in relation to child conduct problems indicates that effect sizes are significantly enhanced when intervention participation is accounted for (i.e., effect sizes of d = .44 for one feedback versus d = .83 for three feedbacks; Dishion et al., 2012). Nonetheless, future work should examine the relative costbenefit of this intervention. In sum, the results suggest that the FCU has the potential to improve child academic achievement, particularly if developing skills necessary to succeed academically is included as a focus of the intervention. Fourth, although random assignment to the parenting intervention enables us to draw causal conclusions about the association

between the FCU and PBS, it is possible that the indirect effect of the intervention on academic outcomes could operate through a third variable that is omitted from the model but correlated with both PBS and academic achievement. However, based on the strong theoretical ties and prior empirical links between positive parenting and child academic functioning (Carr et al., 2002; Englund et al., 2004), we believe it is reasonable to conclude that the indirect effect of the FCU operates through PBS. Fifth, analyses examining potential selective attrition effects revealed that primary caregivers who dropped out of the control group reported having lower levels of education at the study outset than did caregivers who remained at age 7.5; however, this selective attrition effect in primary caregiver educational attainment was not observed in the intervention group. Although a covariate reflecting this caregiver education by intervention group interaction was included in the analysis, it is possible this differential attrition affected the study's findings. However, based on the associations between caregiver education level and child academic functioning (Brooks-Gunn & Duncan, 1997), the greater loss of low educated caregivers from the control group would be expected to offset, rather than augment, any associations between the FCU and academic achievement at elementary school. Thus, it would not be expected that differential attrition between the control and intervention groups would account for associations between the FCU, parenting, and academic achievement. Lastly, analyses of intervention engagement by demographic characteristics at each wave revealed that caregivers who reported having some post-high school education participated in more post-feedback treatment sessions at ages 3 and 5, on average, than caregivers with 12 or fewer years of schooling. Perhaps this is not surprising given the broader difficulty noted above in retaining lower educated caregivers over time. However, foUow-up analyses within the intervention group revealed that number of treatment sessions was unrelated to child outcomes.

Implications for Intervention and Social Policy The current study provides promising implications for further intervention and social policy development. This study extends findings fi'om Lunkenheimer et al. (2008) to show that an intervention targeting parenting behaviors associated with reductions in child behavior problems also was related to improving other domains of child functioning, namely, academic achievement on the Academic Skills composite of the W-I, which was not a primary target of the FCU. Given Unks between child behavior problems and school failtire (Hinshaw, 1992), it is an important finding that a relatively brief, family-centered intervention was able to provide positive outcomes in both domains, albeit effects in the school domain were modest. Because improving academic outcomes was not a primary goal of the FCU, further refinement and attention to additional aspects of parenting associated with achievement could lead to even greater effects in this domain and perhaps even further reductions in child problem behavior over time, based on protective effects found between positive academic engagement and child behavior (Maguin & Loeber, 1996; Moilanen & Shaw, 2010). As the FCU is an individually tailored intervention in which feedback about areas in need of attention is provided, the identification of problem areas could be broadened to include academic competencies such that for families of children who do not show elevated problem behaviors but do evidence low academic skills, enhancing positive parenting techniques could also be seen as a relevant goal.

INTERVENTION, PARENTING, AND ACADEMIC ACHIEVEMENT In addition, social policymakers may consider utilizing the FCU as a cost-effective strategy for the prevention of conduct problems and academic underachievement in at-risk children. The FCU has akeady been selected by the Department of Health and Human Services as one of seven evidence-based home visitation programs eligible for federal funding through the Matemal, Infant, and Early Childhood Home Visiting Program established by the Patient Protection and Affordable Care Act (see http://homvee.acf.hhs.gov/ for details). Further, the findings from this study suggest the application of the FCU could even be broadened to target children who are showing problem behaviors and emerging academic difficulties at preschool age. Although more research is needed to determine the potential of the FCU for improving child academic performance, particularly if academic achievement is directly targeted by the intervention, the findings linking a brief parenting-focused intervention with improvements in both child conduct problems and, indirectly, academic achievement are promising.

Future Directions In addition to replicating the current findings with other populations, another important step would be to determine whether child factors, such as self-regulation and early academic skills, account for associations between improvements in early positive parenting and later academic achievement so that future applications of the FCU can help parents focus on promoting specific child skills in need of attention. Furthermore, it will be important to establish whether interventions focused on positive parenting during the late preschool and early school-age periods would have similar beneficial effects on child socioemotional and academic development as during the toddler and early preschool years, as the extant literature and theory suggests they would (Englund et al., 2004; NICHD Early Child Care Research Network, 2005). Finally, additional studies that follow children beyond school age will be crucial for understanding whether participating in the FCU during toddlerhood could lead to sustained higher levels of academic achievement and other positive outcomes into adolescence and adulthood.

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Received January 16, 2012 Revision received December 11, 2012 Accepted December 26, 2012

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Indirect Effects of the Family Check-Up on School-Age Academic Achievement Through Improvements in Parenting in Early Childhood.

This project examined the hypothesis that the impact of the Family Check-Up on parent use of positive behavior support would indirectly improve academ...
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