Lecture 9- Engage, Self-Regulation Training for Preschoolers

Question 1

What is self regulation? What three aspects does it involve?

Answer 1

Self-regulation skills help us to control our emotions, our thoughts and our behaviours. Feeling, thinking, doing.

Question 2

What do self-regulation skills help us to do?

Answer 2

-Remember instructions
-Ignore distractions
-Juggle two or more tasks at once
-Keep going with difficult or frustrating tasks
-Resist the temptation to do something that might not be good for us
-Wait for rewards
-Take turns
-Work well with others
-Recognise our feelings
-Deal with difficult emotions – anger, fear, anxiety, frustration

Question 3

What are some examples of how adults use self-regulation skills?

Answer 3

Adults also use self-regulation skills every day:
-Getting out of bed when the alarm goes off, instead of sleeping in
-Choosing a healthy breakfast instead of something more delicious
-Turning up to a work meeting, even though we feel anxious about it
-Teaching ourselves a new skills – even though it might be frustrating
-Getting on with a work colleague that we find annoying

Question 4

What is the progression that occurs for children in terms of self-regulation?

Answer 4

-First they are externally regulated by those around them e.g. parents, teachers
-Then, eventually through these social interactions they internalize and obtain self-regulation skills

Question 5

What famous longitudinal study looked at self-regulation in children? What did it find?

Answer 5

Dunedin Longitudinal Study (2011):
-Childhood self-regulation strongly predicts a very wide range of
adult life-course outcomes including; physical health, mental
health, education, employment, relationship and criminal
offending outcomes.
-In other words, as self-regulation went down so did functioning (it had an impact on the child’s quality of life).
-Effects of children’s self-regulation could be separated from
intelligence, SES and mistakes they made as adolescents.

Question 6

What was the ENGAGE parent version?

Answer 6

Enhancing Neurobehavioral Gains with the Aid of Games and Exercises (through play)
¤ Focused on building self-regulation in preschoolers
¤ 8 week play-based intervention
¤ Child sessions
¤ Parent sessions

Question 7

What childhood condition results in an extremely poor ability to self-regulate?

Answer 7

ADHD

Question 8

Was ENGAGE the parent version on a computer?

Answer 8

No, that would have made it difficult for children to use and also it’s a social program involving both the parent and child doing the task together.

Question 9

What were the engage games like?

Answer 9

Games (30mins/day)
¤ Target a skill area
¤ Aim it just above current skill level
¤ Increase complexity as skill develops (scaffolding)
¤ Relate skills learnt in the games to everyday life skills
¤ Keep it fun

Note: it’s not so much about the game itself, you could do it with any game. It’s about the approach to teaching the game.

Question 10

What were the 3 engage domains?

Answer 10

Emotional (Feeling)
Recognizing and regulation emotions, calming through breathing and
movement, mindfulness.

Cognitive (Thinking)
Listening and paying attention, working memory, blocking out
distractions, fine and gross motor skills, controlling speed of
movement, balance, etc.

Behavioural (Doing)
Controlling impulses, patience, turn-taking, delaying gratification

Question 11

What are some game examples for the behavioural (doing) domain?

Answer 11

¤ Green-Orange-Red
¤ Musical Statues
¤ Simon Says
¤ Leap frog
¤ Hop Scotch
¤ Ball and spoon

Question 12

What are some game examples for the Cognitive regulation (“thinking”) domain?

Answer 12

¤ Copy Me
¤ “We went to the park”
¤ Cups memory game
¤ Sorting
¤ Snap
¤ Puzzles

Question 13

What are some game examples for the emotional regulation (“feeling”) domain?

Answer 13

¤ Relaxation
¤ Deep Breathing
¤ Yoga

Question 14

Was ENGAGE successful in behavioural regulation?

Answer 14

Yes, decrease in hyperactivity score after ENGAGE and this gain was maintained over time

Question 15

Was ENGAGE successful in cognitive regulation?

Answer 15

Yes, attention problem (inattentive) scores decreased and were maintained over time

Question 16

Was ENGAGE successful in emotional regulation?

Answer 16

Yes, aggression decreased after ENGAGE and remained low in follow ups

Question 17

What is a critique in the improvement of emotional regulation scores as a result of engage?

Answer 17

-How much of this is just from increased interaction with parents as opposed to building regulation skills?

Question 18

What was the referral process for ENGAGE? What kids were accepted?

Answer 18

-Parents self-referred children who they felt could benefit
-Wanted participants who scored above 65 (at risk range) so that could actually help those struggling

Question 19

After success in the parent version of ENGAGE what happened?

Answer 19

Randomized Controlled Trial
-Compared ENGAGE to Triple P (funded by HRC)
-There were no significant differences in behavior ratings within an 8-week waitlist period
-Both interventions lead to significant reductions in parent rated hyperactivity, inattention, and aggression.
-Improvements were maintained at 12 month follow-up for both programmes
-No significant differences between the programmes. Means they are both valid.
-Different approaches work well for different people so it’s good to have multiple possible options

Question 20

What is a waitlist control?

Answer 20

Means there is no individuals who miss out. They will eventually get to benefit from the treatment too.

Question 21

What is the take home message from the ENGAGE randomized control trial?

Answer 21

-Structured play is as effective as behaviour management in
reducing levels of hyperactivity, inattention, and aggression in
pre-schoolers
-Still early days but it appears that the home-based version of
ENGAGE is an effective, novel treatment approach that adds
to the current repertoire of treatments for preschool
behavioural difficulties.

Question 22

After the home/ parent version of ENGAGE what was then suggested as a possible use for the program? Who was a partner for this?

Answer 22

-ECE (early childhood education): population-based approach to fostering self-regulation in ALL preschoolers (not just those at risk)
¤ Partnership with Methodist Mission

Question 23

Was training early childhood education teachers any harder than training parents?

Answer 23

No, didn’t require much adaptation at all.

Question 24

What was the structure and results of the RCT for ENGAGE in early childhood settings?

Answer 24

-10 week research study delivered to 800+ children in ECE centers in Auckland and Southland in 2018.
-Ensured a diverse population in a race but also in a socioeconomic sense
¤ Funded by The Tindall Foundation.

Findings:
-Small modifications needed
-Language, instructions and support important
-Games were enjoyable
-Games were repeatable
-Games felt familiar
-Progressions could be added

-ECE as usual (waitlist control):
¤ Teacher ratings collected at the start and end of a
10 week period of ECE as usual showed no
significant changes in behavioural, cognitive or
emotional self-regulation scores over this period.

ENGAGE_ECE
¤ Teacher ratings of the children’s self-regulation abilities
compared before and after the introduction of the 10
week ENGAGE_ECE programme showed significant
improvements in all areas of self-regulation flowing
ENGAGE.

Question 25

Do you have to buy specialized equipment for ENGAGE to work?

Answer 25

No, it’s very accessible and this is an advantage as opposed to some of the other programs like triple P which cost a lot.

Question 26

What work is still ongoing with ENGAGE in NZ?

Answer 26

MoE is funding the scale-up of ENGAGE within ECEs in New Zealand

Currently working in the Auckland, Bay of Plenty and Otago regions.
-Expanding and adapting ENGAGE for different cultures and settings
-Kaupapa Māori context
-Migrant and Refugee Playgroups (most don’t speech English which make’s it harder to collect data)

Question 27

What international work is being done with ENGAGE?

Answer 27

ENGAGE parent programme
-Finland (Translate. Parent + child version)
-Australia (CBT for adult anxiety and depression approach. Reach rural communities, develop online version)