Video-Feedback Intervention to promote Positive Parenting–Sensitive Discipline^® (VIPP–SD)

Video-Feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) aims to promote sensitive responsiveness and sensitive discipline and serves families with children ages 1 through 7 who have an increased risk of behavioral problems. For the purpose of the HomVEE review, the only VIPP-SD studies included were those of sites that served families with children ages 1 through 5. VIPP-SD consists of six or seven home visits that occur once or twice per month and last about two hours each. During visits, the home visitor video records the interaction between the caregiver and child. At subsequent visits, the home visitor and caregiver review selected clips from the video taken during the previous visit, and the home visitor provides feedback on the caregiver’s discipline practices and sensitivity to the child’s cues. Video-Feedback Intervention to promote Positive Parenting (VIPP) is an adaptation of VIPP-SD that was developed for families with infants from birth to 12 months and consists of six or seven home visits that focus on fostering a positive attachment between the infant and caregiver.

This report also includes studies of VIPP-AUTI and the British Autism Study of Infant Siblings (iBASIS)-VIPP. VIPP-AUTI is an adaptation of VIPP for families who have children diagnosed with autism spectrum disorder. VIPP-AUTI consists of six home visits focused on helping caregivers understand their children’s behavior and enhancing caregiver–child interactions. iBASIS-VIPP is an adaptation of VIPP for families with infants who have a sibling with autism spectrum disorder. iBASIS-VIPP added up to six booster visits after the standard six visits and included additional therapeutic procedures to respond to developmental atypicalities.

For more information, see the research database. For more information on the criteria used to rate research, please see details of HomVEE’s methods and standards.

Video-Feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) is a home visiting model grounded in (1) attachment theory, developed by John Bowlby and Mary Ainsworth; and (2) coercion theory, developed by Gerald Patterson. Attachment theory emphasizes the importance of sensitive responsiveness, which refers to a caregiver accurately perceiving and responding to a child’s signals. Coercion theory rests on the belief that children are more likely to exhibit negative behavior when caregivers use ineffective discipline techniques. VIPP-SD blends the two theories by supporting caregivers when they try to take the child’s perspective and signals into account when providing discipline.

VIPP-SD has been adapted for specific populations, including families with infants, families with children who have autism, and children in foster care (described under Adaptations and Enhancements). VIPP-SD has also been adapted for online delivery (Virtual VIPP-SD). Other adaptations of the model serve teaching staff in child care settings and schools, and VIPP-PRE serves fathers during the prenatal period using ultrasounds to stimulate sensitive interaction before the birth of their child. These versions were excluded from the HomVEE review because they are not delivered by home visits. This profile is based on versions of VIPP-SD that use home visiting as the primary service delivery method.

VIPP-SD was developed by researchers at the Centre for Child and Family Studies at Leiden University in the Netherlands. The VIPP Training and Research Centre, part of the Centre for Child and Family Studies, administers and oversees the model’s implementation together with the Tavistock and Portman National Health Service Foundation Trust in the United Kingdom and the Lab of Attachment and Parenting Support at the University of Pavia in Italy.

Implementation support is available in person in Belgium, Italy, the Netherlands, and the United Kingdom. Online implementation support is also available for implementation in the United States and other countries.

Please contact the model developer for information on whether ongoing technical assistance is available and who provides such assistance.

VIPP-SD consists of visits conducted in the caregiver’s home while the child is present. During the first visit, the home visitor introduces the caregiver to the VIPP-SD model and answers any questions. The home visitor also records a video of the caregiver and child interacting. After the visit, the home visitor views the recording, selects clips of the video to share with the caregiver, and prepares feedback on the selected clips. During subsequent home visits, the home visitor begins by recording another round of caregiver–child interactions, followed by a discussion between the home visitor and caregiver about the prepared video clips from the previous visit. The home visitor provides feedback and tips on the following topics:

Parental sensitivity, which involves the following:

• Attending to the child’s subtle signals and expressions
• Appropriately reacting to the child’s signals
• Sharing positive and negative emotions

Sensitive discipline, which involves the following:

• Using consistent discipline strategies and setting limits
• Using distraction and noncoercive responses to challenging behavior from the child
• Providing positive reinforcement by praising the child’s positive behavior and ignoring attention-seeking behavior
• Providing sensitive pauses (time-outs) to de-escalate temper tantrums
• Empathizing with the child

Although the intervention manual specifies the general content of each visit, the home visitor tailors feedback to each family based on the home visitor’s video-recorded observations.

The model has been adapted for specific populations. The developer’s process for considering modifications to the model involves asking experts on the population the model is designed for to propose revisions, gathering feedback from a focus group of families from that population, piloting the revision with 4 families and adapting as necessary, and piloting with an additional 10 families.

The following adaptations are designed for delivery in the home:

• Video-Feedback Intervention to promote Positive Parenting (VIPP) is the precursor to VIPP-SD. VIPP, developed for families with infants from birth to 12 months, focused on fostering a positive attachment between the infant and caregiver. VIPP-SD extends VIPP to families with children ages 1 through 6 and adds a focus on supporting positive discipline. VIPP-SD is now the core model, and VIPP is considered a version of VIPP-SD. VIPP consists of six or seven home visits. The VIPP-SD training covers how to implement VIPP.
• Video-Feedback Intervention to promote Positive Parenting adapted to Autism (VIPP-AUTI) serves caregivers of children from birth through age 6 who are diagnosed with autism spectrum disorder. VIPP-AUTI consists of six home visits focused on helping caregivers understand their children’s behavior and enhancing caregiver-child interactions. Home visitors must complete the VIPP-SD training before enrolling in the VIPP-AUTI course. The VIPP-AUTI training includes two full-day, in-person training sessions, three post-training coaching sessions, and a certificate.
• Video-Feedback Intervention to promote Positive Parenting adapted to Foster Care (VIPP-FC) serves caregivers with a foster child whose age is birth through 6. This adaptation consists of seven visits and uses the same model components as VIPP-SD. The home visitor tailors feedback to the needs of the caregivers and the specific behavioral characteristics of the foster child. Home visitors must complete the VIPP-SD training before enrolling in the VIPP-FC course. The VIPP-FC course includes two full-day training sessions and three post-training coaching sessions.
• British Autism Study of Infant Siblings (iBASIS)-VIPP served families with infants who had a sibling with autism spectrum disorder. iBASIS-VIPP provided up to six booster visits after the standard six VIPP visits and included additional therapeutic procedures to respond to developmental atypicalities and reduce the risk for later autism.

Please contact the model developer for information about the recommended or required type of organization or the characteristics of organizations that can implement VIPP-SD. Implementing organizations should have the capacity to supervise the home visitors to support the fidelity of the VIPP-SD implementation.

The model requires home visitors to meet a set of ongoing fidelity guidelines related to, for example, the relevance and quality of the feedback the home visitors provide families. Please contact the model developer for additional information about the guidelines.

Home visitors trained by VIPP-SD trainers implement the model under the supervision of VIPP-SD supervisors.

Any professional working with caregivers of young children, including teachers, special educators, psychologists, nurses, social workers, child psychiatrists, and behavioral health staff, can implement the model. Home visitors should have a basic understanding of attachment theory and child development.

To be eligible to be a supervisor, home visitors must have documented experience as a supervisor-in-training with at least 20 families and 10 home visitors, giving them face-to-face and written feedback. To receive trainer certification, supervisors must have successfully served as a co-trainer in at least three VIPP-SD trainings. 

The developer requires the VIPP-SD supervisor to discuss an average of 20 percent of the home visitor’s visits with the home visitor. Please contact the model developer for information on the required or recommended mode of supervision.

The developer requires home visitors to participate in pre-service training. Before implementing the model, home visitors must complete the four-day VIPP-SD training. Trainers discuss examples of cases, and home visitor trainees complete exercises. After the training, trainees must complete three coaching sessions with a VIPP-SD supervisor or trainer. Trainees practice preparing feedback for an example case and then meet with the supervisor or trainer to discuss their practice feedback. Please contact the model developer for additional information about the pre-service training requirement.

The developer recommends, but does not require, that home visitors participate in ongoing professional development, which is organized by the VIPP Training and Research Centre regularly. Please contact the model developer for additional information about ongoing professional development.

Centre for Child and Family Studies
Leiden University
The Netherlands

Phone: +31 (071) 527-3434
Email: vipp@fsw.leidenuniv.nl
Website: http://vippleiden.com/en