Positive Parenting Practices Research Articles

25. KEYSTONES OF DEVELOPMENT ONLINE RESIDENCY CURRICULUM: WEAVING ATTACHMENT, AUTONOMY, AND EXECUTIVE FUNCTION INTO WELL-CHILD VISITS, BIRTH TO 5.

Background Research has identified specific parenting behaviors that promote children's cognitive, social and emotional health. Per the AAP, pediatricians should counsel on these behaviors, but they may not do so without formal training during residency. An e-learning curriculum allows dissemination to multiple programs with little demand on faculty while providing a flexible learning experience for residents. Objectives To assess the likability and efficacy of an online resident curriculum focused on improving residents’ ability to promote positive parenting behaviors that foster optimal child development in their primary care practice. Methods/Design In this pilot study, pediatric residents at 5 institutions completed the Keystones of Development, an online 13-module curriculum, in their behavior and development rotation. We used a pre-posttest study design to assess intervention effect of self-reported behavioral outcomes (discussing, modeling, and praising positive parenting practices) and predictors of behavior with paired t-tests. Likability and use were assessed at posttest using a 5-point Likert scale. Results 24 pediatric residents (mean age=28.4yrs;79% female) participated. Within one-month post-intervention, there was a large statistically significant increase in the counseling behaviors that promote positive parenting, specifically, discussing (p Conclusion The Keystones of Development online curriculum was well received by pediatric residents and resulted in increased promotion of positive parenting practices during well-child visits. This study yields promising results that suggest benefits to the field through wider dissemination and use.

Early childhood developmental delay in Consuelo, Dominican Republic: A study of parental beliefs and early educational practices

Background: Early childhood development (ECD) is a strong predictor of school readiness and academic achievement, which in turn predict health and economic productivity. Delays in ECD can cause lifelong negative effects on health and economic productivity. Positive parenting practices, including reading with young children, are associated with improved attachment and developmental outcomes. Studies have demonstrated that parental beliefs about reading predict the extent to which parents read with their children, and that children from low socio-economic status families generally receive less verbal engagement and access to reading. CHOP …

Randomized cluster trial of a parenting program in Chile: Key mediators in the decrease in behavior problems in preschool children.

Parenting training is a proven strategy for the promotion of positive parenting practices and for the prevention and treatment of behavior problems in children. The processes that explain this efficacy are less clear. The aim of this study was to assess the mediating role of parenting practice modification, encouraged through the implementation of a universal parenting training program, for the decrease of behavior problems in 3- to 6-year-old children. A cluster randomized trial was carried out in 19 educational centers in low and middle socioeconomic areas. A total of 178 families received the program and 154 of them were the control group. The following parenting practices were assessed: positive reinforcement, involvement, inconsistency, unsuitable treatment behaviors and physical punishment, as well as hostility and humiliation behaviors. Parent-child interaction was also assessed using an observational instrument. A multiple mediation analysis was carried out, identifying the indirect effects. Reduction of harsh discipline and physical punishment, and parental inconsistency mediated the effects observed in the reduction of child behavior problems during the program. Within Chilean families, harsh discipline, physical punishment, and parental inconsistency are important aspects to be considered in the implementation of universal parenting training programs.

P88 The Development of a Nutrition Education Mobile Application (Mhealth) for Latino Families: The Padres Preparados, Jóvenes Saludables Experience

Objective Childhood obesity rates remain high specially for ethnic communities. The Padres Preparados, Jovenes Saludables (Prepared Parents, Healthy Youth— Padres for short) is a family-based intervention that aims to increase father involvement in positive parenting practices to address youth energy balance-related behaviors (EBRBs) (i.e. sugar sweetened beverage, fruit and vegetable, and breakfast consumption; physical activity and sedentary behavior). Participants are Latino immigrant fathers with an adolescent youth (10 to 14 years old). The in-person format however can limit the participation of some fathers. Use of Theory or Research This proposal describes the development of a mHealth Application (APP) to implement a blended (in-person and APP) delivery to address some barriers for participation by enabling fathers to access three sessions remotely. Padres is based on social cognitive theory, modeling reasoning and teaching, home availability and accessibility, and social support. Additionally, we followed principles of design thinking during the development of the APP. Target Audience Latino immigrant families (especially fathers) with adolescent children (10-14 years old). Program Description Padres is a culturally grounded, family-skills program for Latino immigrant families. The original in-person intervention includes eight sessions (2.5 hours each) focusing on improving diet and physical activity levels for children by strengthening parenting practices. The APP includes the content of three out of the eight original sessions: adolescent development, rules and expectations, and monitoring and supervision. Each of the three sessions follows an active learning steps including instructional videos, reflection, skills building and text follow-ups. Evaluation Methods A pilot study of the blended approach is underway and will be concluded in mid-March with intervention assessments and incudes a comparison among in-person and blended format delivery on parenting practices and both youth physical activity and dietary habits. Conclusions There are few mHealth programs designed for Latino families. This blended approach is an innovative way to flexibility for program participation among Latino families. Funding USDA.

Confirmation of the five-factor structure of the Parent Global Report version of the Alabama Parenting Questionnaire in a Polish community sample

AbstractSince parenting practices have been shown to play an important role in the development of a child’s emotional, cognitive and social functioning, it is important to reliably measure this construct across various cultures and countries. A widely used instrument to assess parenting practices is the Alabama Parenting Questionnaire (APQ). However, no previous studies have verified the five-factor structure of this measure using confirmatory factor analysis. The aim of this study was to verify factor structure and examine psychometric properties of the Parent Global Report version of the APQ in a Polish sample. A total of 911 mothers and 497 fathers of children in the age range of 6–13 years from the community sample completed the Alabama Parenting Questionnaire as well as the Rating Scales for Parents assessing symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional-defiant disorder (ODD). Confirmatory factor analysis indicated that the five-factor model is characterized by a good fit in the Polish sample of mothers and quite a good fit in the sample of fathers. The Polish version of the APQ has a good construct validity. Children’s ODD symptoms were positively correlated with negative parenting practices and negatively with positive parenting practices. Children’s ADHD symptoms were the most strongly correlated with the inconsistent discipline subscale. Relations between ADHD and ODD symptoms and positive parenting practices were lower than with negative parenting practices. Our study confirms the five-factor structure of the Polish version of the APQ for parents and shows that parenting practices can be reliably measured in a Polish sample with the use of the Parent Global Report version of the APQ.

Práticas parentais positivas e programas de treinamento parental: uma revisão sistemática da literatura

O objetivo do presente estudo foi caracterizar programas de treinamento de maes e pais, utilizados para a promocao de praticas parentais positivas na primeira infância, especificamente aquelas destinadas a pais de criancas de zero a sete anos de idade, com desenvolvimento tipico. Para fins deste trabalho, desenvolvimento tipico e compreendido como o padrao geral de desenvolvimento da crianca, de acordo com parâmetros esperados para sua faixa etaria, incluindo relacionamento, comportamento e aprendizagem escolar. Foi realizada uma revisao sistematica da literatura nacional e internacional, com base em artigos empiricos publicados nas bases de dados Web of Science, PsycINFO e BVS, de 2012 a 2017. As bases foram acessadas via Periodicos CAPES?MEC. Utilizaram-se dois descritores indexados em portugues e ingles: parentalidade (parenting) e treinamento de pais (parent training). Foram localizados ao todo 300 artigos, os quais foram importados para o gerenciador de referencias Zotero. Excluiram-se 28 trabalhos que estavam duplicados. Na sequencia, procedeu-se a leitura dos titulos e resumos que continham os descritores mencionados e chegou-se a 27 trabalhos. Apos leitura e analise do material, oito artigos quantitativos foram considerados. Os resultados apontaram para a ampliacao de programas de treinamento para pais em âmbito internacional, abordando a participacao macica feminina nos mesmos. Fatores como melhor?maior condicao socioeconomica, escolaridade, idade dos pais?maes indicaram para maior adesao e permanencia nos programas de treinamento. Palavras-chave: parentalidade; treinamento de pais; praticas parentais positivas.

Preventive intervention for strengthening effective parenting practices: A randomized controlled trial

The present study evaluated the efficacy of the ACT Raising Safe Kids Parenting Program for improving parenting practices and reducing child behavior problems. Mothers of children aged 3 to 8 years were randomly allocated into the intervention (IG, n = 40) or wait list control (CG, n = 41) groups, and 67 caregivers were second informants on the children's behavior. Results showed that, after participation in the ACT program, the IG mothers reported improvements in their parenting practices, and the mothers and the other caregivers reported less child behavior problems. These positive improvements were maintained at the 3–4 month follow-up. During the waiting period the CG did not report changes in parents and child outcomes, however, after participating in the intervention, they also reported improvements in both outcomes. In conclusion, the ACT Program showed efficacy for improving the mothers' positive parenting practices and reducing the children's behavior problems.

Group PCIT for Preschoolers with Autism Spectrum Disorder and Externalizing Behavior Problems

The purpose of the current study was to evaluate the feasibility and initial efficacy of a large-group, time-limited Parent Child Interaction Therapy (PCIT) adaptation for parents of children with autism spectrum disorder (ASD) and externalizing behavior problems (EBP). Participants included parents of 37 preschoolers (Mage = 4.80, 87% Male, 73% Hispanic/Latino) with ASD and comorbid EBP. Parents reported on their positive and negative parenting practices and parenting stress at a pre-and-post treatment assessment as well as at a 6-month follow-up assessment. Positive and negative parenting skills were observed and coded during a parent-child interaction. Additionally, parents were objectively assessed on their knowledge of principles learned in treatment at pre-and-post-treatment. The treatment was delivered with a high level of fidelity and was well received and attended by families. At post-treatment, parents reported improved parenting stress and parenting practices. Parents were also rated as engaging in more positive parenting skills and less negative parenting skills during play. Lastly, parents increased their knowledge of principles presented in treatment. Improvements in positive parenting practices were also maintained at a 6-month follow-up assessment. Findings highlight the initial efficacy and transdiagnostic nature of group PCIT for improving outcomes for children with ASD and comorbid EBP.

Positive Parenting Matters in the Face of Early Adversity

A negative relationship between adverse childhood experiences and both physical and mental health in adulthood is well established, as is the positive impact of parenting on child development and future health. However, few studies have investigated unique influences of adverse childhood experiences and positive parenting together within a large, diverse early childhood sample. The study used data on all children aged 0-5 years (n=29,997) from the National Survey of Children's Health 2011/2012 to examine effects of positive parenting practices and adverse childhood experiences on early childhood social-emotional skills and general development. All analyses were performed in 2017 and 2018. More than a third of the sample reported experiencing at least one adverse childhood experience. More than a fourth (26.7%) met study criteria for social-emotional deficits, and 26.2% met criteria for developmental delay risks. The number of adverse childhood experiences exhibited negative marginal associations with social-emotional deficits and developmental delay risks, whereas the number of positive parenting practices showed independent protective effects. Risks associated with an absence of positive parenting were often greater than those of four or more adverse childhood experiences, even among no/low adversity families. The population attributable fractions for social-emotional deficits and developmental delay risks were 17.3% and 13.9% (translating to prevalence reductions of 4.5% and 3.6%) when adopting all positive parenting practices and 4.5% and 7.2% (prevalence reductions of 1.2% and 1.9%) when eliminating adverse childhood experiences. The number of adverse childhood experiences was associated with both social-emotional deficits and developmental delay risks in early childhood; however, positive parenting practices demonstrated robust protective effects independent of the number of adverse childhood experiences. This evidence further supports promotion of positive parenting practices at home, especially for children exposed to high levels of adversity.

Parent Mindfulness, Parenting, and Child Psychopathology in China

ObjectivesConsidering the Western-Eastern cultural differences in parenting practices, as well as the relative paucity of research on the use of mindfulness-based programs by Chinese parents, we replicated a recently proposed Western model of mindfulness. The purpose of this study was to test the direct and indirect relations between parents’ dispositional mindfulness, mindful parenting, parenting practices, and child internalizing and externalizing behaviors.MethodA total of 2237 Chinses parents (M = 38.46, SD = 4.43) of 6- to 12-year-old children participated in the current study.ResultsThe results showed that parents’ dispositional mindfulness was indirectly associated with child internalizing and externalizing behaviors through mindful parenting and positive parenting practices, whereas this pathway was not significant through negative parenting practices. In addition, mothers and fathers demonstrated almost equal effects on direct and indirect pathways except that mothers showed stronger effects on the relationships between dispositional mindfulness and mindful parenting, as well as on the link between negative parenting practices and child externalizing behaviors.ConclusionsThese findings contribute to a better understanding of the mechanisms underlying how mindfulness and parenting associated with child internalizing and externalizing behaviors, and have important implications for research on interventions aimed at promoting children’s psychological well-being.

When Behavioral Barriers are Too High or Low: How Timing Matters for Parenting Interventions

The time children spend with their parents affects their development. Parenting programs can help parents use that time more effectively. Text-messaged-based parenting curricula have proven an effective means of supporting positive parenting practices by providing easy and fun activities that reduce informational and behavioral barriers. These programs may be more effective if delivered during times when parents are particularly in need of support, such as after work, or, alternatively when parents have more time to interact with their child, such as on a day off of work. This study compares the effects of an early childhood text-messaging program sent during the weekend to the same program sent on weekdays. We find that sending the text messages on the weekend is, on average, more beneficial to children's literacy and math development. This effect is particularly strong for initially lower achieving children, while the weekday texts show some benefits for higher achieving children on higher order skills. These results are consistent with the hypothesis that the parents of lower achieving students, on average, face such high barriers during weekdays that supports are not enough to overcome these barriers, while for parents of higher achieving students, weekday texts are more effective because weekdays are more challenging, but not so difficult as to be untenable for positive parenting. In sum, the findings suggest that parenting support works best when parents have time, attention, and need.

Parental Self-Efficacy on Temper Tantrum Frequency in Children

Although typical in children between the ages of 18 months and 4 years, temper tantrums can be predictive of maladaptive outcomes, particularly if they continue into later ages. Parental self-efficacy (PSE) has emerged as a powerful mediator of children temperament and a predictor of specific positive parenting practices. This study aimed to determine the correlation between PSE and temper tantrum frequency in children aged 2-5 years. This study was a correlational research. Ninety-six parents of children aged 2-5 years participated in this study. The Self-efficacy for Parenting Task Index-Toddler Scale and Multidimensional Assessment of Preschool Behaviour Problem were used to assess the study variables. The data was analysed using Spearman�s rank correlation test. The statistical test results showed a significant correlation between parental self-efficacy and temper tantrum frequency (p-value = 0.000; r = -0.669). The majority of respondents had a moderate level of PSE, and most of the children had low temper tantrum frequency that was mostly expressed with screaming, stamping feet and holding breath. It can be concluded that there was a correlation between PSE and temper tantrum frequency in children aged 2-5 years in a negative direction, which means the higher the PSE, the lower the temper tantrum frequency. © 2019, Indian Journal of Public Health Research and Development. All rights reserved.

Supporting positive parenting practices within a community-based music therapy group program: Pilot study findings.

The aim of this study was to evaluate the benefits of a short-term, community-based music therapy group program on positive parenting practices. Parent-child dyads receiving early intervention family services (N=199) participated in 8 weekly, 45-60 minute, music-based group play sessions. We analyzed pre-post parent self-reports that measured parenting competency and clinician-observed ratings of parental responsiveness that evaluated behavioral domains of play, praise, and consistency. Significant results were found for parent-reported efficacy (p = 0.008, d = 0.21) and satisfaction (p=0.004, d=0.19) but not for interest (p=0.149, d=0.12). Significant results were found for clinician-rated observations of parental responsiveness, including play (p<0.001), praise (p<0.001), and consistency (p<0.001). Short-term, music-based parenting programs may be an effective way to improve parents' sense of competency and foster greater parental responsiveness for those receiving family services.

Group-based parenting program to improve parenting and children's behavioral problems in families using special services: A randomized controlled trial in a real-life setting

This randomized controlled trial (RCT) evaluated the effectiveness of the Incredible Years® (IY) Parenting Program in modifying children's behavioral problems, parenting practices and parents' psychological well-being among families under child protection and using other special support services. Participants in the study were 3–7-year-old children with behavioral problems (n = 102, intervention group n = 50, control group n = 52) and their parents (n = 122). The results show that parent reported child problem behavior as well as clinical levels of behavioral problems decreased to a greater extent in the intervention group than in the control group. The intervention also increased positive parenting practices. Changes in parental stress or parents' psychological well-being in the intervention did not differ from those in the control group over time. The results suggest some promising evidence that the IY parenting intervention may be effective in the context of child protection and other family support services in real-life conditions.

Effect of Caregiver's Mental Health on Early Childhood Development across Different Rural Communities in China.

Previous research has found that there are high rates of developmental delays among infants and toddlers in rural areas of China. Caregiver mental health problems might be one significant predictor of developmental delays among infants and toddlers, as has been found in other areas of the world. One way that the mental health of caregivers could affect early childhood development is through its effect on parenting practices. In this study, we used data from four major subpopulations of rural China to measure the correlation of caregiver mental health problems with the developmental outcomes of infants and toddlers. To do so, the study used the Bayley Scales of Infant Development III (BSID III) to examine the rates of developmental delays among 2514 rural infants/toddlers aged 6–30 months old. The results of the testing demonstrate that 48% of the sample’s infants/toddlers have cognitive delays; 52% have language delays; 53% have social-emotional delays; and 30% have motor delays. The data collection team also assessed caregiver mental health by using the Depression Anxiety Stress Scales (DASS-21) questionnaire. According to the findings, 39% of caregivers in the sample have symptoms of at least one kind of mental health problem (depression, anxiety, or stress). We also found that most caregivers do not engage in positive parenting practices, while a significant share of caregivers engage in negative parenting practices. The statistical analysis found that showing signs of mental health problems is significantly and negatively associated with infant/toddler developmental outcomes. The study also found that caregivers who show signs of mental health problems are significantly less likely to engage in interactive parenting practices. The study confirms that society needs to pay more attention to caregiver mental health problems in order to improve infant/toddler developmental outcomes in rural China and increase human capital accumulation in China as a whole.

Breaking the mold: Socio-ecologic factors to influence the development of non-harsh parenting strategies to reduce risk for child physical abuse

Corporal punishment (CP) continues to be a common form of discipline in the U.S despite indications of its long-term harm to children, including strong risk for child physical abuse. Parents that are exposed to CP or physical abuse in childhood are at heightened risk for using CP with their own children. In examining parenting practices relevant to preventing child physical abuse, Positive Deviance relates to those parents who choose effective, positive parenting strategies to discipline their children, despite being exposed to CP and physical abuse in childhood. Little is known about buffering or motivating factors that prevent parents from using CP, or how these factors are influenced by parental childhood history or CP social norms. Therefore, this study examines the motives for use of positive parenting practices, including non-use of CP, for mothers who were exposed to CP and physical abuse in childhood (Positive Deviance). Qualitative interviews were conducted with seventeen mothers with a history of childhood CP and physical abuse. Results indicate that participating mothers believe CP is not an effective discipline strategy and is harmful for children. Mothers opted to use positive parenting practices, rather than CP, with their own children based on empathy, knowledge of harm, as well as rejection of intergenerational transmission of CP and community norms. Findings provide evidence that a Positive Deviance approach can inform target areas for primary prevention strategies aimed at reducing child physical abuse. Directions for multi-level public health prevention approaches and educational campaigns are discussed.

Bridging the Divide Between Psychodynamic and Behavioral Approaches for Children with Oppositional Defiant Disorder

ABSTRACTOppositional defiant disorder (ODD) is one of the primary reasons youth are referred to mental health services. Disruptive behavior disorders such as ODD are heterogeneous in their presentation, developmental trajectories, and treatment needs. Given the high attrition rates in child psychotherapy in general, there is a need for a range of interventions tailored to meet the unique needs of each family to help increase familial engagement and positive outcomes for children with ODD.This article outlines composite clinical case material of a child with ODD who was treated with Regulation Focused Psychotherapy for Children (RFP-C), a manualized, psychodynamic intervention for ODD. The case presented is then reconceptualized from a behavioral parent training perspective. This approach uses parent training to encourage positive parenting practices and reduce coercive reinforcement cycles. The case material and its reconceptualization are followed by a discussion of the distinctions between psychodynamic and behavioral approaches to children with ODD. An integrated psychotherapy approach is proposed, and the benefits and challenges of psychotherapy integration are discussed.

Effectiveness of a Positive Parental Practices Training Program for Chilean Preschoolers' Families: A Randomized Controlled Trial.

Background: Evidence for the effectiveness of parental training as a strategy for promotion of positive parental practices and prevention of child behavior problems in low and middle income countries is not conclusive. This study aims to assess the effectiveness of a universal positive parental training program designed for this context, “Día a Día” UdeC © (“Day by Day” University of Concepción), in Chilean preschoolers’ families (3–6 years old children).Methods: A cluster randomized controlled trial (cRCT) was carried out in 19 preschool education centers. There were two treatment arms: 10 centers (including 178 families) were randomly assigned to the intervention group and nine centers (including 154 families) were assigned to the waiting list control condition. Intervention groups received Day by Day UdeC, a six group sessions program for parents, including two group sessions for preschool educators, focused in affective communication; daily and child-directed play; directed attention; routines and transitions; reinforcement and incentive programs; planned inattention-ignore and time out; and logical consequences. Parental practices, parental satisfaction, and presence of children behavioral problems were examined at two-time points: T1 (4 weeks before intervention) and T2 (5–6 weeks after intervention).Results: Intention-to-treat analysis shows a reduction in physical punishment and an increase in parental involvement, as well as a reduction in children behavioral problems. A per-protocol analysis revealed an additional effect: increase in observed parental practices.Conclusion: This cRCT provided evidence for the effectiveness of a parental training program for the promotion of positive parental practices in low and middle income countries. The observed effects of the program in decreasing physical punishment and children’s behavioral problems make it a promising strategy for prevention purposes.Trial Registration: This study was registered under ISRCTN.com (ISRCTN90762146; https://doi.org/10.1186/ISRCTN90762146).

Adverse Childhood Experiences and Their Relation to Parenting Stress and Parenting Practices

The objective of this study was to understand the relationship between the early adverse childhood experiences (ACEs) of parents and their later parenting stress and practices. At the baseline visit of an 8-week course of cognitive behavioral therapy, parenting women completed the Parenting Stress Index-Short Form (PSI-SF) and the Positive Parenting Practices (PPP) scale. Linear regression procedures were used to assess the relationship between a parent’s own early experience of ACEs and current parenting stress and practices, including if there was a dose–response relationship. For the PSI-SF, significant dose–response relationships were observed between ACEs and the PSI Total Stress score (p < 0.05) and the difficult child subscale (p < 0.05). Additionally, a relationship was suggested with the parental distress subscale (p < 0.10). No significant relationships were found between ACEs and the parent–child dysfunctional interaction subscale of the PSI-SF or the PPP scale. Given the association observed between ACEs and parenting stress, it is important that future psychosocial interventions and policy initiatives preventing ACEs are developed.

A qualitative study to explore paraprofessionals' role in school-based prevention and early intervention mental health services.

This study explored the role of paraprofessionals within a school-based prevention and early intervention program to promote children's engagement in learning and positive parenting practices. Study aims were designed to understand how paraprofessionals perceive their role in high-need communities and how they define their work within schools. Two focus groups were conducted with school family liaisons (SFLs) during the 2015-2016 school year. Transcribed audio recordings were coded using thematic analysis wherein 2 authors coded independently, followed by audited discussion and final consensus codes. SFLs acknowledged the importance of serving high-need communities and relationship building was central to their role. They leveraged contextual knowledge (culture, language, and neighborhood) to engage parents, allowing them to serve as effective advocates for parents/families in the school setting. Findings support the importance of paraprofessionals in prevention-focused services and highlight how leveraging shared experiences and prioritizing relationship building facilitates their work as advocates within schools.