None listed
Conditions
Brief summary
This project is a pilot study aiming to examine the initial feasibility, acceptability and preliminary efficacy of a seven-week early intervention programme among a sample of very young children with emerging disruptive behaviours and their families. The empirically-supported PCIT protocol will be adapted to meet the needs of 12-24-month old children. In particular, the intervention under investigation involves an initial parent-only session, which focuses on teaching parents how to positively engage with their child. Parent(s) and children will then attend six-weekly 60-minute sessions, in which parents receive in-vivo coaching from a clinician using skills taught in the initial session, using a wireless headset from behind a one-way mirror. Parents will then be asked to complete daily 5-minute skills practice activities involving playtime with their child at home. It is hypothesized that families will show improvement in the primary outcomes at post-treatment and 6-month follow-up. Primary outcome measures include improvements in child disruptive behaviours, precursor markers of callous-unemotional (CU) behaviours (e.g., lack of empathy/ guilt, uncaring attitudes/behaviours), and parental stress and wellbeing.
Interventions
Participating families will receive a modified version of Parent-Child Interaction Therapy (PCIT), adapted to meet the needs of children aged 12 to 24 months with emerging disruptive behaviour.
PCIT is a clinic-based protocol, which draws on real-time, wireless technology to provide in-vivo coaching of parent-child interactions by a therapist observing the parent-child dyad from behind a one-way mirror. Due to the developmental needs of children 12-24 months old, the adapted PCIT intervention u
Participating families will receive a modified version of Parent-Child Interaction Therapy (PCIT), adapted to meet the needs of children aged 12 to 24 months with emerging disruptive behaviour. PCIT is a clinic-based protocol, which draws on real-time, wireless technology to provide in-vivo coaching of parent-child interactions by a therapist observing the parent-child dyad from behind a one-way mirror. Due to the developmental needs of children 12-24 months old, the adapted PCIT intervention under investigation includes the Child-Directed Interaction phase of PCIT (CDI) only. During sessions, parents are coached in traditional play therapy skills, including following the child’s lead and engaging in warm/affectionate and emotionally responsive parenting. Parents are taught to consistently attend to and reinforce positive child behaviours via "do" skills, including praise, descriptions of child behaviour, reflections of appropriate child speech, imitations of appropriate child behaviour, and expressing warm and affectionate behaviours towards the child (e.g., positive touch, increased eye contact), while simultaneously withdrawing their attention from negative, inappropriate behaviours. The overall purpose of applying these skills is to improve the quality of the parent-child relationship, which help promote changes in behaviour. The first intervention session is a Teach session during which parents are taught specific skills. These skills are then practiced in the following six Coach sessions. The current protocol utilises a fixed approach to dosage, with all families receiving seven weekly, 60-minute intervention sessions. Prior research indicates improved outcomes and lower attrition rates using a fixed approach to dosage. The therapy will be delivered by a provisional, general or clinically registered psychologist trained in the protocol, one-on-one in a research setting. Parents will be provided handouts designed specifically for this study. These handouts will include the skills taught and age-appropriate toys recommended for 5 minutes of daily practice. Each week, parents will be given homework sheets to complete detailing whether they completed their daily practice, what toys they used, and problems or questions that arose during daily practice. Adherence to the protocol will be monitored via the number of sessions that participating families attend and adherence to session and homework demands/requirements (i.e., five minutes of daily skill practice).
Sponsors
Associate Professor Jenny Richmond
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
12 Months to 24 Months
Healthy volunteers
No
Inclusion criteria
Inclusion criteria include: i) Child aged 12-24 months of age; ii) T-score greater than or equal to 60 on the ITSEA Externalising domain; iii) Participating parent/caregiver and child fluent in English, as PCIT is heavily language-based; iv) Participating parent/caregiver and child not deaf or have significant visual impairment.
Exclusion criteria
Exclusion criteria include: i) Participating parent/caregiver has intellectual disability ii) Child is receiving concurrent psychological treatment for emotional/behavioural problems iii) Child diagnosed with Autism Spectrum Disorder iv) Parent/caregiver has significant mental health problems that are likely to interfere with the treatment engagement v) Active intimate partner/domestic violence where the abusive partner is current residing in the home (risk issue will first be dealt with, before commencing intervention).
Outcome results
None listed