For most children the terrible 2s is a healthy stage of development, but some toddlers can be difficult to manage.
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Parents of difficult toddlers can benefit from group training sessions, where parents learn the skills needed to deal with temper tantrums and other disruptive behaviors alongside other parents, researchers say.
In a new study, researchers looked at 150 parents of children ages 2 to 4, and randomly assigned them to either groups of six to 12 parents who received training, or to a control group, on a waiting list group for the training sessions. Parents were included in the study if their child had moderately or severely disruptive behavior, as indicated by a diagnostic test.
Parent-training groups were led by a psychologist or a social worker who taught the parents how to modify behaviors of their children(for example, by reinforcing positive behaviors and avoiding harsh parenting) during a 10-week program. The sessions included group discussion and role-playing, and were held at a pediatrician's office.
A year later, the results from parents' reports and videotaped observations suggested children of parents in the training groups showed less disruptive behavior compared with the beginning of the study. No differences were found in the waiting-list group before and after the year, according to the study published today (Nov. 5) in the journal JAMA Pediatrics. [10 Scientific Tips For Raising Happy Kids]
Growing evidence shows that parent-training groups are cost-effective in reducing children’s disruptive behaviors, the researchers wrote in their study. "Offering them in pediatric practices, using trained practice staff represents a critical opportunity to provide access to effective mental health care to a wide population," the researchers wrote.
What's normal during the terrible 2s?
Behavior problems often happen around age 2 as toddlers go through a normal stage of development, called the terrible twos, when an emerging sense of "an independent self" and a desire for autonomy puts them in clashes with parents, and results in mood changes, temper tantrums and oppositional behaviors.
"In most children, these behaviors are manageable, especially if parents are experienced," said Dr. Martin Stein, a professor of pediatrics at the University of California, San Diego, who wasn't involved with the study.
But some children are more aggressive and disobedient than usual, and persistently show disruptive behaviors that impair child and family function, he said.
"Group care is not the focus of most pediatric practices. We rely on building a relationship with a family, and provide care with one child and one parent or caretaker at a time," Stein told LiveScience.
Location, location, location
But although most pediatricians' offices are probably not equipped to accommodate group sessions, the approach has several potential benefits, Stein said. It provides an opportunity to educate more parents at the same time compared with sitting one-on-one with the physician, and it encourages interaction among parents.
The location itself may be a benefit.
"Often, when we have [children with] behavioral problems, we might refer them to a psychologist in an office 10 miles away, so the chance that parents would follow the referral is not always great," Stein said.
The other problem with current approaches is that the insurance companies don't consistently reimburse referrals for behavioral help.
"If we can incorporate behavioral approaches in a primary care setting such as the pediatrician's office, perhaps we can involve more families," Stein said.