Family Check-Up for Children (also known as Family Check-Up or FCU) is a parenting intervention for families with a preschool child. It is delivered by a therapist or social worker to individual families for between 3 and 15 weekly sessions, depending on the family’s needs. Parents learn strategies for encouraging positive parent–child interaction and managing challenging child behaviour.
The information above is as offered/supported by the intervention provider.
2 to 6 years old
Individual
Family Check-Up for Children (also known as Family Check-Up and FCU) is a strengths-based, family-centered intervention aimed at providing parents with strategies for improving the parent–child relationship and supporting postivie child development. It can be delivered in various settings, such as schools, primary care, and community clinics.
FCU is typically implemented by therapists or social workers, but can also be delivered by bachelor-level or paraprofessional providers with appropriate supervision. The intervention model is tailored to address the specific needs of each family and can be integrated into a variety of service settings, including schools, primary care settings, and community clinics.
FCU consists of three main components:
Follow-up services include the Everyday Parenting intervention, which can be delivered in three to five weeks, depending upon the family’s needs. Everyday Parenting’s content includes strategies for encouraging positive child behaviour, setting limits, and relationship-building. Everyday Parenting may be deliverd in three sessions for prevention or up to 15 sessions to manage specific child behavioural difficulties. Additional community services may follow as needed.
Family Check-Up typically begins when the child is aged two years old at an assessment that can be integrated into a routine health visit at the GP surgery or the 2.5-year health visiting check. Check-ups and booster sessions may then continue until the child enters primary school.
2 to 6 years old
All parents with a 2.5-year-old child, with an offer of additional support for families with identified concerns about their child’s behaviour.
Disclaimer: The information in this section is as offered/supported by the intervention provider.
Science-based assumption
Young children naturally behave in challenging and non-compliant ways
Challenging child behaviours during preschool increase the risk of behavioural problems becoming entrenched in primary school.
Science-based assumption
Effective parenting behaviours help child to regulate their own behaviour and reduce the risk of child behavioural problems persisting
Ineffective parenting strategies can increase the risk of child behavioural problems persisting.
Science-based assumption
Parents experiencing difficulties with the behaviour of a young child.
Intervention
Parents learn how to:
Promote positive parent–child interaction
Reinforce positive child behaviour through praise and rewards
Discourage challenging child behaviour through age-appropriate discipline.
Short-term
Parents implement effective parenting strategies in the home
Parents’ confidence increases
Parental stress reduces
Parent–child interaction improves.
Medium-term
Children’s self-regulatory capabilities and behaviour improves.
Long-term
Children are at less risk of antisocial behaviour in adolescence
Children are more compliant and better able to engage positively with others.
All parents with a preschool child, with additional support provided to families with concerns about their child’s behaviour.
FCU is delivered by on Family Check-Up practitioner to individual families in 3 to 15 sessions lasting 50 to 60 minutes each.
FCU is delivered in two phases. The first is a brief, three-session intervention based on motivational interviewing. The three meetings are conducted by a professional therapist in the home. The sessions consist of a one-hour assessment session, an interview session, and a feedback session.
The second phase involves the delivery of Everyday Parenting, a family management training programme that builds parents’ skills in positive behaviour support, healthy limit-setting, and relationship-building. As a health-promotion and prevention strategy, phase two of the FCU can be limited to one to three Everyday Parenting sessions. As a treatment approach, phase two can range from 3 to 15 Everyday Parenting sessions. The first phase may be followed by additional community referral services as indicated.
FCU practitioners are typically therapists, psychologists, or social workers with a master’s qualification. With the appropriate consultation and supervisory support, a paraprofessional/non-bachelor-level practitioner also may implement the intervention.
Practitioners received 35 hours of intervention training. Booster training of practitioners is recommended.
It is recommended that practitioners are supervised by one host-agency supervisor trained in the FCU model, with additional 28 to 45 hours of additional training support.
Intervention fidelity is maintained through the following processes:
Organisation: Northwest Prevention Science
Email address: fcu@nwpreventionscience.org
Websites: thefamilycheckup.com
*Please note that this information may not be up to date. In this case, please visit the listed intervention website for up to date contact details.
FCU qualifies for a Level 3+ rating, as it has evidence from at least one Level 3 study, along with evidence from other studies rated 2 or better.
The first study was conducted in the United States and is consistent with Foundations’ Level 3 evidence strength criteria. This study observed statistically significant improvements in FCU parents’ reports of their children’s behaviour and emotional symptoms up to three years following the start of the intervention in comparison to the reports of parents not exposed to the intervention. These reports were further corroborated by teacher assessments of children’s behaviour when they were 7.5 years old at a five-year follow-up assessment. Specifically, teachers’ ratings of FCU children’s classroom behaviour were significantly better than those of children not receiving the intervention.
The second study was conducted in the United States and is consistent with Foundations’ Level 2+ evidence strength criteria. This study observed statistically significant improvements in FCU parents’ reports of their children’s behaviour at 12-month and 24-month follow-up assessment in comparison to parents not receiving the intervention.
The third study was also conducted in the United States and is consistent with Foundations’ Level 2+ evidence strength criteria. FCU children were offered the intervention at age 6 years old (in comparison to age 2 in Studies 1 and 2) and teacher assessments were taken immediately post-intervention and then one year after. The study observed statistically significant improvements in teacher reports of FCU children’s behaviour at immediately post-intervention (age 6 years old) and again at a 12-month follow-up (age 7 years old) in comparison to children who did not receive the intervention.
FCU can be described as evidence-based: it has evidence from at least one rigorously conducted RCT or QED demonstrating a statistically significant positive impact on at least one child outcome.
Reduced disruptive behaviour
N/A
Improvement index
Interpretation
Study
Reduced internalising behaviour
Long-term – Between post-test and 2-year follow-up
Improvement index
Interpretation
Study
Reduced externalising behaviour
Long-term – Between post-test and 2-year follow-up
Improvement index
Interpretation
Study
Reduced problem behaviour
Long-term – Between post-test and 2-year follow-up
Improvement index
Interpretation
Study
Reduced defiant behaviour
Long-term – Between post-test and 5-year follow-up
Improvement index
Interpretation
Study
Decreased emotional and behaviour problems
N/A
Improvement index
Interpretation
Study
| Identified in search | 5 |
| Studies reviewed | 3 |
| Meeting the L2 threshold | 2 |
| Meeting the L3 threshold | 1 |
| Contributing to the L4 threshold | 0 |
| Ineligible | 2 |
| Study design | RCT |
| Country | United States |
| Sample characteristics | 731 mother child dyads with children aged 2 to 3 years old who had socioeconomic, family, and/or child risk factors for future behaviour problems. |
| Race, ethnicities, and nationalities |
|
| Population risk factors | More than two-thirds of the families had an annual income of less than $20,000. |
| Timing |
|
| Child outcomes |
|
| Other outcomes |
|
| Study rating | 3 |
| Citations | Study 1a: Dishion, T. J., Shaw, D., Connell, A., Gardner, F., Weaver, C. & Wilson, M. (2008) The Family Check-Up with high-risk indigent families: Preventing problem behaviour by increasing parents’ positive behaviour support in early childhood. Child Development. 7, 1395–1414. Study 1b: Shaw, D. S., Connell, A., Dishion, T. J., Wilson, M. N. & Gardner, F. (2009) Improvements in maternal depression as a mediator of intervention effects on early childhood problem behaviour. Developmental Psychopathology. 21, 417–439. Study 1c: Lukenheimer, E. S. (2008) Collateral benefits for the Family Check-Up on early childhood school readiness: Indirect effects of parents’ positive behaviour support. Developmental Psychopathology. 44, 1737–1752. Study 1d: Dishion, T. J., Brennan, L. M., Shaw, D. S., McEachern, A. D., Wilson, M. N. & Booil, J. (2014) Prevention of problem behaviour through annual Family Check-Up in early childhood: Intervention effects from home to early elementary school. Journal of Abnormal Child Psychology. 42, 343–354. |
| Study design | RCT |
| Country | United States |
| Sample characteristics | The study involved 120 mother–son dyads recruited from the Women, Infants, and Children (WIC) programme in the Pittsburgh, Pennsylvania metropolitan area, with boys identified as being at-risk for future behaviour problems |
| Race, ethnicities, and nationalities |
|
| Population risk factors | Participants were predominantly from low-income backgrounds. Families had a mean annual income of $15,374. |
| Timing |
|
| Child outcomes | Reduced disruptive behaviour (12-month follow-up, parent report) |
| Other outcomes | Increased maternal involvement (24-month follow-up, researcher-led observation) |
| Study rating | 2+ |
| Citations | Shaw, D. S., Dishion, T. J., Supplee, L., Gardner, F. & Arnds, K. (2006) Randomized trial of a family-centered approach to the prevention of early conduct problems: 2-year effects of the Family Check-Up in early childhood. Journal of Consulting and Clinical Psychology. 74 (1), 1–9. |
| Study design | RCT |
| Country | United States |
| Sample characteristics | 365 children and their caregivers, from five early elementary schools in an urban city and surrounding suburban areas in the Pacific Northwest region of the United States |
| Race, ethnicities, and nationalities |
|
| Population risk factors | Approximately 65% of students across the five schools were eligible for a free or reduced-price lunch |
| Timing |
|
| Child outcomes | Reduced emotional and behavioural problems (teacher report) |
| Other outcomes | None |
| Study rating | 2+ |
| Citations | Garbacz, S. A., McIntyre, L. L., Stormshak, E. A. & Kosty, D. B. (2018) The efficacy of the Family Check-Up on children’s emotional and behavior problems in early elementary school. Journal of Emotional and Behavioral Disorders. 48 (2), 67–79. |
The following studies were identified for this intervention but did not count towards the intervention’s overall evidence rating. An intervention receives the same rating as its most robust study or studies.
Garbacz, S. A., Stormshak, E. A., McIntyre, L. L. & Kosty, D. (2019,) Examining family-school engagement in a randomized controlled trial of the family Check-Up. School Psychology. 34 (4), 433–443.
Stormshak, E. A., McIntyre, L. L., Garbacz, S. A. & Kosty, D. B. (2020) Family-centered prevention to enhance parenting skills during the transition to elementary school: A randomized trial. Journal of Family Psychology. 34 (1) 122–127.
Note on provider involvement: This provider has agreed to Foundations’ terms of reference (or the Early Intervention Foundation's terms of reference), and the assessment has been conducted and published with the full cooperation of the intervention provider.
Rated 1: Set up and delivery is low cost, equivalent to an estimated unit cost of less than £100.
Rated 2: Set up and delivery is medium-low cost, equivalent to an estimated unit cost of £100–£499.
Rated 3: Set up and delivery is medium cost, equivalent to an estimated unit cost of £500–£999.
Rated 4: Set up and delivery is medium-high cost, equivalent to an estimated unit cost of £1,000–£2,000.
Rating 5: Set up and delivery is high cost. Equivalent to an estimated unit cost of more than £2,000.
Set up and delivery cost is not applicable, not available, or has not been calculated.
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Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing child maltreatment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Enhancing school achievement & employment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing crime, violence and antisocial behaviour: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing substance abuse: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing risky sexual behaviour & teen pregnancy: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing obesity and promoting healthy physical development: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Rated 2: Has preliminary evidence of improving a child outcome from a quantitative impact study, but there is not yet evidence of causal impact.
Rated 2+: Meets the level 2 rating and the best available evidence is based on a study which is more rigorous than a level 2 standard but does not meet the level 3 standard.
Rated 3: Has evidence of a short-term positive impact from at least one rigorous study.
Rated 3+: Meets the level 3 rating and has evidence from other studies with a comparison group at level 2 or higher.
Rated 4: Has evidence of a long-term positive impact through at least two rigorous studies.
Rated 4+: Meets the level 4 rating and has at least a third study contributing to the Level 4 rating, with at least one of the studies conducted independently of the intervention provider.
Rating has a *: The evidence base includes mixed findings i.e., studies suggesting positive impact alongside studies, which on balance, indicate no effect or negative impact.
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