Education and Human Sciences, College of (CEHS)


Date of this Version



Sjuts, Tara M. (2014). Supporting positive parent-toddler relationships and reducing toddler tantrums: Evaluation of PCAT-E (Doctoral dissertation). Open Access Thesis and Dissertations from the College of Education and Human Sciences.


A DISSERTATION Presented to the Faculty of The Graduate College at the University of Nebraska In Partial Fulfillment of the Requirements For the Degree of Doctor of Philosophy, Major: Interdepartmental Area of Psychological Studies in Education (School Psychology), Under the Supervision of Professor Susan M. Sheridan: Lincoln, Nebraska: May, 2014

Copyright (c) 2014 Tara M. Sjuts


At the most fundamental level, a positive parent-child relationship is the foundation of child success. However, the toddler period may present difficulties for the parent-child relationship. As toddlers explore their autonomy, they challenge parents with noncompliance and temper tantrums, which may be difficult for the parent-child relationship. This study examined the impact of an extension of Parent-Child Attunement Therapy (Parent Child Attunement Therapy – Enhanced; PCAT-E) on parenting behaviors, toddler tantrum behaviors, and the parent-toddler relationship. This extension featured eight individual didactic and coaching sessions with parent-child dyads focused on teaching positive parenting skills, effective commands, and emotion language modeling.

Participants were four parent-toddler dyads. Dyads participated in therapy sessions wherein parents were coached by the therapist in the use of nondirective play therapy and operant conditioning strategies with their toddler. Parenting behaviors were assessed through coded video of play sessions using the Dyadic Parent-Child Interaction System-III (DPICS-III; Eyberg, Nelson, Duke, & Boggs, 2005). Toddler tantrums behaviors were tracked via daily parent report, and the parent-toddler relationship was assessed using the Parenting Relationship Questionnaire (PRQ; Kamphaus & Reynolds, 2006). A concurrent multiple probe across participants design was used to evaluate the effect of the intervention on parenting behaviors. A within participants design was used to evaluate the effect on toddler tantrum behaviors, and changes in the parent-toddler relationship were evaluated using clinical significance. Data were analyzed through visual inspection, conservative dual criterion, calculation of percentage of all nonoverlapping data, and determination of clinical significance.

Results of the study indicated improvements in four parenting behaviors (i.e., labeled praise, behavioral description, questions, and commands), mixed results for toddler tantrums but improvements in broad toddler behaviors, and improvements in the parent-toddler relationship. Treatment integrity data suggested parent treatment integrity was generally high. Social validity data suggested high levels of perceived effectiveness and acceptability of the PCAT-E intervention. Overall, the results of the study extended the literature on Parent-Child Attunement Therapy, a promising intervention to address parent-toddler relationships and externalizing toddler behaviors.

Adviser: Susan M. Sheridan