Jun 13, 2012


This parent-training program for mothers with infants involves pediatricians having regular discussions with mothers about their child-rearing attitudes, feelings, and practices.

The results of this study show that at six years of age, intervention children were less likely than control group children to demonstrate some problem behaviors such as sleep disorders and fears, but not others such as bedwetting, stealing, destructiveness, and lying. At the 20-year follow-up the Busselton Health Study group individuals had a significantly higher percentage of university degree holders, lower neurotic symptoms, and fewer sleep disturbances. But no significant impacts were found for smoking, vocational school attendance, body-mass index (height and weight taken into account together), or depressive symptoms.


Target population:Children with behavior disorders

In the Busselton Health Study, 12, 20- to 30-minute interviews take place every three months in the first year and every six months for the next four years. In the interview, the doctor encourages the parent to change interactions with the child a little at a time. The interview covers questions about family illness and events, the child’s developmental progress, behavioral symptoms exhibited in the child’s age group, the mother’s feelings about the child, the mother’s relationship with the child, and the mother’s attitudes toward parenting techniques. The mother is then encouraged to ask questions, and the doctor summarizes the child’s progress and mentions the value of the mother to the child.

Several standardized questions are asked during each interview, which include the following:

  • “Do you agree it is good to be yourself with your child?”
  • “How do you manage to have the courage of your convictions?”
  • “Is it bribery to reward children after they have done well?”
  • “Should children learn to expect unfairness from others?”
  • “Can you protect your child from much that is painful?”
  • “Should a child learn to tolerate frustrations and boredom?”
  • “Do children need to trust someone?”
  • “Do children watch how we live?”
  • “Has your child learned this fear from someone?”
  • “Can you teach him to get over this fear?”
  • “Do children become accident prone by watching our own impulsiveness?” and
  • “Don’t you think it takes time for a child to learn self-control?”

Suggestions made for parenting techniques during the child’s first year include the following: breast feeding; confident, consistent, secure holding during nursing; and weaning needs to occur before toilet training. In the second year, the following are suggested: being patient, communicating clearly, giving love and praise spontaneously, being consistent, using reasoning rather than forcing the child to be obedient, expecting obedience, resisting coercion from the child, encouraging learning, supervising behavior, allowing time to play together, and demanding reasonable amounts of responsibility, self-sufficiency, and self-control.


Cullen, K. J. (1976). A six-year controlled trial of prevention of children’s behavior disorders. Behavioral Pediatrics, 88(4), 662-666.

Evaluated Population: A total of 246 children from Busselton, Australia were evaluated. Of these, 124 were in the treatment group (60 boys and 64 girls) and 122 were in the control group (58 boys and 64 girls).

Approach: Children were randomly assigned to a treatment group or to a control group. Those in the experimental group received the intervention as described above. The control group was interviewed annually about family events in the last year. Contact was maintained by the study secretary and photos of the children were taken every six months to maintain interest in the study.

When the children were six years old, the following were measured by a preschool teacher: behavioral symptoms, family relations, IQ, readiness for formal work, learning ability, vocabulary, and spontaneous speech.

Results: According to the mothers; reports of the children’s behavior, the children in the experimental group were less likely to have as many fears, to have sleep disorders, to have eating problems, to fear snakes, to fear blood, to “gulp” food at the table, to talk loudly, and to hit others, but more likely to be late for school. There were no significant differences between the treatment and control groups on the following: school performance, IQ, abdominal pains, nausea, headaches, limb pains, bedwetting, soiling, asthma, eczema, food allergies, twitching, blinking, hair pulling, hair twirling, nail biting, teeth grinding, thumb sucking, lip chewing, sore picking, nose picking, nose sniffling, stuttering, timidity, impatience, clumsiness, school difficulties (besides being late), cursing, destructiveness, stubbornness, stealing, lying, or fire lighting.

The children in the experimental group had both more positive and negative feelings toward their mothers as well as more total involvement than the children in the control group.

Cullen, K. J., & Cullen, A. M. (1996). Long-term follow-up of the Busselton six-year controlled trial of prevention of children’s behavior disorders. Journal of Pediatrics, 129(1), 136-139.

Evaluated Population: Adults followed from the Busselton Health Study to prevent children’s behavior disorders, ranging from 27 to 29 years old, were evaluated. Ninety percent (209 participants) of the original group participated in follow-up.

Approach: The participants were surveyed about smoking, going to a vocational school, acquiring a university degree, height, weight, depressive symptoms (fatigue, anxiety, apathy, lethargy, depression, and unhappiness), neurotic symptoms (anxiety, nervousness, irritability, and fears), and sleep disturbances (poor sleep, nightmares, and snoring).

Results: At the 20-year follow-up, participants in the treatment group were less likely to report neurotic symptoms, more likely to report fewer sleep disturbances and more likely to have received a university degree than the control group. There were no significant impacts on smoking, vocational school attendance, height, weight, or depressive symptoms. Women in the experimental group were more likely to report fewer depressive and neurotic symptoms than women in the control group. They also were more likely to have university degree and less likely to have a body mass index above 25.



The Busselton Population Medical Research Foundation,


Cullen, K. J. (1976). A six-year controlled trial of prevention of children’s behavior disorders. Behavioral Pediatrics, 88(4), 662-666.

Cullen, K. J., & Cullen, A. M. (1996). Long-term follow-up of the Busselton six-year controlled trial of prevention of children’s behavior disorders. Journal of Pediatrics, 129(1), 136-139.

Clinic/Provider-based, Infants (0-12), Toddlers (12-36), Children (3-11), Parent or Family component, Conduct/Disruptive Disorders, Other Social/Emotional Health, Depression/Mood Disorders, Anxiety Disorders/Symptoms, Parent Training/Education, White/Caucasian, Males and Females (co-ed), Eating Disorders, Tobacco Use, College Enrollment/Preparation, Other Education, Delinquency, Aggression, Other Physical Health, Other Mental Health.

Program information last updated 6/13/12.