Interventions Supporting Mental Health and Positive Behavior in Children Ages Birth-5 Yr: A Systematic Review

Karrie Kingsley; Grace Sagester; Lindy L Weaver

doi:10.5014/ajot.2020.039768

Interventions Supporting Mental Health and Positive Behavior in Children Ages Birth-5 Yr: A Systematic Review

Am J Occup Ther. 2020 Mar/Apr;74(2):7402180050p1-7402180050p29. doi: 10.5014/ajot.2020.039768.

Authors

Karrie Kingsley¹, Grace Sagester², Lindy L Weaver³

Affiliations

¹ Karrie Kingsley, OTD, OTR/L, is Associate Professor, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles.
² Grace Sagester, OTD, OTR/L, is Occupational Therapist, Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, OH.
³ Lindy L. Weaver, PhD, MOT, OTR/L, is Assistant Professor, Division of Occupational Therapy, Ohio State University, Columbus; lindy.weaver@osumc.edu.

PMID: 32204776
DOI: 10.5014/ajot.2020.039768

Abstract

Importance: It is critical for providers to use evidence-based interventions to address mental health and behavioral barriers to occupational performance during early childhood.

Objective: To identify evidence-based interventions within the scope of occupational therapy practice to improve mental health and positive behavior for children ages 0-5 yr and their families.

Data sources: PsycINFO, Cochrane, ERIC, MEDLINE, and OTseeker databases were searched for publications from 2010 through March 2017.

Study selection and data collection: This review was completed in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Risk of bias was assessed for each article using either A Measurement Tool to Assess Systematic Reviews (AMSTAR) or the Cochrane method. Articles meeting inclusion criteria were critically appraised.

Findings: Forty-six articles met inclusion criteria and were organized into three themes: touch-based interventions (n = 9), parent-child interaction therapy (PCIT; n = 4), and instruction-based interventions (n = 33). Statistically significant findings and overall risk of bias supported the use of touch-based interventions, PCIT, and parent training.

Conclusions and relevance: The evidence indicates that touch-based interventions can improve infant self-regulation (strong), social behavior, and attachment (moderate) and reduce maternal stress, anxiety, and depression (low). Moderate-strength evidence supports PCIT to improve child behavior. The evidence indicates that parent training can improve parent behavior, maternal-infant attachment (strong), and parent mental health (moderate). Teacher training can improve mental health and behavior (moderate). Group-based parent training and sleep training have insufficient support (low).

What this article adds: Occupational therapy professionals working with children younger than age 5 yr can use the results of this systematic review to guide clinical decision making related to mental health and behavioral outcomes.

Publication types

Systematic Review

MeSH terms

Child, Preschool
Depression / psychology
Humans
Infant
Infant, Newborn
Mental Health*
Occupational Therapy* / methods
Occupational Therapy* / standards
Parent-Child Relations