Identifying early indicators of Emotional and Behavioural Difficulties in Irish children and testing the feasibility of an online parenting intervention for improving child mental health

Abstract

Background: Emotional and behavioural difficulties (EBDs) are the most common reason for referral of children and adolescents to mental health services. It is important, therefore, to assess the overall prevalence of EBD in different contexts and in different age groups, whilst identifying and addressing early risk factors in their development. Parental training programmes have been shown to be particularly effective in reducing EBD in children. The need for better access to evidence-based parenting interventions has been widely recognised and the internet may offer an alternative means of delivering evidence-based parenting programmes to larger numbers of parents. Triple P Online (TPOL) is an example of an online parenting programme. Previous research suggests that TPOL leads to positive outcomes for children, but few independent studies have examined this programme outside Australia where it was developed. Aims and objectives: The aims of this research were twofold: (1) to identify early risk factors of EBD in Irish children at different ages; and (2) to test the feasibility of implementing the TPOL parenting intervention in an Irish context. Method: This research involved three separate, but related studies designed to address the study objectives. Longitudinal data from the Growing Up in Ireland study were examined to establish the prevalence and predictors of EBD in (a) early childhood (5-year-old children) (N= 8,706) and (b) in adolescents (13-year-old children (N=7,488)). A feasibility study was also undertaken to test the feasibility of implementing TPOL among the parents of Irish children who have EBD (N= 22). Results: The results show that almost 12% of five-year-old children and just over 12% of 13- year-old children in Ireland have EBD. In terms of early childhood risk factors, EBD was best predicted by the child having EBD at the age of three, mothers reporting high levels of harshness/hostility in parenting style and mothers reporting high levels of stress. The most significant predictors of EBD in 13-year-old children were: having EBD at the age of nine, having a Specific Learning Difficulty (SLD) at nine-years-old and the mother reporting high levels of conflict with the child (also when aged nine). With regard to the TPOL, parents reported that they were satisfied with the quality of the programme and that they would return to TPOL if they needed help with parenting issues in the future. However, the results are limited by a very small sample size. Conclusion: The findings from the longitudinal analyses provide some important insights into risk factors for the development of EBD both in the early childhood years and in early adolescence. The RCT findings, whilst limited, suggest that it may be possible to improve parental outcomes using non-traditional parenting interventions such as TPOL but a need for larger-scale research is indicated.