Caregiver-child Interactions Research Articles

Association between caregiver-child interaction and autistic-like behaviors at around three years of age

BackgroundThe prevalence of autistic-like behaviors is increasing worldwide, both in developed and developing countries. With a high disease burden and complex developmental causes, there has been much interest in the etiology of the disease, and there is a lack of evidence on the relationship between caregiver-child interaction and autistic-like behaviors. Aim/objectiveThis study investigated the association between caregiver-child interaction and children's autistic-like behaviors during early childhood. MethodThe subjects of this study were 171 kindergartens selected from the Longhua Child Cohort Study (LCCS), and a total of 40,237 children around the age of three were included. Sociodemographic characteristics, family income, and frequency of interaction between caregivers and children were all filled in by the child's primary caregiver, and the adapted Chinese Autism Behavior Checklist was used to assess children's autism-like behaviors. Tobit Regression and ancovariance analysis (ANCOVA) were used to measure the relationship between caregiver-child interactions (family and social activities) and autism-like behaviors, with a two-tailed p value of <0.05 being significant. ResultsTobit regression analyses found that in the 0–1 year age group, different frequencies of singing activities by caregivers with children (<3 times per week, 3–6 times per week, 6 times or more per week) were significantly negatively associated with autistic-like behaviors in a dose-response manner (B values of −0.323, −0.381, −0.544, all p < 0.0001); in the 1–3 year age group, different frequencies of reading interactions by caregivers with children (<3 times per week, 3–6 times per week, 6 times or more per week) were also significantly negatively associated with autistic-like behaviors in a dose-response manner (B values of −0.388, −0.632, −0.956, all p < 0.0001), and similar associations were found in singing and chatting interactions. ConclusionsOur findings suggest that higher frequencies of early caregiver-child interactions are associated with lower levers of autistic-like behaviors in children around the age of three years.

Early assessment of communicative competence in children with hearing loss using the Child-Caregiver Communication Assessment through Rebesco's Evaluation (CC-CARE) method

PurposeThis work presents a new frame-by-frame video analysis method called Child-Caregiver Communication Assessment through Rebesco's Evaluation (CC-CARE), developed in the context of pediatric hearing loss as a rehabilitation tool for assessing children's early communication skills. CC-CARE stems from the commonly used Tait video analysis and extends it by including a new set of parameters aimed at disentangling between hearing-dependent and hearing-independent aspects of communication. Method: In this paper, we collected video samples of child-caregiver interactions in a group of 65 normal-hearing children and a group of 165 hearing-impaired children. For each group, we present the CC-CARE method and describe the parameters, their score distributions, correlations and we estimate the adherence of the CC-CARE scores with children's developmental trajectory. Moreover, we compare the results of CC-CARE scores between the two groups having had different development of the auditory system. Finally, a fully-data driven approach was employed to assess the consistency of the communicative efficacy index (CEI), a score aiming to capture a global result of the CC-CARE procedure. Results: Correlations among parameter scores were found in each within-group analysis, revealing CC-CARE's internal consistency in measuring associated but nonoverlapping communication dimensions. For both groups, CC-CARE scores were associated with participants' age. Differences between scores emerged for a between-group analysis, indicating CC-CARE sensitivity to extract communication differences as a function of the hearing status. For both groups, the data analysis revealed that the CEI captures large variance portions across all parameter scores of the CC-CARE method. Conclusions: Results provide the first evidence that the CC-CARE video analysis method could be a reliable tool capable of highlighting the cascading effects of hearing impairment on children's preverbal communicative efficacy. The CC-CARE method aims to support early rehabilitation of hearing loss by describing a child's communicative efficacy.

Parental communicative input as a protective factor in Bangladeshi families living in poverty: A multi-dimensional perspective.

Studies from high-income populations have shown that stimulating, supportive communicative input from parents promote children's cognitive and language development. However, fewer studies have identified specific features of input supporting the healthy development of children growing up in low- or middle-income countries. The current study proposes and tests a multi-dimensional framework for understanding whether and how caregiver communicative input mediates the associations between socio-economic conditions and early development. We also examine how caregiver conceptual scaffolding and autonomy support uniquely and synergistically explain variation in child outcomes. Participants were 71 Bangladeshi families with five-year-olds who were exposed to a range of biological and psychosocial hazards from birth. Caregiver-child interactions during snack sharing and semi-structured play were coded for caregiver conceptual scaffolding, autonomy support, and child engagement. Findings indicate that the two dimensions of input were correlated, suggesting that caregivers who provided richer conceptual scaffolds were simultaneously more supportive of children's autonomy. Notably, conceptual scaffolding and autonomy support each mediated associations between maternal education and child verbal intelligence quotient (IQ) scores. Further, caregivers who supported greater autonomy in their children had children who participated in conversations more actively, and these children in turn had higher performance IQ scores. When considered simultaneously, conceptual scaffolding was associated with verbal IQ over and above autonomy support, whereas autonomy support related to child engagement, controlling for conceptual scaffolding. These findings shed new light on how environmental factors may support early development, contributing to the design of family-centered, culturally authentic interventions. A video abstract of this article can be viewed at https://youtu.be/9v_8sIv7ako RESEARCH HIGHLIGHTS: Studies from high-income countries have identified factors mitigating the impacts of socio-economic risks on development. Such research is scarce in low- and middle-income countries. The present study conceptualized and evaluated caregiver communicative input in Bangladeshi families along two interrelated yet distinct dimensions: conceptual scaffolding and autonomy support. Conceptual scaffolding and autonomy support individually mediated associations between maternal education and child verbal IQ, shedding light on protective factors in families living in poverty. Parents providing richer conceptual scaffolds were simultaneously more supportive of children's autonomy. However, the two dimensions each related to cognition and language through unique pathways.

Evaluating caregiver-child interactions in low- and middle-income countries: a systematic review of tools and methods.

The United Nations Sustainable Development Goals (SDGs) has placed emphasis on improving early child development globally. This is supported through the Nurturing Care Framework which includes responsive caregiving. To evaluate responsive caregiving, tools to assess quality of caregiver-child interactions are used, however there is little information on how they are currently employed and/or adapted particularly in low- and middle-income countries (LMICs) where children have a greater risk of adverse outcomes. The aim of this review is to provide a comprehensive guide on methodologies used to evaluate caregiver-child interaction - including their feasibility and cultural adaptation. We conducted a systematic review of studies over 20years in LMICs which assessed caregiver-child interactions. Characteristics of each tool, their validity (assessed with COSMIN Risk of Bias checklist), and the quality of the study (Mixed Methods Appraisal Tool) are reported. We identified 59 studies using 34 tools across 20 different LMICs. Most tools (86.5%) employed video-recorded observations of caregiver-child interactions at home (e.g. Ainsworth's Sensitivity Scale, OMI) or in the laboratory (e.g. PICCOLO) with a few conducting direct observations in the field (e.g. OMCI, HOME); 13.5% were self-reported. Tools varied in methodology with limited or no mention of validity and reliability. Most tools are developed in Western countries and have not been culturally validated for use in LMIC settings. There are limited caregiver-child interaction measures used in LMIC settings, with only some locally validated locally. Future studies should aim to ensure better validity, applicability and feasibility of caregiver-child interaction tools for global settings.

Factors that influence stress in caregivers of 5-year-old children with hearing loss wearing hearing aids or cochlear implants

ObjectiveStress levels among caregivers of children with hearing loss could influence caregiver-child interactions and ultimately, children's developmental outcomes. Given the limited understanding of stress levels among caregivers of Australian children with hearing loss, the present study aimed to examine stress in caregivers of 5-year-old children with hearing loss wearing hearing aids or cochlear implants and to identify factors associated with greater stress levels. MethodsA total of 99 caregivers of 70 hearing aid users and 29 cochlear implant users participated in the study. Caregivers' stress was measured using the 68-item Pediatric Hearing Impairment Caregiver Experience (PHICE) questionnaire that examines caregivers’ context-specific stress levels in relation to caring for a child with hearing loss. Factors contributing to stress were identified in relation to eight domains including communication, education, emotional well-being, equipment, financial, healthcare, social, and support. ResultsAcross domains, the three most common predictors of increased stress were the use of cochlear implants over hearing aids, use of sign and oral language (mixed) over oral language as the communication mode at home, and increased behavioural difficulties of the child. ConclusionOverall, reported stress levels among Australian caregivers were low. Identified factors influencing stress levels can inform service provision improvement.

Caregiver self-efficacy providing nutritional support for pediatric patients undergoing hematopoietic stem cell transplant is associated with psychosocial factors.

Caregiver self-efficacy in providing nutritional support to pediatric hematopoietic stem cell transplantation (HSCT) patients has been little studied despite the increased risk of these children potentially being over- or under-nourished after HSCT, and nutritional status could possibly affect treatment outcomes. The current study aimed to describe caregiver dietary self-efficacy and its associated psychosocial factors and barriers to following dietary recommendations. Caregivers completed questionnaires pre-HSCT and 30 days, 100 days, and one year post-HSCT. A subset provided a 24-h recall of food intake. Results showed generally high caregiver confidence and low difficulty supporting their child nutritionally. However, lower confidence was associated with higher caregiver depression, anxiety, and stress 30 days post-HSCT. Further, higher difficulty at various time points was correlated with lower income, higher depression and anxiety, stress, and miscarried helping (i.e., negative caregiver-child interactions surrounding eating), as well as child overweight status and failure to meet protein intake guidelines. Nutritional criteria for protein, fiber, added sugar, and saturated fat were met by 65%, 0%, 75%, and 75%, respectively. Caregiver attitudes and child behavior were the most frequently reported barriers to healthy eating. Results suggest that directing resources to caregivers struggling emotionally, economically, or transactionally could support pediatric patients undergoing HSCT in maintaining optimal nutritional status.

Caregiving relationships are a cornerstone of developmental psychopathology.

The interdisciplinary field of developmental psychopathology has made great strides by including context into theoretical and empirical approaches to studying risk and resilience. Perhaps no context is more important to the developing child than their relationships with their caregivers (typically a child's parents), as caregivers are a key source of stimulation and nurturance to young children. Coupled with the high degree of brain plasticity in the earliest years of life, these caregiving relationships have an immense influence on shaping behavioral outcomes relevant to developmental psychopathology. In this article, we discuss three areas within caregiving relationships: (1) caregiver-child interactions in everyday, naturalistic settings; (2) caregivers' social cognitions about their child; and (3) caregivers' broader social and cultural context. For each area, we provide an overview of its significance to the field, identify existing knowledge gaps, and offer potential approaches for bridging these gaps to foster growth in the field. Lastly, given that one value of a scientific discipline is its ability to produce research useful in guiding real-world decisions related to policy and practice, we encourage developmental psychopathology to consider that a focus on caregiving, a modifiable target, supports this mission.

Annual Research Review: 'There, the dance is - at the still point of the turning world' - dynamic systems perspectives on coregulation and dysregulation during early development.

During development we transition from coregulation (where regulatory processes are shared between child and caregiver) to self-regulation. Most early coregulatory interactions aim to manage fluctuations in the infant's arousal and alertness; but over time, coregulatory processes become progressively elaborated to encompass other functions such as sociocommunicative development, attention and executive control. The fundamental aim of coregulation is to help maintain an optimal 'critical state' between hypo- and hyperactivity. Here, we present a dynamic framework for understanding child-caregiver coregulatory interactions in the context of psychopathology. Early coregulatory processes involve both passive entrainment, through which a child's state entrains to the caregiver's, and active contingent responsiveness, through which the caregiver changes their behaviour in response to behaviours from the child. Similar principles, of interactive but asymmetric contingency, drive joint attention and the maintenance of epistemic states as well as arousal/alertness, emotion regulation and sociocommunicative development. We describe three ways in which active child-caregiver regulation can develop atypically, in conditions such as Autism, ADHD, anxiety and depression. The most well-known of these is insufficient contingent responsiveness, leading to reduced synchrony, which has been shown across a range of modalities in different disorders, and which is the target of most current interventions. We also present evidence that excessive contingent responsiveness and excessive synchrony can develop in some circumstances. And we show that positive feedback interactions can develop, which are contingent but mutually amplificatory child-caregiver interactions that drive the child further from their critical state. We discuss implications of these findings for future intervention research, and directions for future work.

Care-giver child interactions and early cognitive development in West and Central Africa

ABSTRACT This paper studies the association between caregiver–child interactions and early childhood development in literacy and numeracy in West and Central Africa. Data comes from Multiple Cluster Indicator Surveys (MICS) conducted in Central African Republic, Chad, Democratic Republic of the Congo, Gambia, Ghana, Guinea-Bissau, Sierra Leone, and Togo between 2017 and 2020. A multilevel logistic regression is used to estimate the likelihood of being developmentally on track for 35,752 children aged 3–4 years. The results indicate that cognitively stimulating interactions with caregivers such as reading and telling stories are correlated with a higher likelihood of being developmentally on track. Interactions with mothers are associated with significantly higher odds of being developmentally on track but not interactions with fathers.

The everyday speech environments of preschoolers with and without cochlear implants.

Children who receive cochlear implants develop spoken language on a protracted timescale. The home environment facilitates speech-language development, yet it is relatively unknown how the environment differs between children with cochlear implants and typical hearing. We matched eighteen preschoolers with implants (31-65 months) to two groups of children with typical hearing: by chronological age and hearing age. Each child completed a long-form, naturalistic audio recording of their home environment (appx. 16 hours/child; >730 hours of observation) to measure adult speech input, child vocal productivity, and caregiver-child interaction. Results showed that children with cochlear implants and typical hearing were exposed to and engaged in similar amounts of spoken language with caregivers. However, the home environment did not reflect developmental stages as closely for children with implants, or predict their speech outcomes as strongly. Home-based speech-language interventions should focus on the unique input-outcome relationships for this group of children with hearing loss.

Investing in disadvantaged children for common prosperity in China

Despite rapid economic growth in China since 1978, rural-urban inequality has widened. High levels of socioeconomic inequality can have profound implications for child development and lifelong educational equity. Using a dataset containing early childhood development (ECD) outcomes of 0- to 3-year-olds (N = 9,053) from study sites in Eastern, Central, and Western China, the study finds that the risks of cognitive, language, and motor delay are, respectively, 43.2, 18.3, and 20.7 percentage points higher in rural study sites than in urban Shanghai (ps < .01). Impact evaluation of cluster-randomized experiments shows that parental training (focusing on child psychosocial stimulation and caregiver-child interaction) can improve parenting beliefs and practices (or investments) and ECD outcomes of disadvantaged rural children (p<.01). Such programs can play an important role in advancing progress toward more social equality and economic equity, the stated goals of China’s “Common Prosperity” policy.

Observational Methods in Studies of Infant and Young Child Feeding Practices in Low- and Middle-Income Countries: A Twenty-Year Retrospective Review.

This narrative review describes the observational approaches used to study infant and young child feeding (IYCF) practices in low- and middle-income countries (LMICs) published between 2001 and 2021. Articles were included in this narrative review if they were (1) original peer-reviewed articles published in English in PubMed and Web of Science; (2) published between 1 January 2001, and 31 December 2021; (3) conducted in an LMIC; and (4) employed observations and focused on IYCF practices among children aged 6-59 months. The studies (n = 51) revealed a wide-ranging application of direct meal and full-day observations, as well as indirect spot checks, to study IYCF. The findings revealed that meal observations were typically conducted during a midday meal using precise recording approaches such as video and aimed to understand child-caregiver interactions or specialized nutritious food (SNF) usage. Conversely, full-day observations lasted between 6 and 12 h and often used a field notes-based recording approach. Behaviors occurring outside of mealtime, such as snacking or interhousehold food sharing, were also a primary focus. Finally, spot checks were conducted to indirectly assess SNF compliance during both announced and unannounced visits. This review highlights the adaptability of observations across contexts and their versatility when used as a primary data collection tool to help monitor and evaluate nutrition programs.

Psychometric properties of the Marschak Interaction Method of Psychometrics and the Assessment of Parent-Child Interaction within residential care and non-referred settings.

Assessment and identification of children with developmental needs and their interaction with primary caregivers are critical for emotional and social development. However, to the best of our knowledge, there is a scarcity of valid observation-based tools that guide the work with family communication, which is essential for the child's healthy development. The Marschak Interaction Method of Psychometrics (MIM-P) and Assessment of Parent-Child Interaction (APCI) are both interaction and observation-based assessment tool, and they were explored for their validity and reliability in assessing caregiver-child interaction. The study included 30 trained and certified professionals who recruited referred and non-referred caregiver-child dyads over 11 months. Assessment data was collected from 139 caregiver-child dyads for the MIM-P with 278 individuals (100 referred and 178 non-referred) and 129 caregiver-child dyads for the APCI with 257 individuals (95 referred and 162 non-referred). The psychometric analyses show that both the MIM-P and APCI presents relevant sources of reliability and validity for assessing caregiver-child interaction including interrater reliability, internal consistency, test re-test reliability as well as concurrent and construct validity. The study highlights the need for observation-based assessment tools within social work and contributes to the understanding of the importance of relationships and interaction in children's emotional and social development. However, further research is needed to explore norms and further strengthen implementation and quality of the tools.

Smartphone use by children in fast food restaurants in Barcelona (Spain): a direct observation study

To explore the use of smartphones at mealtimes by children in fast food restaurants in the city of Barcelona and to assess the variables associated with this use. A cross-sectional study was carried out. Data from 1616 children of estimated ages between 4 to 10 years were collected in fast-food restaurants in the ten districts of Barcelona between October 2021 and July 2022. The percentage of smartphone use, overall and according to covariates, were calculated. Chi-squared and Fisher's exact tests, and crude and adjusted Poisson regression models with robust variance, were carried out to assess the association between use and covariates. Direct observation revealed that in 28.1% of meals with children at fast food restaurants, children used smartphones. Smartphone use was significantly higher in older children if their caregivers were younger than 30 years and when there was no caregiver-child interaction. In the adjusted model, higher patterns of smartphone use were associated with older children (aPR [95% CI]: 1.36[1.20-1.55]) and younger parents (aPR [95% CI]: 1.38[1.09-1.73]). Almost one in three meals with children at fast-food restaurants in Barcelona involves smartphone use. This finding underlines the importance of raising awareness of responsible screen use and promoting healthier environments for children at mealtimes.

Взаимодействие с близким взрослым в замещающих семьях у детей с опытом институционализации в зависимости от типа окружения в доме ребенка и длительности проживания в семье

&lt;p&gt;&lt;strong&gt;Background. &lt;/strong&gt;To date there is a lack of information in the scientific literature on the influence of children's early institutionalization experience on their interaction with caregivers after their placement in foster care. In order to develop effective early support programs for children and parents in substitute families, it is important to understand the specifics of their interaction, including in connection with children's early experience of interaction with caregivers in baby home and the duration of their living in the substitute family. &lt;strong&gt;Objective. &lt;/strong&gt;The study was aimed to investigate the characteristics of interaction of post&amp;ndash;institutional parents and children with the experience of living in the baby home (BH) after implementation of changes in the socio&amp;ndash;emotional caregiving environment (T+SC) and in a baby home with no intervention (NoI) and care as usual. &lt;strong&gt;Participants. &lt;/strong&gt;A total of 18 couples of adults with children from NoI (mean age of children M = 40.7; SD = 20.3 months; 9 boys; mean age of caregivers M=43; SD=7,6) and 42 couples with children from T+SC (mean age M = 38,6; SD = 20 months; 21 boys; mean age of caregivers M=43,9; SD=8,8). &lt;strong&gt;Study design. &lt;/strong&gt;Interaction was assessed at 3 stages (in BH before transition to family; &amp;lt;24 months in a post&amp;ndash;institutional family (PI family); 25&amp;ndash;48 months in the PI family). &lt;strong&gt;Measurements. &lt;/strong&gt;Video recordings of free play of dyads were analyzed using the PCERA method (The Parent &amp;ndash; Child Early Relational Assessment, R. Clark) to assess caregiver&amp;ndash;child interaction. &lt;strong&gt;Results. &lt;/strong&gt;The results indicate higher interaction quality in dyads with children who have experience of living in T+SC baby home, compared with children brought up in NoI baby home. In the first 24 months after the transfer of children to post&amp;ndash;institutional families (PI) from the T+SC baby home, the quality of interaction between children and parents in the PI families is lower than at the assessment of children and caregivers in the T+SC baby home. An indicator of interaction on the part of children and the indicator of interaction in dyads are higher in the T+SC group then in NoI group after two years of children living in the PI families. &lt;strong&gt;Conclusions. &lt;/strong&gt;These results confirm that stable and sensitive socio&amp;ndash;emotional early environment (in T+SC) is crucial for establishing relationships and interacting with close adults in a new family. Low quality of caregiver-child interaction &amp;ndash; such as low level of sensitivity, involvement and predictability on the part of substitute parents, the lack of reciprocity and regulation of interaction in dyads during the first two years of living in the PI family, as well as low emotional stability and unwillingness to cooperate in children from NoI BH after two years of living in the PI family &amp;ndash; is discussed in the terms of need for evidence&amp;ndash;based psychological follow&amp;ndash;up programs for the PI families with focus on the caregiver&amp;ndash;child interaction.&lt;/p&gt;

Caregiver-child interaction as an effective tool for identifying autism spectrum disorder: evidence from EEG analysis

BackgroundAutism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that affects individuals across their lifespan. Early diagnosis and intervention are crucial for improving outcomes. However, current diagnostic methods are often time-consuming, and costly, making them inaccessible to many families. In the current study, we aim to test caregiver-child interaction as a potential tool for screening children with ASD in clinic.MethodsWe enrolled 85 preschool children (Mean age: 4.90 ± 0.65 years, 70.6% male), including ASD children with or without developmental delay (DD), and typical development (TD) children, along with their caregivers. ASD core symptoms were evaluated by Childhood Autism Rating Scale (CARS) and Autism Diagnostic Observation Schedule-Calibrated Severity Scores (ADOS-CSS). Behavioral indicators were derived from video encoding of caregiver-child interaction, including social involvement of children (SIC), interaction time (IT), response of children to social cues (RSC), time for caregiver initiated social interactions (GIS) and time for children initiated social interactions (CIS)). Power spectral density (PSD) values were calculated by EEG signals simultaneously recorded. Partial Pearson correlation analysis was used in both ASD groups to investigate the correlation among behavioral indicators scores and ASD symptom severity and PSD values. Receiver operating characteristic (ROC) analysis was used to describe the discrimination accuracy of behavioral indicators.ResultsCompared to TD group, both ASD groups demonstrated significant lower scores of SIC, IT, RSC, CIS (all p values < 0.05), and significant higher time for GIS (all p values < 0.01). SIC scores negatively correlated with CARS (p = 0.006) and ADOS-CSS (p = 0.023) in the ASD with DD group. Compared to TD group, PSD values elevated in ASD groups (all p values < 0.05), and was associated with SIC (theta band: p = 0.005; alpha band: p = 0.003) but not IQ levels. SIC was effective in identifying both ASD groups (sensitivity/specificity: ASD children with DD, 76.5%/66.7%; ASD children without DD, 82.6%/82.2%).ConclusionOur results verified the behavioral paradigm of caregiver-child interaction as an efficient tool for early ASD screening.

Coding Dyadic Behavior in Caregiver-Child Interaction from a Clinical Psychology Perspective: How Should Multiple Instruments and Outcomes Be Dealt with?

The experiences children have in the interactions with their caregivers influence their developmental outcomes. To target caregiving and optimize intervention effects, the assessment of caregiver-child interactions is highly relevant for families affected by parental mental disorders. Behavioral observation is a widely used method for assessing family dynamics, and the literature offers a wide variety of instruments with which to code such data. However, a structured overview of behavioral observation instruments (BOIs) is lacking, and the multitude of types of dyadic behaviors (DBs) assessed within each BOI are complicating their application. We aim to provide an overview of the BOIs applied to families affected by mental disorders and suggest a DB taxonomy that may be used across BOIs. We first conducted a systemic literature search to identify the most frequently used BOIs and the DBs they capture in clinical psychology. Second, we asked 13 experts to sort DB terms based on perceived conceptual similarity and analyzed these results using multidimensional scaling. We found approximately 450 different terms for DBs, and we argue that DBs can be classified within two overarching dimensions, i.e., in terms of structure and in terms of reaction to a child's signals. These efforts can facilitate the coding and application of BOIs in clinical practice.

Assessment and Diagnostic Classification Using DC:0-5 in Early Childhood Mental Health Clinics: The Protocol for the Developmental Psychiatry Diagnostic Challenges Study (DePsy).

Mental health problems in early childhood are common, but there is a lack of psychiatric research on this age group. DC:0-5 is a multiaxial classification system for mental disorders in early childhood, providing a framework for standardizing clinical practice and research. However, research on the validity of DC:0-5 is scarce. The Developmental Psychiatry Diagnostic Challenges Study (DePsy) is a multi-site, prospective clinical study including six German early childhood mental health (ECMH) clinics. The main objective of the study is to contribute to the validation of Axis I and Axis II of DC:0-5. A second aim of the study is to describe the population of the participating clinics regarding diagnoses, family context, and treatment outcomes. Additionally, the impact of environmental risk factors, including parental Adverse Childhood Experiences (ACEs) and media use, on child psychopathology and caregiver-child relationships will be examined. Over two years, patients aged 0.0-5.9 years old will be enrolled in the study. Assessments include ICD-10 and DC:0-5 diagnoses, developmental tests, video-based observations of caregiver-child interactions, and questionnaires on child psychopathology, media use, parental stress, and treatment satisfaction. Study results will promote the standardization of assessment and treatment in ECMH clinics aiming to improve the development of patients and their families.

Efficacy of a Self-Directed Video-Based Caregiver-Implemented Language Programme

Introduction: Caregiver-implemented language programmes are effective for alleviating early language difficulties. This study examined the efficacy of a self-directed video-based caregiver-implement language programme in Chinese families. Method: This study consisted of two stages. In stage 1, 31 caregiver-child dyads (typically developing children) completed the training programme (group 1) in the form of six video-based training modules. In stage 2, 28 caregiver-child dyads (children with language difficulties) receiving active speech therapy were randomly assigned to the training (group 2) and control arms (group 3). Group 2 received the same training as group 1 in addition to their regular therapy while group 3 was kept as status quo. Caregivers completed a quiz on their knowledge of language facilitation techniques (LFTs) and submitted caregiver-child interaction videos at the start and end of the training. Outcome measures included programme completion rate, quiz scores, and use of LFTs and children’s communication skills in the videos. A pre-post design and a between-group design were adopted in the stage 1 and 2 studies, respectively. Results: A completion rate of about 60% in both stages was noted. Significantly higher post-training knowledge scores were found in groups 1 and 2. General but nonsignificant growth in use of parallel talk and gesture, and significant gains in children’s vocalization in the training arm were observed. Conclusion: The self-directed video-based training programme would be useful in imparting information to caregivers. However, the modest improvements in the use of LFTs suggested direct coaching appeared to still play a significant role in enhancing the actual implementation of LFTs. Further investigation on a larger scale is required to evaluate the effectiveness of the training programme for promoting the wider use of this mode as a preventive measure.

How does sensitivity influence early executive function? A critical review on hot and cool processes

There is compelling evidence that the quality of caregiver-child interactions during toddlerhood and the preschool years supports the development of executive function (EF) (Bernier et al., 2010; 2015; 2016; Fay-Stammbach et al., 2014; Geeraerts et al., 2021). Based on such findings, we make the case herein that sensitivity may be one of the most important dimensions of parenting contributing to early EF. In the present article, we will review empirical evidence, integrating findings from a wide range of scientific disciplines – cognitive psychology, neuroscience, and developmental psychopathology – and present theoretical ideas about how two contexts of sensitive caregiving – i.e. sensitivity to distress and non-distress cues - may be contributing differently to hot and cool EF development. Implications for future investigations on the environmental contributors of early EF, and its mechanisms, are discussed.