Positive Parent-child Interactions Research Articles

Supporting children with fetal alcohol spectrum disorder: Potential applications of a Snoezelen multisensory room

ABSTRACTHow are mental health practitioners using Snoezelen rooms with children with fetal alcohol spectrum disorder (FASD) within a community mental health setting? Using purposive sampling, we collected information from seven practitioners on how they currently use Snoezelen rooms to support children with FASD and what evidence they believe is needed to assess Snoezelen’s treatment efficacy. Using grounded theory methodology, results indicated that priority research areas include the efficacy of Snoezelen for increasing self-regulation skills, positive parent–child interactions, and parent education. To support evidence-driven use of Snoezelen rooms for mental health treatment, we recommend that future research be focused in these areas.

P205 - Understanding Parenting Practices and Values Related to Physical Activity with Preschoolers: A Qualitative Study to Inform Intervention Design

Background (Background, Rationale, Prior Research, and/or Theory): Parents create the social and physical environment that allows preschoolers to participate in physical activity (PA) and learn gross motor skills (GMS). Understanding parenting practices and values related to PA is important for designing effective interventions. Objective: To understand the beliefs, values and practices of low-income parents related to their preschoolers' PA and GMS to inform development of a nutrition and PA intervention. Study Design, Setting, Participants, Intervention: Participants were recruited from five Head Start/preschool centers in rural Colorado. Semi-structured, in-person interviews were conducted to explore parents' experiences with PA and GMS, their preschoolers' current PA and GMS, and parents' engagement with GMS. Outcome Measures and Analysis: Interviews were audio-recorded, transcribed verbatim, and coded and analyzed using an iterative approach. Results: Participants (n = 31) were 80% female and 37% Hispanic. Parents predominately viewed PA as a way to spend time with family and model an active lifestyle. PA was promoted for both child-centric (physical health, development) and parent-centric (behavior management) reasons. Parents enjoyed playing with their preschooler and appreciated their child's creativity and imagination. GMS were valued as a way to build confidence, enhance coordination, and enable social interactions. Parents reported being confident in their ability to teach their preschoolers basic skills. Many believed that GMS are “naturally learned” and were ambivalent towards the need to deliberately teach their preschooler GMS. Common practices included creating a physical and social environment conducive to their preschooler participating in PA and encouraging their child's attempts at learning GMS. Conclusions and Implications: Parents valued their preschoolers' participation in PA and development of GMS as part of a healthy lifestyle and as a way to bond with family. Intervention strategies should promote positive parent-child interaction during PA and educate parents on the need to teach and practice GMS with preschoolers, thus building physical literacy in children. Funding: NIFA.

The efficacy of VIPP-V parenting training for parents of young children with a visual or visual-and-intellectual disability: a randomized controlled trial

ABSTRACTVideo-feedback Intervention to promote positive parenting-visual (VIPP-V) or visual-and-intellectual disability is an attachment-based intervention aimed at enhancing sensitive parenting and promoting positive parent–child relationships. A randomized controlled trial was conducted to assess the efficacy of VIPP-V for parents of children aged 1–5 with visual or visual-and-intellectual disabilities. A total of 37 dyads received only care-as-usual (CAU) and 40 received VIPP-V besides CAU. The parents receiving VIPP-V did not show increased parental sensitivity or parent–child interaction quality, however, their parenting self-efficacy increased. Moreover, the increase in parental self-efficacy predicted the increase in parent–child interaction. In conclusion, VIPP-V does not appear to directly improve the quality of contact between parent and child, but does contribute to the self-efficacy of parents to support and to comfort their child. Moreover, as parents experience their parenting as more positive, this may eventually lead to higher sensitive responsiveness and more positive parent–child interactions.

Pathways linking war and displacement to parenting and child adjustment: A qualitative study with Syrian refugees in Lebanon

Forcibly displaced children are at risk of a range of negative outcomes, yet little is known about how to support war-affected caregivers in promoting children's psychosocial resilience. The current study uses qualitative methods to examine the mechanisms underlying the effects of war and displacement on parenting and child adjustment in order to inform intervention development. In April and November 2016, group and individual interviews were conducted with 39 Syrian parents and 15 children in partnership with a humanitarian organization in Lebanon. Interviews were transcribed and analyzed using a grounded theory approach. Results show three interrelated pathways linking daily displacement stressors to various dimensions of parenting: (1) economic hardship prevents parents from meeting their children's basic needs and forces adaptation strategies that impair positive parent-child interactions; (2) parental psychological distress contributes to harsh parenting; and (3) perceptions and experiences of insecurity in the community results in increased parental control. Greater economic resources and social support emerged as potential protective factors for maintaining positive parenting despite exposure to war and displacement-related adversity. Our findings suggest that implementation of policies and programs to remove structural barriers to refugees' physical and economic security can have tangible impacts on parental mental health, parenting quality, and child psychosocial outcomes. Future research priorities include a stronger focus on the effects of war and displacement on family processes, taking into account interactions with the broader social, economic and political context.

Could Treating Childhood Insomnia Reduce Psychiatric Disorders?

Could Treating Childhood Insomnia Reduce Psychiatric Disorders?

Parenting practices and children's dental caries experience: A structural equation modelling approach.

To evaluate the direct and mediated associations between parenting practices and dental caries experience in Indian school children. The target population consisted of school children and their parents (N=1539) of Medak district in the state of Telangana, India. Parents completed a questionnaire that consisted of questions related to socioeconomic status (SES), family structure, the number of children, their own oral hygiene behaviour and parenting practices. Parenting practices were assessed using a translated version of the short form of Parent-Child Relationship Questionnaire (PCRQ) which was found to have two factors, power assertion (ie over control and coercion) and positive parenting (warmth and positive parent-child interaction). Children completed a questionnaire on tooth brushing frequency, dental visiting and sugar consumption practices to evaluate their oral hygiene behaviour, and underwent a clinical examination for dental caries by a single examiner. Path analysis was used to explore the influence of parent-child relationship, SES and other family-level variables on dental caries experience of children. Parents' oral hygiene behaviour was positively (β=0.18, P=0.009), and power assertion negatively (β=-0.06, P=0.041) associated with children's oral hygiene behaviours. Families reporting higher SES had children with less dental caries experience (β=-0.10, P=0.028) and better oral hygiene behaviour (β=0.13, P=0.009). Power assertion parenting had an indirect association with dental caries experience (β=0.003, P=0.038). Children had higher dental caries experience when they lived in families with lower SES and used more power assertion parenting practices.

The Observed Experiences of Music Therapy on Parent-Child Interaction for Families with Children with Down Syndrome

The relationship between the quality of parent-child interactions and positive child development is well established in the literature. Nevertheless, parental and familial factors may pose risks to parents’ capacity to participate in quality interactions with their children. Families with a child with a disability in particular are more likely to experience social isolation, and higher levels of parenting stress. Early intervention programmes to promote positive parent-child interaction for these families is well recognised. However, there is a lack of literature about the effectiveness of such programmes for these families. This research study explores music therapy on parent-child interaction, specifically focusing on children with a diagnosis of Down syndrome (DS). This case study involves two in-depth cases of children diagnosed with DS and their primary caregivers. The study documents individual music therapy sessions which took place over a six week period. The case study materials were gathered through the researcher’s direct observations, fieldwork notes, and reflective journal logs. The music therapy block encouraged the primary caregivers to be more responsive during parent-child interactions. Furthermore, the children involved learned to engage and share musical activities with their mothers.

Keeping the Spirits Up: The Effect of Teachers' and Parents' Emotional Support on Children's Working Memory Performance.

Working memory, used to temporarily store and mentally manipulate information, is important for children’s learning. It is therefore valuable to understand which (contextual) factors promote or hinder working memory performance. Recent research shows positive associations between positive parent–child and teacher–student interactions and working memory performance and development. However, no study has yet experimentally investigated how parents and teachers affect working memory performance. Based on attachment theory, the current study investigated the role of parent and teacher emotional support in promoting working memory performance by buffering the negative effect of social stress. Questionnaires and an experimental session were completed by 170 children from grade 1 to 2 (Mage = 7 years 6 months, SD = 7 months). Questionnaires were used to assess children’s perceptions of the teacher–student and parent–child relationship. During an experimental session, working memory was measured with the Corsi task backward (Milner, 1971) in a pre- and post-test design. In-between the tests stress was induced in the children using the Cyberball paradigm (Williams et al., 2000). Emotional support was manipulated (between-subjects) through an audio message (either a weather report, a supportive message of a stranger, a supportive message of a parent, or a supportive message of a teacher). Results of repeated measures ANOVA showed no clear effect of the stress induction. Nevertheless, an effect of parent and teacher support was found and depended on the quality of the parent–child relationship. When children had a positive relationship with their parent, support of parents and teachers had little effect on working memory performance. When children had a negative relationship with their parent, a supportive message of that parent decreased working memory performance, while a supportive message from the teacher increased performance. In sum, the current study suggests that parents and teachers can support working memory performance by being supportive for the child. Teacher support is most effective when the child has a negative relationship with the parent. These insights can give direction to specific measures aimed at preventing and resolving working memory problems and related issues.

Child and Parenting Outcomes After 1Year of Educare.

Educare is a birth to age 5 early education program designed to reduce the achievement gap between children from low-income families and their more economically advantaged peers through high-quality center-based programming and strong school-family partnerships. This study randomly assigned 239 children (<19months) from low-income families to Educare or a business-as-usual control group. Assessments tracked children 1year after randomization. Results revealed significant differences favoring treatment group children on auditory and expressive language skills, parent-reported problem behaviors, and positive parent-child interactions. Effect sizes were in the modest to medium range. No effects were evident for observer-rated child behaviors or parent-rated social competence. The overall results add to the evidence that intervening early can set low-income children on more positive developmental courses.

Targeting Parenting in Early Childhood: A Public Health Approach to Improve Outcomes for Children Living in Poverty.

In this article, the authors posit that programs promoting nurturing parent-child relationships influence outcomes of parents and young children living in poverty through two primary mechanisms: (a) strengthening parents' social support and (b) increasing positive parent-child interactions. The authors discuss evidence for these mechanisms as catalysts for change and provide examples from selected parenting programs that support the influence of nurturing relationships on child and parenting outcomes. The article focuses on prevention programs targeted at children and families living in poverty and closes with a discussion of the potential for widespread implementation and scalability for public health impact.

Day-to-day Consistency in Positive Parent-Child Interactions and Youth Well-Being.

The frequency of positive parent-child interactions is associated with youth adjustment. Yet, little is known about daily parent-child interactions and how day-to-day consistency in positive parent-child interactions may be linked to youth well-being. Using a daily diary approach, this study added to this literature to investigate whether and how day-to-day consistency in positive parent-child interactions was linked to youth depressive symptoms, risky behavior, and physical health. Participants were youth whose parents were employed in the IT division of a Fortune 500 company (N = 129, youth's mean age = 13.39, 55 % female), who participated in an 8 day daily diary study. Analyses revealed that, controlling for cross-day mean levels of positive parent-child interactions, older (but not younger) adolescents who experienced more consistency in positive interactions with parents had fewer depressive and physical health symptoms (e.g., colds, flu). The discussion focuses on the utility of daily diary methods for assessing the correlates of consistency in parenting, possible processes underlying these associations, and intervention implications.

A pilot study of parent education intervention improves early childhood development among toddlers with sickle cell disease.

Young children with sickle cell disease (SCD) are at risk for cognitive delay. In addition to biologic risk factors associated with SCD, environmental factors contribute to cognitive dysfunction within this cohort. We completed a single-arm, prospective cohort study. Children with SCD between the ages of 3 and 36 months and their caregivers were followed between October 2010 and December 2013. The aim was to describe the role of a home visitation model, the home environment, and socioeconomic status in the development of young children with SCD. Primary outcome measures were the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) and the Home Observation for Measurement of the Environment (HOME). We hypothesized that the home visitation model, Parents as Teachers® (PAT), would encourage positive parent-child interactions and improve cognitive outcomes. Thirty-five participants had at least two PAT visits and BSID-III assessments. Mean scores within all five subtests of the BSID-III improved between enrollment and exit, with significant changes within cognitive (P = 0.016) and expressive language (EL) domains (P = 0.002). Multivariate modeling found the HOME score associated with the exit results of the cognitive domain. We report longitudinal results of the first home visitation program within the early childhood SCD population and show significant improvement in cognitive and EL development. Additionally, home environment was a significant predictor of cognitive development. Randomized controlled trials to test the impact of interventions targeting the home environment are warranted for this vulnerable population.

In It for the Long Haul: Parent–Teacher Partnerships for Addressing Preschool Children’s Challenging Behaviors

The Getting Ready intervention aims to strengthen parent–teacher partnerships to promote positive child outcomes. This study focused on the team process and social validity of the intervention when young children displayed challenging behaviors. Qualitative analysis yielded seven themes that provided a rich description of the preschool experiences of four children, their parents, and the preschool teachers and Early Intervention (EI) coaches serving them. Parent–professional partnerships, positive parent–child interactions, and team members’ engagement in collaborative problem solving and planning were reported. The social validity of the Getting Ready intervention was confirmed by participants valuing the academic and behavioral goals established for children, the parents’ partnerships with teachers to address chronic behavioral challenges, and reports of the durability of intervention impacts as three children completed kindergarten.

Pengaruh Kelekatan dan Komunikasi dengan Orang Tua terhadap Karakter Remaja Perdesaan

Positive parent-child interaction, that is characterized by positive communication and secured attachment, will affect teenager’s character development. This study aimed to analyze the effect of attachment and communication with parents on teenager’s character development in rural area. A total of 109 teenagers consist of 43 girls and 66 boys were selected using proportional random sampling technique in selected school in study site. Data were collected through self-report techniques by questionnaire. Respondents were asked to fill out questionnaires of the Parent-Adolescent Communication Scale, Adolescent Attachment Questionnaire, and VIA-Youth to measure attachment with parents, communication with parents, and adolescent character. Data were analyzed with descriptive analysis, correlation, and regression. The results showed that the scores of the attachment, communication, and teenager’s characters in rural areas were significantly low. Regression analysis showed that there was no significant effect between teenager’s attachment to parents on all dimensions of adolescent characters. Instead, it was discovered that communication between parent and teenager are positively affected on the dimensions of moral feeling, moral action, and overall characters.

Primary Care-Based Interventions to Promote Positive Parenting Behaviors: A Meta-analysis.

Utilization of primary care settings offers a promising approach to enhance parenting practices that are critical for promoting early childhood development. Determining the impact of existing primary care interventions on key parenting behaviors will aid providers and policy makers as they seek strategies to improve early child outcomes. To evaluate the efficacy of primary care-based interventions on parenting practices that promote early child development among children younger than 36 months. PubMed, Excerpta Medica dataBASE, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature databases were searched electronically. English-language articles that were quasi-randomized or randomized controlled trials, included parents of children <36 months of age, and reported outcomes related to parenting behaviors that promote early child development. Two reviewers independently extracted data regarding participants, interventions, and outcomes. Quantitative meta-analyses were conducted with random effects for study and fitted with restricted maximum likelihood methods. The review included 13 studies reporting parenting outcomes in 2 categories: participation in cognitively stimulating activities and positive parent-child interactions. We found a statistically significant positive effect of primary care-delivered interventions and parent-child interactions (summary standardized mean difference 0.29, 95% confidence interval [CI] 0.06-0.52, P < .0001) and participation in cognitively stimulating activities (summary standardized mean difference 0.34, 95% CI 0.03-0.54; summary odds ratio 0.13, 95% CI 0.01-0.25, P < .0001). Limitations included heterogeneity in measures used, outcomes, and timing of assessments. Primary care-based interventions modestly affect positive parenting behaviors important for early childhood development. Randomized controlled trials with comparable outcome measures using standardized assessments are needed to assess further beneficial impacts.

Day-to-day Consistency in Positive Parent–Child Interactions and Youth Well-Being

Day-to-day Consistency in Positive Parent–Child Interactions and Youth Well-Being

A Pilot Study of Parent Education Intervention Improves Early Childhood Development Among Toddlers with Sickle Cell Disease

Background: Young children with sickle cell disease (SCD) are at high risk of cognitive delay. In a previous study, >50% of the infants and toddlers in our SCD clinic were significantly delayed (scaled scores 7 or below) in cognitive and language skills. These developmental delays were related to the home environment, but not to biologic risk factors associated with SCD. We hypothesized that a parent education program to encourage positive parent-child interactions would improve developmental outcomes.Methods: Children with SCD, ages 1 - 36 months, living in stable housing within 30 miles of the hospital and with caregivers who spoke fluent English were enrolled over a three-year period in a pilot study of a single-arm behavioral intervention. Caregivers consented to participate in an accredited Parents as Teachers (PAT) Born to Learn curriculum, and to complete Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) and the Home Observation for Measurement of the Environment (HOME) assessments. An occupational therapist, certified as a PAT provider, completed all services and assessments. Home visits were scheduled monthly, but participants could cancel or reschedule at their discretion. Participation continued until the child was older than 3.5 years, or the parent chose to exit, or at the end of the three-year pilot period. SCD measures were extracted from medical records upon enrollment in the study. Analyses were conducted using IBM SPSS Statistics (Version 22, Chicago, IL). Continuous data were analyzed using the Wilcoxon signed ranks test for comparisons over time.Results: Thirty-five participants (20 male; 16 HbSS, 15 HbSC, 1 HbS beta thalassemia0, 1 HbS beta thalassemia+, 2 HbS with hereditary persistence of fetal hemoglobin) had at least 2 PAT visits with BSID-III assessments. The mean ages of children was 7.9 + 6 months (range, 1-34 months) and of primary caregivers was 25.2 + 5 years (range, 15-35). At baseline, the children's hematocrit was 28.0 + 3.5% (range, 22-39) and their pulse oximetry was 99 + 1.3% (range, 96-100). The median number of home visits was 12 (range, 2-41) over a median of 18 months (range, 2-32). None of the biological variables significantly correlated with the BSID-III domains, but the HOME scores correlated with cognition (r=.410, p=.014). While there was no significant difference in the pre/post HOME scores over time (pre: 29.2, post: 31.3, n=14; p=.161), statistically significant improvements occurred in the cognitive (p=.016) and expressive language domains (p=.002). Table I provides longitudinal BSID-III results.Table 1BSID-III Scores of Toddlers with SCD at Entry and Exit to Parent Education Intervention.% with scaled scores < 7MeanMean change ± SDGross MotorTime 132.68.70.7 + 3.0Exit11.49.5Fine MotorTime 131.78.01.0 + 3.9Exit28.68.8CognitiveTime 151.27.31.4 + 3.4*Exit29.48.8Receptive LanguageTime 144.27.60.9 + 3.9Exit38.28.6Expressive LanguageTime 158.16.91.9 + 3.0*Exit26.58.7*= p < .05.Conclusion: Young children with SCD are at high risk for poor developmental outcomes. This is the first parenting intervention to specifically target parents of young children with SCD, and significant improvements occurred in the children's cognitive and expressive language domains. Further investigation is warranted to test the effect of implementation of this evidence-based intervention in a larger cohort of this vulnerable population. DisclosuresFields:Neurophage: Equity Ownership, Membership on an entity's Board of Directors or advisory committees.

A realist review of family-based interventions for children of substance abusing parents.

BackgroundMillions of children across North America and Europe live in families with alcohol or drug abusing parents. These children are at risk for a number of negative social, emotional and developmental outcomes, including an increased likelihood of developing a substance use disorder later in life. Family-based intervention programs for children with substance abusing parents can yield positive outcomes. This study is a realist review of evaluations of family-based interventions aimed at improving psychosocial outcomes for children of substance abusing parents (COSAPs). The primary objectives were to uncover patterns of contextual factors and mechanisms that generate program outcomes, and advance program theory in this field.MethodsRealist review methodology was chosen as the most appropriate method of systematic review because it is a theory-driven approach that seeks to explore mechanisms underlying program effectiveness (or lack thereof). A systematic and comprehensive search of academic and grey literature uncovered 32 documents spanning 7 different intervention programs. Data was extracted from the included documents using abstraction templates designed to code for contexts, mechanisms and outcomes of each program. Two candidate program theories of family addiction were used to guide data analysis: the family disease model and the family prevention model. Data analysis was undertaken by a research team using an iterative process of comparison and checking with original documents to determine patterns within the data.ResultsPrograms originating in both the family disease model and the family prevention model were uncovered, along with hybrid programs that successfully included components from each candidate program theory. Four demi-regularities were found to account for the effectiveness of programs included in this review: (1) opportunities for positive parent-child interactions, (2) supportive peer-to-peer relationships, (3) the power of knowledge, and (4) engaging hard to reach families using strategies that are responsive to socio-economic needs and matching services to client lived experience.ConclusionsThis review yielded new findings that had not otherwise been explored in COSAP program research and are discussed in order to help expand program theory. Implications for practice and evaluation are further discussed.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-015-0158-4) contains supplementary material, which is available to authorized users.

Neurodevelopmental Profile, Growth, and Psychosocial Environment of Preterm Infants with Difficult Feeding Behavior at Age 2 Years

To examine the association of difficult feeding behaviors in very preterm infants at age 2 years with growth and neurodevelopmental outcomes and family factors and functioning. Eighty children born ≤30 weeks gestation were studied from birth until age 2 years. Feeding difficulties were assessed using the Eating Subscale of the Infant-Toddler Social Emotional Assessment at age 2 years, along with growth measurement and developmental testing. Maternal mental health and family factors were assessed using standardized questionnaires. ANOVA and χ(2) analyses were performed to determine associations between feeding difficulties and growth, neurodevelopmental outcomes, and family characteristics. Twenty-one children (26%) were at risk for feeding difficulties, and an additional 18 (23%) had definite feeding difficulties at age 2 years. Those with feeding difficulties were more likely to be subject to a range of neurodevelopmental problems, including impaired cognition (P = .02), language (P = .04), motor (P = .01), and socioemotional (P < .007) skills. Compared with the parents of children with fewer feeding difficulties, parents of the children with feeding difficulties had higher parenting stress (P = .02) and reported more difficulty managing their child's behavior (P = .002) and more frequent parent-child interaction problems (P = .002). No associations were found between difficult feeding behaviors and growth, maternal mental health, or family factors. Difficult feeding behaviors in children born very preterm appear to be highly comorbid with other developmental and family challenges, including neurodevelopmental impairment and parent-child interaction difficulties. Focusing on improving feeding skills, in conjunction with supporting positive parent-child interactions, may be beneficial for improving outcomes.

Evaluation of a game-based parent education intervention to increase positive parent–child interactions in parents with learning difficulties.

Children of parents with learning difficulties (LD) are at risk for a variety of developmental problems including behavioral and psychiatric disorders. However, there are no empirically supported programs to prevent or reduce these problems in such children. The purpose of this study was to test the