Jim Kling

May 07, 2015

SAN DIEGO — A video-based program designed to improve parent–child interactions during reading and play also reduces spanking and slapping, new research shows.

"By bringing the parent and child closer together, we reduced the parents' feelings that they needed to engage in physical punishment," said Alan Mendelsohn, MD, from the NYU School of Medicine and Bellevue Hospital Center in New York City.

Reducing physical punishment is important. Research has shown that it is associated with poor outcomes, including aggression and mental health issues, Dr Mendelsohn told Medscape Medical News.

He presented findings from the Video Interaction Project here at the Pediatric Academic Societies 2015 Annual Meeting.

The 325 mothers involved in the study were recruited after giving birth, and the mother–infant pairs were randomized to one of two intervention groups or to a control group that received no intervention.

In the video intervention group, mothers were recorded interacting with their children during play or while reading aloud, and a trained interventionist then reviewed the recording with each mother and offered guidance to improve interactions.

In the nonvideo intervention group, mothers were sent newsletters, learning materials, and developmental surveys every month.

Only 39.4% of the mothers in the study had completed high school and 92.6% of the cohort was Hispanic.

At 6 months, positive parenting behavior was assessed in all women using the StimQ Cognitive Home Environment test. At 14 and 24 months, physical punishment was assessed with Socolar's Discipline Survey.

Improving the Parent–Child Bond

At 24 months, the incidence of physical punishment reported by mothers was lower in the video group than in the control group (75.0% vs 84.7%; odds ratio [OR], 0.54; 95% confidence interval [CI], 0.30 - 0.97).

This reduction was mediated by positive parenting behaviors (regression coefficient B, –0.11; standard error, 0.06; P < .05).

There was no difference in physical punishment between the nonvideo group and the control group.

"This is one of the first demonstrations I can think of in which an intervention designed to improve the quality of parent–child interaction in play resulted in less aversive discipline by the parent," said Robert Needlman, MD, from Case Western Reserve University in Cleveland, who attended the presentation.

"It's wonderful validation of what we think we understand about how relationships between parents and children work," he told Medscape Medical News.

The results are encouraging, agreed Kofi Essel, MD, from the Children's National Medical Center in Washington, DC.

However, "they didn't show how the effect size compares with other techniques trying to reduce physical punishment," he told Medscape Medical News. "I think we need to see more of a comparison before we can make a bigger jump."

Dr Essel said he thinks such a program might be a challenge to implement because of time constraints. "From what I saw, there would need to be tweaks before it could easily fit into a busy primary care practice," he explained.

Dr Mendelsohn, Dr Needlman, and Dr Essel have disclosed no relevant financial relationships.

Pediatric Academic Societies (PAS) 2015 Annual Meeting: Abstract 2145.8. Presented April 26, 2015.

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