Child's Home Environment Research Articles

Collaborating for Impact

This article presents Healthy Kids, Healthy Futures, a multilevel initiative in Boston, Massachusetts, which brings major institutions' missions and resources together to address early childhood obesity prevention. Programming is designed to facilitate healthy eating and physical activity in preschool children's home, school, and community environments by engaging parents and early childhood educators in the places where they live, learn, and play. This article describes how established interventions were implemented in a novel setting to engage the parents of children attending Head Start and staff, and presents pilot data from the first 2 years of the initiative. Healthy Kids, Healthy Futures is a feasible initiative, which has shown concrete, positive results that can be replicated.

State of the Science: The Association Between Perinatal Brain Injury and School Performance in Very-Low-Birth-Weight Infants

Preterm infants are a vulnerable population. Their shorter gestation and lower birth weight place them at greater risk for a variety of health and developmental problems including long-term motor, cognitive, behavioral, and growth problems. This article reviews the epidemiology and morbidities of low-birth-weight infants, with a specific emphasis on perinatal brain injury and its impact on school performance. The pathogenesis of brain injury is complex and not fully understood. The principle brain lesions that underlie much of the neurologic manifestations seen in preterm infants are intraventricular hemorrhage (and its accompanied complication, periventricular hemorrhagic infarction) and periventricular leukomalacia. Nursing participation in advocating for interdisciplinary services including physical therapy, speech therapy, and using position devices and appropriate stimulation while the infant is in the neonatal intensive care unit is essential to maximize functional capacity. Nurses are also uniquely positioned at the forefront of public health to substantially improve school performance in these children by optimizing a child's home environment for maximal environmental stimulation.

Children's early child care and their mothers' later involvement with schools.

Theory and policy highlight the role of child care in preparing children for the transition into school. Approaching this issue in a different way, this study investigated whether children's care experiences before this transition promoted their mothers' school involvement after it, with the hypothesized mechanism for this link being the cultivation of children's social and academic skills. Analyses of 1,352 children (1 month-6 years) and parents in the NICHD Study of Early Child Care and Youth Development revealed that mothers were more involved at their children's schools when children had prior histories of high-quality nonparental care. This pattern, which was fairly stable across levels of maternal education and employment, was mediated by children's academic skills and home environments.

Surveillance of home environment in children with atopic dermatitis: a questionnaire survey

BackgroundThe increasing prevalence of atopic dermatitis (AD) suggests a role for environmental factors in triggering a genetic predisposition in sufferers.ObjectiveThe purpose of this study was to investigate home environmental factors related to AD severity.MethodsWe conducted a questionnaire survey about the home environmental factors in 380 children from two daycare centers and the Samsung Medical Center outpatient clinic. AD was diagnosed by Hanifin and Rajka's criteria and its severity was assessed by the Severity Scoring of Atopic Dermatitis index. Children were divided into normal control group, mild AD group and severe AD group. Home environmental factors were compared among the three groups and were statistically analyzed using analysis of variance, Chi-square test, Fisher's exact test, and multiple logistic analysis.ResultsIndoor remodeling activities, such as painting (p = 0.004), floor covering (p = 0.001) and wallpaper changing (p = 0.002) were associated with severity of AD. Those in the severe AD group were more likely to live in an apartment (p < 0.001). Severe AD was observed more frequently when the monthly income of household (p = 0.027) and final educational status of mother (p = 0.001) were higher.ConclusionSome home environmental factors were associated with AD severity, but its causal relationship is not clear. Further research is needed to confirm these associations and to clarify whether they are causative.

Home environment: association with hyperactivity/impulsivity in children with ADHD and their non-ADHD siblings.

We wished to ascertain if there is an association between symptoms of attention-deficit/hyperactivity disorder (ADHD) and home environment in children with ADHD and non-ADHD siblings, controlling for other environmental measures. 96 children with ADHD combined type (ADHD-CT) and their siblings participated in the study. Parent and teacher Conners' rating scales were completed and home environment was assessed using the middle childhood and early adolescent Home Observation for Measurement of the Environment (HOME). ADHD symptoms were assessed for correlation with HOME in children with ADHD-CT and non-ADHD siblings and multiple regression analysis was used to control for gender, socio-economic status, exposure to nicotine, exposure to alcohol in utero, birth weight, gestational age, pregnancy and perinatal risk factors. The presence of oppositional disorders was assessed for association with HOME score in those with ADHD-CT. The multiple regression analysis was repeated controlling for environmental factors and for oppositional disorders in those with ADHD-CT. Oppositional symptoms were assessed for correlation with HOME score in non-ADHD siblings. Teacher-rated hyperactive/impulsive scores correlated with HOME (r=-0.27, P < 0.01) in children with ADHD-CT. This association remained significant when other environmental factors and oppositional disorders were controlled for. Environmental factors and gender contributed to 30% of the variance of ADHD symptoms in ADHD-CT. Parent-rated hyperactive/impulsive scores also correlated with HOME (r=-0.28, P < 0.05) for non-ADHD siblings. An association between HOME and diagnosis of oppositional defiant disorder or conduct disorder was found for children with ADHD-CT and between HOME and oppositional symptoms in non-ADHD siblings. The home environment has a small but significant association with hyperactive/impulsive symptoms in children with ADHD-CT and non-ADHD siblings. This association remained when other environmental factors were taken into account. Oppositional symptoms are associated with home environment in ADHD-CT and in non-ADHD siblings.

Developmental status and home environment among children born to immigrant women married to Taiwanese men

The aims of this cross-sectional study were to examine (a) the developmental status and home environments of children (6-24 months) of immigrant women married to Taiwanese men, and (b) the association of child developmental status with parental socio-demographics, maternal language abilities, and home environment qualities. Participants were 61 children and their mothers from China and Vietnam. Data were collected with interviews, home observations, and developmental testing. The children had lower cognitive and language but higher motor and social development scores compared with native norms. Home environment and maternal perceived language ability were positively associated with child development. The association of home environment and maternal language ability with early childhood development was supported for immigrant populations in Taiwan.

Chaotic homes and school achievement: a twin study

BackgroundChaotic homes predict poor school performance. Given that it is known that genes affect both children's experience of household chaos and their school achievement, to what extent is the relationship between high levels of noise and environmental confusion in the home, and children's school performance, mediated by heritable child effects? This is the first study to explore the genetic and environmental pathways between household chaos and academic performance.MethodChildren's perceptions of family chaos at ages 9 and 12 and their school performance at age 12 were assessed in more than 2,300 twin pairs. The use of child-specific measures in a multivariate genetic analysis made it possible to investigate the genetic and environmental origins of the covariation between children's experience of chaos in the home and their school achievement.ResultsChildren's experience of family chaos and their school achievement were significantly correlated in the expected negative direction (r = −.26). As expected, shared environmental factors explained a large proportion (63%) of the association. However, genetic factors accounted for a significant proportion (37%) of the association between children's experience of household chaos and their school performance.ConclusionsThe association between chaotic homes and poor performance in school, previously assumed to be entirely environmental in origin, is in fact partly genetic. How children's home environment affects their academic achievement is not simply in the direction environment → child → outcome. Instead, genetic factors that influence children's experience of the disordered home environment also affect how well they do at school. The relationship between the child, their environment and their performance at school is complex: both genetic and environmental factors play a role.

The early home environment and developmental outcomes for young children in the child welfare system

The quality of the early home environment is predictive of young children's subsequent cognitive, academic, and behavioral functioning. Limited research has focused on the effects of the early caregiving environment on the functioning of young children involved with the child welfare system. This study investigated the influence of children's home environments (i.e., number of children in the home, number of moves the child experienced, level of cognitive stimulation, and level of emotional support) during the first 2 years of life on their preschool developmental outcomes (i.e., cognition, language, social skills, and behavior problems). As anticipated, a high-quality early home environment promoted the well-being of preschool children who had entered the child welfare system as infants. Children who lived with greater numbers of children incurred more compromised cognitive, language, behavioral, and social outcomes. No significant associations emerged between the total number of placements and developmental outcomes; children who remained in the same home during infancy (typically the birth family home) had more compromised developmental outcomes in every domain except behavioral problems. Both cognitive stimulation and emotional support in the home predicted higher cognitive and language scores, decreased behavioral problems, and increased social skills. Early out-of-home placement and lack of emotional support interacted to predict children's behavioral problems. These findings are considered in the context of extant research and policy relevant to young children in the child welfare system.

Mealtime family interactions in home environments of children with loss of control eating

Experimental and self-report studies have shown that parents have a strong influence on their normal or overweight children's eating behavior, i.e. through parental feeding behavior or communication. Studies in children with loss of control (LOC) eating that have investigated this relationship are scarce, and ecologically valid observational studies are missing. This study examined family functioning at mealtimes in home environments in 43 families of a child with LOC eating and 31 families of a child without LOC eating; the children were 8–13 years old. Familial interactions, child eating behavior, and parental mealtime behavior were assessed using the Mealtime Family Interaction Coding System, observation of bite speed of the child, and self-report questionnaires. Less healthy patterns of communication ( U = 201.53, p < .01) and interpersonal involvement ( U = 207.54, p < .01) and more maladaptive overall family functioning ( U = 233.52, p < .05) were observed but not self-reported in families of a child with LOC eating compared to those without LOC eating. Children with LOC eating ( M = 4.73, SD = 1.88) ate faster than controls ( M = 3.71, SD = 1.19; p < .05), with highest bite speed in a group with high recurrent LOC eating ( p < .01). The results indicate that maladaptive patterns of family functioning during family mealtimes are present in LOC eating in children and are associated with the child's eating behavior. Parent–child communication training should be tested as an intervention for children with LOC episodes.

Exploring the Mental Life and Home Life of Children: The Role of a Television History

Media entertainment is a pervasive presence in the lives of our children. It presents a series of stories that a child can select as important or intriguing to him or her. A good history of television and media viewing uses this omnipresent influence in a child's life to attempt to gain insight into the child's hopes and fears as well as information concerning the structure of the home. It is a useful exercise that could be done with each new child patient, and could provide a quick means to assess the child's thoughts as well as assessing the child's home environment.

Structural equation modeling in epidemiology

Structural equation modeling (SEM) is an important statistical tool for evaluating complex relations in several research areas. In epidemiology, the use and discussion of SEM have been limited thus far. This article presents basic principles and concepts in SEM, including an application using epidemiological data analysis from a study on the determinants of cognitive development in young children, considering constructs related to organization of the child's home environment, parenting style, and the child's health status. The relations between the constructs and cognitive development were measured. The results showed a positive association between psychosocial stimulus at home and cognitive development in young children. The article presents the contributions by SEM to epidemiology, highlighting the need for an a priori theoretical model for improving the study of epidemiological questions from a new perspective.

대학생의 아동기 집과 현재 집에 대한 장소애착의 관련성

This study explored Korean college students' place attachment to current home environments and their place attachment to childhood home environments. The study sought to confirm the relationship between childhood place attachment and collegehood place attachment to home environment. Data were collected from 336 students at four universities in Jellabuk-Do, Korea, and questionnaire survey was performed. Exploratory and confirmatory factor analysis was computed and showed five factors related to place attachment of home environment. Place intimacy, rootedness, place identity, place dependence, and place palyness showed in childhood place attachment to home; place identity, place affection, place restfulness, place dependence, and rootedness in collegehood place attachment to home. Canonical correlation analysis showed that childhood place attachment to home explained 43.9% variance with regard to collegehood place attachment to home. This relationship implied that childhood place attachment strongly affected subsequent collegehood place attachment.

The role of the home environment in phonological awareness and reading and writing ability in Tanzanian primary schoolchildren

In developing countries, the role of the home environment in children’s development of literacy skills is largely unknown. This study examines the relationship in a sample of 75 grade two children from rural eastern Tanzania. It also discusses the role of house building material and domestic facilities, in addition to parents’ education and occupation, in describing socioeconomic status in developing countries in general, and in the current study. Most of the factors were significantly (ANOVA) related to phonological awareness and reading and writing. Hierarchical multiple regression analysis identified fathers’ education and mothers’ occupation as strong predictors. The home environment variables accounted for 25% of the variance in phonological awareness and 19% in reading and writing ability. Early screening and support of children in the risk zone of becoming poor readers are proposed. Activities like children’s book projects and school library facilities are suggested, aiming at supporting literacy-related activities in low capacity homes.

The Orphans International Tanzania (OIT) Family Care Model: Strengthening Kinship Networks and Empowering Families

As the AIDS/HIV epidemic grows exponentially in Tanzania, the number of children who are orphaned due to this illness has increased in alarming proportions. Utilizing a preliminary exploration of a case study, this article explores a unique, collaborative, grassroots model of comprehensive community care. Orphans International Tanzania (OIT) operates a unique family preservation and support program, the Family Care Program, which aims to maintain orphaned children in home environments with access to education, basic medical care, and good nutrition. Incorporating a strategic international agency/community-based nongovernment organization partnership design and an internationally recognized family support model, comprehensive services are provided to children and their caregivers. This article provides information on impact of HIV/AIDS on Tanzania, illustrates the components of the program model, highlights critical community partnership development, and describes its influence on the children, their kinship caregivers and the community in general. Implications for replication in other communities impacted by HIV/AIDS are provided.

Using Telepractice in Parent Training in Early Autism

There is a growing body of literature indicating that intense early intervention is current best practice for treating children with autism spectrum disorders (ASD). Several studies demonstrate the effectiveness of parents as agents of intervention in the child's home environment. However, this approach requires intense one-on-one supervision by highly trained professionals. Consequently, there is a significant gap between the intensive service requirements for children with ASD and the available resources to provide these services. In the current pilot study, the use of remote technology, telepractice, is evaluated as a tool for coaching parents of two children found to have ASD. Two clinical models of intervention are compared: a traditional model of twice-weekly speech and language therapy sessions (traditional clinical model) and a model where a once-a-week clinical session is followed by a home-based session administered by the parents and remotely supervised and coached by the clinician (clinic/telepractice model). Results suggest that gains obtained in traditional therapy can be maintained and even exceeded in a treatment model that uses telepractice. Parents reported that they perceived telepractice sessions to be as valuable as those delivered directly by the clinician, felt comfortable using the technology, and were willing to continue intervention with their children at home. These preliminary results suggest that use of telepractice holds promise for reducing the demands on available resources of service for this population. A study with a larger population is currently underway including cost-benefit analyses to examine the implications for such a treatment model to its users and to the healthcare system.

Parental influences on television watching among children living on the Texas–Mexico border

PurposeWe examined the association of parental television (TV) rules and compliance with the American Academy of Pediatrics' (AAP) recommendations of ≤2h of television per day in a primarily Hispanic sample of elementary school children (n=734) living on the U.S. side of the Texas–Mexico border. The potential modifying effects of children's home environment (parental TV watching, parent at home after school, and TV in bedroom) were also examined. MethodsA cross-sectional analysis was performed on baseline survey data merged from two waves (2006 and 2007) of a CDC-funded TV reduction intervention with 4th grade children (mean age: 9.5years). Logistic regression analyses were conducted to examine associations. ResultsChildren who had TV rules were 1.4 (95% CI: 1.04, 1.94) and 1.7 (95% CI: 1.22, 2.32) times more likely to meet the AAP recommendation for weekend and weekday TV watching, respectively. Parental TV watching and TV in bedroom modified the effect of TV rules on children's TV watching, with null associations found for children whose parents watch TV frequently and for children with no TV in bedroom. No interaction effect was found for children's afterschool context. ConclusionsParental TV limits is one strategy for reducing children's television watching that merits further investigation.

Intimate Partner Violence

Intimate Partner Violence

Continuing Education Mitigates the Negative Consequences of Adolescent Childbearing

Beginning childbearing during adolescence is consistently linked with negative outcomes for both children and parents. Many have attributed this association to maternal background characteristics which are often difficult to change through policy. Though maternal educational attainment is often a side effect of adolescent childbearing, it also represents a potential avenue through which we can help young mothers overcome the obstacles associated with an early birth. The data for this study come from the 1997 Child Development Supplement of the Panel Study of Income Dynamics, a nationally representative sample of mothers and their children (N=3,193). Data are used to explore the cognitive stimulation and emotional support in the home, measured using the HOME Scale (Caldwell and Bradley in Home observation for measurement of the environment. University of Arkansas at Little Rock, Little Rock, 1984). OLS regression models how maternal education moderates the association between age at first birth and quality of children's home environment. Adolescent mothers scored significantly lower on the indicator of home environment than older mothers. However, when continuing education was considered, maternal age at first birth was no longer significantly associated with the home environment. The negative consequences of early births were mediated by adolescent mothers' continuing education efforts. While interventions are needed to reduce adolescent childbearing, these results highlight the need to ensure that adolescent mothers are provided support to continue their education following delivery. The negative consequences of adolescent births are not inevitable. Encouraging school retention may help young mothers form a safe, healthy, nurturing, and developmentally appropriate home environment.

Use of Family Care Indicators and Their Relationship with Child Development in Bangladesh

Poor stimulation in the home is one of the main factors affecting the development of children living in poverty. The family care indicators (FCIs) were developed to measure home stimulation in large populations and were derived from the Home Observations for Measurement of the Environment (HOME). The FCIs were piloted with 801 rural Bangladeshi mothers of children aged 18 months. Five subscales were created: 'play activities' (PA), 'varieties of play materials' (VP), 'sources of play materials', 'household books', and 'magazines and newspapers' (MN). All subscales had acceptable short-term reliability. Mental and motor development of the children was assessed on the Bayley Scales of Infant Development and their language expression and comprehension by mothers' report. After controlling for socioeconomic variables, VP and PA independently predicted four and three of the developmental outcomes respectively, and MN predicted both the Bayley scores. The FCI is promising as a survey-based indicator of the quality of children's home environment.

Health and Home Environments of Caregivers of Children Investigated by Child Protective Services

The goal was to describe the mental and physical health of caregivers and the home environments of children who have been investigated by child protective services (CPS). Subjects were 5299 children 0 to 14 years of age, from the National Survey of Child and Adolescent Well-being, a cohort study of children investigated by CPS. The Short-Form Health Survey was used to measure mental and physical health. The Home Observation for Measurement of the Environment-Short Form (HOME-SF) total and cognitive stimulation subscale scores were used to measure developmentally appropriate characteristics of children's home environments. These validated measures were compared across placement types, that is, remaining at home (investigated home), nonrelative foster care (foster care), and relative foster care (kin care). Kin and foster caregivers had better-than-average mental health, but 11% to 13% of kin/foster caregivers and 24% of investigated-home caregivers had scores consistent with untreated mental illness. All caregivers had worse-than-average physical health; 25% of foster and 26% of kin caregivers had scores consistent with serious physical illness. There was no significant difference in mean HOME-SF scores between foster and investigated homes. Kin care homes of 6- to-10-year-old children were superior to investigated and foster homes. All setting types had more homes in the lowest quartile than in the highest quartile for HOME-SF and cognitive stimulation subscale scores. A sizable minority of children investigated by CPS subsequently live in homes with mentally or physically ill caregivers and with developmentally inadequate nurturing and stimulation. Foster homes are indistinguishable from investigated homes on the HOME-SF. Clinicians should assess the mental and physical health of caregivers and should facilitate access to appropriate resources, including parent/caregiver training programs.