Abstract
BackgroundIt is common for toddlers to display disruptive behaviors (e.g., tantrums, aggression, irritability) but when these become severe and persistent they can be the start of a trajectory towards poor outcomes in childhood and adolescence. Parent Child Interaction Therapy - Toddler is an intervention model designed to meet the specific developmental needs of toddlers aged 12–24 months presenting with disruptive behaviors.MethodsThis study will use a randomized controlled design to evaluate the efficacy of the Parent Child Interaction Therapy - Toddler intervention for children aged 14–24 months with disruptive behaviors. Ninety toddlers with parent-reported disruptive behavior will be randomly allocated to either Parent Child Interaction Therapy - Toddler, Circle of Security– Parenting™ or a waitlist control group. Key parenting capacity outcome variables will include positive and negative parenting, parenting sensitivity, parental sense of competence in managing negative toddler emotions, parent sense of caregiving helplessness, parent mentalizing about the child, parent emotion regulation, child abuse potential and parental stress. Key outcome variables for children will include child social-emotional functioning (initiative, relationship functioning, self-regulation), child emotion regulation, child attachment security, and child behavior.DiscussionDelivered in the early intervention period of toddlerhood, Parent Child Interaction Therapy - Toddler has the potential to bring about significant and lasting changes for children presenting with early onset behavioral issues.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR), 12618001554257. Registered 24 September 2018 – retrospectively registered.
Highlights
It is common for toddlers to display disruptive behaviors but when these become severe and persistent they can be the start of a trajectory towards poor outcomes in childhood and adolescence
Evidence points to the value of parent-child relationship focused interventions for children with early onset attachment and/or behavioral difficulties
Evidence suggests that interventions that are brief, have a behavioral component, and enhance parental sensitivity are most likely to bring about lasting improvements in children’s attachment security and capacity for behavioral and emotional regulation [50]
Summary
It is common for toddlers to display disruptive behaviors (e.g., tantrums, aggression, irritability) but when these become severe and persistent they can be the start of a trajectory towards poor outcomes in childhood and adolescence. Observed in the SSP as odd, contradictory, disorganized behaviors in the presence of the parent, this pattern is thought to represent a breakdown or incoherence in the child’s organisational strategy and is known to be associated with the poorest psychological outcomes [17,18,19,20] These theoretical assertions are backed by empirical evidence showing that insecure and disorganized attachment patterns in infancy predict disruptive/externalizing behaviors in later childhood [21]
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