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Watch, Wait, and Wonder (WWW)

Scientific Rating:
3
Promising Research Evidence
See scale of 1-5
Child Welfare Relevance Rating:
2
Medium
See scale of 1-3

Note: The WWW program was not responsive to the CEBC's inquiry. The following information was obtained from publicly available sources.

Brief Description

The Watch, Wait, and Wonder (WWW) program has been rated by the CEBC in the area of: Infant and Toddler Mental Health (0-3).

  • Child Welfare Outcome: Permanency
  • Types of Maltreatment: Does not target any specific kind of maltreatment
  • Target Population: Not Specified

WWW is aimed at parents and their children who are experiencing relational and developmental difficulties. It was designed for children 0 to 4 years of age, but has been used with older children. The focus of the approach is on strengthening the attachment relationship between caregiver and child, in order to improve the child's self-regulating abilities and sense of efficacy and enhance the caregiver's sensitivity. A unique feature of the approach is the use of infant-led play sessions in which mothers are encouraged to observe their infants and allow them to initiate activities.

Education and Training Resources

Publicly available information indicates there is a manual that describes how to implement this program, and there is some training available for this program.
See contact info below.

Training Contact:

Relevant Published, Peer-Reviewed Research

This program is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list study) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. Please see the Scientific Rating Scale for more information.

Show relevant research...

Cohen, N. J., Muir, E., Lojkasek, M., Muir, R., Parker, C. J., Barwick, M. B., & Brown, M. (1999). Watch, Wait, and Wonder: Testing the effectiveness of a new approach to mother-infant psychotherapy. Infant Mental Health Journal, 20(4), 429-451.

Type of Study: Randomized trial (see summary)
Number of Participants: 67 infants and their mothers

Population:

  • Age range — 10 to 30 months
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Mothers and children referred to the mental health center for feeding, sleeping, or behavioral regulation problems.

Location / Institution: Hincks-Dellcrest Centre for Children's Mental Health, Ontario, Canada.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The authors note that two-thirds of study participants were randomly assigned to intervention conditions, while the remaining pairs were assigned based on caseload and scheduling factors. No significant demographic differences were found between the two groups. The study design did not include a no-treatment comparison group. Participants received either the Watch, Wait, and Wonder (WWW) intervention or mother-psychodynamic psychotherapy (PPT), in which the mother and therapist talked while she played with the infant. At baseline, mothers completed a symptom report about their infants' problems. Attachment was also assessed using the Strange Situation and mother infant interaction was coded using the Chatoor Play Scale. Infant development was assessed using the Mental Scales of the Bayley Scales of Infant Development. Mothers also completed the Parenting Stress Index (PSI) #fix-link, the Parenting Sense of Competence Scale and the Beck Depression Inventory (BDI). Both intervention groups showed improvements in infants' problem symptoms, PSI scores and mother-infant interaction (specifically maternal intrusiveness and conflict). The WWW intervention produced significantly greater improvements in attachment, cognitive development, emotional regulation, and maternal depression.

Length of post-intervention follow-up: None.

Cohen, N. J., Lojkasek, M., Muir, E., Muir, R., & Parker, C. J. (2002). Six-month follow-up of two mother-infant psychotherapies: Convergence of therapeutic outcomes. Infant Mental Health Journal, 23(4), 361-380.

Type of Study: Randomized trial (see summary)
Number of Participants: 58

Population:

  • Age range — 10 to 30 months at onset of treatment
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Mothers and children referred to the mental health center for feeding, sleeping or behavioral regulation problems.

Location / Institution: Hincks-Dellcrest Centre for Children's Mental Health, Ontario, Canada.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study is a follow-up of 58 mother-infant pairs from the Cohen et al. (1999) study described above. The same measures were obtained from mothers and infants. Results showed that for both groups, improvements in infant symptoms, parenting stress, and interaction were maintained or strengthened at six-month follow-up. In addition, the PPT group gains in cognitive development, emotional regulation, and attachment similar to those exhibited by the WWW group. At six months, the WWW group still showed better ratings on mothers' comfort in responding to infant behaviors and ratings of parenting stress.

Length of post-intervention follow-up: 6 months.

References

Muir, E., Lojkasek, M., & Cohen, N. J. (1999). Watch, Wait and Wonder: A manual describing a dyadic infant-led approach to problems in infancy and early childhood. Ontario, Canada: Hincks-Dellcrest Institute.

Contact Information

Name: Mirek Lojkasek, PhD
Title: Lecturer
Agency/Affiliation: University of Toronto
Website: watchwaitandwonder.com
Email:
Phone: (416) 972-1935 x3313
Fax: (416) 924-9808

Date Reviewed: December 2009