Parent-child Dyads Research Articles

The influence of early childhood education and care on the relation between early-life social adversity and children's mental health in the environmental influences for Child Health Outcomes Program.

Early adversity increases risk for child mental health difficulties. Stressors in the home environment (e.g., parental mental illness, household socioeconomic challenges) may be particularly impactful. Attending out-of-home childcare may buffer or magnify negative effects of such exposures. Using a longitudinal observational design, we leveraged data from the NIH Environmental influences on Child Health Outcomes Program to test whether number of hours in childcare, defined as 1) any type of nonparental care and 2) center-based care specifically, was associated with child mental health, including via buffering or magnifying associations between early exposure to psychosocial and socioeconomic risks (age 0-3 years) and later internalizing and externalizing symptoms (age 3-5.5 years), in a diverse sample of N = 2,024 parent-child dyads. In linear regression models, childcare participation was not associated with mental health outcomes, nor did we observe an impact of childcare attendance on associations between risk exposures and symptoms. Psychosocial and socioeconomic risks had interactive effects on internalizing and externalizing symptoms. Overall, the findings did not indicate that childcare attendance positively or negatively influenced child mental health and suggested that psychosocial and socioeconomic adversity may need to be considered as separate exposures to understand child mental health risk in early life.

How do children understand and respond to the EQ-5D-Y-3L? A mixed methods study in a community-based sample of 6–12-year-olds

BackgroundThe EQ-5D-Y-3L is widely used for measuring and valuing HRQoL in paediatric populations. This mixed methods study used the EQ-5D-Y-3L measure and applied a retrospective think-aloud approach to examine the self-report validity in children of varying chronological age.MethodsA mixed methods study was conducted in a community-based sample of 39 children aged 6–12 years. In a semi-structured interview, children self-completed the EQ-5D-Y-3L and then engaged in retrospective think-aloud. Conversations were audio-recorded and transcribed for analysis in NVivo using the Tourangeau four-stage response model framework to assess comprehension, judgment, recall, and response mapping issues. Fisher’s exact test was used to assess the differences between child-self reported HRQoL across subgroups. The inter-rater agreement between child-parent dyads was assessed with CCC for overall HRQoL and Gwet’s AC1 for dimension level HRQoL.ResultsOverall, response issues were detected in n = 18 (46%) children. Comprehension issues were apparent in the “having pain or discomfort” dimension where children found it challenging to understand ‘discomfort’. Recall-related issues were observed where children’s responses were influenced by their typical tendencies (e.g., being usually worried) or past incidences (e.g., feeling pain sometimes). Judgement-related issues were the most common, particularly in the “doing usual activities” dimension, where children tended to respond based on their self-perceived ability to engage in activities rather than health-related limitations. None of the participants were found to have problems with response mapping. A healthy lifestyle that included diet and exercise was a notable consideration in EQ VAS ratings.The younger age groups had a higher proportion of response issues (6–7 years: 64%, 8–10 years: 62%), compared to older children (11–12 years: 20%). Moreover, children with response issues demonstrated significantly lower EQ-5D-Y-3L scores (mean = 0.78, se = 0.04) as compared to those without (mean = 0.95, se = 0.02) (p-value < 0.001). The overall inter-rater agreement was higher for those without any response issues (CCC = 0.33) than those with (CCC = 0.14). Additionally, higher agreement was noted across all the five dimensions in the subgroup with no response issues relative to those with.ConclusionsChildren in the general community may have different perceptions of HRQoL when responding to the EQ-5D-Y-3L possibly due to their limited experience with health-related challenges. The retrospective think-aloud approach adopted highlighted the relatively higher prevalence of response issues in the younger children (ages < 11 years), indicating the need for careful interpretation of self-reported HRQoL using the current version of the EQ-5D-Y-3L in this population.

Effects of the dyadic FirstStep2Health intervention on parents’ behaviour and anthropometric outcomes: a secondary analysis of a cluster randomised trial

ObjectivesThis study aimed to examine the preliminary efficacy of the FirstStep2Health versus usual care control on improving parents’ lifestyle behaviours (moderate to vigorous physical activity, screen time, fruit/vegetable and fibre...

Parent and Child Reactivity During Dyadic Parent–Child Interaction Coding System (DPICS) Behavior Observations

Parent and Child Reactivity During Dyadic Parent–Child Interaction Coding System (DPICS) Behavior Observations

The influence of access to care on the health literacy of families in Mexico.

Health literacy (HL) is essential to understanding health information and achieving health goals. Unfortunately, limited information is available on how parent HL impact child health outcomes. This is critical to understand in areas of the world where access to healthcare services is limited or unavailable. Thus, the purpose of this study was to assess the moderating influence of access to care on the relationship between parent HL and child health outcomes in Mexico. Using a geographically stratified convenience sample survey design, we gathered a sample of 373 parent-child dyads throughout Mexico in August of 2021. Using the HLS-Q12, the Warwick-Edinburgh Mental Wellbeing Scale, healthcare access questions developed by Levy and Janke, a single-item self-report overall health measure, and questions about substance use frequency, we found that parent HL was positively associated with youth mental wellbeing and overall health. Limited healthcare access was associated with increased youth cigarette, marijuana and alcohol use. Our results indicate that efforts to increase parent HL may be effective in improving youth health behaviors and outcomes.

Dyadic interaction of parentification in Chinese families of maternal depression: A qualitative study.

This qualitative study explores the lived experiences of parent-child dyads to understand the occurrence of parentification in Chinese families affected by parental depression. Utilizing purposive sampling, families were recruited from community mental health services in Hong Kong, focusing on parents with major depressive disorder and their adolescent children. Data were collected from 14 families through in-depth, semistructured interviews with adolescents (n = 8) and parents (n = 12), as well as dyadic interviews (n = 8), and analyzed utilizing thematic analysis. The central theme, "Complementary Dynamic Interaction: Rippled Relationship," captures the mutual, circular, and reciprocal interactions within parent-adolescent dyads in the context of parental depression. These findings highlight the unique dynamics of parentification in Chinese families affected by parental depression.

Parent-Child Communication Intentions and Adolescents’ Dating Behaviour in the Assin South District, Ghana

&amp;lt;i&amp;gt;Background&amp;lt;/i&amp;gt;: Most parents conceive that discussion sexual related matters are a bad practice and does not need to occur. This study investigates the parent-child communication intentions and adolescents’ dating behaviour in the Assin South District, Ghana. &amp;lt;i&amp;gt;Methods&amp;lt;/i&amp;gt;: A cross-sectional descriptive design was employed with 400 participants which comprised parents age 30-59 and older adolescents age 15-19 years. Data were analysed using frequency distribution, Pearson’s chi-squared test of independence and binary logistic regression. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: Parent-child dyad communication easiness was statistically significant related to adolescents’ dating behaviour at p&amp;lt;0.05, (OR=2.504, 95%CI ([1.063-5.896]). Parent-child dyad do not discuss sexual health matters was statistically significant at P&amp;lt;0.05, (OR=0.429, 95%CI [0.187-0.985]). Parent-child dyad engage in talks for adolescents’ positive social conduct was statistically significant at P&amp;lt;0.05, (OR=0.211, 95%CI [0.046-0.972]). Parent-child dyad engage in communication for adolescents’ appropriate nurturing was also observed as statistically significant to adolescents’ dating behaviour at p&amp;lt;0.05, (OR=0.223, 95%CI [0.051-0.978]). Parent-child dyad engage in communication to share thoughts, feelings and ensure stable relations during adulthood among adolescents was also observed as statistically significant to adolescents’ dating behaviour at p&amp;lt;0.05, (OR=5.988, 95%CI [1.192-30.088]). &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: Parents in Assin South District could guide adolescents to make informed decisions about dating if they (adolescents) choose to engage in or are already dating.

Prevalence and psycho-social factors associated with alcohol use among primary school-going children aged 6 to 13 years in Mbale district, Uganda: a cross-sectional study

BackgroundAlcohol use among children in low-resource settings has received limited attention. This study investigated the prevalence of and biopsychosocial factors associated with alcohol use among children aged 6 to 13 years enrolled in primary education in Uganda.MethodsThis cross-sectional study conducted in primary schools within Mbale district, employed stratified random sampling to select 470 child-parent dyads. Screening for child alcohol consumption utilized the validated Ugandan (Lumasaaba) version of the Car, Relax, Alone, Forget, Family/Friends, Trouble (CRAFFT) tool. Alcohol Use Disorder (AUD) was diagnosed using the AUD module of the Mini International Neuropsychiatric Interview for children and adolescents (MINI KID). Logistic regression analysis explored associations between alcohol consumption (CRAFFT cut-off score: 1 or more) and biopsychosocial factors (age, sex, nutrition, family dynamics, socioeconomic indicators, and school environment). Data analysis utilized STATA-17 statistical software.ResultsThe median age of the participants was 11 years, with an interquartile range (IQR) of 9 to 12 years and a male to female ratio of 1:1.3. The screened prevalence of alcohol consumption among the children in the past 12 months was 25.2% (95% CI: 21.4–29.4) and 7.2% (95% CI: 5.1–10.0) were diagnosed with AUD. The study found a comparable prevalence of alcohol use between boys (25.0%, 95% CI: 19.4–31.5) and girls (25.4%, 95% CI: 20.0-31.1). Age-specific variations indicated that early adolescents (10 to 13 years), were more likely to consume alcohol 28.1% (95% CI: 23.5–33.3) compared to pre-adolescent children (6 to 9 years) 17.6% (95% CI: 11.9–25.1) in the past 12 months. Factors associated with alcohol use included single-parent households, lower caregiver education, low socioeconomic status, maternal drinking, food insecurity, under-weight, physical discipline by parents, peer influence, rural school attendance, and the school environment.ConclusionThe prevalence of alcohol consumption among children in Mbale district, eastern Uganda was high with one-in-four primary-school-children aged 6 to 13 years consuming alcohol in the past year, and no significant gender differences. It highlights various interconnected factors associated with alcohol use among school-aged children. We recommend awareness campaigns at all levels, stricter implementation of alcohol policies, school prevention programs, and family-focused and socio-economic interventions. Nationwide school surveys should target pre-adolescent alcohol use.

A Comparative Analysis of Language Skills and Parent–Child Interactions in Monolingual and Bilingual Children Born Preterm

Children born preterm are at an elevated risk of language delays compared to children born full-term. However, there is a dearth of research investigating language outcomes in premature children exposed to more than one language. There is also limited empirical evidence linking the quantity and quality of parent input and language outcomes in premature children and the strength of these relationships in bilingual contexts remains unknown. Therefore, the current study examined language skills, parent input, conversational turns, and their associations at 16 months to 36 months in monolingual and bilingual children born preterm. Nine English-speaking monolingual parent–child dyads, and nine Spanish–English bilingual parent–child dyads participated in parent–child interactions that occurred over time in play-based contexts. Results revealed that preterm monolingual and bilingual children exhibited similar language abilities at all time points assessed. While both monolingual and bilingual dyads engaged in a comparable number of conversational turns at 16 m, monolingual mothers produced more words than bilingual mothers during play. Significant associations were observed between children’s vocabulary skills and their ability to combine words within and across most time points. Notably, relationships between parental input, conversational turns, and language skills were limited to a significant association between conversational turns at 16 m and vocabulary skills at 24 m. Together, findings indicate that bilingual children born preterm acquire language on the same timeline as monolingual children born preterm. While it is crucial that the current work be replicated in larger samples of children born preterm, the current work is the first to compare relationships between children’s language outcomes and the quantity and quality of parental input in monolingual and bilingual contexts.

Parents Plus: A Parent-Implemented Intervention for Preschool Children With Developmental Language Disorders.

Parent engagement is a critical component of optimizing services for young children with disabilities, including those with language disorders. Without training, however, many parents may lack the knowledge and skills to effectively facilitate their children's language development during the essential early childhood years. The Parents Plus intervention was designed to support parents, through online training and coaching, in using focused stimulation, an evidence-based strategy for fostering early language development. Thirty-one parents and their children with developmental language disorder participated in a small-scale randomized controlled trial to provide a preliminary test of Parents Plus. Sixteen parent-child dyads completed the Parents Plus intervention, while 15 parent-child dyads were in the control condition. Findings indicate that Parents Plus shows promise in improving children's vocabulary and morphosyntactic skills. Additionally, Parents Plus emerged as a socially valid approach, with parents reporting that its goals, content, procedures, and outcomes were acceptable. Implications for education and directions for future research are discussed.

A Psychometric Evaluation of the Parenting Anxious Kids Rating Scale (PAKRS-PR) in a Sample of Families with Clinically Anxious Children.

The Parenting Anxious Kids Rating Scale-Parent Report (PAKRS-PR) measures five types of anxiogenic parenting. The present study aimed to extend the previous psychometric evaluation of the PAKRS-PR to a treatment-seeking sample and examine sensitivity to change over 15 sessions of cognitive behavioral therapy. The sample included 383 parent-child dyads presenting to treatment at a specialty outpatient clinic. Cronbach's α was acceptable for the PAKRS-PR Total scale and several subscales, although the Accommodation/Beliefs and Warmth/Support subscales were in the unacceptable/questionable range. Convergent validity was found to be mixed with the closest relationship between anxiety severity and the Accommodation/Beliefs, Warmth/Support, and Conflict PAKRS-PR subscales. Additionally, the PAKRS-PR Total score and subscales changed significantly throughout treatment, but were not associated with treatment response or child- or clinician-rated treatment outcome measures. Overall, the current findings demonstrate some support for the psychometric properties of the PAKRS-PR; however, further refinement of the PAKRS-PR at the item-level is recommended to further strengthen the measure.

Feeding Practices Used by Australian Parents of Young Children Living With Food Insecurity and Household Chaos.

Responsive feeding practices are crucial for developing healthy eating behaviours in children. However, chaotic households and financial stress may disrupt these practices. This cross-sectional study aimed to characterise feeding practices among Australian parents experiencing financial hardship. Parents of children aged 5-35 months, who identified as experiencing financial hardship, completed an online questionnaire from October 2021 to June 2022. Validated tools gathered data on feeding practices, mealtime structure and environment, household chaos (HC), household food insecurity (HFI) and sociodemographic characteristics. Bivariate correlations and hierarchical regression assessed relationships between these variables, adjusted for parent age, education and number of children. Data from 213 parent-child dyads were analysed (97% mothers, median age = 31 years, IQR 28-36; 50% boys, median age = 12 months, IQR 8-17). Median HC score was 4 (IQR 2-7). Seventy-six percent of families reported experiencing HFI (median = 6, IQR 3-9). Over 80% of parents often or always ate meals as a family and never or rarely engaged in 'parent-led' feeding (median = 1.75, IQR 1.00-2.50), or used '(non)-food as reward' (median = 1.33, IQR 1.00-2.00). '(Non)-food as reward' was positively correlated with HC (p = 0.016), and 'food to calm' was positively associated with HC (p = 0.004). 'Feeding on demand' was negatively associated with HC and HFI (p = 0.002). 'Persuasive feeding' was not associated with either. Findings suggest that HC had more influence than HFI on some nonresponsive feeding practices. Increasing levels of HC and HFI may result in less structured mealtimes. Interventions must consider how financial hardship, HFI and HC can impact parents' ability to engage in responsive feeding practices. This cross-sectional study examined feeding practices among Australian parents facing financial hardship. Over 75% were food insecure. While the meal environment supported responsive feeding, increasing household chaos and food insecurity led to fewer structured mealtimes and household chaos increased coercive practices such as using (non)-food rewards and food to calm.

Attachment & biobehavioral catch-up participation & reunification in a family treatment court

BackgroundChildren impacted by substances are at increased risk for child welfare involvement, which often leads to out-of-home care. Substance use disorder (SUD) impacts the family unit, and thus, prevention and intervention efforts need to target the family, not just the individual with a SUD. There are efficacious interventions for families impacted by SUD, but limited information exists on family reunification outcomes following services. ObjectiveThis study examined whether participation in the Attachment and Biobehavioral Catch-Up (ABC) model was associated with a higher likelihood of reunification among families involved with a family treatment court (FTC) per conditions of an open child welfare case. MethodsThe study sample includes a total of 215 children from 112 families, ages six months to forty-seven months, and their caregivers, all enrolled in an FTC due to SUD. Children were considered exposed to the intervention (N = 39; 18.1 %) if either they or a sibling participated with either a biological or foster parent. The ABC treatment was delivered by a trained therapist either in the home or via telehealth. Results74 % of children exposed to the ABC model reunified by study end compared to 57 % of children who were not exposed to the intervention. In a multivariable Cox regression model controlling for covariates, reunification was driven by cases with biological parent participation. Compared to no exposure, cases with biological parent exposure were 2.3 times more likely to reunify. Reunification was not impacted by foster parent exposure. ConclusionsFamilies impacted by substances need interventions that target the caregiver-child dyad. Facilitating family bonding and attachment with direct caregiver involvement is critical to serving caregivers and their children. This study shows the ABC model, particularly when delivered to biological parent-child dyads, is associated with a higher likelihood of reunification for children in child welfare, an outcome that, when safe, secure, and stable, critically improves long-term, healthy development.

Concordance, motivations and associated factors of COVID-19 vaccination among parent–child dyads: a cross-sectional study in Caraga Region, the Philippines

BackgroundCOVID-19 vaccination rates remain low for children aged 11 and below, and understanding the extent to which parental decisions impact their children’s vaccination status remains a challenge. This study aimed...

The effect of parents' lifestyle on Schoolchildren's consumption of ultra-processed food

ObjectivesTo assess the association between schoolchildren's consumption of ultra-processed foods (UPFs) and various lifestyle factors of their parents in Brazil. Study designCross-sectional population-based study with parent-child dyads aged 6–11. MethodsThe sample was distributed proportionally across Brazilian macro-regions and type of school. Recruitment utilized the snowball technique, and participants filled in an online questionnaire. Initially, parents provided data on education, eating practices, food consumption markers, screen time, and physical activity. Subsequently, their children reported their UPF consumption using the Illustrated Questionnaire on Food Consumption for Brazilian Schoolchildren. The UPF consumption among children was assessed using the NOVA score. Poisson's regression log-linear analysis was performed (p < 0.05) with adjustments for macro-regions, type of school (as a proxy for socioeconomic status), gender, and age of the child. ResultsThis study included a total of 2021 child-parent dyads. On average, children consumed 3.5 UPFs on the previous day. We found a significant association between high consumption of UPFs by the child and parents with less healthy eating practices (p < 0.05), excessive screen time (p < 0.05), and high UPF consumption (p < 0.05). ConclusionsThese findings demonstrate a relationship between Brazilian schoolchildren's consumption of UPFs and various lifestyle factors of their parents, particularly regarding eating practices, food consumption markers, screen time, and physical activity. This underscores the importance of the home food environment in shaping children's health during this critical developmental stage of life, emphasizing the need to incorporate support for family lifestyle factors into public health policies.

The impact of the type of playful massage movements on the perception of tactile stimulation in children: EEG study

Tactile play and playful massage are a normal interaction between adults and children in many cultures. Experimental data show that activation of the C-tactile system during such playful touches contributes to children’s socialization and the establishment of psychoemotional bonds in the parent-child dyad. However, comprehensive studies of the effects of different types of touch on perception of tactile stimulation in children have not been conducted before. Twenty-three children participated in the present study: 10 in the preschool age group and 13 in the elementary school age group. Children in both groups received play massage containing different types of touch with simultaneous recording of electroencephalogram (EEG) and heart rate. EEG processing included determination of spectral power, alpha rhythm peak frequency and fractal dimension. Analysis of the results showed that the relaxing effect of the procedure was more pronounced in children of primary school age, which can be explained both by the greater maturity of the CNS and the greater need for tactile contact, which is not realized in the school environment.

Assessing Fears of Negative Consequences in Children With Symptoms of Avoidant Restrictive Food Intake Disorder.

Fear of Aversive Consequences (FOAC), such as choking or vomiting, is an important associated feature of Avoidant/Restrictive Food Intake Disorder (ARFID). However, the manifestation of FOAC in young children is poorly understood. This study aimed to describe the fears of children with ARFID symptoms and examine the concordance between parent and child ratings of fear. Child-reported FOAC was assessed using an interview designed for children between 6 and 10 years old, the Gustatory Avoidance and Gastrointestinal Stress Symptoms (GAGSS). Parents were administered a semi-structured diagnostic interview regarding their child's symptoms, the Pica, ARFID, and Rumination Interview. Among 68 children with ARFID diagnoses or symptoms (41.2% female, 85.3% White, mean age = 8.2 years, SD = 1.1 years; range 5.2-9.9 years), 91.2% of children endorsed at least one fear relative to 26.5% of parents. Among parent-child dyads, 36.8% disagreed about the child's fear of stomach pain (κ = 0.12) and 48.5% disagreed about the child's fear of vomiting, (κ = 0.08), both indicating low inter-rater reliability. On average, children endorsed 4.3 (SD = 2.3) fears out of 9 options. The most frequently endorsed fears were that food will "taste bad," (n = 43, 63.2%), "make you gag" (n = 37, 54.4%), and "look disgusting" (n = 36, 52.9%). Findings highlight ways in which fear may manifest in children with ARFID that are not easily discernable by adults. Greater precision in depicting childhood fears may facilitate the earlier detection of problematic eating behaviors.

Parental warmth and parent-child conflict among U.S. Latinx families in middle childhood.

Grounded in family systems theory and using latent profile analysis, the present study examined (a) patterns of parent-child warmth and parent-child conflict within multiple dyads (mother-older child, mother-younger child, father-older child, father-younger child) among 305 U.S. Latinx families with fifth graders (Mage = 10.6; 46.6% female) and younger siblings (Mage = 8.20; 47.2% female) and (b) tested links of profile membership with child academic competence, negative peer relationships, and depressive symptoms. Two profiles were characterized by differential maternal and paternal warmth toward older versus younger siblings, with one of the profiles characterized by higher levels of conflict than the other, and a third profile included families where parent-child dyads were similar in their levels of moderately high warmth and low conflict. Profile membership was concurrently linked with children's academic competence, peer relationships, and depressive symptoms, with notable within-family differences for older versus younger siblings. Findings underscore the value of studying families as interrelated subsystems by capturing multiple dimensions of two children's relationships with mothers and fathers and provide insights for family-based prevention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exploring the Utility of the Limited Prosocial Emotions Specifier for Subtyping Conduct Problems and Oppositional Defiant Problems: A Multi-informant Study.

This study aimed to assess the clinical utility of the "Limited Prosocial Emotions" (LPE) specifier in subtyping conduct problems (CP) and oppositional defiant problems (ODP) among two samples including 1203 parent-child dyads and 1,937 school-attending youths in Iran. The prevalence of LPE across the entire sample, as well as subsamples of youths with clinically elevated levels of CP and ODP, were examined. CP + LPE individuals scored significantly higher than CP-Only youths on several measures of externalizing psychopathology and depression, although these findings were not fully consistent across informants. Several anticipated differences in measures of aggression and antisocial behavior were not found. Also, no significant group differences were observed between the ODP + LPE and ODP-Only groups concerning externalizing and internalizing psychopathology. In the total sample, youths with LPE scored significantly higher in measures of externalizing and internalizing psychopathology than those without LPE, though the magnitude of these differences was in small ranges. Overall, the findings provide only limited support for the clinical utility of the LPE specifier for CP and none whatsoever for ODP.

The role of parenting in autonomy and executive function development among young children experiencing homelessness

A large body of research has shown homelessness is a risk factor for academic difficulties. However, some children experiencing homelessness begin kindergarten well-prepared and continue to succeed; this variability has motivated a search for protective factors supporting academic achievement in the context of homelessness. Two such factors might be children’s autonomy and executive function (EF), which allow children to take control of their own learning. The current study examined links between autonomy and EF skills, as well as the role of parenting in their development among young children experiencing homelessness. Participants included 78 parents and their children (Mage = 53 months) residing in emergency housing. Children were given an autonomy assessment and both cool and hot EF tasks; parent–child dyads completed a problem-solving task to measure autonomy-supportive parenting. Results indicated that child autonomy was significantly correlated with both cool and hot EF. Cool EF was related to academic skills. Autonomy-supportive parenting was significantly linked only to children’s cool EF above and beyond parental warmth, suggesting this dimension of parenting may play a unique role in the development of cool EF in the context of homelessness.