Toddlers Without Tears

TODDLERS WITHOUT TEARS

OVERVIEW

Toddlers Without Tears is a universal parenting program that targets three risk factors for early childhood behavioral problems: unreasonable expectations, harsh parenting, and lack of nurturing parenting. Maternal and child health care centers were randomly assigned to the intervention group or treatment as usual group. This program was found to have impacts on the mother's parenting when the child was 2 years old, specifically for unreasonable developmental expectations and harsh discipline practices. No impacts on child outcomes were found.

DESCRIPTION OF PROGRAM

Target Population: Mothers of infants

This program consists of three sessions, one at 8 months, one at 12 months, and one at 15 months of age. At the 8-month visit, the mother receives four handouts outlining normal development for the next year. At the 12-month visit, parents attend a group session lasting two hours discussing ways to develop positive relationships with their children and how to plan for situations in which toddlers are likely to misbehave. At 15 months, parents attend another two-hour group session where they learn to identify low priority and high priority misbehaviors. For low priority misbehaviors, parents are encouraged to use planned ignoring, distraction, and logical choices as strategies. For high priority misbehaviors, "quiet time" is suggested.

Training for program nurses is a half hour for the 8-month session, and 2.5 hours each for the 12- and 15-month sessions. The nurses receive a program manual and handouts for parents. The nurses sit for lecture, role play, and watch video vignettes of parenting situations.

EVALUATION OF PROGRAM

Hiscock, H., Bayer, J. K., Price, A., Ukoumunne, O. C., Rogers, S., & Wake, M. (2008). Universal parenting programmer to prevent early childhood behavioural problems: Cluster randomised trial. British Medical Journal, 336(7639), 318.

Evaluated Population: Mothers (N=733) of 8 month old children were evaluated. The mothers were about 33 years of age. About 96 percent of the mothers were married or cohabiting. The women were recruited during free, routine well-child appointments in greater Melbourne, Victoria, Australia.

Approach: Maternal and child health centers were randomly assigned to intervention and control groups. The control group received usual care from the Maternal and Child Health Center. All outcomes were reported by the mother. They answered questionnaires at child age 7 months, 12 months, 18 months, and 24 months. Mothers were asked about child externalizing and internalizing behaviors, child temperament, maternal depression, anxiety, and stress, and parenting practices.

Results: When the child was 24 months old, mothers reported significantly fewer unreasonable developmental expectations of their children and significantly fewer harsh discipline practices. In each case, the effect size was small (0.2). These two outcomes were not significant at child age 18 months. The following were nonsignificant for both ages: child externalizing, child internalizing, parent warm nurturing, maternal depression, maternal anxiety, and maternal stress.

This study adjusted for randomization at the center-level while analysis occurred at the participant level.

SOURCES FOR MORE INFORMATION:

http://www.rch.org.au/ccch/research.cfm?doc_id=10631

http://www.familyservices.govt.nz/our-work/strong-families/toddlers.html

Vicky.Ellison001@msd.govt.nz

References:

Program categorized in this guide according to the following:

Evaluated Age Range: 0-2 years

Program Components: Clinic/provider-based

Program Outcomes: Behavior problems, Social and emotional health

KEYWORDS: Early Childhood (0-5), Infants (0-12 months), Toddlers (12-36 months), Clinic-based, Externalizing Problems, Urban, Depression, Anxiety, Parent-management Skills.

Program information last updated on July 15, 2009

		© Child Trends 2003