Parent-child Interaction Measures Research Articles

In sync with your child: The potential of parent-child electroencephalography in developmental research.

Healthy interaction between parent and child is foundational for the child's socioemotional development. Recently, an innovative paradigm shift in electroencephalography (EEG) research has enabled the simultaneous measurement of neural activity in caregiver and child. This dual-EEG or hyperscanning approach, termed parent-child dual-EEG, combines the strength of both behavioral observations and EEG methods. In this review, we aim to inform on the potential of dual-EEG in parents and children (0-6years) for developmental researchers. We first provide a general overview of the dual-EEG technique and continue by reviewing the first empirical work on the emerging field of parent-child dual-EEG, discussing the limited but fascinating findings on parent-child brain-to-behavior and brain-to-brain synchrony. We then continue by providing an overview of dual-EEG analysis techniques, including the technical challenges and solutions one may encounter. We finish by discussing the potential of parent-child dual-EEG for the future of developmental research. The analysis of multiple EEG data is technical and challenging, but when performed well, parent-child EEG may transform the way we understand how caregiver and child connect on a neurobiological level. Importantly, studying objective physiological measures of parent-child interactions could lead to the identification of novel brain-to-brain synchrony markers of interaction quality.

Programa Parental ACT: Um Piloto com Medidas Observacionais da Interação Cuidador-Criança

Considering the lack of studies involving primary prevention of child abuse, this pilot study aimed to evaluate the effectiveness of the ACT Parenting Program, a universal violence prevention program, through observational measures of parent-child interactions and parental self-report. The study included 10 parents, randomly assigned to wait-list control group (CG) and experimental group (EG), with pre-test/post-test/follow-up measures. The observation sessions were conducted in a lab-house with one-way mirror and filming equipment. Comparing the groups, the EG had a significant increase in self-reported problem-solving skills after program completion. However, no differences were found among observational measures. Further studies are required to attest the effectiveness of the program with behavioral measures.

ACT Parenting Program: A pilot study with observational measures of parent-child interaction

Considering the lack of studies involving primary prevention of child abuse, this pilot study aimed to evaluate the effectiveness of the ACT Parenting Program, a universal violence prevention program, through observational measures of parent-child interactions and parental self-report. The study included 10 parents, randomly assigned to wait-list control group (CG) and experimental group (EG), with pre-test/post-test/follow-up measures. The observation sessions were conducted in a lab-house with one-way mirror and filming equipment. Comparing the groups, the EG had a significant increase in self-reported problem-solving skills after program completion. However, no differences were found among observational measures. Further studies are required to attest the effectiveness of the program with behavioral measures.

68.3 LONG-TERM OUTCOMES OF PARENT-CHILD INTERACTION THERAPY ON ADHD SYMPTOMS

This study examines the long-term effects of Parent-Child Interaction Therapy (PCIT) on female and male caregiver ratings of ADHD symptoms, as well as on observational interaction measures in preschoolers randomized to individual or group PCIT. Data from 128 children participating in treatment were examined (mean age at study entry = 4.8 years). Children with ADHD, half of whom also met the criteria for disruptive behavior disorder (DBD), were randomized to group or individual PCIT and outcomes were assessed posttreatment as well as 1 and 2 years after treatment completion. Pretreatment and posttreatment measures included: 1) parent rating scales, like the Child Behavior Checklist (CBCL) Externalizing Problems Subscale; the SNAP-IV; the Eyberg Child Behavior Inventory (ECBI) Intensity Score; and the Columbia Impairment Scale (CIS); and 2) observations of the parent-child interaction using the Dyadic Parent-Child Interaction Coding System (DPICS). PCIT results in clinically and statistically significant improvements in ADHD symptoms and reductions in impairment as rated by female and male caregivers. There are no differences in outcomes at posttreatment between children with and without DBD, or between those in individual or group PCIT. For both PCIT treatment formats, improvements are maintained at 1- and 2-year follow-up on all caregiver measures, including ADHD-specific ratings, externalizing behavior ratings, CIS scores, and observational measures of parent-child interactions. ADHD symptom reduction is not an original goal of PCIT intervention, yet significant improvements occur in ADHD symptoms based on both caregivers’ reports and observational data. These findings suggest that PCIT may be an effective treatment for the behavioral and attentional symptoms of ADHD in preschoolers with or without DBD and that it merits further study as a promising intervention for preschoolers with ADHD.

Measuring parent positive support of social communication among toddlers with autism: a systematic review

There are no systematic reviews of the use of parent-child interaction measures employed within studies examining the effects of parent-mediated intervention on toddlers with autism. Best practices recommend using parent-child interaction measures to assess whether interventions aimed at strengthening parent-child interactions are functioning as intended. A systematic review of parent-mediated early intervention studies of toddlers with autism was conducted. The purpose was to examine the use of parent-child interaction measures to assess parent positive support of toddler social communication and report feasibility characteristics for early interventionist practitioners. Experimental parent-mediated intervention studies of social communication among children with autism younger than 36 months were identified. Measurement approaches to parent support of social communication were quantified. Of 25 studies, only 7 studies reported parent and child outcomes using an instrument designed to measure the construct of parent support of child social communication during observed parent-child interaction. Measures reported are of limited relevance for early intervention practitioners due to administration burden and lack of feasibility for repeated measurement of progress toward increasing parent support of toddler social communication. This study highlights the need for feasible practitioner tools for monitoring progress of parent support of social communication for toddlers with autism.

Effects of pivotal response treatment on reciprocal vocal contingency in a randomized controlled trial of children with autism spectrum disorder.

A recent randomized controlled trial found that children with autism spectrum disorder who received a pivotal response treatment package showed improved language and social communication skills following the intervention. The pivotal response treatment package includes clinician-delivered and parent-implemented strategies. Reciprocal vocal contingency is an automated measure of vocal reciprocity derived from daylong audio samples from the child's natural environment. It may provide stronger and complementary evidence of the effects of the pivotal response treatment package because it is at lower risk for detection bias than parent report and brief parent-child interaction measures. The current study compared reciprocal vocal contingency for 24 children with autism spectrum disorder in the pivotal response treatment package group and 24 children with autism spectrum disorder in the control group. The pivotal response treatment package group received 24 weeks of the pivotal response treatment package intervention. The control group received their usual intervention services during that time. The groups did not differ in reciprocal vocal contingency when the intervention started or after 12 weeks of intervention. However, after 24 weeks the pivotal response treatment package group had higher ranked reciprocal vocal contingency scores than the control group. These findings are consistent with results from parent report and parent-child interaction measures obtained during the trial. The participants in the pivotal response treatment package exhibited greater vocal responsiveness to adult vocal responses to their vocalizations than the control group. Findings support the effectiveness of the pivotal response treatment package on vocal reciprocity of children with autism spectrum disorder, which may be a pivotal skill for language development.

Measures of Challenging and Excitatory Parenting Behavior as Predictors of Later Child Self-Regulation

Challenging and excitatory parenting behaviors play an important role in children’s development, particularly in regard to the development of selfregulation; however, no well-established measures of parent-child interactions exist that record such behaviors. In the current study, I compare two recently developed coding systems that intend to address this issue: the Risky Interaction Support and Challenging (RISC) and Marbach coding systems. A subset of videos from the New Parents Project (NPP) data set at 12 and 18 months was coded using both scales, then a factor analysis was conducted for each scale. Regressions were conducted to look at the predictive power of each scale on children’s self-regulation at two and seven years. I hypothesized that the Challenging Regulatory Competence (CRC) and the Excitation, Arousal, and Destabilization (EAD) subscales of the RISC and Marbach scales, respectively, would have the most predictive power for later self-regulation. The regressions did not support the hypotheses, revealing no significant relationship between one-year parent behaviors and later self-regulation.

Personality traits and parent-adolescent interactions: An observational study of Mexican origin families.

Parent-child interactions are likely influenced by the personality characteristics of both the parent and the child. However, questions remain concerning the bidirectional nature of these effects (e.g., does a child's personality evoke changes in his or her parent's behavior?). Furthermore, the existing literature is based primarily on European American children and generally relies on questionnaire measures of parent-child interactions rather than assessing behavior during observed interactions. To address these gaps in the literature, the authors evaluated reciprocal associations between personality traits and observed interactions between Mexican origin adolescents (N = 674) and their parents in 5th- and 7th-grade using the Actor-Partner Interdependence Model (Kenny, Kashy, & Cook, 2006). Adolescent effortful control and aggressiveness were associated with adolescent warmth and hostility (i.e., actor effects) and parent warmth and hostility (i.e., partner effects). Thus, adolescents with poor self-control seem to evoke more negative behaviors from their parents than adolescents with better self-control. Parental extraversion, agreeableness, and neuroticism predicted parent warmth (actor effects), but there was little evidence that parent personality was associated with specific adolescent behaviors (partner effects). These results help to clarify how personality attributes are associated with adolescent relationships. (PsycINFO Database Record

Family functioning and child asthma severity: A bio-behavioral approach.

Family factors are directly associated with the psychosocial adjustment of children with chronic illnesses such as asthma (Kaugars, Klinnert, & Bender, 2004). Research indicates that negative family factors may also contribute to child disease severity via bio-behavioral mechanisms of effect. For instance, children from more conflicted families often experience greater internalizing symptoms that subsequently impact their asthma severity (Wood et al., 2006). These pathways have yet to be examined with a comprehensive focus on strength-based family factors. This study examined whether factors such as family cohesion, problem-solving abilities, and communication influence asthma severity via their effects on child depression and anxiety symptoms. Participants were 215 children (136 males and 79 females), ages 5 to 12 years old, and their families. Primary caregiver, child, and teacher ratings of child and family functioning in addition to objective measures of parent-child interactions and asthma severity were collected. Using structural equation modeling, the authors identified significant indirect associations between family factors and child asthma severity via child depressive symptoms; however, these associations were not present in models with child anxiety symptoms. Results suggest an indirect effect of family functioning on children's lung function, with differential roles of anxiety and depression in these pathways. This article also highlights the importance of incorporating multirater multimethod measures to understand children's experiences in pediatric asthma. (PsycINFO Database Record

Parent-Child Interaction Therapy: A Meta-analysis.

Parent-child interaction therapy (PCIT) is effective at reducing children's externalizing behavior. However, modifications are often made to PCIT, and it is not known whether these impact effectiveness. To systematically review and meta-analyze the effects of PCIT on child externalizing behaviors, considering modifications, study design, and bias. We searched PubMed, PsycINFO, Education Resources Information Center, Sociological Abstracts, and A+ Education. We selected randomized controlled or quasi-experimental trials. We analyzed child externalizing and internalizing behaviors, parent stress, parent-child interactions, PCIT format, and study design and/or characteristics. We included 23 studies (1144 participants). PCIT was superior to control for reducing child externalizing (standardized mean difference [SMD]: -0.87, 95% confidence interval [CI]:-1.17 to -0.58). PCIT studies that required skill mastery had significantly greater reductions in externalizing behavior than those that did not (Mastery: SMD: -1.09, 95% CI: -1.44 to -0.73; Nonmastery: SMD: -0.51,95% CI: -0.85 to -0.17, P = .02). Compared with controls, PCIT significantly reduced parent-related stress (mean difference [MD]: -6.98, 95% CI: -11.69 to -2.27) and child-related stress (MD: -9.87, 95% CI: -13.64 to -6.09). Children in PCIT were observed to be more compliant to parent requests (SMD: 0.89, 95% CI: 0.50 to 1.28) compared with controls. PCIT effectiveness did not differ depending on session length, location (academic versus community settings), or child problems (disruptive behaviors only compared with disruptive behavior and other problems). Results for parent-child observations were inconsistently reported, reducing the ability to pool important data. PCIT has robust positive outcomes across multiple parent-reported and observed parent-child interaction measures, and modifications may not be required even when implemented in diverse populations.

“You are our eyes and ears”: A new tool for observing parent-child interactions in large samples

Differences in parent-child interactions have implications for a range of developmental outcomes, yet it has traditionally been difficult for large cohort studies that traverse multiple domains to include such detailed behavioural observations. We describe a new method for observing parent-child interactions specifically designed to be a component of a more comprehensive collection of data about child health and development. Participants were mothers and their two-year-old children who were part of the Growing Up in New Zealand study. During a series of brief, structured parent-child conversation tasks, observers were trained to rate mothers’ warmth, use of open-ended questions, talk about emotions and ‘linking’ talk, children’s emotional expression and mothers’ overall use of discipline. Reliability was established before and reviewed mid-way through the one-year data collection wave. We observed differences in parent-child interaction construct ratings as a function of socio-demographic variables, ethnicity and child gender that were in agreement with published research. Inter-scale correlations and correlations between observer ratings and maternal self-report measures provide preliminary evidence of convergent and discriminant validity. Specifically, higher maternal self-reported affiliation and more frequent book reading were significantly correlated with observer ratings of maternal warmth, maternal language style and children’s emotional expression, and negatively correlated with observer ratings of maternal discipline. Higher maternal self-reported parenting hostility was negatively correlated with observed maternal warmth and language and positively correlated with observed maternal discipline. This observational method is a potentially useful technique for obtaining independent measures of parent-child interactions during the preschool years within large cohort studies.

Observational Measures of Parent-Child Interactions during Painful Procedures: A Systematic Review

Observational Measures of Parent-Child Interactions during Painful Procedures: A Systematic Review

Parent-infant psychotherapy for improving parental and infant mental health.

Parent–infant psychotherapy (PIP) is a dyadic intervention that works with parent and infant together, with the aim of improving the parent–infant relationship and promoting infant attachment and optimal infant development. PIP targets the mother’s view of her infant, linking her own early

Parent-Child Interactions During Cancer Treatment-Related Procedures: What is Still Missing?

Children being treated for cancer receive a variety of treatment-related procedures, such as lumbar punctures, bone marrow aspirations and port starts. These invasive and painful procedures can negatively influence children with cancer in the short- and long-term run. Parents play important roles in physically and emotionally caring for their child during these procedures and parent-child interactions can significantly influence children’s experiences during painful procedures. The purpose of this editorial was to discuss the impact of parent-child interactions during painful procedures and future research directions through the following aspects: the impact of treatment-related painful procedures in children with cancer, parent-child interactions during cancer treatment-related procedures and observational measures of parent-child interactions during painful procedures.

Community‐based early intervention for language delay: a preliminary investigation

A trial parent-focused early intervention (PFEI) programme for children with delayed language development is reported in which current research evidence was translated and applied within the constraints of available of clinical resources. The programme, based at a primary school, was run by a speech-language pathologist with speech-language pathology students. To investigate the changes in child language development and parent and child interactions following attendance at the PFEI. Eighteen parents and their children attended six, weekly group sessions in which parents were provided with strategies to maximize language learning in everyday contexts. Pre- and post-programme assessments of vocabulary size and measures of parent-child interaction were collected. Parents and children significantly increased their communicative interactions from pre- to post-treatment. Children's expressive vocabulary size and language skills increased significantly. Large-effect sizes were observed. The positive outcomes of the intervention programme contribute to the evidence base of intervention strategies and forms of service delivery for children at risk of language delay.

FC14-05 - Parent-mediated communication-focused treatment for preschool children with autism (MRC PACT); a randomised controlled trial

IntroductionEvidence from previous small trials has suggested the effectiveness of early social communication interventions for autism.ObjectivesThe Preschool Autism Communication Trial (PACT) investigated the efficacy of such an intervention in the largest psychosocial autism trial to date.AimsTo provide a stringent test of a pre-school communication intervention for autism.Methods152 children with core autism aged 2 years - 4 years 11 months in a 3 site 2 arm single (assessor) blinded randomised controlled trial of the parent-mediated communication-focused intervention added to treatment as usual (TAU) against TAU alone. Primary outcome; severity of autism symptoms (modified social communication algorithm from Autism Diagnostic Observation Schedule-Generic, ADOS-G). Secondary outcomes; blinded measures of parent-child interaction, child language, and adaptation in school.ResultsAt 13 month endpoint the treatment resulted in strong improvement in parental synchronous response to child (adjusted between-group effect size 1.22 (95% CI 0.85, 1.59) and child initiations with parent (ES 0.41 (0.08, 0.74) but small effect on autism symptomatology (ADOS-G, ES -0.24 (95% CI -0.59, 0.11) ns). Parents (not blind to allocation) reported strong treatment effects on child language and social adaptation but effects on blinded research assessed language and school adaptation were small.ConclusionsAddition of the PACT intervention showed clear benefit in improving parent-child dyadic social communication but no substantive benefit over TAU in modifying objectively rated autism symptoms. This attenuation on generalisation from ‘proximal’ intervention effects to wider symptom change in other contexts remains a significant challenge for autism treatment and measurement methodology.

Parent-mediated communication-focused treatment in children with autism (PACT): a randomised controlled trial

SummaryBackgroundResults of small trials suggest that early interventions for social communication are effective for the treatment of autism in children. We therefore investigated the efficacy of such an intervention in a larger trial.MethodsChildren with core autism (aged 2 years to 4 years and 11 months) were randomly assigned in a one-to-one ratio to a parent-mediated communication-focused (Preschool Autism Communication Trial [PACT]) intervention or treatment as usual at three specialist centres in the UK. Those assigned to PACT were also given treatment as usual. Randomisation was by use of minimisation of probability in the marginal distribution of treatment centre, age (≤42 months or >42 months), and autism severity (Autism Diagnostic Observation Schedule-Generic [ADOS-G] algorithm score 12–17 or 18–24). Primary outcome was severity of autism symptoms (a total score of social communication algorithm items from ADOS-G, higher score indicating greater severity) at 13 months. Complementary secondary outcomes were measures of parent-child interaction, child language, and adaptive functioning in school. Analysis was by intention to treat. This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN58133827.Results152 children were recruited. 77 were assigned to PACT (London [n=26], Manchester [n=26], and Newcastle [n=25]); and 75 to treatment as usual (London [n=26], Manchester [n=26], and Newcastle [n=23]). At the 13-month endpoint, the severity of symptoms was reduced by 3·9 points (SD 4·7) on the ADOS-G algorithm in the group assigned to PACT, and 2·9 (3·9) in the group assigned to treatment as usual, representing a between-group effect size of −0·24 (95% CI −0·59 to 0·11), after adjustment for centre, sex, socioeconomic status, age, and verbal and non-verbal abilities. Treatment effect was positive for parental synchronous response to child (1·22, 0·85 to 1·59), child initiations with parent (0·41, 0·08 to 0·74), and for parent-child shared attention (0·33, −0·02 to 0·68). Effects on directly assessed language and adaptive functioning in school were small.InterpretationOn the basis of our findings, we cannot recommend the addition of the PACT intervention to treatment as usual for the reduction of autism symptoms; however, a clear benefit was noted for parent-child dyadic social communication.FundingUK Medical Research Council, and UK Department for Children, Schools and Families.

Neurocognitive function in same-sex twins following focal radiation for medulloblastoma

Increased neurotoxicity and poor long-term neurocognitive outcome of preschool children treated for brain tumors have led to innovative therapeutic strategies in order to delay or avoid the use of craniospinal radiation and to improve survival. Because these protocols are relatively new, few data exist regarding cognitive outcome. We conducted a twin case-control study to investigate neurocognitive and behavioral outcome in a preschool patient who was 16 months old at diagnosis of medulloblastoma and was treated with surgery, chemotherapy, stem cell transplant, and focal radiation to the tumor bed. Stability and change over two assessments were compared for the patient and her nonaffected twin for standardized measures of cognitive function and experimental measures of parent-child interaction, social competence, and goal-directed play. A striking finding was improvement in intelligence, receptive language, and visual-motor functioning in the affected twin from 12 months to 24 months after treatment. Improvement in ratings of parent-child interaction and social competence for the affected twin was also evident. These findings are notable compared with the potentially devastating impact of craniospinal tumor, and this study is among the first to document the relative benefit of focal radiation in sparing cognitive function, albeit in a single case study.

The Empirical Development of the Child-Parent Communication Apprehension Scale for Use With Young Adults

The empirical development of a Child-Parent Communication Apprehension scale for use with young adults (C-PCA, YA) is presented, along with tests of conceptual and predictive validity. An argument is made for the need to develop an instrument that distinguishes between a young adult's anxiety, or apprehension, about engaging in communication with his or her mother and father, or both, and general measures of parent-child interaction. Results indicate that the 12-item measure of C-PCA, YA developed for this research project is (a) a reliable measure of a young adult child's communication apprehension regarding both mother and father, (b) empirically distinct from both general parent-child communication and dyadic communication apprehension, and (c) useful for predicting satisfaction in the parent-child relationship, above and beyond general measures of parent-child interaction. Understanding and measuring the characteristics of young adults who are apprehensive about communicating with their parents are important steps toward advancing the study of family communication.

Are sons and daughters treated more differently by fathers than by mothers?

According to reciprocal role theory, the father's socialization behavior promotes sex-typing in children. While sex-typing is encouraged by both parents, the father makes a greater differentiation between sons and daughters. In this article, the research on differential socialization behavior is reviewed. Some studies have used multiple measures of parent-child interaction and often only a few of these have revealed differences related to the sex of the parent. However, as indicated both in a qualitative review of the literature and in a meta-analysis, results that are significant provide a modest degree of support for father-specific socialization behaviors. In 20 of 39 independent published studies, the father's ratings or treatment of boys and girls differed significantly. By contrast, the differences for mothers, if present at all, were comparatively few in any of the studies. The pattern of father-specific effects was most evident in the area of discipline and physical involvement and was weak in the areas of affection and everyday speech with infants and toddlers. Research on children's perceptions of parental socialization behavior is consistent with the existence of differential socialization practices used by the father in particular. Reciprocal role theory is discussed in terms of influences on parent-child interaction with regard to traditional and nontraditional family arrangements. Further research using within-family designs is required to examine fathers' differential treatment in the context of changing family and work roles.