Parent–Child Interaction Therapy with Toddlers: A Community-based Randomized Controlled Trial with Children Aged 14-24 Months

ABSTRACT

Objective: Children with early-onset behavioral issues are at high risk for ongoing behavioral, psychological, and social issues.

Method: This study examined the efficacy of the first phase of Parent–Child Interaction Therapy with Toddlers, Child-Directed Interaction – Toddler, using a randomized control design. Sixty-six mother-toddler dyads (Child Mage = 19.13 months; 63% male; 34% from a non-English speaking background) referred to a community-based child behavior clinic in Australia received CDI-T immediately or were assigned to a waitlist control condition. At baseline (Time 1) and post-treatment/post-waitlist (Time 2), mothers completed questionnaires (Child Behavior Checklist, Edinburgh Postnatal Depression Scale, Parenting Stress Index – Short Form) and participated in a structured parent–child dyadic play-based interaction later coded using the Dyadic Parent–Child Interaction Coding System and the Emotional Availability Scales.

Results: Compared to those who did not receive treatment, mother-child dyads who received the intervention showed significantly better parenting skills (increases in positive parenting skills and decreases in negative parenting skills), emotional availability (increases in parental sensitivity and parental non-intrusiveness), child behavior (decreases in externalizing and internalizing behaviors) and parental perceptions of child difficulty.

Conclusions: Results suggest that the CDI-T phase of PCIT-T is a promising intervention for toddlers presenting with behavioral issues. Future studies should be conducted to assess efficacy in other settings and to assess longer-term outcomes.

Acknowledgments

The authors would like to thank the families who participated in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

¹ To be differentiated from a later iteration of the PCIT-T model, described in Girard et al. (2018), that includes a PDI-Toddler phase.

² The data for this case was deemed invalid for the study as different parents (same-sex couple) had completed the observational and questionnaire-based measures.

³ Of the participants allocated to the intervention condition and who were included in the Intention-to-Treat sample (ITT; see Analysis section), the mean number of sessions was 7.12 (SD = 4.52, range 0–13).

⁴ Also, when we re-ran our CBCL analyses excluding children aged less than 18 months we found that results followed a similar pattern to those reported for the larger sample.

Additional information

Funding

This work was supported by the Liverpool Catholic Club.