Parental Perception Of Child Vulnerability Research Articles

Self-Management in Youth With Spina Bifida: Associations With Parent Factors in the Context of a Summer Camp Intervention.

To investigate cross-sectional and longitudinal associations between parent factors and self-management for youth with spina bifida (SB). Participants were 89 camper-parent dyads recruited for a summer camp program for youth with SB (Myouthage = 12.2 years); 48 of these families participated across 2 years. Campers and parents completed assessments at Time 1 (pre-camp) and Time 3 (post-camp) for one or two summers. Parents reported on demographics, their own adjustment, perceptions, attitudes, and behaviors, and youth condition-related responsibility and task mastery. Youth also reported on condition-related responsibility. Hierarchical multiple regression analyses and multilevel modeling were used to examine relationships between parent factors and youth self-management. Parents' expectations for future goal attainment were positively associated with camper responsibility and task mastery, and these associations were moderated by camper age (only significant for older campers). When examining changes over one summer, parental expectations for the future were significantly associated with changes in campers' condition-related task mastery. When examining trajectories across summers, parental perception of child vulnerability was negatively associated with the slope of condition-related responsibility and parents' expectations for future goal attainment were positively associated with the slope of task mastery. Parent perceptions and behaviors may be important targets for assessment and intervention when promoting condition-related independence for youth with SB.

Parental Perception of Child Vulnerability in Parents of Young Children.

Parental perception that one's child may be vulnerable to a threatening illness appears to be negatively associated with the child's socioemotional development. However, there are no studies that have analyzed the association of these dysfunctional parental perceptions on the emotional development of children who have not suffered a previous serious illness. The main objective of the present study was to study the relationship between parental perception of child vulnerability (PPCV) and children's socioemotional development, hypothesizing that PPCV is associated both directly and indirectly with children's socioemotional development through parental reflective functioning and parental competence. The study involved 433 mothers and 113 fathers of infants between 0 and 3 years. PPCV was negatively associated with children's socioemotional development. Likewise, PPCV was indirectly and positively related to children's socioemotional development through the dimension of Interest and Curiosity of parental reflective functioning and parental competence. The literature has shown that parental dysfunctional perceptions about the health of their children can be negatively associated with children's socioemotional development. However, if these concerns are associated with increased interest and curiosity about the mental states of the child, this may actually promote the child's socioemotional development.

Discrepancies in Parent Perceptions of Child Vulnerability in Youth With Spina Bifida.

This study aimed to describe informant discrepancies between mother and father reports of child vulnerability in youth with spina bifida (SB) and examine variables that were associated with these discrepancies. Ninety-two parent dyads, with a child with SB (ages 8-15 years), were recruited as a part of a longitudinal study. Mothers and fathers completed questionnaires assessing parental perception of child vulnerability (PPCV), as well as medical and demographic information, behavioral aspects of the couple relationship, parenting stress, mental health of the parent, and child behavioral adjustment. The degree to which there was a parenting alliance was assessed with observational data. Mother-father discrepancies were calculated at the item level. Findings revealed that greater father mental health symptoms, parenting stress, and child behavior problems were associated with "father high and mother low" discrepancies in PPCV. There were also lower scores on observed parenting alliance when there were higher rates of "father high and mother low" discrepancies in PPCV. For families of youth with SB, discrepancies in PPCV where fathers perceive high vulnerability and mothers perceive low vulnerability may be a "red flag" for the presence of other parental and child adjustment difficulties. Findings are discussed in terms of the Attribution Bias Context Model and underscore the importance of including fathers in research on families who have children with chronic health conditions.

Parental perception of child vulnerability and parental competence: The role of postnatal depression and parental stress in fathers and mothers

IntroductionParents' perception that their child may be vulnerable to serious life-threatening illnesses can have negative effects on how they exercise their parenting. No studies have yet been carried out on parent´s perception of their child’s vulnerability, when the child has not suffered a severe illness. This study tries to analyze the relationship between parent´s perception of their children´s vulnerability and parental competence, and analyzes the mediating role of postnatal depression and parental stress.MethodThe study was carried out on mothers and fathers of full-term infants who did not have any serious illnesses. A total of 965 people (385 fathers and 580 mothers) participated in the study.ResultsThe results revealed an association between parental perception of their child’s vulnerability and parent’s perception of parental competence through depression and parental stress. However, this association was different for fathers and mothers.ConclusionThe variable of perception of child’s vulnerability was a relevant factor to understand parental competence.

Parental perception of child vulnerability in childhood cancer survivors.

Parents' perception of their children's vulnerability to illness following cancer treatment is largely unknown, but is important to understand given known challenges of transitioning survivors to postcancer care. We investigated the frequency of and factors associated with perceived vulnerability by parents of childhood cancer survivors attending a regional survivorship clinic. This cohort study was offered to all parents of pediatric patients (currently≤18years) attending the Yale childhood cancer survivorship clinic January 2010 to October 2016 who were≥1 year postcurative cancer therapy. Participating parents (one per patient) completed the standardized Child Vulnerability Scale at the beginning of the clinic visit (cutoff score≥10 for perceived vulnerability). Patient sociodemographics, cancer history, and posttherapy complications were abstracted from medical records. Overall, 116 parents participated (98% participation rate) consisting of 89% mothers; survivors were 46% female, had a current mean age of 12.7±3.9years, and were a mean of 6.4±3.8years posttherapy. Twenty-eight percent (n=33) of parents perceived their children as vulnerable. Survivor sociodemographics (age, sex, race/ethnicity, family income, insurance, parental marital status, number of siblings), cancer diagnosis, years off-therapy, survivorship visit number, treatment intensity, and late complications (number, type, severity) were not associated with perception of vulnerability. A sizeable proportion of parents continue to perceive their children as vulnerable even years after cancer therapy completion independent of current health status or past cancer history. Our data suggest the need to educate all parents of childhood cancer survivors regarding health risk, including those at lower risk for late complications.

Parental Perceptions of Child Vulnerability in Families of Youth With Spina Bifida: the Role of Parental Distress and Parenting Stress.

This longitudinal study aimed to investigate parental distress and parenting stress in relation to parental perception of child vulnerability (PPCV) in youth with spina bifida (SB). Parents of 140 youth with SB (ages 8-15 years at Time 1) were recruited as part of a longitudinal study; data were collected at two time points, spaced 2 years apart. Mothers and fathers completed questionnaires assessing levels of personal distress, parenting stress, and PPCV. Mothers and fathers reported similar levels of personal distress, parenting stress, and PPCV, but reports of PPCV increased over time. For mothers, both personal distress and parenting stress were significantly associated with PPCV cross-sectionally, but not longitudinally. For fathers, there were significant cross-sectional and longitudinal associations between parenting stress and PPCV. The cross-sectional association between maternal parenting stress and PPCV was moderated by age, with a significant association only for older youth. For parents of youth with SB, personal distress, and parenting stress are related to parental perceptions of child vulnerability, and child age may moderate this relationship. Parental personal distress and parenting stress are important targets for future interventions.

Parental perception of child vulnerability among mothers of very low birth weight infants: psychological predictors and neurodevelopmental sequelae at 2 years.

ObjectiveTo examine the impact of maternal psychological distress on the development of parental perception of child vulnerability (PPCV) in mothers of VLBW infants; and to examine the impact of PPCV on neurodevelopmental outcome in VLBW infants in the 2nd year of life.Study DesignProspective study of 69 mothers and their VLBW infants recruited in 2011-2012 for whom maternal psychological data was collected during the NICU hospitalization. Maternal PPCV was assessed at 4 months corrected age (CA). Neurodevelopmental outcome was assessed at 20 months CA. Regression analyses modeled the development of PPCV and the impact of PPCV on neurodevelopmental outcome.ResultsPPCV at 4 months CA was predicted by maternal anxiety and history of previous fetal loss reported during the NICU stay. Higher PPCV at 4 months CA was associated with lower language scores at 20 months CA.ConclusionsTargeted interventions aimed reducing PPCV in the NICU are supported.

Educational intervention for parents of adolescents with chronic illness: a pre-post test pilot study.

This pilot experimental study tested the feasibility and intended effect of an educational intervention for parents to help them assist their adolescent child with chronic illness (CI) in becoming autonomous. A two-phase pre-post pilot intervention study targeting parents of adolescents with CI was conducted. Parents were allocated to group 1 and 2 and received the four-module intervention consecutively. Intended effect was measured through online questionnaires for parents and adolescents before, at 2 months after, and at 4-6 months after the intervention. Feasibility was assessed through an evaluation questionnaire for parents. The most useful considered modules concerned the future of the adolescent and parents and social life. The most valued aspect was to exchange with other parents going through similar problems and receiving a new outlook on their relationship with their child. For parents, improvement trends appeared for shared management, parent protection, and self-efficacy, and worsening trends appeared for coping skills, parental perception of child vulnerability, and parental stress. For adolescents, improvement trends appeared for self-efficacy and parental bonding and worsening trends appeared for shared management and coping skills. Parents could benefit from peer-to-peer support and education as they support the needed autonomy development of their child. Future studies should test an online platform for parents to find peer support at all times and places.

부모의 양육태도가 유아 행동평가 척도에 미치는 영향 연구

Objectives The aim of this study was to explore the effect of parental attitude on the behavioral problems in children who visited the traditional Korean pediatrics clinic. Methods The subjects were consist of 190 outpatients (<TEX>$56.6{\pm}12.9$</TEX> months) and their mother. The Behavior problems of children were measured with Korean version of Child Behavior Checklist for Ages 1.5-5 (K-CBCL1.5-5) while parental perception of child vulnerability, parent overprotection, parenting stress were measured by Child Vulnerability Scale (CVS), Parent Protection Scale (PPS), Korean-Parenting Stress Index-Short Form scale (K-PSI-SF), respectively. Correlation and multiple regression were conducted for the analysis. Results Significant correlations between child total problems score and child vulnerability (r=.272, p<.001), parent overprotection (r=.243, p=.001), and parenting stress (r=.597, p<.001) were reported. Multiple regression analysis revealed that the parenting stress (<TEX>${\beta}$</TEX>=.548, p<.001) was a major predictor for the child behavior problems rather than child vulnerability and parent overprotection. Conclusions It was shown that the parenting stress has a significant influence on the emotional and behavioral development of children. These results can be useful for improving clinical diagnosis and treatment in traditional Korean pediatrics.

Vulnerable Child Syndrome, Parental Perception of Child Vulnerability, and Emergency Department Usage

Vulnerable child syndrome (VCS) describes children perceived to be at risk for behavioral, developmental, or medical problems. Families with the dynamics of VCS overuse health care resources with frequent visits to doctors' offices. The objective of the study was to explore the relationship between VCS, parental perception of child vulnerability (PPCV), and frequency of emergency department (ED) visits. Parents of patients 1 to 15 years old presenting with nonurgent complaints to a pediatric ED were eligible. Participants completed questionnaires in which the Vulnerable Child Scale was used to generate a measure of PPCV. Primary outcomes included number of ED visits and PPCV assignment. Children were divided into 2 PPCV groups by Vulnerable Child Scale score: less than 40 (high PPCV) versus 40 or greater (low PPCV). The cutoff point was chosen as 1 SD (7.3) from the sample mean (46.8) on the vulnerable end of the scale (low scores). The mean ages of the 351 parents and children were 30 (SD, 7.7) years and 5 (SD, 3.9) years, respectively; 17% of children had high PPCV. Eleven variables differed statistically between subjects with high and low PPCV including number of ED visits and hospital admissions, excellent reported child health, pregnancy problems, delivery problems, child mental health problems, parent mental health problems, and child developmental problems. Our results reveal that children with higher PPCV had an increased number of ED visits, and risk factors for higher perceived vulnerability scores were identified. Future investigation on ways to intervene with families with the dynamics of VCS may be warranted.

Factors Associated With Parental Perception of Child Vulnerability 12 Months After Abnormal Newborn Screening Results

We identified factors associated with elevated parental perceptions of child vulnerability (PPCV) 12 months after newborn screening (NBS) of 136 children: healthy, normal results (H, n = 37), cystic fibrosis carriers (CF-C, n = 40), congenital hypothyroidism (CH, n = 36), and cystic fibrosis (CF, n = 23). Controlling for infant and parent characteristics, mixed logit structural equation modeling showed direct paths to elevated PPCV included parent female sex, CF diagnosis, and high documented illness frequency. PPCV was positively associated with maternal parenting stress. Infants with CF and CF carriers had significantly more documented illness frequency than H group infants. The CH group did not differ significantly from the H group and had no paths to PPCV. Unexpectedly high documented illness frequency among infants who are CF carriers warrants further investigation.

Parenting children with hypoplastic left heart syndrome: Finding a balance

PURPOSE. This study described the role normalization played for parents related to their young children with hypoplastic left heart syndrome. DESIGN AND METHODS. The data source for this secondary analysis was 30 interviews with 16 parents. RESULTS. Three themes were identified: normalization, parental perception of child vulnerability, and optimistic appraisal. Parents engaged in a balancing act between worrying about their children's vulnerability and marveling at their children's survival, using normalization as a coping strategy. PRACTICE IMPLICATIONS. Nurses can collaborate with parents to determine strategies to restore a sense of normalcy to simultaneously promote child independence and parent well-being.

Psychological Effects of False-Positive Results in Cystic Fibrosis Newborn Screening: A Two-Year Follow-Up

To evaluate parental stress after a false-positive result at the time of the cystic fibrosis (CF) newborn screening (NBS), attributable to heterozygotism or persistent hypertrypsinemia. A prospective study was conducted in 86 French families at 3, 12, and 24 months after NBS. A psychologist conducted interviews with a questionnaire, the Perceived Stress Scale, and the Vulnerable Child Scale. Overall, 96.5% of parents said they had been anxious at the time of the sweat test. However, 86% felt entirely reassured 3 months after the test. The mean Perceived Stress Scale score did not differ from that observed in the French population. Mean Vulnerable Child Scale scores were high, associated with a low Parental Perception of Child Vulnerability. These results did not differ significantly at 1 and 2 years. In total, 86% to 100% of families no longer worried about CF. All parents stated that they would have the test performed again for another child. CF NBS can lead to false-positive results, causing parental anxiety, which quickly decreases after a sweat test performed soon after the phone call.

Perception of child vulnerability among mothers of former premature infants.

Parents of premature infants often perceive their infants as medically vulnerable. High parental perception of child vulnerability (PPCV) is associated with disproportionately high health care utilization. The objectives of this study were to determine whether higher PPCV is correlated with worse developmental outcome in premature infants at 1-year adjusted age and to identify factors, present at neonatal discharge, that predict high PPCV. This prospective cohort study assessed mothers of 116 premature infants who were </=32 weeks' gestation and required supplemental oxygen at 36 weeks postmenstrual age. At neonatal discharge, mothers completed the Spielberger State Anxiety Inventory, Beck Depression Inventory, Impact on Family Scale, Life Orientation Test, General Health Survey, and Medical Outcomes Study social support survey. At 1-year adjusted age, child development was assessed using the Bayley Scales of Infant Development and Vineland Adaptive Behavior Scales, and mothers completed the Vulnerable Child Scale, a 16-item self-report measure of PPCV. Chart review was performed to determine the presence or absence of specific indicators of medical vulnerability at 1-year adjusted age. Mean infant gestational age and birth weight were 26.5 +/- 2.5 weeks and 894 +/- 287 g. A total of 69% of mothers were white, and 78% were high school graduates. Higher PPCV (lower Vulnerable Child Scale score) was correlated with lower scores on the Vineland Adaptive Behavior Composite and Bayley Psychomotor Developmental Index but not on the Bayley Mental Developmental Index. After controlling for the presence of 1 or more indicators of medical vulnerability, higher PPCV was still correlated with lower adaptive development. This correlation was stronger in the group of children with no indicators of medical vulnerability. In univariate analyses, higher PPCV was predicted by nonfirstborn status; longer neonatal hospitalization; higher maternal anxiety and depression; greater impact of the illness on the family; and lower maternal optimism, life satisfaction, and social support. PPCV was not associated with maternal age, education, marital status, income, or ethnicity or with child gender, gestational age, birth weight, or length of mechanical ventilation. A linear regression model containing all variables significant at the univariate level explained 29% of the variance in PPCV. Maternal anxiety was the only variable that was statistically significant in the full model. Higher PPCV is associated with worse developmental outcome in premature infants at 1-year adjusted age. Maternal anxiety at neonatal discharge predicts later high PPCV. Interventions to prevent or decrease PPCV in premature infants should be targeted at parents who are more anxious at hospital discharge.

Caretaker perception of child vulnerability predicts behavior problems in NICU graduates.

This study explores parental perception of child vulnerability (PPCV) and parent overprotection (POP) and their relationship to neonatal medical problems, child development and behavior. Participants included 90 lower income parents of NICU graduates ages 22-81 months consecutively enrolled at a high-risk neonatal developmental follow-up clinic. Parents completed the Child Vulnerability Scale (CVS), the Parent Protection Scale (PPS) and the Child Behavior Checklist (CBCL) regarding their children. Step-wise regression analysis revealed the CVS as the sole predictor of child behavior, accounting for 13% of the variance in the CBCL Total T-score (R(2) =.13, $be =.86, p <.006). Neonatal medical problems, Child DQ, and most parental demographic variables did not correlate with CVS or PPS scores. A significant correlation between CVS and the separation subscale of the PPS was noted (r =.31, p <.01). We conclude that NICU graduates perceived vulnerable by their caretakers have significant behavioral difficulties compared to those perceived as not vulnerable. Future research should address early parental antecedents of PPCV, the persistence of PPCV, and its effects on behavioral outcomes.

Parental perceptions of child vulnerability, overprotection, and parental psychological characteristics.

While a parental perception of child vulnerability to illness/injury is often used interchangeably with parental overprotection, research suggests that these constructs are independent. Distinct parental psychological characteristics were hypothesized for each construct. The parents of 871 children, ages 22-72 months, completed a four-part protocol (clinical background data, Child Vulnerability Scale, Parent Protection Scale, and Brief Symptom Inventory). A distinct parent symptom profile was found for perceived child vulnerability (somatization, obsessive-compulsiveness, and anxiety). Overprotection was associated with phobic anxiety, psychoticism, and paranoid ideation. These findings provide further support for the differentiation of these constructs.

The 2-Year Stability of Parental Perceptions of Child Vulnerability and Parental Overprotection

Clinicians often identify parent-child relationships that are believed to be problematic for the child's future emotional growth, yet there are minimal outcome data on which to base anticipatory guidance. This 2-year follow-up study examined the stability and child behavioral correlates of parental perceptions of increased child vulnerability and parental overprotection. Of 192 potential participants, 114 parents (93% mothers, 86% white, 75% married, 90% middle-upper socioeconomic status) with children age 4 to 7 years successfully completed the Parent Protection Scale, Child Vulnerability Scale, Child Behavior Checklist 4-18, and the Parental Bonding Instrument. The 2-year stability of high parental overprotection was 37%; for high parental perception of child vulnerability, it was 31%. High perceived vulnerability at enrollment was significantly associated with both internalizing (somatic complaints, anxious/depressed) and externalizing (aggressive) behaviors at follow-up. A history of overprotection in the parent's childhood was not associated with current parental report of overprotective behaviors toward the child.

Parent-Child Relationship Disorders. Part II. The Vulnerable Child Syndrome and its Relation to Parental Overprotection

Parents who are excessively concerned about their child's health are often characterized as being overprotective. We hypothesized that parental overprotection is independent of parental perception of child vulnerability to illness or injury despite their presumed interchangeability. A community-based sample of 892 parents (92% white, 84% married, 88% middle-upper socioeconomic status, 90% mothers) completed a three-part protocol (clinical background data, the Child Vulnerability Scale, and the Parent Protection Scale). Correlates of high parental perception of child vulnerability included a medical condition in the child, a history of life-threatening illness or injury, and the child being seen for a sick visit. Correlates of high parental overprotection included younger age of child and parent. Only 20% of those parents who considered their child vulnerable were also considered overprotective.

The Vulnerable Child Syndrome Revisited

Dimensions of the vulnerable child syndrome are clarified in a critical review of the research and clinical literature. The central construct of the vulnerable child syndrome, an increased parental perception of child vulnerability to illness or injury, is examined in the context of separation and loss. Measures of perceived child vulnerability are reviewed. A new conceptual model of parental perception of child vulnerability is presented that takes into account child, parent, parent-child, parent-clinician, and family factors. Directions for future research are suggested.