Feature

Each year, more than 2 million children are reportedly abused or neglected in the United States, which leads to more than 166,000 of them entering child welfare systems, according to the U.S. Department of Health and Human Services. In an effort to curb that trend, a number of psychologists are working to intervene before abuse occurs by teaching parents how to effectively discipline and interact with their children.

"By…helping parents deal with their daily challenges, hopefully we can prevent inappropriate discipline that, in some cases, amounts to abuse," explains Purdue University psychologist Jean Dumas, PhD.

His Parenting Our Children to Excellence (PACE) program aims to reduce the risk of adverse child outcomes by teaching effective parenting techniques in socially disadvantaged areas. Dumas is currently testing the program's effectiveness in a study involving nearly 500 parents in Indianapolis.

In another study, University of South Carolina psychologist Ronald J. Prinz, PhD, and University of Queensland psychologist Matthew Sanders, PhD, are testing whether the Triple P--Positive Parenting Program, a multilevel evidence-based intervention tailored to individual parents' needs, can reduce child abuse while also increasing children's well-being. The program is being rolled out in nine South Carolina counties as part of an 18-county population-level randomized trial that has already involved more than 12,000 families with at least one child 7 years old or younger. With the program, Prinz and Sanders are attempting to reduce the stigma related to parenting interventions by engaging the entire community in a large-scale media blitz urging parents to tap available parenting resources.

"We want to make parenting everyone's business," says Prinz. "We can't affect maltreatment if we don't also promote healthy parenting."

PACE and Triple P are just a few of the applied research programs emerging from the Centers for Disease Control and Prevention (CDC) "Positive Actions for Parents" campaign that aims to reduce reported abuse cases through the promotion of positive parenting.

Population-based approach

In addition to media outreach, the Triple P trains professionals such as primary health-care providers, social workers and teachers to teach adults effective parenting skills.

It also partners with other early childhood education programs, such as South Carolina First Steps to School Readiness--a state-funded initiative that supports programs promoting quality child care and family strengthening. One such program is the Parents as Teachers program, through which home visitors teach parents about brain developmental stages of learning by modeling behavior with the parent and child. Triple P leaders equip First Steps providers with additional training on day-to-day child behavior management through, for example, use of time-outs rather than threats or violence, says First Steps administrator Debbie Robertson.

"We deal with many parents who don't know how to cope with their children's behavior," she says. "Triple P empowers them to understand that they can do it--they can be a good parent."

By casting a wide net, Prinz aims to eliminate any barriers that might prevent parents from accessing the program. For instance, Triple P facilitators help parents choose which topics they'd like to learn about and whether an individual consultation or group program would best fit their needs. Moreover, the program offers parents various strategies to try that can be tailored to families with infants, preschoolers and teenagers, or blended families.

The Triple P model also seeks to garner positive-parenting articles in local newspapers, broadcast public service announcements about positive parenting and Triple P programming, distribute informational flyers and brochures at community centers and advocacy organizations, and mail information to families.

"For families willing to make the commitment, Triple P provides them a very structured approach to dealing with their issues," says Sara Castillo, PhD, a psychologist at the Catawba Family Center in Rock Hill, S.C.

Prinz and his colleagues are longitudinally tracking the cases of nearly 600 practitioners in the nine South Carolina counties to document the backgrounds of parents who are using the program, the parents' perceptions of its effectiveness and the program's impact on abuse statistics.

Targeting at-risk populations

Like Prinz, Dumas believes that helping parents learn to manage their daily challenges, such as keeping children entertained or coping with their meltdowns, is essential for preventing abuse. During the eight-week program, each PACE group of five to 15 parents covers topics such as setting clear limits and teaching children to behave well at home and elsewhere.

Yet regardless of the program's content, the key to its effectiveness is ensuring participation, he says.

"We have to deal with the broad challenge of how to get people to participate in a time-consuming activity that has real, positive benefits," says Dumas.

To test the effectiveness of the PACE program, Dumas teamed with several Indianapolis day-care centers to conduct the program. In each center, Dumas and his colleagues hung posters detailing the program's goals and staffed a registration table for two days to talk to parents about the program. He also sent registration forms to all parents with children 3 to 5 years old. He then assessed parents' intent to enroll in the PACE program by conducting a pre-intervention telephone survey four weeks before the eight-week program began.

Each PACE group, which met weekly for two hours, was led by a trained group leader and assistant. Leaders were also graded each week on their adherence to the program's outline based on recordings of their session.

To reduce common attendance barriers, Dumas and his colleagues used CDC grants to keep participation free and to provide parents and children a free meal, free on-site child care and money to cover transportation costs.

During the sessions, parents watched videos and discussed their own parenting experiences. Group leaders reflected on parents' strategies and suggested alternative ideas and approaches that work for others.

According to group leader Matthew Ellis, the format encourages parents to analyze their actions.

"The first night the parents seem to be feeling each other out…but after that the parents are very supportive of each others' progress," Ellis says. "So many times parents don't have time to think about strategy; instead they react after the fact. [PACE] gives them the opportunity to think about how they will react to their children's behavior in the future."

In his initial results, Dumas has found that the lone predictor of attendance was availability of time. That being the case, Dumas aims to continue to find ways to ease the time constraints and expand availability of the program as he continues to collect data.

Anecdotally, Ellis is confident that the program helps parents and children.

"Each week I see the progress the parents are making," he says. "And it's amazing."