Preschool-based mother-child emotional preparation program improves emotional connection, behavior regulation in the home and classroom: a randomized controlled trial

Martha G Welch; Robert J Ludwig; Amie A Hane; Judy Austin; Elizabeth S Markowitz; Marc E Jaffe; Michael M Myers

doi:10.3389/frcha.2023.1232515

Preschool-based mother-child emotional preparation program improves emotional connection, behavior regulation in the home and classroom: a randomized controlled trial

Front Child Adolesc Psychiatry. 2023 Oct 20:2:1232515. doi: 10.3389/frcha.2023.1232515. eCollection 2023.

Authors

Martha G Welch^{1

2}, Robert J Ludwig¹, Amie A Hane^{1

3}, Judy Austin⁴, Elizabeth S Markowitz¹, Marc E Jaffe⁵, Michael M Myers^{1

2}

Affiliations

¹ Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States.
² Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States.
³ Department of Psychology, Williams College, Williamstown, MA, United States.
⁴ Mailman School of Public Health, Columbia University, New York, NY, United States.
⁵ Children's Learning Centers of Fairfield County, Stamford, CT, United States.

Abstract

Introduction: Based on the theory that increasing emotional connection and reducing emotional stress between mother and child at home will reduce dysregulated behavior in the classroom, we tested a novel family-based school intervention aimed at facilitating mother-child emotional connection. This question has gained great importance following the COVID-19 pandemic, as child mental health has been declared a national emergency.

Methods: Subjects were randomized into two groups; one (Control: n = 32) receiving the standard curriculum in a large community-based preschool education program, and another (MCEP) receiving the standard curriculum plus the Mother Child Emotional Preparation Program (MCEP: n = 30). Two to eight MCEP mother-child pairs participated in eight elective weekly 2-h group sessions over a 16-week period. During the 2-h sessions, the pairs were engaged in face to face calming sessions. At 6 months post-enrollment, we assessed mother-child emotional connection on the Welch Emotional Connection Screen (WECS). In addition, mothers and teachers completed validated questionnaires and instruments.

Results: We found that the percentage of MCEP mother-child pairs who became emotionally connected at 6 months was five-fold higher than Control pairs (47.4%, vs. 8.3% p = 0.004, effect size = 0.44). Also at six months, MCEP children had fewer behavioral symptoms (p = 0.024)) (effect size >0.5); fewer autism symptoms (p = 0.048) (effect size = 0.53); fewer emotional symptoms (p = 0.01) (effect size >0.76); better personal, social skills (p = 0.045) (effect size = 0.51); better executive function (p = 0.032) (effect size = 0.59). Importantly, teachers reported MCEP children showed more improved behavior in the classroom, compared to controls.

Discussion: This trial was retrospectively registered in the clinicaltrial.gov registry (NCT02970565) on April 9, 2019.

Keywords: ASQ questionnaire; Welch Emotional Connection Screen; autism treatment evaluation checklist; classroom behavior; emotional dysregulation; family intervention; relational health; socioemotional behavior.

Associated data

ClinicalTrials.gov/NCT02970565

Grants and funding

This study was supported by Kathy Emmett and David Golub, the Einhorn Family Charitable Trust, Deki Stephenson, Fleur Fairman Family, John and Rainy Erwin and Morgan Rutman Family, who had no influence upon the study design, data collection, analysis and interpretation of data, nor participated in the writing of the manuscript or submission/publication process.