LOUIS, Mo. — While every toddler has tantrums and mood
swings, some have more serious mental health problems,
including depression and anxiety. Researchers at Washington
University are now enrolling preschoolers and young children
in a study of therapy designed to treat depression without
university’s Early Emotional Development Program hopes to
recruit 250 children ages 3 to 7 for the free study. The
children must meet criteria for depression through assessments
— they are socially withdrawn, disengaged, fatigued and
unable to shake feelings of guilt. The children may have
problems with sleep and appetite and are usually not
enthusiastic about play time. Eligible children must not have
a diagnosis of autism or take any medications for mood
treatment, called parent-child interaction therapy and emotion
development, involves 18 weeks of one to two-hour sessions in
three parts. In each phase, the parent and child are together
in a room while a therapist watches through one-way glass,
sending directions to the parent’s earpiece.
the parents (the researchers requested anonymity for
participants because the study is ongoing) said her 4-year-old
daughter has reduced her defiant behaviors from 75 percent of
the time to 25 percent since starting the therapy in May.
took our life from being very, very difficult, where
everything you do is a struggle, to suddenly now your child is
able to brush their teeth," the mother said. "I was
constantly searching for the better way to do things. Now I
don’t have to do that because I know this works."
first six sessions focus on child-directed interaction. The
parent is coached to follow the child’s lead as they play
and give lots of praise and positive feedback. So if the child
colors, the parent colors too while giving a running
commentary — "you’re coloring the sun with a yellow
crayon, now you’re stacking the blue blocks."
focus is "to let the child know that the parent is paying
attention and really approves of the child’s play,"
said staff therapist Mary Grace Portell.
next phase, the activity is led by the parent, who gives the
child specific commands to set expectations. The child is told
to sit in the chair or clean up the toys, for example. Parents
are coached on fair, consistent and structured discipline.
last six weeks, the sessions are focused on emotional
development and symptoms of depression. The children learn how
to regulate their emotions with help from the parents. They
learn kid-friendly relaxation and breathing techniques.
the exercises in the last phase are designed to provoke
frustration, anger or guilt in the child. They’ll get a
see-through lock box with an attractive toy in it, but the key
won’t work. Or during a tea party, the child’s cup is
rigged to break.
are taught to physically connect with the child by getting
down to their level and putting a hand on their back. They
validate the child’s feelings but don’t try to fix the
situation right away. Eventually, the right key or a new cup
is offered. Other tasks are aimed at helping the child sustain
joyful emotions, such as a bubble machine.
study’s first year, 35 children are expected to complete the
therapy and receive evaluations four months later. So far,
parents have reported fewer tantrums and decreased
irritability. And the children are better able to express
their feelings, Portell said.
are seeing dramatic declines in problematic behavior,"
said Dr. Joan Luby, who directs the study. "Every single
kid is improving."