Family Strengthening
in a
Developing Country Context
through
Positive Parenting Training
Caroline Bishop, MPH, MCHES
San Francisco, CA - April 7, 2014
Joint Council on International Children’s Services
Question
How does one
learn how to be
a good parent?
Policies and programs should empower families with
attitudes, skills, capacities and tools to enable them to
provide adequately for the protection, care and
development of their children.
To prevent child abandonment, relinquishment and
separation of the child from his/her family
These measures should include family strengthening
services, such as parenting courses and sessions, the
promotion of positive parent-child relationships, conflict
resolution skills
United Nations (1989). Convention on the Rights of the Child . pp. 7-8.
Question
What does it
mean to be a
parent?
Who is considered
a parent or caregiver?
• Long-term
relationship
• Providing care and
protection for a
child
Parenting Around The World
• Varies between societies, governments and
cultures.
• Three major goals:
• To ensure the health and safety
• To prepare the child for a productive life
• To transmit cultural values and practices
• A healthy parent-child relationship critical for
healthy development.
Richter & Naicker, 2013
• 2000-2012
• Focus: strengthening
child-caregiver
relationships
particularly in context
of HIV and poverty
• Identified 600+ peerreviewed papers
Parenting/Caregiver Programs
“Parenting support programs aim to
change parental beliefs and actions
with the goal of changing child
behavior which, in turn, is likely to
lead to changes in parental well-being
including the couple and family
relationships”
(Richter & Naicker, 2013)
Findings
• Parent support
programs are effective
• Core elements can be
adapted for use across
different settings and
cultures
• Need to be situated
within a broader
context
Findings continued
• Parents can be supported to promote their
children’s early development, learning,
literacy and school performance.
• https://www.youtube.com/watch?v=m_5u
8-QSh6A
Findings Continued
Common elements
identified in effective
parenting support
programs
Core Elements
•
•
•
•
•
Information
Positive parenting
Understanding
Promotion of pro-social behavior
Responding to parent’s needs
A question…
What is your
understanding
of positive
parenting?
Positive Parenting
• Supports a healthy parent-child
relationship
• Positive discipline, gentle
guidance, or loving guidance
• Keeps children on the right path,
offered in a positive way.
Positive parenting for whom?
Everyone especially:
• New parents
• Young mothers
• Ill parents/caregivers
• Destitute families
• Aged caregivers
• Caregivers or children living with a disability
• Socially isolated caregivers with little social
support
Brian’s Story
• https://www.dropbox.com/s/bmlpoe12u14
w2gj/Living%20with%20HIV%20as%20a%2
0child.mp4
Results of Positive Parenting
Interventions
• Comprehensive educational and family support resulted in 52
percent reduction in child maltreatment (Reynolds &
Robertson, 2003)
• Nurse home visitation program for low-income teaching
appropriate parenting skills, and links parents to community
services. Resulted in 48 percent reduction in child
maltreatment at the 15-year follow-up (Olds et al., 1997)
Positive Parenting Training
• Lilongwe,
Malawi
• July 2013
• 5-day training
of trainers
Positive Parenting Training
•
•
•
•
•
•
•
Malawi
Kenya
Tanzania
Lesotho
Nigeria
Ghana
Sierra Leone
Training Content
• Developmental milestones
and norms
• Behavior management
• Parental support
Developmental
milestones and norms
• Children are not “little adults”
• Varies by age group and domains of
child development
• Supports appropriate interactions
throughout development
When the going gets tough…
Behavior Management &
Assertive Discipline
• Boundaries and consistency help children feel safe and secure
• Parents need skills to manage behavior and respond
accordingly
• Assertive discipline helps children understand consequences
• Assertive discipline means parents are prepared
• If set rules are broken, parents act quickly, stay calm and follow
up with fair, age-appropriate consequences,
• Parents should remember to praise behavior they like.
– Catch them doing something good!
Behavior Management
CRS Lesotho
Self Care for Parents
• Makes parenting easier
– Feel more patient and calm
– Feel more confident
• With multiple demands, they tend to decrease
their own self-care
• Parents need support from friends or family
• Parents should take time to things they enjoy
Parent-Child
Interactive Skills
PRIDE Skills
P
R
I
D
E
Praise
Reflection
Imitation
Description
Enthusiasm
Purpose of PRIDE
•
•
•
•
•
•
•
Show love
Follow your child’s lead
Build healthy self-esteem
Help the child focus
Help the child to make sense of his/her world
Widen the child’s experience
Help your child to learn rules, limits and values
PRIDE
P
R
I
D
E
Praise
Reflection
Imitation
Description
Enthusiasm
Praise
Child Directed Interaction
The Do Rules
Unlabeled praise is nonspecific
– Good!
– That's great!
Labeled praise tells child specifically what is good
– Thank you for using your indoor voice.
 Increases the behavior it follows
 Increases child's self-esteem
 Increases positive feeling between parent and child
Sheila Eyberg, 2005
PRAISE: Saying Nice Things
Practice Saying Nice Things for
Positive Opposites
HANDOUT
2nd column: write-in a good behavior
3rd column: put in labeled praise
PRIDE
P
R
I
D
E
Praise
Reflection
Imitation
Description
Enthusiasm
Reflections tell a child…
•
•
•
•
that you are listening to your child
that you understand what your child is saying
that what your child says to you is important
that you approve of what your child is saying
Reflections (Repeating!)
“Mom, this is a funny thing on top of his head!”
“Yes, his hat is very silly!”
 Allows child to lead the conversation
 Shows that parent is listening
 Shows that parent understands
 Improves and increases child’s speech
Reflection Exercise
Pretend like you’re a
mirror for your
neighbor.
– Neighbor: tell the mirror
about your morning.
– Mirror: reflect back what
your neighbor is saying.
PRIDE
P
R
I
D
E
Praise
Reflection
Imitation
Description
Enthusiasm
Child Directed Interaction
The Do Rules
Imitation
 Doing the same thing as the child
– Parallel play
– Cooperative play
 Lets the child lead
 Teaches parent how to “play”
 Shows approval of child’s activity
 Teaches child how to play with others
– Sharing
– Taking turns
Sheila Eyberg
Imitation exercise
• Groups of 3
– 1 child
– 1 parent
– 1 coach
• Child plays; parent
follows
• Coach is there to help
the parent along if the
parent misses a cue
PRIDE
P
R
I
D
E
Praise
Reflection
Imitation
Description
Enthusiasm
Descriptions
Telling the child exactly what he or she is doing
– “You’re
drawing a sun.”
 Lets the child lead
 Shows you are interested and paying attention
 Shows approval of child’s activity
 Models speech
 Teaches vocabulary and concepts
 Holds child’s attention to the task
Descriptions
Child: (drawing a huge sun with a yellow crayon)
• Behavioral: You are drawing a picture of the sun
with a yellow crayon.
• Informational: The sun is very big and very hot
and far away from the earth.
Practice in Groups of 3
• 1 parent, 1 child, 1
coach
– Child plays
– Parent describes
behavior
– Coach offers
suggestions (gently)
• Change roles after 2
minutes so everyone
has a chance to play
each part
PRIDE
P
R
I
D
E
Praise
Reflection
Imitation
Description
Enthusiasm
Enthusiasm
 Conveying excitement by voice and gesture
– “Wow! You finished that so quickly!”
 Lets child know the parent enjoys being with the child
 Makes the play more fun for both parent and child
 Adds a quality of warmth to the interaction
Practice
Turn to your neighbor and make these
statements enthusiastic.
• That’s a big tower that you’re building.
• Your picture is beautiful.
• You’re drawing a picture of a flower.
• Thank you for putting away your toys.
• You have been listening to Mommy so well!
• Good job following Daddy’s directions.
Pre-Post Test Results
Percentage of participants answering correctly
Baseline
Evaluation
Basic brain connections are laid down before birth
89
100
Babies can see at birth
59
100
A human baby’s brain has the greatest density of brain
cell connectors (synapses) at age 3.
74
100
Parents should ignore most unwanted behaviors instead
of disciplining a child when she acts out
22
83
Mothers are more important to their children’s
development than fathers
67
91
It is important for parents to lead all interaction with their
children, as parents are the authority and should always
demonstrate that they are in charge
63
87
Evaluation-Self report
• Training interesting to me:
– 90% strongly agree; 10% agree
• Training provided me with new knowledge
and skills
– 70% strongly agree; 30% agree
• Training will be useful in my work
– 95% strongly agree; 5% agree
Momentum
• Kenya: adapted own
positive parenting
manual
• Sierra Leone:
incorporated PP and
ECD into child survival
• Nigeria: incorporated
into OVC programming
Challenges
• Limited number of trainers
• Ensuring cultural
appropriateness
• Disinterest if don’t provide
other support (e.g.,
economic strengthening)
• When combined with other
interventions – overload
Thank you!