Parental Perceptions Of Child Vulnerability Research Articles

The association between overprotective parenting, parental perceptions of child vulnerability and growth and development of children with congenital heart disease

Abstract Background Congenital Heart Disease (CHD) is the most prevalent childhood birth defect, leading to health concerns in growth and development post-surgery. Parents mostly shoulder the responsibility for post-hospitalization care. The chronic nature of caring for a child with CHD induces significant stress, fostering perceptions of the child as highly vulnerable and resulting in overprotective behaviors. These behaviors could restrict the child's developmental opportunities, affecting overall growth and development. Purpose The purpose was to investigate the association between parental perceptions of child vulnerability, overprotective parenting, and growth and development of children with CHD. Methods The study employed a cross-sectional, comparative design. The total sample included 186 [93 CHD and 93 healthy controls] parents and their child aged 1-5 years. Data on parenting practices were gathered using the Child Vulnerability Scale and Parental Protection Scale. Child development was examined using the Ages and Stages Questionnaire-3. Growth and other clinical variables were gathered from the medical records. Data were analyzed using descriptive statistics, correlational and mediation analyses. Results CHD parents exhibited higher overprotective parenting (p=0.008) and perceived their child as more vulnerable (p<0.001) than healthy controls. In CHD, parental perception of child vulnerability was associated with worse gross motor (p=0.010) and problem-solving development (p=0.011), while among the controls, overprotective parenting was negatively associated with height (p=0.027) and weight (p=0.003). The path analyses revealed direct effects but no mediating or moderating effects of perceived child vulnerability and overprotectiveness on growth and development of the child with CHD. Higher parental perceptions of child vulnerability were associated with lower height (b1= -0.253, 95% CI: -0.397 to -0.087) and weight (a2= -0.098, 95% CI: -0.195 to 0.003). The higher the parental stress, the greater the perceptions of child vulnerability were (d1= 0.108, 95% CI: 0.058 to 0.160) and the worse communication skills of the child (cʹ2= -0.250, 95% CI: -0.422 to 0.091). Higher education level of the parents was associated with less perceptions of child vulnerability (d1= -1.562, 95% CI: -2.753 to -0.623), better fine motor development (c2=6.948, 95% CI: 4.137 to 9.552) and less overprotective parenting (f1=-1.874, 95% CI: -3.186 to -0.499). Higher perceptions of child vulnerability were associated with lower personal-social development (b1= -0.378, 95% CI: -0.803 to 0.046). Top of Form. Conclusion Healthcare providers should consider the diverse parental and child factors identified to initiate interventions aimed at parenting practices, realistic perceptions of their child’s condition, and reducing parental stress to optimize growth and development in children with CHD.

Vulnerable Child Syndrome and Newborn Screening Carrier Results for Cystic Fibrosis or Sickle Cell

To measure parental perceptions of child vulnerability, as a precursor to developing a population-scale mechanism to mitigate harm after newborn screening. Participants were parents of infants aged 2-5months. Parental perceptions of child vulnerability were assessed with an adapted version of the Vulnerable Baby Scale. The scale was included in the script for a largerstudy of telephone follow-up for 2 newborn blood screening samples (carrier status for cystic fibrosis or sicklecell hemoglobinopathy). A comparison sample was added using a paper survey with well-baby visits to an urban/suburban clinic. Sample sizes consisted of 288 parents in the cystic fibrosis group, 426 in the sickle cell hemoglobinopathy group, and 79 in the clinic comparison group. Parental perceptions of child vulnerability were higher in the sickle cellgroup than cystic fibrosis group (P<.0001), and both were higher than the clinic comparison group (P<.0001). Parental perceptions of child vulnerability were inversely correlated with parental age (P<.002) and lower health literacy (P<.015, sickle cell hemoglobinopathy group only). Increased parental perceptions of child vulnerability seem to be a bona fide complication of incidental newborn blood screening findings, and healthcare professionals should be alert to the possibility. From a public health perspective, we recommend routine follow-up after incidental findings to mitigate psychosocial harm.

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.

Maternal and Paternal Perception of Child Vulnerability and Behaviour Problems in Very Preterm Born Children

Preterm born children have more behaviour problems than term born children. Perinatal risks, current child functioning, sociodemographic characteristics, parental psychological distress and parental perceptions of child vulnerability (PCV) have been shown to be risk factors for behaviour problems. However, the role of maternal and paternal PCV is unclear, as these have not been investigated as a risk factor for behaviour problems, with all other risk factors taken into account. Aim of this study is to investigate whether maternal and paternal PCV are independent risk factors for behaviour problems in very preterm (VP) and term born children. The present study is a single centre prospective cohort study. Preterm children (n = 104), born at <30 weeks' gestation and/or birth weight <1000 g, and term children (n = 95) were assessed at age 5. Results showed that risk factors for parent-rated behaviour problems were low/middle parental education, VP birth, parental stress and, in VP children, maternal PCV. Risk factors for teacher-rated behaviour problems were low/middle parental education, foreign parental country of birth, intrauterine growth restriction and objective child vulnerabilities. It can be concluded that maternal PCV is a risk factor for parent-rated behaviour problems in VP children. When VP children are presented with behavioural problems, clinicians ought to be aware of the possibility that parents might still perceive their child as vulnerable. The neonatal history of the child, the way parents experienced that period, their perceptions of the child and possible consequences of these perceptions could be subjects for conversation during visits at follow-up clinics. Copyright © 2015 John Wiley & Sons, Ltd.

Parental perceptions of child vulnerability in a community-based sample: Association with chronic illness and health-related quality of life.

The study aimed to assess the prevalence of parental perceptions of a child's vulnerability (PPCV) in a Dutch community-based sample and its relationship with children's health and health-related quality of life (HRQoL). Parents completed the Child Vulnerability Scale and a socio-demographic questionnaire. The Pediatric Quality of Life Inventory 4.0 was administered to measure HRQoL. The prevalence of PPCV was assessed in relation to socio-demographic and health-related characteristics. In a three-step multiple hierarchical regression model, the mediational role of PPCV in the association between chronic illness and HRQoL was investigated. Participants were 520 Dutch children aged 5-18 years from nine Dutch schools. In all, 69 (13.3%) had a chronic illness; 1.9% was perceived vulnerable, 3.0% in groups 5-7 and 1.7% in groups 8-12 and 13-18. Younger age of the child, presence of a chronic illness and low HRQoL were associated with PPCV. PPCV partially mediated the negative association between chronic illness and HRQoL. In conclusion, PPCV is associated with adjustment to chronic illness. More research is needed regarding the mechanisms through which PPCV affects HRQoL and to examine whether PPCV can be targeted in parenting interventions.

Health related quality of life and perceptions of child vulnerability among parents of children with a history of Kawasaki disease

Kawasaki disease (KD) is an acute paediatric vasculitis. The psychosocial consequences of this sudden illness for parents are unknown. This study aimed to evaluate health related quality of life (HRQOL) and parental perceptions of child vulnerability (PPCV) in parents of children with KD, and to identify variables associated with PPCV. This cross-sectional study included 288 parents (83% mothers) of KD patients (mean age 8.7years). HRQOL was assessed using the TNO-AZL Questionnaire for Adult's HRQOL (TAAQOL) and PPCV using the Child Vulnerability Scale (CVS). Scores of KD parents were compared with reference groups of Dutch parents. Logistic regression analyses were performed to examine associated variables. The HRQOL of KD parents was comparable to the HRQOL of parents of healthy children. However, KD parents showed significantly higher PPCV, regarding both the median CVS total score and the percentage in the clinical range. No differences were found in CVS outcomes between KD parents and parents of a chronically ill child. None of the studied parental, child and disease characteristics were significantly associated with PPCV. Parents perceived their KD child more vulnerable to illness than healthy children, while in reality the majority had fully recovered from KD.

Parental perceptions of child vulnerability in parents of children with Kawasaki Disease

Abstracts ingediend voor het Amsterdam Kindersymposium 2013 Parental perceptions of child vulnerability in parents of children with Kawasaki Disease Hedy A. van Oers MSc (1), Carline E. Tacke MD (2), Lotte Haverman MSc (1), Heleen Maurice-Stam PhD (1), Taco W. Kuijpers MD PhD (2), Martha A. Grootenhuis PhD (1) (1) Psychosocial Department, Emma Children’s Hospital, AMC.(2) Department of Pediatric Hematology, Immunology and Rheumatology, Emma Children’s Hospital, AMC. INTRODUCTION Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology that predominant-ly aff ects children <5 years. 25% of untreated patients develops coronary artery aneurysms (CAA). Studies evaluating the long-term impact of the acute KD episode are scarce. The aim of this abstract is to evaluate parental perceptions of child vulnerability (PPCV) in parents of children with a history of KD. METHODS A cross-sectional study was conducted in parents (82% mothers) of 288 KD patients (mean 8.6 years). PPCV was assessed using the Child Vulnerability Scale (CVS). PPCV scores of KD parents were compared to parents of healthy and chronically ill children (Chi2). PPCV scores of parents of KD patients with and without CAA were compared (Chi2) and the correlation between PPCV and time since KD onset was calculated (Spearman’s rho).

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.

Parental Perceptions of Child Vulnerability and Parent Stress as Predictors of Pain and Adjustment in Children With Chronic Arthritis

Parental predictors of child psychological adjustment and pain were investigated in 51 children with arthritis. Children rated depressive symptoms, anxiety, and pain. Disease severity was determined by a physician provided active joint count, as well as a physician's global assessment. Parents rated their own depressive symptoms, stress, and perceptions of child vulnerability. Regression analyses indicated that higher parental perceptions of child vulnerability predicted increased child depressive symptoms and anxiety. Parent stress predicted both child anxiety and pain. Thus, the important role parent variables play in child health outcomes was reinforced, thereby strengthening the indication to assess parent functioning when performing clinical evaluations of adjustment to juvenile arthritis.

Brief report: Parental perceptions of child vulnerability in children with chronic illness.

To determine the extent to which parental perceptions of child vulnerability predict school and social adjustment in children with chronic illness. Sixty-nine child-parent dyads were recruited from pediatric rheumatology and pulmonary clinics. Parents completed a self-report measure of parental perceptions of child vulnerability. Children completed measures of social adjustment. Parents also provided written permission to obtain school attendance records. Physicians provided a global assessment of children's disease severity. Increased parental perceptions of child vulnerability were related to increased social anxiety in children, even after controlling for child age and disease severity. Lower levels of parental education related to both increased perceptions of child vulnerability and increased school absences. Health providers should assess parental beliefs and parenting practices in assessing the adjustment of children with chronic illness. Moreover, interventions aimed at enhancing child adjustment to chronic illness might best target parents as well as children.

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.

The child vulnerability scale: an instrument to measure parental perceptions of child vulnerability.

Developed and validated an instrument for identifying children perceived as vulnerable. Mothers of 1,095 children, aged 4-8 years, completed interviews that included the original 12-item Child Vulnerability Scale. Eight items that correlated best with each of two major variables that contribute to vulnerability were retained in the revised scale and a cutoff score was identified for children perceived as vulnerable. The internal consistency of the revised scale was good. Using the revised scale, 10.1% of children were identified as perceived vulnerable. Children categorized as perceived vulnerable had a significant increase in behavior problems and acute medical visits. The revised Child Vulnerability Scale should be useful in providing a better understanding of the causes and effects of an important factor in child development.