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The Play Nicely™ Program

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Program content for the 50 minute Play Nicely program has partly been derived from material from three organizations: the American Psychological Association, the American Academy of Pediatrics, and the National Association for the Education of Young Children. Input has been obtained from dozens of experts in the areas of pediatrics, child psychology and early child education. Due to their "front-line" experience, the author has given particularly strong weight to input from experienced teachers.

To teach the basics in managing hurtful behavior, Play Nicely consists of narration and over 10 video clips. Here is a summary of the content:

  1. Separate introductions and narration for different learners.
  2. Definition of hurtful behavior/aggression.
  3. Why managing hurtful behavior in the early years is important.
  4. Five major teaching points with video clips to enhance learning.

* Teach children not to be a victim
* Learn alternatives to respond to hurtful behavior. As part of the second teaching point, learners have 16 different interactive options to respond to a child with hurtful behavior and receive multimedia feedback. Watch a caregiver set the rule, redirect, and promote empathy. The program stresses that caregivers are role models and teaches why there are better responses to hurtful behavior than spanking, speaking angrily, or ignoring the behavior. With a review of 16 strategies, participants build a large cognitive database that will help them to choose an appropriate option to respond to a child with hurtful behavior.
* Decrease exposure to violence
* Show Love
* Be consistent. Emphasis on consistency and speaking with all family members who care for the child.
5. Warning signs - when to seek professional help.
6. Supplemental material - for use in educational settings
* Educational Handout
* Knowledge Assessment Tool

Who Can Use Play Nicely™?

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Play Nicely™ is an option for anyone who helps take care of young children. The program has widespread applicability to many, including parents, child care workers, teachers, health care professionals, counselors, researchers, lecturers, and others.

The Play Nicely™ program contains three separate educational tracks for:

  • Parents
  • Childcare workers and Teachers
  • Health Care Professionals and Counselors

Play Nicely's format also makes it useful for:

  • Lecturers
  • Researchers
  • Credentialing organizations
  • Others who care for young children

Parents: The Play Nicely™ program is a great option for parents of young children, ages 1-7 years. Parents reported that they felt more comfortable managing aggression after a Play Nicely™ presentation.

Childcare workers and teachers: Childcare workers, preschool teachers, and elementary teachers will benefit by having aggression management skills. As it is difficult to teach children who are hitting each other, Play Nicely™ is likely to aid in school readiness. Play Nicely has been found to increase comfort level and knowledge of how to manage hurtful behavior in young children.

Health care professionals/mental health professionals/counselors: Play Nicely has been shown to significantly increase professionals' comfort level and knowledge in managing childhood aggression.

Lecturers: Play Nicely™ has buttons to pause/continue and reverse/forward on every screen, making it a very useful resource for those who lecture in the areas of parenting, early child education, child behavior, health, and mental health.

Researchers: Researchers may consider Play Nicely™ as part of intervention programs designed to improve child behavior and/or decrease violence.

Credentialing organizations: Credentialing organizations may consider Play Nicely™ for educational credit for child care workers and preschool teachers. To aid credentialing organizations, questions have been developed to assess knowledge.

Others: Relatives, baby-sitters, Sunday school teachers, school bus drivers, and others who care for young children may benefit by having aggression management skills.

How the Play Nicely™ CD Increases Knowledge

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Childcare workers and Pediatric Residents scored significantly higher in their knowledge of why and how to respond to childhood aggression after a Play Nicely CD ROM demonstration. Clin Pediatr (Phila). 2005 Jun;44(5):413-7.

Methods: Half of the participants completed Form A before the program demonstration and Form B after the demonstration. The other half of the participants completed Form B before the program demonstration and Form A after the demonstration. Correct answers in italics.

PLAY NICELY SURVEY QUESTIONS: FORM A

1. When children have seen violence on TV or video games, what should parents do?
* Nothing, it's normal
* Take away the TV/video game for a few days
* Explain the difference between "real" and "pretend" and tell them that in real life people get hurt
* Ask the children what they thought about the violence they saw
2. After stopping children's aggressive behavior, what is an important step later in the day?
* Watch them for the rest of the day to make sure it doesn't happen again
* Give them time alone to think about the aggressive act and their punishment
* Don't let them play with other children for the rest of the day
* Later catch them being good and thank them for playing so well
3. Which is the best way to promote empathy in children?
* Tell them not to hurt others
* Ask them how they would feel if someone hurt them
* Tell them that they are loved
* Encourage affectionate behavior
4. "Time-out" works best for which ages?
* All ages
* Children under 3 years
* Children over 3 years
* None, it doesn't work
5. What is the peak age for aggression in young children?
* Same at all ages
* 6 years
* 4 years
* 2 years
6. What is the best way to set the rules for young children?
* Use an angry voice
* Spank them when a rule is broken
* Explain in detail why the rule is important
* Firmly state the rule
7. When a three-year old child hits another child, which of the following is a great first option?
* Set the rule by saying "No hitting"
* Spank the child
* Send the child to "Time-out"
* Take away a privilege or something the child likes
8. Taking away a privilege is best for:
* Older kids, after other options have been tried
* Older kids, as a first step
* Younger kids, after other options have been tried
* Younger kids, as a first step
9. What should a child to do if another child hits them?
* Walk away
* Hit back
* Ignore the hit
* Firmly say "No, do not hit me" and tell an adult
10. What is an example of "redirecting behavior" when a child kicks someone?
* Giving the child a chore to do
* Removing the child from that setting
* Saying, "Use your feet to kick balls, not people."
* Saying, "No."
11. "Time-out" means:
* Taking away a toy for a little while
* Spending time with your children
* Making children sit by themselves for a little while
* Letting children play outside
12. Why is there a concern about aggression in young children?
* It's common, almost all children show it
* It can develop into more serious problems
* For all children, it only gets worse as they age
* It is at the beginning of interaction with peers.
13. When should you respond to aggressive behavior from a child?
* Only when the behavior happens more than once in a short period
* Only when the behavior may hurt another child
* Only when ignoring the behavior does not make it stop.
* Every time the child is aggressive
14. How can adults teach children that the rules are the same, always?
* Say them often
* Speak angrily when stating the rule
* Say you will punish the children (for example, take away something) but do not actually do it
* Make sure all adults that help with the children act the same way when the children misbehave

PLAY NICELY SURVEY QUESTIONS: FORM B

1. When should you discipline a child for aggressive behavior?
* Every time the child shows aggressive behavior
* When the aggressive behavior may hurt someone
* When the aggressive behavior is repeated
* When the child is older than 2 years
2. What should a child do if another child hits them?
* Walk away
* Hit back
* Ignore the hit
* Firmly say "No, do not hit me" and tell an adult
3. When should taking away something your child likes be used as a punishment?
* With younger children, as a first step
* With younger children after other options have been tried
* With older children, as a first step
* With older children after other options have been tried
4. How should you "Redirect behavior" with older children who act aggressively?
* Ask children why they were aggressive
* Say "No."
* Give them a choice in the form of a question "Are hands for hurting or helping?"
* Tell them that the next time they act that way they will be punished
5. Children learn rules best when:
* An angry voice is used
* The rule is explained in detail
* The rule is firmly stated
* The rule is accompanied by a punishment
6. When children act aggressively, the best thing to do first is:
* Spank them
* Take away a toy or something they
* Send them to "Time-out"
* Set the rule by saying "No hitting"
7. What is a way to keep rules consistent?
* Agree on rules with everyone who cares for the child
* Make threats you don't follow through with
* Correct other caregivers in front of the child
* Alternate responses between time out and setting the rule
8. Making a child sit by his/herself for a little while is an example of:
* Redirecting behavior
* Time-out
* Setting the rules
* Teaching empathy
9. Why should you try to stop aggressive behavior when children are still very young?
* All children are aggressive when they are young
* Children who do not learn to control aggression by 3-7 years of age are much more likely to be violent as they grow up
* It is easier to punish young children
* Most children get more aggressive as they grow up
10. If a 2-year old child hits another child, which is the LEAST appropriate response?
* Time-out
* Being consistent
* Setting the rules
* Same at all ages
11. At what age do children show the most aggressive behavior?
* 2 years
* 4 years
* 6 years
* Same at all ages
12. After a child is disciplined for aggressive behavior, it is important to:
* Have them play alone rather than with other kids
* Reward them with a toy or treat
* Catch them being good and praise them
* Look for further signs of aggression
13. How much television should children over 2 years old be allowed to watch each day?
* None
* Less than 2 hours
* 2-4 hours
* As much as they want
14. What is the best way to help a child learn to care about other children and not hurt them?
* Tell the child not to hurt others
* Teach the child how others feel by asking "How do you think he felt when you hit him?"
* Tell the child that you love him/her often
* Don't let the child watch violence on television

Play Nicely™ Reviews

Unpublished

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Play Nicely earned good reviews from pediatricians-in-training at Vanderbilt University...

"The program provided me with more specific strategies to use when teaching parents. Now I'm able to give parents more exact things to do and say." -- Vanderbilt University pediatric resident

"Although I know many of the things in the video (not all), I didn't necessarily know the best way to explain them to parents. The video helped me think about how to teach parents better." -- Vanderbilt University pediatric resident

"I now have clinical strategies to give parents rather than simply telling them what my parents did with me with behavior problems." -- Vanderbilt University pediatric resident

"I feel now I will have better options to guide parents in the discipline of their children (i.e. redirecting, setting the rule, etc.)" -- Vanderbilt University pediatric resident

From a Vanderbilt Medical School student...

"Play Nicely is an excellent instructional program. The content was straightforward, easy to understand, and reiterated the key points a suitable number of times. I hope to have access to this program when I become a parent. I think it would be very valuable for other medical students to see this program. As medical students, most of us do not have children and are unaware of what is normal or abnormal behavior per age group. This CD highlighted normal and abnormal behavior and also counseled how to correct behavior - very helpful." -- 3rd year Vanderbilt University medical student

And from a variety of other professionals...

"I sat down with a few women of Pacific Island background with Play Nicely and they were blown away with it all - very impressed and immediately began talking about their own childhoods of abuse, and the challenge to know just what approach to take with their own children... never hitting, but wanting to get more skilful in the alternatives. They started plotting how to use it and who to take it to... very exciting!" -- E.D.; health educator in Auckland, New Zealand; 5/6/04

"I just wanted to let you know that I saw an extremely aggressive 5 year old girl a couple of months ago--very smart and pretty. Mom was in tears because she couldn't get her daughter to behave in public situations (at home she was much better). When I examined her it was constant kicking, screaming, scowling and biting. The parents had just tried to take care of things themselves. I honestly have never seen a child that was so difficult (she was evil!!!). She had absolute control of the situation--she did not want to be examined and was unusually combative. I found the "Play Nicely" website, printed a handout for mom from the site, and gave her the order form for the CD. She called me yesterday to tell me her daughter has made a complete turn around. Mom had tried bribing, spanking, restraining without success, but when she tried the suggestions in the handout, she said she was amazed at how quickly her behavior turned around. Just thought you might want to know! It was very satisfying because mom was convinced that she was going to be a juvenile delinquent." -- T. Rundus, MD; pediatrician in Nashville, Tennessee; 11/1/03

"I just wanted to thank you for your outstanding work with the video presentation on the prevention of aggression in young children. I attended your presentation at the NAEYC conference in New York and thought that it was awesome! I work as a Community Options Facilitator for Green Bay Public Schools. The day care setting gives me an opportunity to share your work with the day care providers as well as the parents of the children that I serve. It is a very valuable resource for me. Thank you again and best wishes for continued success with your work." -- Peggy Simonis; Early Childhood Community Options Facilitator, Green Bay Public Schools; 12/2/02

"I just finished watching Play Nicely and plan to use it as part of my training program for new staff members. It reinforces our company policy of "Positive Guidance" as our method of discipline. It gives good, concrete examples, and with the pause feature, I will stop the CD periodically and ask new staff to generate their own responses. In this way we can personalize it. This format is especially useful to me. Thank you!!!" -- M.A.R.; Toledo, Ohio; 4/29/02

Play Nicely™ in the News

Unpublished

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Parents view a brief violence prevention program in clinic.   Clin Pediatr. 2007. 

The Reporter. 'Play Nicely' program spreading across state of Tennessee.  July 2007.

Head Start teachers watch Play Nicely and provide feedback.  The program builds teachers' confidence related to aggression management.  Teachers feel that the program could improve school readiness if parents viewed the program prior to their children starting school. 2007.  

The Morgan Family Foundation provides funding to Vanderbilt Children's Hospital to develop a Spanish language version of Play Nicely.  We anticipate completion of the Spanish language version of Play Nicely in early 2008.       

Two Tennessee Head Start programs place orders for Play Nicely for all of their teachers (over 70 total). 2007.   

Four research abstracts were accepted for poster presentations at the Pediatric Academic Societies meeting in Toronto. May 2007. 

Play Nicely McNeilly Preschool Study (2007) :  Preschool teachers and assistants provide feedback after the program is included in their curriculum.    

The Reporter. 'Play Nicely' program showing results. Nov. 2006

One year after receiving the program from their pediatrician, parents who independently viewed the Play Nicely program at home reported that it helped them manage aggression in their own child.  Clin Pediatr. 2006 Nov;45:835-840.

The Reporter.  'Playing Nice' at heart of new campaign.   August 4, 2006. Program results in parents being more willing to discuss behavior and discipline issues with their pediatrician.   

AAP News (The official newsmagazine of the American Academy of Pediatrics).  Behavior Management 101:  Beyond time-out. July 2006.  Play Nicely is discussed as an option "to help parents and child care providers deal with aggressive children."   

A study finds that there are "gaps in pediatricians' advice to parents regarding early childhood aggression."  Clin Pediatr. 2006 Jan-Feb;45(1):23-28.  Pediatricians often forget to mention the importance of redirecting and promoting empathy.  By addressing these strategies and many others, Play Nicely can help fill the gaps in advice offered to parents of young children.

Play Nicely 2nd Edition is available.  The second edition has an improved interactive component, featuring 16 different strategies to respond to hurtful behavior.  October 2005. 

For childcare workers and pediatric residents, a Play Nicely CD ROM demonstration was found to increase knowledge  about managing aggression in young children. Clin Pediatr. 2005 Jun;44(5):413-7.

Presentations focusing on Play Nicely were selected for conferences in 2005.

  • Managing Hurtful Behavior in Young Children – Play Nicely.  American Academy of Pediatrics.  Conference for Pediatric Advocates in Early Education and Child Care.  Orlando . FL. April 16, 2005.    
  • A Multimedia Program Helps Parents Manage Child Aggression.  Pediatric Academic Societies' Meeting.  Platform presentation.  Washington DC .   May 17, 2005. 
  • A Multimedia Violence Prevention Program Improves Counseling of Mothers with Aggressive Children.   Pediatric Academic Societies' Meeting.  Poster presentation.  Washington DC .   May 17, 2005.

For parents, child care workers, pediatricians, and other pediatric professionals, Play Nicely has been shown to significantly increase comfort level in managing aggression. Clin Pediatr. 2003 Nov;42(9):789-96.

Play Nicely is described as "The Resource You've Been Waiting For..." Early Childhood Health Link. New Jersey Edition. Volume 1: Issue 4. Spring 2003.

The
Play Nicely Handout is made available on-line. This popular 2-page handout summarizes appropriate responses to an aggressive child. It also provides an outline to help instructors and learners navigate the CD. March 2003.

Play Nicely CD-ROM
in feature article in EarlyChildhood NEWS. January/February, 2003.

Presentations focusing on Play Nicely were selected for conferences in 2002

  • Ambulatory Pediatric Association. May 2002.
  • International Society for Research on Aggression. July 2002.
  • American Academy of Pediatrics. October 2002.
  • National Association for the Education of Young Children. November 2002.

Nashville City Paper - April 2, 2002

Contemporary Pediatrics - March, 2002

Nashville Parent - March, 2002

Fox TV - February 19, 2002. Healthbeat. Reporter: Kristine Soeldner.

The Reporter (Vanderbilt Medical Center) - February 8, 2002

Play Nicely™: Childhood Aggression References

Unpublished

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Tremblay RE, Boivin M, Zoccolillo M, Montplaisir J. The search for the age of 'onset' of physical aggression: Rousseau and Bandura revisited. Criminal Behaviour and Mental Health, 9, 8-23. 1999

Tremblay RE. Prevention of injury by early socialization of aggressive behavior. Injury Prevention. 8 Suppl 4:IV, 17-21, 2002 Dec.

Tremblay RE, Nagin DS, Seguin JR, et al. Physical aggression during early childhood: trajectories and predictors. Pediatrics. 2004 Jul;114(1):e43-50.

Patterson GR, Debaryshe BD, Ramsey E. A developmental perspective on antisocial behavior. Am Psychol. 1989 Feb;44(2):329-35.

Reid JB, Patterson GR, Snyder J. Antisocial behavior in children and adolescents. Washington DC. American Psychological Association; 2002: 195-201.

Olweus, D. Stability of aggressive reaction patterns in males: A review. Psychological Bulletin, 86, 852-875. 1979.

World report on violence and health. WHO. Geneva. 2002 http://www.who.int/violence_injury_prevention/violence/world...

Best practices of youth violence prevention. A sourcebook for community action. National Center for Injury Prevention and Control. Centers for Disease Control and Prevention. 2000. Atlanta, Georgia. http://www.cdc.gov/ncipc/dvp/bestpractices.htm

The role of the pediatrician in youth violence prevention in clinical practice and at the community level. American Academy of Pediatrics, Task force on violence. Pediatrics Vol. 103. January 1999. URL accessed December 18, 2000: http://www.aap.org/policy/re9832.html

Bredekamp, S. & Copple, C. (Eds.). 1997. Developmentally Appropriate Practice in Early Childhood Programs, revised edition. Washington, DC: NAEYC. http://www.naeyc.org/

Accreditation Criteria & Procedures of the National Association for the Education of Young Children - 1998 Edition. National Association for the Education of Young Children. 1998 Washington, DC: NAEYC. http://www.naeyc.org/

Raising children to resist violence. American Academy of Pediatrics and American Psychological Association, 1995. Media violence. American Academy of Pediatrics, Committee on Communications. Pediatrics. Vol. 95. June 1995.

Helping children learn self-control. National Association for the Education of Young Children. Washington, DC. 1998.

Miller TR. Fisher DA. Cohen MA. Costs of juvenile violence: policy implications. [Journal Article] Pediatrics. 107(1):E3, 2001 Jan.

Webster-Stratton C. Intervention approaches to conduct disorders in young children. [Review] [41 refs] [Journal Article. Review] Nurse Practitioner. 8(5):23-4, 29, 33-4, 1983 May.

EBM Reviews - Cochrane Database of Systematic Reviews Montgomery, P. Media-based behavioural treatments for behavioural disorders in children. Cochrane Developmental, Psychosocial and Learning Problems Group Cochrane Database of Systematic Reviews. Issue Issue 2, 2001.

American Academy of Pediatrics, Committee on Psychosocial Aspects of Child and Family Health. Guidelines for effective discipline. Pediatrics. 1998;101:723-728

Scholer SJ, Goad S. Feedback on a multimedia violence prevention program. Clinical Pediatrics. 2003 Nov-Dec;42(9):789-96.

Scholer SJ, Reich SM, Boshers RB, Bickman L. A Multimedia Violence Prevention Program Increases Pediatric Residents and Childcare Providers' Knowledge About Responding to Childhood Aggression. In press: Clinical Pediatrics.

American Academy of Pediatrics. Discipline Methods. 2001.

Play Nicely™ Development Team

Unpublished

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Play Nicely was developed at Vanderbilt University.

Author
Seth J. Scholer, MD, MPH, FAAP
Associate Professor of Pediatrics
Director of Early Childhood Anger Management Clinic
Department of Pediatrics, Vanderbilt University Medical Center
seth.scholer@vanderbilt.edu

Acknowledgements
The Play Nicely program is a distillation of multiple sources of content and feedback. Very strong consideration was given to feedback from experienced preschool teachers.

We acknowledge Dr. Richard Tremblay (University of Montreal), whose epidemiologic research in the area of childhood aggression provided inspiration for the development of the Play Nicely CD ROM.

A portion of the program was developed based upon information published by the following professional organizations (see references):

American Academy of Pediatrics
American Psychological Association
National Association for the Education of Young Children*

We gratefully acknowledge the involvement of several organizations in the development process.

Cumberland Pediatric Foundation and its members, Nashville, TN
West End Weekday Preschool Ministries and its teachers, Nashville, TN
Vanderbilt University Child Care Center, Nashville, TN
Vanderbilt University Department of Pediatrics, Nashville, TN
The Learning Center, Vanderbilt University, Nashville, TN

We gratefully acknowledge feedback from dozens of individuals in the development process. Some of the most helpful critiques were received from:

Sharon Goad, MMFT: Director of Programs at West End Weekday Preschool Ministries
Kate Driskill Kanies: Coordinator of the Regional Intervention Program
Diane Neighbors Ed. D.: Director of Vanderbilt Child Care Center
Kathy Ennis: Director of Woodmont Christian Preschool.
Mark Wolraich, MD: Developmental/Behavioral Pediatrician
Kim Bergeron, MD: Pediatrician
Bob Mallard, MD: Pediatrician
Conrad Shackleford,Jr. MD: Pediatrician
Ellen Clayton, MD, JD: Pediatrician
Patty van Eys, Ph.D.: Child psychologist
Evon Lee Ph.D.: Child psychologist
Wendy Stone Ph.D.: Child psychologist
Jane Hannah Ph.D. Educationalist
Debbie Miller: Director of Child and Family Policy Center at Vanderbilt University
Rob Nix, Ph.D. Child psychologist
Peggy Buchanan, Parent

Performers in Play Nicely
Ovidio Bermudez - doctor
Dan Butler - narration of 1st edition and father
Jennifer Dammeyer - narration of 2nd edition
Tyler Ralph - child actor
Linda Manish - mother/caregiver
Daniel Meyerowitz - child's voice
Evan Miller - child actor

Technical Support
Second edition - 2005
Software engineer: Brian Connatser, Digital Dog, Inc.

First edition - 2002
Consultant and software engineer: Carla Beals
Filming and video clip production: Cummings Video and Film.

The author would be eager to discuss possible collaboration with organizations or researchers with an interest in violence reduction. Priority areas include providing the program to those in need, product development (e.g., alternate language versions), and studying the efficacy of the program. If you represent an agency or organization that is interested in the publication, distribution, development, or study of Play Nicely, please contact the author. Sponsors of the program provide funding to Vanderbilt University, targeting specific Play Nicely development projects. Vanderbilt University is exempt from income taxation under section 501(c)(3) of the Internal Revenue Code.

Play Nicely™ Legal Disclaimer

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This program contains general recommendations for managing aggression in young children. Some children's behavior may warrant approaches that are different than those described in this program. This program should not be used as a substitute for consultation with a professional. See your health care provider or other appropriate counselor if you have any questions about your child's behavior.

The author would be eager to discuss possible collaboration with organizations or researchers with an interest in violence reduction. Priority areas include providing the program to those in need, product development (e.g., alternate language versions), and studying the efficacy of the program. If you represent an agency or organization that is interested in the publication, distribution, development, or study of Play Nicely, please contact the author. Sponsors of the program provide funding to Vanderbilt University, targeting specific Play Nicely development projects. Vanderbilt University is exempt from income taxation under section 501(c)(3) of the Internal Revenue Code.

Play Nicely™ Feedback Form

Unpublished

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For those who have viewed Play Nicely™, we would be delighted to hear your feedback. Please complete this form and submit it to us. (Submitting your name and e-mail address is optional.)

CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Play Nicely™-Related Research

Unpublished

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Play Nicely™-Related Published Research

Scholer SJ, Hudnut-Beumler, J, Dietrich MS, A brief primary care intervention affects parents' plans to discipline. Pediatrics. 2010;125:e242-e249.
Scholer SJ, Mukherjee AB, Gibbs KI, Memon S, Jongeward KL. Parents view a brief violence prevention program in clinic. Clin Pediatr. 2007.Participants: Participants were 89 parents from diverse backgrounds with 1-7 year old children presenting to a pediatric clinic.

Summary of findings:
Previewing, 90% of parents were already very comfortable responding to childhood aggression. Post-viewing, 90% of parents stated that they were going to change how they respond to aggression with their own children.

Implications: Brief, clinic-based interventions may be able to help parents address one of the strongest risk factors for violence, early childhood aggression. Health care professionals who provide anticipatory guidance to parents should not rely on parents' comfort level with managing childhood aggression to determine who might benefit from the program.


Scholer SJ, Cherry R, Garrard HG, Gupta AO, Mace R, Greeley N. A multimedia program helps parents manage childhood aggression. Clin Pediatr. 2006;45:835-840.Participants: Participants were parents of 6-18 month old children presenting for a routine well child visit.

Summary of Findings: One year after receiving the program from their pediatrician, 65% of parents who independently viewed the program at home reported that it helped them manage aggression in their own child. Many parents had recommended the program to others. One parent, who was an early education major, stated that the program did not help her, but she recommended the program to a colleague at work who was having difficulties with her son.

Implications: To our knowledge, this is the first brief intervention that has been found to help parents manage early childhood aggression. Parents were enrolled before aggression usually becomes a concern, suggesting that an easily implemented intervention may contribute to population-based violence prevention efforts.


Scholer SJ, Nix RL, Patterson B. Gaps in pediatricians' advice to parents regarding early childhood aggression. Clin Pediatr (Phila). 2006 Jan-Feb;45(1):23-28.Summary of Findings: This study finds that there are "gaps in pediatricians' advice to parents regarding early childhood aggression." Pediatricians often forget to mention the importance of redirecting and promoting empathy.

Implications: By including discussions about redirecting, promoting empathy, and many other strategies, Play Nicely can supplement the advice offered to parents of young children.


Scholer SJ, Reich SM, Boshers RB, Bickman L. A multimedia violence prevention program increases pediatric residents' and childcare providers' knowledge about responding to childhood aggression. Clin Pediatr (Phila). 2005 Jun;44(5):413-7.

Summary of Findings:
The researchers used a split-half, alternate-form design to assess pre-post knowledge of how to manage aggression in young children. Click here to review the multiple choice questions. The Play Nicely CD ROM demonstration was found to increase knowledge (p<0.001) about managing aggression in young children.


Scholer SJ, Goad S. Feedback on a multimedia violence prevention program. Clin Pediatr (Phila). 2003 Nov-Dec;42(9):789-96.Summary of Findings: Feedback was obtained from 314 participants who watched a demonstration of the Play Nicely CD ROM. Participants included groups of preschool teachers, childcare workers, parents, pediatric health professionals, and pediatric residents.

1. Participants felt more comfortable managing childhood aggression after the program (p<0.001). Pediatric residents felt more comfortable counseling parents about aggression (p<0.001).

2. On a scale of 1-10 (1 = not effective and 10=very effective), the program was rated as being highly effective in teaching
– appropriate options for managing childhood aggression - average score = 8.0
– importance of decreasing exposure to violence - average score = 7.7
– importance of consistency - average score = 8.2
– how to teach children not to be a victim - average score = 7.3

3. Approximately 90% of participants would either strongly or very strongly recommend the program to others.

Unpublished Head Start Teacher Study (2007)

Unpublished Head Start teacher study (2007)
In May and June of 2007, Kristen Rector from Prevent Child Abuse Tennessee demonstrated Play Nicely to preschool teachers in a group setting in five locations across the state of Tennessee. Approximately two-thirds of the teachers completed a feedback form. The teachers viewed the program in a group setting.

Demographic characteristics of teachers:

80% were Head Start teachers, with an average age of 37 years, averaging 7.8 years' experience working in childcare or preschool.
The majority were either African American (65%) or Caucasian (32%). Most (78%) had at least some college education; many (32%) had majored in education.

    1. I am pleased that the Play Nicely program is provided for me to view.

    Strongly disagree 1 (1.6%)
    Disagree 0
    Neutral 5 (8.2%)
    Agree 12 (19.7%)
    Strongly agree 43 (70.5%)


    2. The program makes me feel more confident that I can respond to hurtful behavior in the classroom.

    Strongly disagree 0
    Disagree 0 Neutral 0
    Agree 25 (41.0%)
    Strongly agree 36 (59.0%)


    3. I would like for the parents of students in my class to view the Play Nicely program.

    Strongly disagree 0
    Disagree 1 (1.6%)
    Neutral 1 (1.6%)
    Agree 10 (16.4%)
    Strongly agree 49 (80.3%)


    4. I feel that school readiness could be improved if parents viewed Play Nicely before their children started school.

    Strongly disagree 0
    Disagree 0 Neutral 4 (6.7%)
    Agree 14 (23.3%)
    Strongly agree 42 (70.0%)


    General comments:

    "This was terrific! We as educators of the very young need to get this information to parents."

    "The program should be provided to all early childhood programs."

    "It was really great."

    "It is very useful for teachers."

    "I think that it is a good program that will help parents as well as people who work with children."

    "The program is well developed and set-up. It gives clear cut ideas and suggestions to difficulties that a teacher may have with children in their class."

    "Your program is very helpful and I will use your tips often."

    "Very informative."

Unpublished McNeilly Preschool Study (2007)

Play Nicely Feedback from Teachers and Assistants at the McNeilly Center

Method: The Play Nicely program was included in the continuing education curriculum for preschool teachers and assistants at the McNeilly Preschool Center in Nashville Tennessee during the week of March 19th, 2007. Each teacher viewed the program individually.
    1. I am pleased that the Play Nicely program was included in the curriculum for teachers this year.
    Strongly disagree 1 2 3 4 5 Strongly agree
    Number of teachers 1 0 3 15 36
    % who agreed: 93%


    2. I would like for the parents of students in my class to view the Play Nicely program.
    Strongly disagree 1 2 3 4 5 Strongly agree
    Number of teachers 0 0 2 12 41
    % who agreed: 96%


    3. I feel that school readiness could be improved if parents viewed Play Nicely before their children started school.
    Strongly disagree 1 2 3 4 5 Strongly agree
    Number of teachers 0 1 3 13 39
    % who agreed: 93%



    General comments about the program:

    "Showed a lot of wonderful and helpful strategies"

    "Overall great program and presentation. Easy to navigate format."

    "Play Nicely was very informative."

    "I really enjoyed viewing the play nicely and I learned a lot."

    "I think that the program was a very helpful option for teachers and parents to look at and learn from."

    "This video really needs to be shown in pediatricians offices also because many children don't enter a preschool setting until they are 3 years or more. Consider having it available for Head Start programs also."

    "Good. Great strategy that could get some positive results for parents as well as in the classroom."

    "I like the video a lot. It taught me some things that I didn't know and gave me a variety of ideas of how to deal with violent children."

    "Excellent program for the teachers."

    "I think Play Nicely is a very good program for childcare and parents."

    "I think anything that tells parents how to improve children is good."

    "I feel the video "Play Nicely" would be helpful to parents of pre-school children (ages 2-4)."

    "I was glad they explain different options for explaining to a child that hitting is not acceptable."

    "The film is put together so that anyone can get a clear understanding of ways to help or work with your child, or children. Very good."

    "I think this is a good tool for teachers and parents."

    "They have a lot of helpful strong points in the program. Points that I didn't know and it is very helpful within my home and on the job."

    "Please allow parents to see this. Very, very important."

    "I do the options already so this encourages me that I'm doing it right. I do believe the children will benefit if parents are made to view the film."

    "I really appreciate viewing this film. I highly encourage parents to see this film."

    "I think the Play Nicely program would be a great program for teachers and parents."

    "I enjoyed the video of the Play Nicely film. It helps to know all you can while working with children and to be all you can be to be helpful with children."

    "It is an interesting program."

    "It was a good program."

    "The program was very simple and easy."

    "I strongly agree that this video should be included in the parent orientation prior to children enrolling in the program."

    "It is helpful."

    "I feel like this was very informative and everyone should be exposed to this information."

    "I feel that this is a program that should be implemented in all schools and centers because there is so much behavior going on now which is truly because parents are not educated. Further more, this only works if every parent in every community is doing the same thing."

    "This would be a great video for the parents to see."

    "It was good to hear and see what the program had to say. Thank you."

    "It think this program is a good for parents to watch if having aggressive problems with child."

    "I think this video should be a part of parent training. This would really help a lot of parents who deal this type of behavior."

    "It's a good program."

    "Good program. Parents should see."

Unpublished Parent Study, Post-Pediatrician Visit (2005-06)

Feedback from parents who viewed the interactive part of the Play Nicely CD 2nd Edition in the Vanderbilt Primary Care Clinic after they were seen by their pediatrician.
    1. Watching the Play Nicely CD program was a waste of my time.
    Strongly disagree 1 2 3 4 5 Strongly agree
    # of parents answering 55 16 7 1 0


    2. The program makes me feel more comfortable responding to hurtful behavior.
    Strongly disagree 1 2 3 4 5 Strongly agree
    # of parents answering 0 3 4 24 46


    3. I would recommend the program to first-time mothers.
    Strongly disagree 1 2 3 4 5 Strongly agree
    # of parents answering 0 0 0 1 51


    4. I plan to use what I learned at home with my children when I see hurtful behavior.
    Strongly disagree 1 2 3 4 5 Strongly agree
    # of parents answering 0 3 5 15 54
    5. If you plan to use what you learned, what will you do differently?

    Responses from individual parents:

    "No yelling. No spanking."

    "Try not to use spanking as an option. Redirect their attention elsewhere."

    "I will redirect them before spanking them or putting them in time-out."

    "Redirect by giving examples"

    "Talk to him first. Give good examples".

    "Reward good behavior. Only use Time Out as a last resort. Don't yell or speak angrily to him."

    "Do not say "no" as much and do not spank anymore."

    "Not use an angry voice."

    "Use redirecting more"

    "Redirect, praise later for good behavior, ask about feelings."

    "To use a strong voice. Try to use time out rather than spanking my child."

    "I won't yell as much."

    "Tell them how to use their hands in other ways. Limit what they watch on TV."

    "Ask how others feel."

    "Show more love and be consistent with him."

    "Not spank my child."

    "Will try not to spank."

    "Redirect - what should you use your hands for?. Praise for playing nicely."

    "Use redirecting - tell him what to do with his hands and feet."

    "Time out"

    "Try time-out. Talking about other kid's feelings. Redirection."

    "I will try telling them hitting is not allowed. I will take away a privilege."

    "Time-out. Redirect. Not good to ignore behavior."

    "Restrict saying No. Not yelling."

    "Redirection."

    "I will not spank. Explain to him what parts of our body are really for."

    "Set specific rules. No hitting."

    "Not use an angry voice."

    "Redirecting. Praising them later."

    "Tell your child what to expect if he is hurtful."

    "Redirecting by asking what to do with teeth/feet."

    "Redirecting!"

    "Set specific rules - No hitting."

    "Won't ignore the behavior. Redirecting."

    "Praising children. Will try not to punish him physically."

    "Spanking - will not use it."

    "Redirecting, setting the rule, promote empathy, praising."

    "Redirecting, setting a rule. Changing a negative situation into a positive one."

    "Limit time-out. Setting the rule."

    "Taking away a privilege as a second option [rather than a first option]."

    "Limit [saying] 'No'".

    "Try not to spank. Saying 'No' less often. Redirecting."

    "Less yelling. Redirecting. Promote empathy."

    "Redirect. Do not yell. Praising. Take away a privilege - I will think before doing."
    Other comments from parents:

    "It should be part of every pediatric clinic. Very helpful indeed. Parents do not have to be aggressive in order to deal with aggression."

    "It teaches how to phrase things, which is really important."

    "A fantastic program. I could watch this all day! I like that this program addresses behavior! This is an important problem in society. Many don't get taught at home."

    "This is a great program. It covers many different options."

    "Will help others a lot. Good program"

    "Good to see details like how to use hands or feet in good ways and use specific praises"

    "It will be good if all parents can see it in the clinic."

    "Great program. Will help a lot of people."

    "I feel this should be mandatory for parents to watch."

    "I think it is a great program!"

    "I learned other options than the ones I use at home. The program was very helpful."

    "Great program to have in a pediatrician's office to hand out to new parents."

    "Helpful program for children with hurtful behavior."

    "It is very helpful and I am going to try these recommendations on my kids. You may think you know how to deal with such behavior but there is never enough that you know."

    "I really like this. Information is specific. It's a different program than others."

    "I think it is a good idea for first time parents to see this Many parents only know to spank. The children then think, "Why should I stop hitting? They are hitting."

    "Make this more accessible! This is a great program to help change future behavior - especially in public schools. Good that this program doesn't offend people by making specific statements that are religious-based."

    "Good information on behavior modification."

    "Helpful program for new parents."

    "This is a great program even for mother who are not first time mothers."

    "This is a great program - I like it a lot. It will be helpful to parents!"

    "Informative."

    "Helpful to anybody who watches it."

    "Very, very good when you have your first child - I would have been thrilled if this had been available then!"

    "Helpful. First time mothers need to watch it."

    "Good for all mothers who have toddlers."

    "Very helpful. Maybe they should show it to mothers at the time of delivery. Prevention is better than cure." [Note: parent stated she had already seen a psychiatrist about her child and felt that she had tried "almost everything"]

    "I am definitely going to try the new things that I have learned from it."

    "All parents should receive copies. I really liked the examples."

    "I am sure all parents will benefit from it."

    "It is very helpful and informative. It will help parents change their attitudes towards hurtful behavior."

    "Very helpful. I have got some great ideas, especially redirecting and limiting time-out. All parents should watch it."

    "Everybody can learn from it - even a grandma!"

    "All parents should receive a copy of the program or watch it hear."

    "A lot of parents don't know how to [respond] to these situation - we think we know but there is a lot to learn. I feel this program is going to be helpful for all parents who watch it."

    "It is a good program to have at home. You can always go back and watch how to discipline your child."

    "All parents, especially young men need to watch and learn from this. It should be part of the well child clinic."

    "Educational, a good learning tool for all mothers, especially first time mothers who do not know how to respond to hurtful behavior." [Note: Mom runs a daycare]

    "Helpful. Everybody should watch it. I am always willing to have more information. This indeed is beneficial."

    "It is very informative. If wonder if all parents have time and could watch it over here [in clinic]. It is a great tool and am sure it will help me."

    "It is a very good program. I would recommend it to all mothers, not just first-time mothers."

    "Very well organized. Good explanations and good examples."

Unpublished Pediatrician Waiting Room Parent Pilot Study (2006)

Participants were parents with children under 7 years of age who were waiting to see their pediatrician for a well child visit. Parents watched the Play Nicely program in the waiting room, viewing at least 4 of the interactive options for responding to the hypothetical situation of a child with aggression.

    1. I am pleased that my pediatrician provides the Play Nicely program for parents with young children.
    59 Yes 0 No 0 Uncertain

    2. The program makes me feel more confident that I can respond to hurtful behavior in an appropriate way.
    58 Yes 1 No 0 Uncertain

    3. Does the Play Nicely program make you more or less willing to discuss your child's behavior with your
    pediatrician in the future?

    43 More willing 0 less willing 15 unchanged

    4. Does the Play Nicely program make you more or less willing to discuss discipline options with your
    pediatrician in the future?

    32 More willing 0 less willing 12 unchanged