Play Nicely program

About the program

The Play Nicely program is a brief, population-based intervention. It is designed to prevent violence and mitigate toxic stress. It aims to teach parents discipline strategies on how to respond to an aggressive child. Inappropriate discipline and childhood aggression are two of the strongest risk factors for violence later in life. Inappropriate discipline can also lead to greater physical and mental health problems in children. The program can be delivered as a multimedia intervention only or accompany a discussion with a physician.

The program is an interactive video that offers 20 different options on how to respond to an aggressive child. It also comes with a handbook. Caregivers are encouraged to view the options that are of most interest to them.

Who does it work for?

The Play Nicely program is aimed at caregivers of children aged 10 years and younger. It has been tested with populations of multiple cultural backgrounds.

The program has only been tested in the USA (Scholer et al. 2011).

A randomised control trial was conducted with 258 people (129 people in the intervention group and 129 people in the control group). Most parents were African American (43%), while 29% were Caucasian and 23% were Hispanic.

The program has not been tested in Australia, or with Aboriginal Australians.      

What outcomes does it contribute to?

Positive outcomes:

• Parenting attitude: Caregivers are more likely to change their plans of how to discipline their children if they received the program in any format (Scholer et al. 2011).

Negative outcomes:

• No negative effects were found.

How effective is it?

Overall, the Play Nicely program has a positive effect on client outcomes.

How strong is the evidence?

Promising research evidence:

• At least one high-quality randomised controlled trial (RCT) or quasi-experimental design (QED)  study reports statistically significant positive effects for at least one outcome, AND
• Fewer RCT or QED studies of similar size and quality show no observed effects than show statistically significant positive effects, AND
• No RCT or QED studies show statistically significant adverse effects.

How is it implemented?

The Play Nicely program can be implemented in three different ways:

• Multimedia program about how to respond to a child’s aggression
• Physician-parent discussion
• Multimedia program + discussions with physicians

The multimedia program is 50 minutes long, but can be effective when used for only 5-10 minutes (Scholer et al. 2011). It is accompanied by a handbook. Caregivers are asked, ‘Assume you see one child hit another, what are you going to do?’ They are presented with 20 different options to choose from, including: say ‘no’ to your child, ask your child how the other child feels, take away a privilege, discuss why hurtful behaviour is wrong, spank your child, ignore your child. Caregivers are encouraged to view the options for the types of discipline that they are most interested in. Caregivers view at least 4 interactive options. After the caregiver chooses an option, they are told if it is great, good or if there are better options.

Discussions with physician included talking about their child’s behavior and how they discipline their child.

How much does it cost?

The online multimedia version is free. See website for details: https://www.childrenshospitalvanderbilt.org/program/play-nicely-healthy-discipline-program

What else should I consider?

The program can be implemented in as little as 5 minutes and shows a positive effect on parenting attitude (Scholer et al. 2011). The online multimedia version of the program is free, and can be used on its own to improve client outcomes.

Where does the evidence come from?

One RCT conducted in the USA, with 258 participants (Scholer et al. 2011).

Further resources

The Play Nicely program website: https://www.childrenshospitalvanderbilt.org/program/play-nicely-healthy-discipline-program

Scholer et al. (2011), ‘The effect of physician-parent discussions and a brief intervention on caregivers' plan to discipline: Is it time for a new approach?’, Clinical Pediatrics, vol. 50, no. 8, pp. 712-719.