A positive behavioural intervention for toddlers: parent-child attunement therapy

Abstract

Parent–child attunement therapy (PCAT) is a promising intervention for toddlers (aged 12–30 months) who have experienced maltreatment. PCAT has two overall purposes: (1) to strengthen caregivers' relationship with their children; and (2) to facilitate caregivers' learning of appropriate child management techniques. PCAT represents an adaptation of parent–child interaction therapy (PCIT), which has been empirically documented in preschool and early elementary schoolchildren to improve behavioural adjustment and engender a stronger bond between caregiver and child. There is, however, a noted paucity of intervention research for toddlers, specifically maltreated toddlers. As toddlerhood represents a critical period for enhancing the relationship between caregivers and children and is a stage when youngsters are at increased risk for maltreatment, the objectives of PCAT become even more salient during the toddler years. The purpose of this study, therefore, is to introduce PCAT and then examine its effectiveness through a single case study of a 23-month-old maltreated toddler and his biological mother. Pre- and post-assessment measures included the Parenting Stress Index, the Dyadic Parent–Child Interaction Coding System (DPICS), the Achenbach Child Behavior Checklist (CBCL), the Emotional Availability (EA) Scales and the Eyberg Child Behavior Inventory (ECBI). The results of this study demonstrate the effectiveness of PCAT in increasing the number of positive caregiver–toddler interactions and enhancing the overall quality of the caregiver–toddler relationship. Practitioners will be able to use the techniques described in this manuscript to improve the parent–toddler relationship and ameliorate many commonly experienced behavioural difficulties found among maltreatment-prone parent–toddler dyads. Therapeutic progress is easily charted so that effectiveness may be documented and termination of therapy may be easily discerned. Copyright © 2005 John Wiley & Sons, Ltd.