Conference Agenda

Empathy is an important part of social relationships. Increasing emotion understanding and perspective-taking abilities can help foster empathy in early childhood. This study examines the long-term effects of a Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) on children’s cognitive empathy. Participants included 300 children (aged 12-36 months) at risk of behavioral difficulties and their primary caregivers, recruited as part of the Healthy Start, Happy Start trial. This study uses data from the 2-year and 6-year post-randomization follow-up points, when children were aged 3.97 years (SD = 0.58) and 8.17 years (SD = 0.65) respectively.

Structural equation modeling was used to evaluate longitudinal pathways linking treatment group, cognitive empathy and prosocial behavior. Assignment to the treatment group was significantly associated with parent-reported prosocial behavior at age 4 (β = 0.74, SE = 0.27, p = 0.00). Prosocial behavior at age 4 significantly predicted cognitive empathy at age 8 (β = 0.27, SE = 0.09, p = 0.00), while the remaining direct effect of treatment group on empathy at age 8 was not statistically significant (β = 0.62, SE = 0.35, p = 0.08). A second model exploring externalizing behavior revealed that treatment group was significantly linked to lower externalizing behavior at age 4 (β = -3.55, SE = 1.27, p = 0.00), which subsequently predicted higher cognitive empathy at age 8 (β = -0.04, SE = 0.19, p = 0.02). Again, the remaining direct effect of treatment group on empathy at age 8 did not reach statistical significance (β = 0.66, SE = 0.36, p = 0.07).

These findings suggest that VIPP-SD exerts enduring benefits on children’s social-emotional development by enhancing early prosocial behaviors and reducing externalizing tendencies, which may facilitate the emergence of cognitive empathy in middle childhood.

Introduction

Quality of parenting and child development are severely affected by parental Substance Use Disorder (SUD), and several studies highlight the need to identify effective interventions to enhance the quality of parent-child relationships in this context. Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD; Juffer et al., 2008), a protocol based on attachment theory and social learning theory, aims to enhance sensitive parenting and sensitive discipline, with increased attachment security and reduced behavioral problems in children as potential correlates of improved parenting. The program has been tested in populations of vulnerable families in several randomized controlled trials, presenting substantial effects both on parents and children. Given its standardized and individualized approach, and clear themes per session, VIPP-SD could be particularly suitable for mothers with SUD.

Aims

We aimed to examine the feasibility (and in a later phase also the effectiveness) of VIPP-SD in mothers with SUD.

Methods

The presentation will introduce five case studies of mothers with SUD (Mage=29.0 years, SD=5.06) and their children (Mage=30.0 months, SD=15.08) attending residential treatment. All dyads were administered the VIPP-SD, consisting of one introductory visit and six intervention sessions. The mothers were assessed before and after the intervention with respect to sensitive parenting (EAS; Biringen, 2008) and sensitive discipline (Discipline scales; Verschueren et al., 2006). Logbooks were used to document the intervener’s impressions after each session.

Results and conclusions

The sessions were delivered in the facility and the mothers presented good adherence to treatment. Changes in sensitive parenting and discipline were highlighted through the logbooks and the assessments, although with individual variability. VIPP-SD appears to be promising in this context, promoting work alliance, increasing relationship quality, and safeguarding child wellbeing. The specificities of each case are described, and clinical considerations with respect to the application of VIPP-SD to this population are presented.

Child behaviour problems pose significant challenges to teacher- child interactions in classroom and is associated with poor school attendance and academic underachievement. Studies have indicated that Kenyan teachers do not use effective strategies to manage behaviour problems and corporal punishment is still being used. The situation points to the urgent need for intervention programs to help teachers use positive teaching and sensitive discipline in schools. We tried out the first VIPP-School intervention in Kenya to answer the question, is VIPP-School feasible in Kenyan schools? What adaptations are necessary? A teacher for learners with mild disability agreed to participate and the implementation was supervised by VIPP-School experts. Logbooks that described the visits as well as anything unusual during video shot and feedback were completed. Analysis of notes in the log from visits 1 to 6 was done, and showed that at the beginning of the intervention, the teacher was mostly a passive listener and once in a while commented on the negative behaviour of the child. Reflecting on herself and the child improved as more skills were learnt in the course of the intervention. During the last visit, the teacher could point out some of the things that were previously discussed; for example, she talked about the importance of complementing not only the child but other learners too, suggesting the possibility of transferring the skills acquired in the dyadic VIPP-School sessions to classroom situations. Some of the positive comments on the child were “concentrating, happy, not giving up”’. Our findings suggest that VIPP-School is feasible in Kenya with cultural modifications such as use of local materials, presence of a private room within the school and flexibility to adapt to the teacher’s program- which implied a more flexible schedule than the intended two-week interval schedule of the manual.