Program

Jan 16, 2013

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/

Vicky.Ellison001@msd.govt.nz

References:

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.

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.

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