Centre for Community Child Health

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Toddlers Without Tears

  • toddlers without tear logo

    Behaviour and emotional problems (also known as mental health problems) affect 1 in 7 Australian children. These problems include aggression, disobedience, anxiety, social withdrawal and depression. Around 50% of preschool children's problems continue through the childhood years. The Toddlers Without Tearsprogram aimed to prevent children from developing behaviour and emotional problems in the first place. It led on to our next major trial, Families in Mind.

    Toddlers Without Tears is:

    • A brief group parenting program.
    • Suitable for all families with young children.
    • Designed by children's doctors, child psychologists, and maternal and child health nurses.
    • Helps parents learn how to encourage positive toddler behaviour and reduce aggressive and anxious behaviours.
    • Uses parenting handouts, group discussion, and video examples.

    Toddlers Without Tears aims to:

    • Understand how child behaviour and emotional problems develop from infancy in the first 6 years of life.
    • Prevent young children from developing behaviour and emotional problems as they grow.
    • Measure the economic costs to deliver this parenting program in the community.

    The study started with a successful pilot in 2002 in Moonee Valley; then took place in six Melbourne local government areas of Greater Geelong, Glen Eira, Kingston, Maribyrnong, Nillumbik Shire, and Stonnington.

    Toddlers Without Tears has five stages:

    • In Stage 1 (2004 to 2005), 733 families (69% of births) were randomly divided into two groups: Intervention and Control. Intervention families were invited to attend two parenting groups run in their local area by maternal and child health nurses when their children were 12 and 15 months old. These groups focused on parenting practices to prevent behaviour problems.
    • In Stage 2 (2006), 655 (89%) families were followed up as their children reach 2 years of age.
    • In Stage 3 (2006), 143 Intervention families were invited to pilot an extra parenting group when children were 2 years old. This group focused on parenting practices to prevent emotional problems.
    • In Stage 4 (2007), 589 (80%) families were followed up at 3 years of age.
    • In Stage 5 (2009 to 2010), all families are followed up as their children turn 5 and 6 years and are starting school. 

    Toddlers Without Tears has so far:

    • Been well received by parents and maternal and child health nurses.
    • Reduced harsh discipline parenting (smacking and yelling).
    • Improved parent's developmental understanding about their young children's behaviour.
    • Not had an impact on child behaviour problems.
    • Helped to understand how parenting shapes children's long-term emotional and behavioural well-being.

    Want to know more about the project?

    Read our publications below:

    • Hiscock H, Bayer J, Wake M. Preventing toddler behaviour problems: pilot evaluation of a universal parenting program. International Journal of Mental Health Promotion 2005; 7:52-58. [Read Article]
      (First published in International Journal of Mental Health Promotion, issue no. 7 by The Clifford Beers Foundation)
    • Bayer J, Hiscock H, Morton-Allen E, Ukoumunne OC, Wake M. Prevention of mental health problems: rationale for a universal approach. Archives of Disease in Childhood 2007; 92:34-38. [Read Article]
      (First published in Archives of Disease in Childhood by BMJ Publishing Group Ltd)
    • Hiscock H, Bayer JK, Price A, Ukoumunne OC, Rogers S, Wake M.  Universal parenting programme to prevent early child behavioural problems: cluster randomised trial.  BMJ 2008; 336:318-321. [Read Article]
      (First published in BMJ by BMJ Publishing Group Ltd)
    • Bayer J, Hiscock H, Ukoumunne O, Price A, Wake M.  Early childhood aetiology of mental health problems: a longitudinal population-based study. Journal of Child Psychology and Psychiatry Nov 2008; 49(11):1166-1174. [Read Article]
    • Hisock H, Bayer J, Hampton A, Ukoumunne O, Wake M. Long-term mother and child mental health effects of a population-based infant sleep intervention: Cluster randomized controlled trial. Pediatrics 2008;122(3):e621-e627 
    • Bayer JK, Hiscock H, Scalzo K, Mathers M, McDonald M, Morris A, Birdseye J, Wake M.  Systematic review of preventive interventions for children's mental health: what would work in Australian contexts? Australian and New Zealand Journal of Psychiatry 2009.
    • Bayer J, Hiscock H, Ukoumunne O, Scalzo K, Wake M. Three-year-old outcome of a brief universal parenting intervention to prevent behaviour problems: randomised controlled trial.Arch Dis Child 2010; 95:187-192 [Read Article]
      (First published in Journal of Child Psychology and Psychiatry by Wiley-Blackwell Publishing - see note below)

    Methodology:

    Population health study
    Randomised control trial
    Date: Start: December 2001
    Finish: ongoing
    Funding: William Buckland Foundation
    Telstra Community Development Fund
    Murdoch Childrens Research Institute Grants
    Project email: twt.study@rch.org.au

    Contacts/Staff involved:

    Dr Jordana Bayer
    jordana.bayer@mcri.edu.au  

    Dr Harriet Hiscock
    harriet.hiscock@rch.org.au

    Note: This is an electronic version of an article published in the Journal of Child Psychology and Psychiatry: complete citation information for the final version of the paper, as published inthe print edition of the Journal of Child Psychology and Psychiatry, is available on the Blackwell Synergy online delivery service, accessible via the journal's website at http://www.blackwellpublishing.com/journal.asp?ref=0021-9630 or http://www.blackwell-synergy.com.

 

Murdoch Childrens Research Institute

The Centre for Community Child Health is a department of The Royal Children’s Hospital and a research group of Murdoch Childrens Research Institute.