One of the most effective treatments for 2-to-7-year-olds prone to frequent high-level meltdowns involves teaching parents to rewire the relationship via play therapy, says the woman known as the Toddler Whisperer.

"The child escalates, the parent escalates and before you know it they're screaming at each other."

For young children prone to frequent high-level meltdowns, one of the most effective treatments involves teaching parents to rewire the relationship via play therapy, says Dr Cheryl McNeil, aka the Toddler Whisperer.

In Parent-Child Interaction Therapy (PCIT), parents and caregivers are coached in real time to rewire the day-to-day mechanics of the relationship with their challenging child.

Listen to Dr Cheryl McNeil on Nine to Noon

First developed in the 1970s by Oregon psychologist Sheila Eyberg, it's been used in New Zealand since 2010.

It has been shown to be effective with 2 to 7-year-olds whose behaviour is in the 95th percentile in terms of defiance, aggression, temper tantrums and hyperactivity and who don't respond to more traditional or typical methods.

So why do some kids get locked into such challenging behaviour?

Trauma such as family violence and maltreatment can contribute, as can a parent's postpartum depression, family separation and the child being on the autism spectrum.

But sometimes kids can still struggle without an apparent cause in the background, McNeil says.

PCIT works by training parents to be like 'super parents' who can do their own play therapy.

"We're teaching them exactly what to say and exactly what to do to manage children who have not responded to average parenting."

In a typical session, the parent will sit on the floor with the child and some toys. A therapist observes the play behind a one-way mirror and provides real-time coaching via an earpiece. (If there are two caregivers they take turns).

Parents are taught to use the five PRIDE skills - Praise, Reflect, Imitate, Describe, Enthusiasm.

"They learn to be very sensitive caregivers and highly reinforcing to their children, noticing all the children's strengths. What do they do well? What's positive? Giving the child very stimulating attention and reinforcing attention when they're behaving well."

Praise is specific and given at a very high rate, McNeil says.

"I love the fact that you're sharing toys with me. You're doing a good job of being very gentle with the cars. That's nice the way you asked me nicely for that toy."

Reflection is a form of active listening, she says…

Go to this episode on rnz.co.nz for more details