Caregiving Environment Research Articles

The role of sustained attention, maternal sensitivity, and infant temperament in the development of early self-regulation.

This study investigated infant predictors of early cognitive and emotional self-regulation from an intrinsic and caregiving environmental perspective. Sustained attention, reactive aspects of infant temperament, and maternal sensitivity were assessed at 10months (n=124) and early self-regulation (including executive functions, EF, and emotion regulation) was assessed at 18months. The results indicated that sustained attention predicted early EF, which provide empirical support for the hierarchical framework of EF development, advocating early attention as a foundation for the development of cognitive self-regulation. Maternal sensitivity and surgency predicted emotion regulation, in that infants of sensitive mothers showed more regulatory behaviours and a longer latency to distress, whereas high levels of surgency predicted low emotion regulation, suggesting both the caregiving environment and temperament as important in the development of self-regulation. Interaction effects suggested high sustained attention to be a protective factor for children of insensitive mothers, in relation to emotion regulation. In addition, high levels of maternal sensitivity seemed to foster development of emotion regulation among children with low to medium levels of sustained attention and/or surgency. In all, our findings point to the importance of both intrinsic and extrinsic factors in infant development of self-regulation.

Associations Between Parent Emotional Arousal and Regulation and Adolescents' Affective Brain Response.

Parents' emotional functioning represents a central mechanism in the caregiving environment's influence on adolescent affective brain function. However, a paucity of research has examined links between parental emotional arousal and regulation and adolescents' affective brain function. Thus, the present study examined associations between parents' self-rated negative emotion, parent emotion regulation difficulties, and adolescent brain responsivity to negative and positive emotional stimuli. Participants included 64 12-14 year-old adolescents (31 females) and their female primary caregivers. Adolescents viewed negative, positive, and neutral emotional stimuli during an fMRI scanning session. Region of interest analyses showed that higher parent negative emotion was related to adolescents' greater ACC and vmPFC response to both negatively- and positively-valenced emotional stimuli; whereas, parent negative emotion was related to adolescents' greater amygdala response to negative emotional stimuli only. Furthermore, parent emotion regulation moderated the association between parent negative emotion and adolescents' brain response to negative emotional stimuli, such that parents with high negative emotion and high emotion regulation difficulties had adolescents with the greatest affective brain response. Findings highlight the importance of considering both parent emotional arousal and regulation in understanding the family affective environment and its relation to adolescent emotion-related brain development.

The use of a developmental continuum in early childhood clinical experiences: building preservice teachers’ knowledge of cognitive development

ABSTRACTThe quality of early caregiving and educational environments has a significant effect on children’s later cognitive outcomes. Early childhood teachers are an important determining factor in the quality of these environments and therefore they need appropriate professional preparation. The purpose of this study was to describe the ways in which early childhood preservice teachers learn about children’s cognitive development and developmentally appropriate pedagogical practices at three select universities. Participants included preservice teachers and faculty members. The researcher collected and analysed data from interviews, documents, and surveys. Participants from this study proposed preservice teachers gained knowledge about children’s cognitive development as well as learned how to use this knowledge in their pedagogical practices by participating in clinical experiences that targeted a developmental continuum approach.

A New Perspective on the Mechanisms of Neglect

Over the past two decades, substantial evidence demonstrates a strong relationship between child abuse and neglect and increased risk for psychopathology that persists across the life course. To date, most studies elucidating the underlying mechanism for this association have focused on the effects of child abuse and neglect on stress pathways and the limbic system ( 1 McLaughlin K.A. Sheridan M.A. Tibu F. Fox N.A. Zeanah C.H. Nelson 3rd, C.A. Causal effects of the early caregiving environment on development of stress response systems in children. Proc Natl Acad Sci U S A. 2015; 18: 5637-5642 Crossref Scopus (275) Google Scholar ). In this issue of Biological Psychiatry, McLaughlin et al. ( 2 McLaughlin K.A. Sheridan M.A. Nelson C.A. Neglect as a violation of species-expectant experience: Neurodevelopmental consequences. Biol Psychiatry. 2017; 82: 462-471 Abstract Full Text Full Text PDF PubMed Scopus (127) Google Scholar ) propose a novel conceptual framework of child neglect as deprivation of experience-expectant learning that compromises neuronal processes during sensitive periods of development.

Against all odds: Vital Few foster families

There is a small, methodologically diverse body of research indicating that approximately 20% of families provide disproportionate amounts of foster caregiving, place fewer restrictions on characteristics of children they are willing to foster and actually do foster, and provide caregiving environments as good as or better than those provided by other foster families. Cherry and Orme (2013) conceptualized this phenomenon in terms of the Pareto Principle, also known as the 80-20 rule or the Vital Few, and they refer to these 20% of families as the Vital Few and the remaining 80% as the Useful Many. This review will examine and synthesize the available research on Vital Few foster families and explore next steps in the development of this body of research.

The crucial role of the micro caregiving environment: Factors associated with attachment styles in alternative care in Chile

The distribution of attachment styles has been shown to differ between groups of children living with their parents and children placed in alternative care (AC), defined as residential or foster. However, this is the first study in Latin America to explore possible factors affecting the quality of attachment in children living in both residential and foster care. Two groups of children (N=57) were compared: one group living in Residential Homes (RC) and the other in Foster Care (FC) in Chile. Children’s, caregivers’ and structural factors (e.g., child: caregiver ratios) and their links with attachment styles were investigated. The micro caregiving environment (i.e., the specific individual child caregiver relationship), especially the caregivers’ engagement, sensitivity, disciplinary control and affection, as well as some structural factors (i.e., child: caregiver ratios), were linked to attachment security in children. Specifically, better emotional caregiving and lower child-caregiver ratios were associated with higher rates of secure attachment. The association between quality of care (as measured by the HOME inventory) and attachment styles seems to be influenced by caregiver relationships (as measured by CCSERSS). Caregiver relationship factors (i.e., affection, engagement and sensitivity) directly impact the quality of the attachment children establish with them while living in AC. However, the relationships that caregivers establish with children under their care can be facilitated by good quality structural factors, particularly child-caregiver ratios.

From the Cradle to the Grave: The Effect of Adverse Caregiving Environments on Attachment and Relationships Throughout the Lifespan.

This paper reviews research examining the effects of adverse early caregiving on relationships throughout the lifespan. Central attachment constructs are summarized and integrated into a review of research on the long-term effects of institutional rearing and child maltreatment. Findings are interpreted within the organizational perspective on development, which conceptualizes attachment as a stage-salient task of infancy that influences the reorganization of adaptive/maladaptive functioning around subsequent stage-salient tasks. Children who experience adverse early caregiving are more likely to exhibit aberrant attachment behaviors, deficits in social-emotional competencies, and persisting difficulties in social functioning and relationship outcomes. Disorganized attachment behavior stemming from adverse early caregiving has been a major focus of this work. Intervention efforts that target mental representations related to attachment relationships can facilitate improved social functioning. Clinical implications of this work are discussed.

Developmental Cascade and Transactional Associations Among Biological and Behavioral Indicators of Temperament and Maternal Behavior.

An empirical model of temperament that assessed transactional and cascade associations between respiratory sinus arrhythmia (RSA), negative affectivity, and the caregiving environment (i.e., maternal intrusiveness) across three time points during infancy (N=388) was examined. Negative affectivity at 5months was associated positively with maternal intrusiveness at 10months, which in turn predicted increased negative affectivity at 24months. RSA at 5months was associated positively with negative affectivity at 10months, which subsequently predicted greater RSA at 24months. Finally, greater RSA at 5months predicted greater negative affectivity at 10months, which in turn predicted greater maternal intrusiveness at 24months. Results are discussed from a biopsychosocial perspective of development.

Association of prenatal cocaine exposure, childhood maltreatment, and responses to stress in adolescence

BackgroundPrenatal cocaine exposure (PCE) may alter responses to stress. Children with PCE tend to grow up in suboptimal caregiving environments, conducive to child maltreatment (CM). Guided by the diathesis-stress model, the present study examined differences in self-reported responses to stress and coping in adolescents with and without PCE and explored whether childhood maltreatment (CM) moderated the effects of PCE. MethodsAdolescents (N=363; 184 PCE, 179 non-cocaine exposed (NCE)), primarily African-American and of low socioeconomic status, were prospectively enrolled in a longitudinal study at birth. The Responses to Stress Questionnaire was used to assess volitional coping (primary control, secondary control, disengagement) and involuntary responses (involuntary engagement, involuntary disengagement) to stress at the 15- and 17-year follow-up visits. CM was assessed retrospectively at age 17 using the Juvenile Victimization Questionnaire. ResultsFindings from longitudinal mixed model analyses indicated that PCE was associated with poorer coping strategies only among adolescents with a history of CM. Adolescents with PCE who experienced CM reported less dominant use of primary (e.g., problem solving, emotional regulation) and secondary control (e.g., cognitive restructuring) and more dominant use of disengagement (e.g., denial, avoidance) and involuntary disengagement (e.g., inaction) than adolescents with PCE who did not experience CM or NCE adolescents regardless of CM. CM was associated with more dominant use of involuntary engagement (e.g., intrusive thoughts). ConclusionsPCE may increase sensitivity to CM, predisposing increased vulnerability to environmental risk. Continued studies into adulthood will elucidate how coping and involuntary stress responses affect social, vocational, and behavioral adjustment.

Out of harm's way: Secure versus insecure-disorganized attachment predicts less adolescent risk taking related to childhood poverty.

Although some risk taking in adolescence is normative, evidence suggests that adolescents raised in conditions of socioeconomic disadvantage are disproportionately burdened with risk taking and its negative consequences. Using longitudinal data from the NICHD Study of Early Child Care and Youth Development, we investigated quality of the early caregiving environment as a potential prospective buffer against the long-term association between childhood poverty and adolescent risk taking. Multicategorical moderation model results indicated that if raised in poverty across age 1-54 months (average family income to needs ratio ≤ 1.02), relative to affluence (income to needs ratio ≥ 6.16), adolescents with histories of secure attachment to caregivers exhibited two times the number of risk behaviors at age 15, whereas adolescents with insecure-disorganized histories exhibited nearly five times the number of risk behaviors. Both early family economic hardship and history of insecure-disorganized attachment remained significant predictors of increased adolescent risk taking, alongside the interactive effect. Probing the interaction's region of significance revealed that history of secure (vs. insecure-disorganized) attachment is associated with protective reductions in risk taking below a family income to needs ratio of 2.24, or about 220% poverty level. Findings support a diathesis-stress model in which children with secure attachment histories are less deleteriously impacted by early socioeconomic adversity than their insecure-disorganized peers.

Signs of reactive attachment disorder and disinhibited social engagement disorder at age 12 years: Effects of institutional care history and high-quality foster care.

Two disorders of attachment have been consistently identified in some young children following severe deprivation in early life: reactive attachment disorder and disinhibited social engagement disorder. However, less is known about whether signs of these disorders persist into adolescence. We examined signs of reactive attachment disorder and disinhibited social engagement disorder at age 12 years in 111 children who were abandoned at or shortly after birth and subsequently randomized to care as usual or to high-quality foster care, as well as in 50 comparison children who were never institutionalized. Consistent with expectations, those who experienced institutional care in early life had more signs of reactive attachment disorder and disinhibited social engagement disorder at age 12 years than children never institutionalized. In addition, using a conservative intent-to-treat approach, those children randomized to foster care had significantly fewer signs of reactive attachment disorder and disinhibited social engagement disorder than those randomized to care as usual. Analyses within the ever institutionalized group revealed no effects of the age of placement into foster care, but number of caregiving disruptions experienced and the percentage of the child's life spent in institutional care were significant predictors of signs of attachment disorders assessed in early adolescence. These findings indicate that adverse caregiving environments in early life have enduring effects on signs of attachment disorders, and provide further evidence that high-quality caregiving interventions are associated with reductions in both reactive attachment disorder and disinhibited social engagement disorder.

Caregiver maltreatment causes altered neuronal DNA methylation in female rodents.

Negative experiences with a caregiver during infancy can result in long-term changes in brain function and behavior, but underlying mechanisms are not well understood. It is our central hypothesis that brain and behavior changes are conferred by early childhood adversity through epigenetic changes involving DNA methylation. Using a rodent model of early-life caregiver maltreatment (involving exposure to an adverse caregiving environment for postnatal days 1-7), we have previously demonstrated abnormal methylation of DNA associated with the brain-derived neurotrophic factor (Bdnf) gene in the medial prefrontal cortex (mPFC) of adult rats. The aim of the current study was to characterize Bdnf DNA methylation in specific cell populations within the mPFC. In the prefrontal cortex, there is approximately twice as many neurons as glia, and studies have recently shown differential and distinctive DNA methylation patterns in neurons versus nonneurons. Here, we extracted nuclei from the mPFC of adult animals that had experienced maltreatment and used fluorescence-activated cell sorting to isolate cell types before performing bisulfite sequencing to estimate methylation of cytosine-guanine sites. Our data indicate that early-life stress induced methylation of DNA associated with Bdnf IV in a cell-type and sex-specific manner. Specifically, females that experienced early-life maltreatment exhibited greater neuronal cytosine-guanine methylation compared to controls, while no changes were detected in Bdnf methylation in males regardless of cell type. These changes localize the specificity of our previous findings to mPFC neurons and highlight the capacity of maltreatment to cause methylation changes that are likely to have functional consequences for neuronal function.

A process model of the implications of spillover from coparenting conflicts into the parent-child attachment relationship in adolescence.

Drawing on a two-wave, multimethod, multi-informant design, this study provides the first test of a process model of spillover specifying why and how disruptions in the coparenting relationship influence the parent-adolescent attachment relationship. One hundred ninety-four families with an adolescent aged 12-14 (M age = 12.4) were followed for 1 year. Mothers and adolescents participated in two experimental tasks designed to elicit behavioral expressions of parent and adolescent functioning within the attachment relationship. Using a novel observational approach, maternal safe haven, secure base, and harshness (i.e., hostility and control) were compared as potential unique mediators of the association between conflict in the coparenting relationship and adolescent problems. Path models indicated that, although coparenting conflicts were broadly associated with maternal parenting difficulties, only secure base explained the link to adolescent adjustment. Adding further specificity to the process model, maternal secure base support was uniquely associated with adolescent adjustment through deficits in adolescents' secure exploration. Results support the hypothesis that coparenting disagreements undermine adolescent adjustment in multiple domains specifically by disrupting mothers' ability to provide a caregiving environment that supports adolescent exploration during a developmental period in which developing autonomy is a crucial stage-salient task.

The relationship between common patterns of prenatal alcohol exposure and neurodevelopment in two‐year old children

Background: Around 60% of women drink some alcohol while pregnant. There is conflicting evidence on the effect on the fetus of common patterns of prenatal alcohol exposure (PAE) e.g. low level or sporadic drinking. Guidelines recommend abstinence as the safest option, creating problems for those advising women who drink at these levels before pregnancy recognition or beyond. The Asking QUestions about Alcohol (AQUA) study aimed to accurately measure PAE and account for important cofactors, to reduce uncertainty about child outcomes. Method: Detailed data on PAE were prospectively collected in a pre-birth cohort of over 1500 mother/child dyads. There was also extensive data collection of predictors of child development at one and two-year's post-partum. A sub-group of children was followed up at two years of age with a neurodevelopmental assessment (Bayley III). Two-step multivariable regression analyses of an effect of PAE accounted for independent risk factors that related to 1) pregnancy, including sociodemographic, psychologic and lifestyle variables such as diet and supplement use, and 2) the postnatal care-giving environment, including breastfeeding and maternal psychological wellbeing. Results: Adjustment for independent risk factors ameliorated any putative associations between PAE and cognitive, language and motor development in 554 two year-old children spread evenly across six PAE groups. Conclusions: Assessing neurodevelopmental outcomes associated with PAE is strongly influenced by other modifiable and non-modifiable risk factors. Although we found no adverse neurodevelopmental outcomes at two years of age, follow-up will be necessary in these children when complex higher-level cognitive, language and motor skills are required.

Diurnal cortisol after early institutional care—Age matters

Several studies have shown that young children who have experienced early caregiving adversity (e.g. previously institutionalization (PI)) exhibit flattened diurnal cortisol slopes; however, less is known about how these patterns might differ between children and adolescents, since the transition between childhood and adolescence is a time of purported plasticity in the hypothalamic-pituitary-adrenal (HPA) axis. PI youth experience a massive improvement in caregiving environment once adopted into families; therefore we anticipated that a developmental increase in HPA axis plasticity during adolescence might additionally allow for an enhanced enrichment effect by the adoptive family. In a cross-sectional sample of 197 youths (PI and Comparison; 4–15 years old) we observed age-related group differences in diurnal slope. First replicating previous findings, PI children exhibited flattened diurnal slope. This group difference, however, was not observed in adolescents. Moderation analyses showed that pubertal development, increased time with family, and early adoption contributed to the steeper diurnal cortisol slope in PI adolescents. These findings add support to existing theories positing that the transition between middle childhood and adolescence may mark an additional sensitive period for diurnal cortisol patterning, allowing PI youth to benefit from the enriched environment provided by adoptive parents during this period of development.

Is level of prematurity a risk/plasticity factor at three years of age?

Children born preterm have poorer outcomes than children born full-term, but the caregiving environment can ameliorate some of these differences. Recent research has proposed that preterm birth may be a plasticity factor, leading to better outcomes for preterm than full-term infants in higher quality environments. This analysis uses data from two waves of an Irish study of children (at 9 months and 3 years of age, n=11,134 children) and their caregivers (n=11,132 mothers, n=9998 fathers) to investigate differences in how caregiving affects social, cognitive, and motor skills between full-term, late preterm, and very preterm children. Results indicate that parental emotional distress and quality of attachment are important for child outcomes. Both being born very preterm and late preterm continue to be risk factors for poorer outcomes at 3 years of age. Only fathers’ emotional distress significantly moderated the effect of prematurity on infants’ cognitive and social outcomes—no other interactions between prematurity and environment were significant. These interactions were somewhat in line with diathesis stress, but the effect sizes were too small to provide strong support for this model. There is no evidence that preterm birth is a plasticity factor.

The effect of heterogeneous race exposure during infancy

Over the first year of life face processing passes through a period of perceptual narrowing. Such narrowing reflects the closure of a sensitive period associated with a loss of perceptual and neural plasticity. One example of perceptual narrowing is the “other-race” effect (ORE), in which humans more easily recognize and discriminate faces of one’s own race than faces different from their own. In the present study, we sought to understand the consequences of having limited racial experience versus exposure to a diverse racial environment with regard to infants’ looking preferences to different race faces. We employed a looking time paradigm with 47 infants to examine race preferences as a function of differential exposure to multiple races in the caregiving environment at 4, 6, 8, 10 and 12 months of age. The results revealed: 1) Caucasian and African-American infants were more likely to have homogenous race exposure to caregivers of their own race; 2) there was no difference in preferential looking behavior between infants exposed to a single race versus multiple races at all ages except 10-months (infants exposed to multiple races fixated longer to a race than infants exposed to only one race); 3) infants allocate their gaze more uniformly across the face pairs over time, and 4) infants in this sample did not exhibit own-race preferences. The results suggest that racial exposure to caregivers has little influence on face preference among infants and that face preferences tend to disappear with age. Further studies are needed to evaluate the role of race preference on the child’s neurobehavioral and social development.

Annual Research Review: Childhood maltreatment, latent vulnerability and the shift to preventative psychiatry - the contribution of functional brain imaging.

BackgroundChildhood maltreatment is a potent predictor of poor mental health across the life span. We argue that there is a need to improve the understanding of the mechanisms that confer psychiatric vulnerability following maltreatment, if we are to progress from simply treating those with a manifest disorder, to developing effective preventative approaches that can help offset the likelihood that such disorders will emerge in the first place.MethodsWe review extant functional neuroimaging studies of children and adolescents exposed to early neglect and/or maltreatment, including physical, sexual and emotional abuse across four neurocognitive domains: threat processing, reward processing, emotion regulation and executive control. Findings are discussed in the context of ‘latent vulnerability’, where alterations in neurocognitive function are considered to carry adaptive value in early adverse caregiving environments but confer long‐term risk.ResultsStudies on threat processing indicate heightened as well as depressed neural responsiveness in maltreated samples, particularly in the amygdala, thought to reflect threat hypervigilance and avoidance respectively. Studies on reward processing generally report blunted neural response to anticipation and receipt of rewards, particularly in the striatum, patterns associated with depressive symptomatology. Studies on emotion regulation report increased activation of the anterior cingulate cortex (ACC) during active emotion regulation, possibly reflecting greater effortful processing. Finally, studies of executive control report increased dorsal ACC activity during error monitoring and inhibition.ConclusionsAn emerging body of work indicates that altered neurocognitive functioning following maltreatment: (a) is evident even in the absence of overt psychopathology; (b) is consistent with perturbations seen in individuals presenting with psychiatric disorder; (c) can predict future psychiatric symptomatology. These findings suggest that maltreatment leads to neurocognitive alterations that embed latent vulnerability to psychiatric disorder, establishing a compelling case for identifying those children at most risk and developing mechanistically informed models of preventative intervention. Such interventions should aim to offset the likelihood of any future psychiatric disorder.

Positive parenting predicts cortisol functioning six years later in young adults.

Research which indicates that adverse experiences influence hypothalamic-pituitary-adrenal (HPA) axis functioning illustrates the social environment 'getting under the skin'. The present study extended this literature by examining whether positive social forces within the caregiving environment can also impact cortisol functioning. We conducted a prospective investigation of over 300 youth, half of whom were White and half were Black. Attachment, bonding and parental rewards for positive behaviors were observed or reported by the youth as an 8th grader. Twelve repeated measures of salivary cortisol were examined six years later when youth were young adults (mean age 20). Race differences were explored. Stronger attachment, bonding and teen-reported positive parenting were predictive of high waking cortisol and steeper diurnal slopes six years later. This effect was nonlinear and additive, such that youth whose social contexts were characterized by the strongest attachment, bonding and rewarding parental relationships had the highest waking cortisol. When effects were moderated by race, findings were such that links of positive parenting with HPA functioning were more consistent for White than Black youth. Findings suggest that positive aspects of the caregiving environment can also 'get under the skin' and these effects are additive across a range of caregiving indices. These findings dovetail with an emerging literature on the powerful role of social support for shaping the body's stress response system and are interpreted as consistent with the Adaptive Calibration Model which suggests that cortisol regulation can have adaptive significance. A video abstract of this article can be viewed at: https://youtu.be/8evHXpt_TXM.

Creating a Holding Environment for Caregivers.

The Journal of Perinatal & Neonatal Nursing 31(1):p E2, January/March 2017. | DOI: 10.1097/JPN.0000000000000238