Optimizing parenting and child outcomes following parent-child interaction therapy - toddler: a randomized controlled trial

Background: Parent-Child Interaction Therapy-Toddler (PCIT-T) is an attachment-informed intervention model designed to meet the specific developmental needs of toddlers aged 12-24 months presenting with challenging behaviors.

Methods: This study used a randomized controlled design to evaluate outcomes of PCIT-T for children aged 14-24 months with disruptive behaviors. Ninety toddlers with parent-reported disruptive behavior were randomly allocated to PCIT-T (intervention), an active control condition (Circle of Security- Parenting™; COS-P), or a non-treatment control condition (wait-list; WL). Outcomes were assessed at baseline (Time 1), post treatment/post waitlist (Time 2) and 4-month follow-up (Time 3).

Results: At follow-up, the PCIT-T group displayed the highest levels of parenting sensitivity and positive parental verbalizations, and the lowest levels of negative child-directed verbalizations and non-attuned mind-minded statements. Of the three groups, the PCIT-T group showed the greatest degree of change on these variables, followed by the COS-P group and then the non-treated controls. The PCIT-T group were also the only group to show significant within-group improvements in sensitivity, self-reported parental reflectiveness, empathy and emotional understanding, parent-reported child social competence, child internalizing problems, and general behavior issues. Significant reductions in parental stress, child externalizing behaviors and parenting behaviors were seen for both the PCIT-T and COS-P groups.

Conclusions: Delivered in the early intervention period of toddlerhood, Parent-Child Interaction Therapy-Toddler has the potential to bring about significant changes for children presenting with early onset behavioral issues.

Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR), 12,618,001,554,257. Registered 24 September 2018 - retrospectively registered, https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001554257 .