Preventative Intervention for Social, Emotional and Behavioural Difficulties in Toddlers and Their Families: A Pilot Study

Abstract

Preventative intervention early in life is key to interrupting trajectories toward subsequent emotional and behavioural problems later in life. This study examined the effectiveness of the Holding Hands program, an innovative program of preventative intervention aimed at improving the behavioural and emotional functioning of 12 to 48-month-old toddlers, and the wellbeing of their parents. This program seeks to synthesise the existing evidence in four ways; it incorporates both traditional Parent Management Training and Direct Coaching methods. It is intensive, significantly reducing session numbers and it explicitly addresses parental emotion regulation. The program also utilises operant learning principals in an effort to contingently reinforce behaviour that parents want to see more of, without employing exclusionary strategies in response to behavior that parents want to see less of. Thirty-one families, with a toddler who met clinical or sub-clinical cut-offs for externalising or internalising problems, were self- or externally-referred to the six- to eight-week program. Results indicated statistically significant improvement in toddler emotional and behavioural functioning, and parent well-being on a range of psychometric measures from pre- to post-treatment. Treatment gains were maintained for parents and children at follow-up. Implications of these findings for clinical practice and suggestions for future research are discussed.

The Effects of Online Behavioral Parenting Interventions on Child Outcomes, Parenting Ability and Parent Outcomes: A Systematic Review and Meta-analysis

“…These processes revolve primarily around the capacity for the expression and regulation of emotion within the family system, the development of child regulation as a result of processes of parent–child co-regulation (Schore, 2005 ; Somers et al, 2021 ), and the extent and manner in which regulation/dysregulation influences/is influenced by relational transactions within that system (Hajal & Paley, 2020 ; Morris et al, 2017 ). It is for these reasons that current programs of preventative intervention for child social, emotional and behavioural difficulties that are developed on the basis of current evidence consider parental emotion regulation as a key target of intervention in addressing family systems that inadvertently engage undesirable child behaviour (McAloon & Lazarou, 2019 ).…”

“…Subsequently, it indicates that parents have succeeded in limiting engagement (inadvertent contingent reinforcement) of undesirable child behavior. This capacity, originally articulated by Hanf ( 1969 ), has consistently been identified as central to the prevention of behavioral difficulties in children, and is applicable to internalizing as well as externalizing child behavior (McAloon & Lazarou, 2019 ; Webster-Stratton, 1990 ).…”

“…Perhaps unsurprisingly, lower levels of parenting self-efficacy have been associated with problematic parenting practices (e.g., hostility, harsh discipline, and coercion) in both low and high-risk child populations (Bor & Sanders, 2004 ; Chau & Giallo, 2015 ). Less self-efficacious parents may resort to problematic parenting practices to manage their child’s behavior which may, in turn, result in greater emotional and behavioral difficulties later in childhood (McAloon & Lazarou, 2019 ; Rominov et al, 2016 ).…”