Assessment of the "Appui Parental": A Program of Early Support to Parenthood
Condition: Infant Development
Study type: Interventional

Summary: 
      In so-called at risk families, the child-parent attachment relationship is more difficult to
      set up and this can be a barrier to social and emotional development of young children. To
      help parents build and sustain this relationship, and to prevent child development disorders,
      many parenting programs have been created, usually with frequent home visits by early
      childhood professionals. In France, therapeutic interventions at home are little used and
      they are not evaluated.

      In Montpellier, an action of this type has been conducted since 2001 by the "Conseil
      Départemental de l'Hérault" in collaboration with the University Hospital of Montpellier
      including, in addition to home visits, supervision of professionals: the Appui Parental
      Program.

      Before extending this action to other areas of Herault, the "Conseil Départemental de
      l'Hérault", the "Abri Languedocien" and the University Hospital of Montpellier are conducting
      an assessment to know the effectiveness of the program for families under care.

      This 3-year multicenter prospective study includes 88 children aged 1 to 20 months from
      families meeting vulnerability criteria previously defined, 44 benefiting Appui Parental
      program (experimental group) and 44 benefiting a regular support (control group).

      A paediatric examination on the basis of the Denver scale, parental questionnaires,
      questionnaires to professionals and an a video of infant-parent interactions are used. The
      data, collected at baseline and 18 months later, will be compared.
    

Detailed description: 
      Objective: the main objective of this study is to determine the efficiency of Appui Parental
      program by evaluating its impact on the development of children aged from 0 to 3 years. The
      secondary objectives are to study the effects of the intervention on: the mother-child
      interactions, the degree of therapeutic alliance between parent and professionals, the
      parenting skills feeling, perceived social support, anxiety and depression of parents,
      frequency of legal interventions (placements, educational measures). An assessment of stress
      among professionals involved in the study and evaluation of the therapeutic alliance with
      families will also be conducted to assess the effectiveness of the supervision included in
      the program.

      Hypothesis: Scores on Symptom Check List after 18 months of follow up will be significantly
      higher in subjects who benefited the Appui Parental program compared to subjects with
      conventional parental support. Similarly, it is expected that other developmental assessments
      of children have the best results in the Appui Parental Program group than in the control
      group. Finally, it is assumed that the mother-child interactions, the parenting skills
      feeling, and the therapeutic alliance between parent and professional are better in the Appui
      Parental program than in the control group.
    

Intervention name(s): "Appui Parental" program; Regular parental support
Intervention type(s): Behavioral; Behavioral
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: vulnerable family