Early prevention with the home visiting program

Theory à „Family as a learning place“
Early prevention with the
home-visiting program
„PAT – Learning with Parents“
with a high-risk sample
Bioecological Model of Human Development
PPCT-design: Process-Person-Context-Time
à  Bronfenbrenner & Morris 2006
Self-Efficacy
à  Bandura 1977
ZEPPELIN-Study:
Andrea Lanfranchi, Simone Schaub & Alex Neuhauser
Parenting, Sensitivity
University of Applied Sciences of Special Needs Education (HfH)
Zürich, Switzerland
EARLI 2015 – Limassol, Cyprus Univ. of Technology, August 29
16. European Conference for Research on Learning and Instruction
à  Roggmann et al. 2008, Crittenden 2008.
1
21.10.15
ZurichEquityPrevenConProject
withParentsParCcipaConandIntegraCon
ZEPPELIN0-3
Pregnancy
nursesspecialisedincounsellingparents
40%employmentà10families
Homevisitevery2weeksduring3years
Group-connecConmonthly(10fam.cometothefam.-center)
HfH,Lanfranchi,Neuhauser,Schaub,Burkhardt,
Ramseier
3
Birth
First3months
Early detection: Network across the disciplines
EssenCals(intervenCon)
21.10.15
2
EarlydetecCon+IntervenConNetwork
-Gynaecologist
- Socialcounceling
-etc.
• 
• 
• 
• 
HfH,Lanfranchi,Neuhauser,Schaub,Burkhardt,Ramseier
-  Midwifeinbirthclinic
-  Pediatrician
-  etc.
-Earlychildhoodservice
-Pediatrician
-Socialcounceling
- etc.
Intervention: PAT parent educators
21.10.15
HfH,Lanfranchi,Neuhauser,Schaub,Burkhardt,Ramseier
4
ZurichEquityPrevenConProject
withParentsParCcipaConandIntegraCon
ZEPPELIN0-3
Homevisits:3programfacets
1.  Parent-child-interacCon
EssenCals(research)
2.  DevelopmentfocusedparenCngbehavior
•  Long-termintervenConstudyinZurich,Switzerland
•  RCT:StraCfiedblockrandomizaConof251families
inintervenCongroup(IG,N=134,143children)andcontrol
group(CG,N=117/123children)
•  datacollecConsat3,12,24and36months
•  Follow-upsat6yearsand12years
3.  Familywell-being
Focus:enhancesensiCvity,secureaWachment
andposiCveparenCngstrategies
HfH,Lanfranchi,Neuhauser,Schaub,Burkhardt,
Ramseier
21.10.15
5
HfH,Lanfranchi,Neuhauser,Schaub,Burkhardt,Ramseier
21.10.15
6
Interkantonale Hochschule
für Heilpädagogik
SampleaWriCon
SamplebasicinformaCons
2011
10/5
132/120
2012
2013
2014
2017
2018
2023
Mother
2010
2024
Alter
..2
..3
6 (Kiga)
9/4
125/114
8/4
118/109
7/3
SatusonMarch1st2015:
119/103
112/104
the
ore
Cca
95/89
l
7 (1. Schuljahr)
13 (7. Schuljahr)
21.10.15
12.9
14.4
37.6
33.3
lowoccup.status(ISEI)
twins
70/65
ZEPPELIN 0-3
ZEPPELIN 6-7
ZEPPELIN 12-13
HfH,Lanfranchi,Neuhauser,Schaub,Burkhardt,Ramseier
prematurity
χ2=2.41,p=.12
7
57.9
59.3
firstchild
73/68
ZEPPELIN/M
31.6
36.8
liWleeducaCon
singleparent
90/84
12 (6. Schuljahr)
72.9
72.9
foreigners
Family
..1
Child
..0
IGCG
32.2
28.8
liWlelocallanguageskills
Zeit
female
5.1
5.1
15
12.9
57.1
47.6
%ofchildren(N=264)/
mothersorfamilies(N=251)
SimoneSchaub&AndreaLanfranchi,16thBiennalEARLIConference,25-29August2015,Limassol,Cyprus
8
Selected results: development
Mothers‘ prôvenance
IG (N = 137)
KG (N = 121)
Schweiz
12%
Schweiz
13%
Kosovo
11%
Kosovo
13%
Andere
49%
Andere
50%
Türkei
12%
Türkei
12%
Portugal
10%
Eritrea
6%
Eritrea
4%
Portugal
8%
HfH,Lanfranchi,Neuhauser,Schaub,Burkhardt,Ramseier
21.10.15
9
21.10.15
HfH,Lanfranchi,Neuhauser,Schaub,Burkhardt,Ramseier
10
Interkantonale Hochschule
für Heilpädagogik
Bayley-ScalesofInfantandToddlerDevelopmentIII
Values(Norm=10+/-3)for •CogniCon
•Language(recepCveandexpressive)
•Motorskills(fineandgross)
Assessment
IG
N
Age
M(SD)
130
12.12
(.54)
24Months
36Months
12Months
Bayley,2006 21Oktober2015
CG
N
Age
M(SD)
Total
N
Age
M(SD)
118
12.15
(.68)
248
12.13
(.61)
119
24.23
(.79)
103
24.54
(1.21)
222
24.30
(1.02)
81*
36.12
(.61)
80
36.47
(1.15)
161
36.30
(.93)
IGCG
d=.51***
d=.54***
d=.33*
d=.47***
d=.41**
d=.27*
d=.32*
33.79
9.11
8.11
70.63%
69.66%
61.39%
58.26%
27.92
8.52
7.63
t1
t2
BSCDII:language,meanscaled
scores
*t3evaluaConongoing,StatusMarch1st2015
HfH,Lanfranchi,Neuhauser,Schaub,Burkhardt,Ramseier
Results:Earlysupport
t2
Vocabulary,meannumberofwords
t1
t2
HOMEInvolvement,
mean%compliance
d=Cohen‘sd
*p<.05,**p<.01,***p<.001
11
SimoneSchaub&AndreaLanfranchi,16thBiennalEARLIConference,25-29August2015,Limassol,Cyprus
12
Interkantonale Hochschule
für Heilpädagogik
Interkantonale Hochschule
für Heilpädagogik
Behavioralproblems
CBCL:AOenPonproblems
ChildbehaviorChecklistCBCLt2(N=189)
IG
102
54%
CG
87
46%
female
97
51%
4.00
3.50
3.00
2.50
2.00
1.50
1.00
0.50
0.00
male
92
49%
à Less attention problems in the IG
100problemitemsforparents
(never=0,someCmes/tosomeextend=1,exact/olen=2)
%
2.50
IG
KG
t(187) = 2.68, p = .008**, d = 0.37 (Effect small /moderate)
Achenbach&Edelbrock,1981
HfHA.Lanfranchi,AlexNeuhauser,SimoneSchaub,Anna
Burkhardt,ErichRamseier
21Oktober2015
3.20
13
21Oktober2015
HfHA.Lanfranchi,AlexNeuhauser,SimoneSchaub,Anna
Burkhardt,ErichRamseier
Interkantonale Hochschule
für Heilpädagogik
Meta-analysisofearly-intervenConprogramsin
German-speakingcountries:Effectsonmaternal
competence
CBCL:HyperakPvity
7.00
6.00
5.00
5.32
4.37
4.00
3.00
2.00
1.00
0.00
IG
KG
à Less hyperactivity in the IG
t(187) = 2.60, p = .010**, d = 0.38 (Effekt small / moderate)
21Oktober2015
HfHA.Lanfranchi,AlexNeuhauser,SimoneSchaub,Anna
Burkhardt,ErichRamseier
15
Taubneretal.,2015
14
Interkantonale Hochschule
für Heilpädagogik
Preliminary conclusions
The next steps
1.  Early recognition was successful: ZEPPELIN reaches
families in psychosocial at-risk situations.
2.  Early intervention is successful: Ø almost 2 visits per month
(= increases the overall rate of early intervention services in the community)
u  Document alternative treatments & consecutive
program participation
u  Plan follow up ZEPPELIN 6-7 (2017/18)
3.  „PAT – Parents as Teachers“: effects on child development at
all measurement points (esp. language; vocabulary
questionnaire validates findings of the BSCD III)
4.  „PAT – Parents as Teachers“: effects on externalized
problems (attention and hyperactivity); no effects on
internalized problems.
21.10.15
HfH,Lanfranchi,Neuhauser,Schaub,Burkhardt,Ramseier
17
Funders
Unter dem Patronat der
Schweizerischen
UNESCO-Kommission
Organisation der
Vereinten Nationen für
Bildung, Wissenschaft,
Kultur und Kommunikation
21.10.15
HfH,Lanfranchi,Neuhauser,Schaub,Burkhardt,Ramseier
18
ZEPPELIN0-3-Acknowledgments
Funding:SwissNaConalScienceFoundaCon,ZurichBoardofEducaCon,ErnstGöhnerFoundaCon,
FederalOfficeforMigraCon,JacobsFoundaCon,MercatorFoundaCon,PaulSchillerFoundaCon,
UNESCO,VontobelFoundaCon
Research:AnnaBurkhardt,WaltraudSempert,FranziskaTempler,HfH,ErichRamseier,Pedagogical
University,Berne
IntervenPon:MargritBachmann,ZeljkaDundjer,KathrinGrogg,DorotheaHollender,ChrisCne
Kramer,BrigiWeKubli,KatjaRüegsegger,EstherStauffer,BarbaraSteinegger,UrsulaStucky,
MarianneKunz,MonikavanBerkum,SilviaWäger,ChristelZwinscherandinterculturalinterpreters
Cooperators:JonCaflisch,OskarJenny,Children‘sHospital,ValonBejic,GiorgioMenghini,Dental
MedicineCentre,UlrikeEhlert,PriskaHubmann,DepartmentofPsychology,ErnstFehr,Daniel
Schunk,DepartmentofEconomics,allUniversityofZurich,MahirMustafa,UniversityofTirana
AdvisoryBoard:HeidiSimoni,MarieMeierhoferChildren‘sInsCtute,MagritStamm,Universityof
Fribourg,UlrichTrautwein,UniversityofTübingen,UteZiegenhain,UniversityClinic,Ulm
TesPng:JessicaBonhoeffer,SabineMayr,ClaudiaMoran,AnneRadtke,Children‘sHospital,
UniversityofZurich
AdministraPon:MichaelBärtschi,UteBodmer,LukasSiegrist,HfH
Coding:AnninaBrunold,MiljenkaJakobovicPayot
Studentassistants:ClaudiaAronis,TanjaGurtner,LieseloWeJud-Graf,GabrielaMasciadri,
NataliaRodriguez,SusanneSCllhart,BeateWaldschmidt,ChrisCnaWirth,SeldaErdemYerlikaya
ThankstoallparPcipaPngparentsandchildren
20
Bibliographie 1
Achenbach, T. M., & Edelbrock, C. S. (1981). Behavioral problems and competencies reported by parents of
normal and disturbed children aged four through sixteen. Monographs of the Society for Research in Child
Development, 46(1), 1-82.
Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman.
Becker, R., Jäpel, F., & Beck, M. (2011). Statistische und institutionelle Diskriminierung von Migranten im
Schweizer Schulsystem. Bern: iew.
Ben Khelil, M., Tegethoff, M., Meinlschmidt, G., Jamey, C., Ludes, B., & Raul, J. S. (2011). Simultaneous
measurement of endogenous cortisol, cortisone, dehydroepiandrosterone, and dehydroepiandrosterone
sulfate in nails by use of UPLC-MS-MS. Analytical and Bioanalytical Chemistry, 401, 1153-1162
Belsky, J. (1984). The Determinants of Parenting: A Process Model. Child Development, 55(1), 83-96.
Belsky, J. (2008). Social-contextual determinants of parenting. In R. E. Tremblay, M. Boivin & R. D. V. Peters
(Eds.), Encyclopedia on early childhood development [online]. (pp. 1-6). Montreal, Quebec:
Boudon, R. (1974). Education, opportunity, and social inequality: Changing prospects in Western society. New
York: Wiley.
Bronfenbrenner, U., & Morris, A. P. (2006). The Bioecological Model of Human Development. In W. Damon
(Ed.), Handbook of child psychology. 6th ed. (pp. 793–828). Hoboken: Wiley.
Camilli, G., Vargas, S., Ryan, S., & Barnett, S. W. (2010). Meta-Analysis of the Effects of Early Education
Interventions on Cognitive and Social Development. Teachers College Record, 112(3), 579-620.
Crittenden, P. M. (2008). Raising Parents: Attachment, Parenting and Child Safety. Cullompton: Willan.
Drury, T. F., Horowitz, A. M., Ismail, A. I., Maertens, M. P., Rozier, R. G., & Selwitz, R. H. (1999). Diagnosing and
reporting early childhood caries for research purposes. Journal of Public Health Dentistry, 59, 192-197.
Jacobson-Chernoff, J., Flanagan, K. D., McPhee, C., & Park, J. (2007). Preschool: First findings from the third
follow-up of the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). Washington DC: NC for Ed Stat.
Kochanska, G., Murray, K. T., Jacques, T. Y., Koenig, A. L., & Vandegeest, K. A. (1996). Inhibitory Control in
Young Children and Its Role in Emerging Internalization. Child Development, 67(2), 490-507.
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Bibliographie 2
Lanfranchi, A., & Neuhauser, A. (2013). ZEPPELIN 0-3: Theoretische Grundlagen, Konzept und Implementation
des frühkindlichen Förderprogramms „PAT –Mit Eltern Lernen“ Frühe Bildung, 2(1), 3-11
Lanfranchi, A., & Burgener Woeffray, A. (2013). Familien in Risikosituationen durch frühkindliche Bildung
erreichen. In M. Stamm & D. Edelmann (Hrsg.), Handbuch Frühkindl. Bildungsfo. (S. 603-616). Springer.
McClelland, M. M., Acock, A. C., Piccinin, A., Rhea, S. A., & Stallings, M. C. (2013). Relations between
preschool attention span-persistence and age 25 educational outcomes. Early Childhood Research
Quaterly, 28(2), 314-324.
Mischel, W., Shoda, Y., & Rodriguez, M. L. (1989). Delay of gratification in children. Science, 244, 933-938.
Neuhauser, A. (2014). A closer look at the effectiveness of early childhood education in at-risk families. Mental
Health and Prevention, 2(3-4), 43-57. doi: 10.1016/j.mhp.2014.09.002
Neuhauser, A. (2015). Predictors of maternal sensitivity in at-risk families. submitted.
Neuhauser, A., Ramseier, E., Schaub, S., Burkhardt, S. C. A., Templer, F., & Lanfranchi, A. (2015). Hard to
reach families – a methodological approach for early detection, recruitment, and randomization in an
intervention study. Mental Health and Prevention, (in press).
Pianta, R. C., Barnett, W. S., Burchinal, M., & Thornburg, K. R. (2009). The Effects of Preschool Education:
What We Know, How Public Policy Is or Is Not Aligned With the Evidence Base, and What We Need to
Know. Psychological Science in the Public Interest, 10(2), 49-88.
Ramey, C. T., Landesman Ramey, S., & Lanzi, R. G. (2006). Children's Health and Education. In U. Sigel & A.
Renninger (Eds.), The handbook of child psychology (pp. 864-892). New York: Wiley.
Roggman, L. A., Boyce, L. K., & Innocenti, M. S. (2008). Developmental parenting.. Baltimore: Brookes.
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from research. European Early Childhood Education Research Journal, 12(2), 5-20.
Wille, N., Bettge, S., Ravens-Sieberer, U. (2008). Risk and protective factors for children's and adolescent's
mental health: results of the BELLA study. European Child and Adolescence Psychiatry, 17 (1), 133-147.
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epigenetic mechanisms of disease risk. American Journal of Preventive Medicine, 44(2), 101-107.
Interkantonale Hochschule
für Heilpädagogik
Substudy Biomarkers (Ehlert/Hubmann)
Substudy dental health (Menghini/Bejic)
u  Aim: analyze psychosocial influences of endocrinologic*
and epigentic** factors
u  Measures: Cortisol in finger nails and
DNA methylation;
u  Started in summer
2013 at t2, now t3
data collection is
ongoing
u  Clinical dentistic examination for all children*
u  Measures: Plaque at front teeth, initial lesions and
dentine caries
* Ben-Kehlil et al 2011;
** Yang et al. 2013
* Drury et al., 1999
21.10.15
HfH,Lanfranchi,Neuhauser,Schaub,Burkhardt,Ramseier
23
u  Started in summer
2013 at t2, now t3
LinksIniCalläsion,rechts(Pfeil)DenCnkaries
data collection is
ongoing
21.10.15
HfH,Lanfranchi,Neuhauser,Schaub,Burkhardt,Ramseier
24
DatacollecCon/homevisit
Interkantonale Hochschule
für Heilpädagogik
Substudy self-control (Fehr/Schunk)
Instrument
u  Experiment with Delay of gratification*:
HeidelbergStressScale(HBS)
a) DINKY TOY: 5 toys presented: Child is asked to keep his hands on his knees:
„Tell me which gift you would like to have without touching it or pointing on
it“ (0=grabs a gift, 1=touches... to 5= hands stay on the knees)
CARE-Index(CriWenden)
b) GIFT DELAY: Present is put on the table, child is told not to touch it for 1
minute. „You must not touch the present until I tell you“ (0=completely
unpacked, 1=opens paper... To
4=doesn‘t touch it)
* Kochanska et al. (1996)
HfH,Lanfranchi,Neuhauser,Schaub,Burkhardt,Ramseier
25
DatacollecCon/familycenter
Instrument
BayleyScalesofInfantandToddler
Development(BayleyIII–coop.Jenni)
t0
t1
t2
t3
3mon 12mon 24mon 36mon
x
x
x
x
Snijders-Oomennon-verbalIntelligence
Test(SON2½-5–coop.Jenni)
x
x
Biomarker(corCsolinfingernails/
methylaConinsaliva–coop.Ehlert)
x
x
Dentalcontrol(coop.Menghini)
x
x
HealthQuesConnaire(ownconstrucCon)
x
ExperimentDelayofgraCficaCon
(coop.Fehr/Schunk)
21.10.15
Self-efficacyinInfantCareScale(SICS)
t1
t2
t3
12mon 24mon 36mon
x
Axtude/EinstellungenvonMüWern
undKindernimKleinstkindalter(EMKK) SocialNetworks
u  What is assessed at t3?
Self control, impuls control,
executive functions
21.10.15
t0
3mon
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
HomeObservaConforMeasurementof
theEnvironment(HOME)
ParentalLanguageAssesmentShort
Quest.
(SBE-2-KT/SBE-3-KT)
ChildbehaviorChecklist1½-5(CBCL)
x
Next-Generation Research
High
Fidelity
Tailored
Dosage
Engage
Fathers
x
LandesmanRamey,2015;Guralnick,1997
Prevent
Dropout
Natural
Spread