Preventive Interventions: Parenting and the Home Environment

Although the central importance of parent-child interaction (PCI) in shaping early child development is well established, the effectiveness of preventive intervention approaches that mainly focus on PCI (as opposed to direct child stimulation) is more controversial. This chapter describes selected PCI-focused approaches in the United States and around the world, including home visiting models, group visit and community-based models, public health and primary care approaches, and comprehensive Early Child Development programs. While quite different in format, duration, and cost, these models share common attributes: they have a strong focus on PCI, they have the most impact with moderate-risk families, and they use participatory, interactive methods to engage parents and/or they take advantage of timing, context, and relationships (such as the primary-care encounter) to effectively promote parenting practices and parent-child relationships that support optimal child development. The importance of integrating these preventive approaches with other early childhood services and larger health systems and infrastructures is discussed.