Family Nurture Intervention for Preschool-Aged Children
Melissa was looking for help. “My son would just out of nowhere act out,” she explains. “Whether it was yelling, throwing things, saying something inappropriate to someone. Basically, looking back on it, anything to get my attention he would do. Hitting his sibling. Ripping something up that might be important. The list goes on. Even at some points walking out of the house, or trying to. It was pretty bad.”
His preschool teachers said they couldn’t handle him anymore. He was referred to a special education school, and started working with a behavioral specialist. But the problems didn’t stop. They were struggling at home, and Melissa was still getting called into school to discuss his behavior. So when she found out about a new parent-child group, offered by the Nurture Science Program, she signed up.
Studying Family Nurture Intervention for Preschool-Aged Children
Over the past three years, the Columbia Nurture Science Program has conducted multiple studies with preschool families like Melissa’s, to study the power of nurture and emotional connection to address emotional, behavioral and developmental challenges. These studies were conducted in two communities in Connecticut – one in collaboration with the Children’s Learning Centers of Fairfield County (CLC), and the other with the Norwalk Housing Authority.
The studies compared Family Nurture Intervention for preschool families with other programs to support families. At CLC, some families participated in eight weeks of a Family Nurture Intervention group, while others continued to participate in CLC’s existing programs. At Norwalk, the study compared the group-based Family Nurture Intervention with group-based “Nutrition and Play.” Participants were offered 24 sessions over the course of 24 weeks, and mothers were encouraged to attend as many sessions as possible. Once the initial study was completed, a follow-on pilot study to test the feasibility and effectiveness of creating a Family Nurture Intervention drop-in center was offered to the mothers of the play group. More than half of the mother-child pairs who had participated in the play group chose to participate in the drop-in Family Nurture Intervention group, despite compensation limited to travel reimbursement.
Mothers and children in the Family Nurture Intervention groups were supported by Nurture Specialists to establish an emotional connection. With the mothers holding their children on their laps, pairs were encouraged to express their full range of feelings. While this closeness is challenging at first, with practice it re-establishes emotional connection between mothers and their children and enables deep emotional communication. The study included assessments to gauge the mother and child’s emotional connection and their behavioral, psychological and physiological states. Follow up assessments and data analysis are ongoing.
Changes at Home
Melissa came to a Family Nurture Intervention group with her son and her daughter, and it was hard. “The first time I thought this isn’t going to work,” she remembers. Her son was in preschool, and her daughter was just a year older. “It was too chaotic,” she says. “All of us were so disconnected. It was so upsetting to see and realize how disconnected we were in that moment.”
The break through happened after just a few sessions. Melissa came to the group with both her daughter and her son. Melissa remembers, “I felt extremely uncomfortable and confused because they kept telling me just get comfortable in the chair. My kids are jumping all over me. They don’t want to be here. They’re flailing their arms, I’m trying not to get hurt.”
Melissa said she always tried to keep her emotions in check. She didn’t think the Nurture Specialists understood how upset she was. “And I was so embarrassed because I couldn’t figure out what I was doing wrong and how to fix it. And you just see everybody staring at you. And your child’s upset. And you can’t calm them down, and it’s just awful. And you hit a point where you’re like – you’re so fed up because you’ve hit a wall and you really don’t know what else to do.”
The Nurture Specialist told Melissa she had to show her children how she was feeling. She had to hold them in her arms and look them in the eye and tell them that it hurt her feelings when they ran away from her, when they were mean to her, when they wouldn’t come sit with her. She was told to cry if that was what she was feeling. No more hiding her feelings. No move covering the pain with a smile.
“Then, right then and there, everything changed,” Melissa says. When her children finally felt how upset she was while they were being held, they became deeply engaged in communicating. They talked with her. They apologized. Soon Melissa and her children were hugging and snuggling. “And I really do think at that point we started moving forward,” Melissa says. “We started using it more as a tool at home and looking forward to the next session. And the children would even sometimes say … now I think about it there were a couple of times I didn’t want to go and [the children] said ‘No, we need to go!’ They were really looking forward to it. Because they knew it was keeping us all on track as a family. And they were feeling how great it felt to experience it. And that made me feel better.”
Melissa’s son started sitting in the bean bag chair at home whenever he became upset, to signal that he needed to spend time with his mom just as he did at the Family Nurture Intervention group. And it didn’t stop there. Her daughter insisted that Melissa’s husband hold her on his lap and talk with her too. Then she wanted to spend this kind of time with her grandparents, who also live with them. Melissa’s parents came to a Family Nurture Intervention group so they could experience emotional connection with the children too.
Friends and family have noticed that something changed. Melissa’s children treat her with respect, they listen to her, and they also listen to other adults. Now her son can spend the day with other family members, or go to a friend’s house. And the phone call that Melissa received from the school psychologist this fall was to tell her that her son was seamlessly transitioning into first grade. “It made me feel great as a parent,” Melissa says.
Changes at School
Melissa isn’t the only person who saw big benefits from Family Nurture Intervention. As the Head Start and Early Head Start Director at CLC, Nicole Clark-Taxiltaridis was excited to bring Family Nurture Intervention to her program. “I hadn’t seen anything like that before, and it also connected with me on a personal level,” she says. “I’ve often thought that there are just some mothers with their children that are seemingly having a really hard time connecting with each other, and I thought this would be a great opportunity to address that.”
While research data is still being collected and analyzed, Head Start teachers at CLC are enthusiastic about the changes they have seen in the classroom. “We’ve heard from teachers having these children back in their classrooms, that they seem to be doing better,” says Clark-Taxiltaridis. “What I didn’t think would happen, which we were able to track, was the impact that it would have on the classroom generally,” she says.
“We employ a tiered intervention process,” Clark-Taxiltaridis explains. “Tier 1, Tier 2, Tier 3. Tier 3 being behaviors and interventions that are most outward, explosive. Children spitting, biting – either their teacher or their parent – those kinds of behaviors that can derail a classroom for up to an hour in a day.” These disruptions are not only difficult for the child and the teacher, but they lead to lost educational time for the entire class. “What we found was, if we’re able to minimize the disruptions of Tier 3 behaviors in a classroom, teachers and administrators were able to really focus on Tier 2 and Tier 1 interventions and ultimately having success for all children in the classroom. Because the reality is more time that children are in the classroom they have access to their education, the better the outcomes are.”
Clark-Taxiltaridis says she would love to see a drop-in center model at her Head Start location, so families can have access to Family Nurture Intervention whenever they need it. “Children and families are always growing and changing and we go through periods of ups and downs,” she says. “It would be great to have that level of support in a center.” She believes parents would come. “They need the level of support. And when they usually come to our center for support they need it then, right in that moment.”
Both the Norwalk and CLC studies are paving the way forward in scaling and disseminating these strategies for children with emotional, behavioral and developmental disorders. The Norwalk study is complete, and data analysis is underway. The CLC study is expected to be completed in the spring of 2020, but given what they are seeing in the classroom, CLC staff is already working with the Nurture Science Program to identify ways to scale this intervention to serve a wider population of children and parents.
It is encouraging to hear from families about how Family Nurture Intervention has helped them, and hear from teachers about how changes at home ripple out into the community. The Nurture Science Program continues working with both research partners and community partners to collect and analyze data to further understand what works, and how to make effective resources available to all families who need them.