Abstract

Social and emotional competencies, such as distress regulation, are established in early childhood and are critical for the development of children’s mental health and wellbeing. Routine vaccinations in primary care provide a unique opportunity to relate responses to a universal, relatively standardized, distress regulation paradigm (i.e., pain-related distress) to key developmental outcomes. The current study sought to examine distress regulation during routine vaccination in infancy and preschool as predictors of outcomes related to socioemotional competence in preschool. It was hypothesized that children with poorer distress regulation abilities post-vaccination would have lower socioemotional development. Furthermore, it was hypothesized that insensitive parenting would exacerbate this relationship for children with poor distress regulation abilities. As part of an ongoing longitudinal cohort, 172 parent–child dyads were videotaped during vaccinations in infancy and preschool, and subsequently participated in a full-day psychological assessment in a university lab. Videotapes were coded for child pre-needle distress (baseline distress), immediate post-needle pain-related distress reactivity (immediate distress reactivity), and pain-related distress regulation (distress regulation). Parent sensitivity during the preschool vaccination was also coded. Baseline distress prior to vaccination predicted greater externalizing problems and behavioral symptoms. Parent sensitivity did not moderate the association between any child distress behaviors and socioemotional development indicators. Child distress behaviors prior to injection, regardless of parent behavior, during the vaccination context may provide valuable information to health care professionals about child socioemotional functioning in the behavioral and emotional domains.

Highlights

  • Based on a large national study of nearly 250,000 Canadian children, 26% of preschool-aged children demonstrated vulnerability in at least one area of development, including the physical, social, emotional, cognitive, and communication domains at school entry [1]

  • Given the aforementioned links between poor distress regulation and long-term mental health and academic difficulties, if distress regulation during routine preschool vaccination could be linked to measures of early socioemotional development including internalizing, externalizing, and behavior problems, this context may provide a new paradigm for supporting parent–child dyads that might be at particular risk for suboptimal child emotional and academic outcomes

  • We hypothesized that the association between poor distress regulation and poor socioemotional competence would be exacerbated for children of parents who demonstrated lower levels of sensitivity

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Summary

Introduction

Based on a large national study of nearly 250,000 Canadian children, 26% of preschool-aged children demonstrated vulnerability in at least one area of development, including the physical, social, emotional, cognitive, and communication domains at school entry [1]. The foundations of distress regulation skills are laid in early childhood and poor development of these abilities put preschoolers at risk of mental health and academic difficulties both at school entry and later in life [5] These long-term and profound implications stress the importance of identifying and providing remediation to children whose distress regulation skills are lagging. Given the aforementioned links between poor distress regulation and long-term mental health and academic difficulties, if distress regulation during routine preschool vaccination could be linked to measures of early socioemotional development including internalizing, externalizing, and behavior problems, this context may provide a new paradigm for supporting parent–child dyads that might be at particular risk for suboptimal child emotional and academic outcomes. We hypothesized that the association between poor distress regulation and poor socioemotional competence would be exacerbated for children of parents who demonstrated lower levels of sensitivity

Sample
Procedure
Child and Parent Behavior during the Vaccination Appointment
Child Self-Regulation Variables during the Psychological Assessment
Data Analysis
Main Analyses
Discussion
Full Text
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