Preventative care, including routine well-child visits and dental cleanings, is common in medicine. Yet when it comes to mental health, people often take a “wait and see” approach, even once interfering behaviors begin to develop. Prioritizing therapy when a child is young can significantly improve family well-being and a child’s emotional, social, and cognitive development.
Several aspects may contribute to parents’ hesitation to bring their young children to therapy. Parents may wonder how therapists can help very young children, assume their children’s behaviors (e.g., shyness, tantrums, delayed speech) are typical, or hope their children will outgrow such behaviors. Additionally, parents can often manage their young children’s behaviors. But as children age, difficult behaviors often exacerbate and become more disruptive. Behaviors that were once managed at home may later interfere with children navigating, enjoying, and succeeding in other environments such as school or extracurricular activities.
Therapy can be helpful at any age. However, symptoms of clinical disorders are often present as early as the first few years of life (Briggs-Gowan et al., 2006; Brown et al., 2022; Finsaas et al., 2018; Pierce et al., 2019). When I speak with parents of older children, most recall that they noticed subtle versions of the later-diagnosed symptoms when their children were younger. For example, the parent of a middle-school aged child with social anxiety explained that her daughter had always been “shy and clingy.” Symptoms tend to persist without intervention. In contrast, early intervention, when children’s brains and behaviors are most malleable, has been shown to be beneficial and to even mitigate the risk of future disorders (Brown et al., 2022; Hirsheld-Becker et al., 2019; MacDonald et al., 2014; Ooi et al., 2022).
Parent coaching is an increasingly popular evidence-based approach to intervention and prevention. It can be particularly helpful for families of young children. It capitalizes on the fact that parents often know their children best and spend the most time with their children. Therefore, across settings, parents can use strategies that will improve their children’s skills and strengthen the parent/child relationship.
What is parent coaching? During parent coaching, a therapist teaches caregivers evidence-based strategies that they can use during daily interactions with their children to reduce problematic behaviors and teach helpful skills (e.g., brave behaviors, emotion regulation strategies, communication skills). The goal is to empower parents to understand the triggers and purpose of their children’s behaviors and to feel comfortable using effective techniques to support their children’s healthy development. The therapist collaborates with the caregiver to learn about the family’s needs and preferences and provides support. Importantly, the therapist can work directly with the child while the parent is observing, so that the parent sees these strategies modeled, and provide coaching and problem-solving strategies to caregivers when they practice using learned strategies with their children.
Parent coaching can be brief and can be helpful for parents of children as young as two years of age. It has been found to be effective in treating a range of behaviors in toddlers and children, including anxiety, disruptive behaviors, and delays in social communication. By addressing emerging concerns promptly, before children and families have developed deeply-ingrained patterns, caregivers and therapists can guide children toward healthy behaviors and coping strategies, which will build a strong foundation for children’s long-term happiness and well-being.
References:
Briggs-Gowan, M. J., Carter, A. S., Bosson-Heenan, J., Guyer, A. E., & Horwitz, S. M. (2006). Are infant-toddler social-emotional and behavioral problems transient? Journal of the American Academy of Child and Adolescent Psychiatry, 45(7), 849–858.
Brown, H.R., Laws, H.B., & Harvey, E.A. (2022). Early development of ADHD and ODD symptoms from the toddler to preschool years. Journal of Attention Disorders, 26(10), 1335-1346.
Finsaas, M. C., Bufferd, S. J., Dougherty, L. R., Carlson, G. A., & Klein, D. N. (2018). Preschool psychiatric disorders: Homotypic and heterotypic continuity through middle childhood and early adolescence. Psychological Medicine, 48(13), 2159–2168.
Hirshfeld-Becker, D. R., Henin, A., Rapoport, S. J., Wilens, T. E., & Carter, A. S. (2019). Very early family-based intervention for anxiety: Two case studies with toddlers. General Psychiatry, 32(6), e100156.
MacDonald, R., Parry-Cruwys, D., Dupere, S., & Ahearn, W. (2014). Assessing progress and outcome of early intensive behavioral intervention for toddlers with autism. Research in Developmental Disabilities, 35(12), 3632–3644.
Ooi, J., Dodd, H. F., Meiser-Stedman, R., Hudson, J. L., Bridges, J., & Pass, L. (2022). The efficacy of interventions for behaviourally inhibited preschool-aged children: A meta-analysis. Journal of Anxiety Disorders, 88, 102559.
Pierce, K., Gazestani, V. H., Bacon, E., Barnes, C. C., Cha, D., Nalabolu, S., … & Courchesne, (2019). Evaluation of the diagnostic stability of the early autism spectrum disorder phenotype in the general population starting at 12 months. JAMA pediatrics, 173(6), 578-587.
Yael Dai, Ph.D. is a clinical psychologist at Cambridge Psychology Group. Dr. Dai specializes in anxiety, OCD, autism, and family therapy and works with clients of all ages. She also has expertise in providing parent coaching to caregivers of children with anxiety, autism, or disruptive behaviors. When working with autistic children’s parents, she helps them process the diagnosis, connect with community services to support their children, and learn strategies to promote their children’s language, social skills, and adaptive behaviors (e.g., toilet training, mealtime behaviors).
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