While problematic behaviors can hamper children’s early positive development, the teacher–child relationship can play a crucial role in mitigating children’s externalizing problem behavior (EPB).This review aims to systematically examine and synthesize evidence on the effectiveness of interventions designed to enhance teacher–child interactions (TCIs) and assess their impact on reducing EPB among children in childcare settings. Systematic literature searches were performed on four electronic databases (EBSCO, ERIC, SCOPUS, and WOS). A complementary search of clinical trial registries (clinicaltrials.gov) was performed. The studies reported on interventions targeting the promotion of TCI to reduce children’s EPB in childcare settings. The children were aged 0–6 years, and their EPB was assessed using self-report questionnaires and/or observational coding instruments. The risk of bias was evaluated using the Joanna Briggs Institute’s Critical Appraisal Tool. The standardized mean differences were pooled using random effects, and a moderator analysis was conducted. The review included 26 studies, 12 of which were included in a meta-analysis, revealing a significant decrease in children’s EPB (SMD = −0.240; 95% CI = [−0.362, −0.117]; p = 0.001). Tier-2 interventions implemented within the Multi-Tiered Systems of Support (MTSS) framework were particularly effective (SMD = −0.508; 95% CI: [−0.755, −0.261]). Furthermore, interventions that integrated video components also showed significant effectiveness (SMD = −0.303; 95% CI: [−0.434, −0.172]). This review emphasizes the importance of enhancing TCIs to reduce children's EPB and recommends innovative training methods and long-term follow-up studies for improved effectiveness.

虽然有问题的行为会阻碍儿童的早期积极发展，但师生关系可以在减轻儿童的外化问题行为 （EPB） 方面发挥关键作用。本综述旨在系统地检查和综合旨在加强师生互动 （TCI） 的干预措施有效性的证据，并评估它们对减少托儿机构儿童 EPB 的影响。对四个电子数据库 （EBSCO、ERIC、SCOPUS 和 WOS） 进行了系统文献检索。对临床试验注册库 （clinicaltrials.gov） 进行了补充检索。这些研究报告了针对促进 TCI 以减少儿童在托儿环境中的 EPB 的干预措施。儿童年龄在 0-6 岁之间，使用自我报告问卷和/或观察性编码工具评估他们的 EPB。使用 Joanna Briggs Institute 的 Critical Appraisal Tool 评估偏倚风险。使用随机效应合并标准化平均差异，并进行调节器分析。该评价纳入了 26 项研究，其中 12 项被纳入荟萃分析，揭示了儿童 EPB 的显著降低 （SMD = −0.240;95% CI = [−0.362， −0.117];p = 0.001）。在多层支持系统 （MTSS） 框架内实施的 2 级干预措施特别有效 （SMD = -0.508;95% CI： [-0.755， -0.261]）。此外，整合视频组件的干预措施也显示出显著的有效性（SMD = -0.303;95% CI： [-0.434， -0.172]）。本综述强调了增强 TCIs 以减少儿童 EPB 的重要性，并推荐了创新的训练方法和长期随访研究以提高有效性。