***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Child development literature suggests a relationship between mother-child interaction and enhanced infant development . We conducted a r and omized clinical trial to determine if a pediatrician 's guidance improves the mother-infant relationship and the infant 's development .  Thirty-two normal mothers and their healthy first-born infants were followed by one pediatrician at 2 , 4 , 8 , 15 , and 21 weeks of age . These dyads were r and omly assigned to a control group , who received customary care , or to an intervention group , who also received guidance based on the infant 's developmental status at each age . Just prior to a 27-week visit , the mother-infant relationship was assessed by a person blind to group assignment . Infant development was assessed with the Bayley Mental Scales of Infant Development and two of the Uzguris-Hunt Ordinal Scales . Intervention group mothers were rated significantly higher on sensitivity , cooperation , appropriateness of interaction , and appropriateness of play ( P less than .05 ) . Experimental infants were advanced on the Vocal Imitation ordinal scale . This study shows the effectiveness of this intervention on both the mother-infant relationship and infant development and supports pediatric involvement in this biosocial approach to well child care OBJECTIVES We evaluated Legacy for Children  , a public health strategy to improve child health and development among low-income families . METHODS Mothers were recruited prenatally or at the birth of a child to participate in Legacy parenting groups  for 3 to 5 years . A set of 2 r and omized trials in Miami , Florida , and Los Angeles , California , between 2001 and 2009 assessed 574 mother-child pairs when the children were 6 , 12 , 24 , 36 , 48 , and 60 months old . Intent-to-treat analyses from 12 to 60 months compared groups on child behavioral and socioemotional outcomes . RESULTS Children of mothers in the intervention group were at lower risk for behavioral concerns at 24 months and socioemotional problems at 48 months in Miami , and lower risk for hyperactive behavior at 60 months in Los Angeles . Longitudinal analyses indicated that children of intervention mothers in Miami were at lower risk for behavior problems from 24 to 60 months of age . CONCLUSIONS R and omized controlled trials documented effectiveness of the Legacy model over time while allowing for implementation adaptations by 2 different sites . Broadly disseminable , parent-focused prevention models such as Legacy have potential for public health impact . These investments in prevention might reduce the need for later intervention strategies Background For the first time to our knowledge , short- and long-term effects of a multi-site r and omized-controlled trial ( RCT ) of video feedback of infant – parent interaction ( VIPI ) intervention in naturalistic setting s are published . The intervention targets families with children younger than 2 years old and parent – child interactions problems . Outcome variables were 1 ) observed parent – child interactions and 2 ) parent-reported child social and emotional development . Between-group differences of the moderating effects of parental symptoms of depression , personality disorders traits , and demographic variables were investigated . Method The study had a parallel-group , consecutively r and omized , single-blinded design ; participants were recruited by health- and social workers . Seventy-five families received VIPI , and 57 families received treatment as usual ( TAU ) .  Videotapes of each parent – child interactions were obtained before treatment , right after treatment , and at a 6-month follow-up and coded according to Biringen ’s Emotional Availability Scales . Parental symptoms of depression and personality disorder traits were included as possible moderators . Results Evidence of a short-term effect of VIPI treatment on parent – child interactions was established , especially among depressed parents and parents with problematic interactions– and , to some extent , among parents with dependent and paranoid personality disorder traits . A long-term positive effect of VIPI compared with TAU on child social/emotional development was also evident . In a secondary analysis , VIPI had a direct positive effect on the depressive symptoms of parents compared with TAU . Conclusion The findings of the study support the use of VIPI as an intervention in families with interaction difficulties . Trial registration Current Controlled Trials IS RCT N99793905 Based on the US Nurse-Family Partnership ( NFP ) program , the German home visiting program “ Pro Kind ” offered support for socially and financially disadvantaged first-time mothers from pregnancy until the children ’s second birthday . A multi-centered , longitudinal r and omized controlled trial ( RCT ) was conducted to assess its effectiveness on mothers and children . A total of 755 women with multiple risk factors were recruited , 394 received regular home visits ( treatment group ) , while 361 only had access to st and ard community services ( control group ) . Program influences on family environment ( e.g. , quality of home , social support ) , maternal competencies ( e.g. , maternal self-efficacy , empathy , parenting style ) , and child development ( e.g. , cognitive and motor development ) were assessed from mothers ’ program intake in pregnancy to children ’s second birthday based on self-reports in regular interviews and developmental tests . Generalized estimating equations ( GEE ) models showed small , but significant positive treatment effects on parental self-efficacy , and marginally significant effects on social support , and knowledge on child rearing . Maternal stress , self-efficacy , and feelings of attachment in the TG tend to show a more positive development over time . Subgroup effects were found for high-risk mothers in the TG , who reported more social support over time and , generally , had children with higher developmental scores compared to their CG counterparts . Post hoc analyses of implementation variables revealed the quality of the helping relationship as a significant indicator of treatment effects . Results are discussed in terms of implementation and public policy differences between NFP and Pro Kind Objective . To evaluate the extent to which a program of home visitation ( Early Start ) , targeted at families who are facing stress and difficulty , had beneficial consequences for child health , preschool education , service utilization , parenting , child abuse and neglect , and behavioral adjustment . Methods . The study used a r and omized , controlled trial design in which 220 families who were participating in the Early Start program were contrasted with a control series of 223 families who were not participating in the program .  Families were enrolled in the program after population screening that was conducted by community health nurses . Families were enrolled in the program for up to 36 months . Outcomes were assessed at 6 , 12 , 24 , and 36 months after trial entry . Results . Families in the Early Start series received a mean of 24 months of service . Comparisons between the Early Start and control series over the 36-month follow-up period revealed that families in the Early Start program showed significant benefits in the areas of improved utilization of child health services , reduced rates of hospital attendance for injury/poisoning , increased preschool education , increased positive and nonpunitive parenting , reduced rates of severe parent/child assaults , and reduced rates of early problem behaviors . Effect sizes ( Cohen 's “ d ” ) were found to be in the small to moderate range , with d ranging from .03 to .31 ( median : .22 ) . Conclusions . The Early Start program was associated with small to moderate benefits in a wide range of areas relating to child health , preschool education , parenting , child abuse , and early behavioral adjustment . Comparisons with other studies are made , and threats to validity are considered Background Psychopathology in women after childbirth represents a significant risk factor for parenting and infant mental health . Regarding child development , these infants are at increased risk for developing unfavorable attachment strategies to their mothers and for subsequent behavioral , emotional and cognitive impairments throughout childhood . To date , the specific efficacy of an early attachment-based parenting group intervention under st and ard clinical outpatient conditions , and the moderators and mediators that promote attachment security in infants of mentally ill mothers , have been poorly evaluated . Methods / Design This r and omized controlled clinical trial tests whether promoting attachment security in infancy with the Circle of Security ( COS ) Intervention will result in a higher rate of securely attached children compared to treatment as usual ( TAU ) . Furthermore , we will determine whether the distributions of securely attached children are moderated or mediated by variations in maternal sensitivity , mentalizing , attachment representations , and psychopathology obtained at baseline and at follow-up . We plan to recruit 80 mother-infant dyads when infants are aged 4 - 9 months with 40 dyads being r and omized to each treatment arm . Infants and mothers will be reassessed when the children are 16 - 18 months of age . Method ological aspects of the study are systematic recruitment and r and omization , explicit inclusion and exclusion criteria , research assessors and coders blinded to treatment allocation , advanced statistical analysis , manualized treatment protocol s and assessment s of treatment adherence and integrity . Discussion The aim of this clinical trial is to determine whether there are specific effects of an attachment-based intervention that promotes attachment security in infants . Additionally , we anticipate being able to utilize data on maternal and child outcome measures to obtain preliminary indications about potential moderators of the intervention and inform hypotheses about which intervention may be most suitable when offered in a clinical psychiatric outpatient context .Trial registration Current Controlled Trials IS RCT The  Parents as Teachers ( PAT ) program is a parent-education program that includes home visiting and is design ed to begin prenatally or at birth . Through home visits , visitors called parent educators help parents to strengthen their parenting skills and knowledge of child development and to prepare young children for school . This article describes the PAT program and reports the results of evaluations of two r and omized trials of PAT  : ( 1 ) the Northern California ( Salinas Valley ) Parents as Teachers Demonstration , which served primarily Latino parents in the Salinas Valley of California 's Monterey County ; and ( 2 ) the Teen Parents as Teachers Demonstration , which served adolescent parents in four counties in Southern California . The two evaluations revealed small and inconsistent positive effects on parent knowledge , attitudes , and behavior , and no gains in child development or health , when analyses compared the experimental and control groups overall . However , subgroup analyses in the Salinas Valley program indicated that children in primarily Spanish-speaking Latino families benefitted more than either non-Latino or English-speaking Latino families , with significant gains in cognitive , communication , social , and self-help development . Subgroup analyses in the Teen PAT Demonstration indicated that families that received both PAT services and comprehensive case management services design ed to help mothers improve their life course benefitted most . Subgroup analyses in the Salinas Valley study suggested that children in families that received more intensive services benefitted more than children whose families received less intensive services . Results from that study suggested that home visits produced about a one-month developmental advantage per 10 visits for participating children OBJECTIVE : To evaluate the extent to which a home-visitation program ( Early Start ) had benefits for child abuse , child behavior , and parental- and family-level benefits to the 9-year follow-up . METHODS : A r and omized controlled trial in which 220 families receiving Early Start were contrasted with a control series of 223 families not receiving the program . Families were enrolled in the program for up to 5 years . Outcomes were assessed at 6 months , annually from 1 year to 6 years , and at 9 years after trial entry . RESULTS : Comparisons between the Early Start and control series showed that families in the Early Start program showed significant ( P < .05 ) benefits in reduced risk of hospital attendance for unintentional injury , lower risk of parent-reported harsh punishment , lower levels of physical punishment , higher parenting competence scores , and more positive child behavioral adjustment scores . Effect sizes ( Cohen ’s “ d ” ) ranged from 0.13 to 0.29 ( median = 0.25 ) . There were no significant differences ( all P values > .05 ) between the Early Start and control series on a range of measures of parental behavior and family outcomes , including maternal depression , parental substance use , intimate partner violence , adverse economic outcomes , and life stress . CONCLUSIONS : The Early Start program was associated with small to moderate benefits in a range of areas relating to child abuse , physical punishment , child behavior , and parenting competence . There was little evidence to suggest that the Early Start program had benefits that extended to the level of parents or family overall Objectives From a developmental perspective , infancy is a critical stage of life . Early childhood interventions aim to support caretakers , but the effects of universal interventions for parents with infants are unknown . The objective is to determine the effects of universal parenting interventions offered to parents with infants 0–12 months on measures of child development and parent – child relationship . Design A systematic review using the Preferred Reporting Items for Systematic Review s and Meta- Analysis . We extracted publications from 10 data bases in June 2013 , January 2015 and June 2016 and supplemented with grey and h and search . Risk of bias was assessed , and effect sizes were calculated . Participants Inclusion criteria are : ( 1 ) r and omised controlled trials of structured , psychosocial interventions offered to a universal population of parents with infants 0–12 months old in western OECD countries , ( 2 ) interventions that include a minimum of 3 sessions with at least half of the sessions delivered postnatally and ( 3 ) programme outcomes reported for child development or parent – child relationship . Results 14 papers representing 7 studies are included . There were no statistically significant effects of the intervention for the majority of the primary outcomes across the studies . Conclusions The findings of this review are mixed . No clear conclusions can be drawn regarding the effects of universally offered parenting interventions on child development and parent – child relationship for this age group BACKGROUND The Copenhagen Child Cohort , CCC 2000 , was established to investigate developmental psychopathology prospect ively from birth in a general population . METHODS A r and om sample of 211 children from the CCC 2000 was investigated when the children were 1(1/2 ) years of age . The prevalence and associates of mental health problems and psychopath 
    Output:
    
CONCLUSIONS Interventions offered to at-risk families in the first year of the child 's life appear to improve child behaviour , parent-child relationship and maternal sensitivity post-intervention , but not child cognitive development and internalising or externalising behaviour .