An outreach approach to high risk parents and their infants

This paper describes a special project designed to evaluate services to high risk parents and their infants. Twenty-three families were served by intensive outreach and home-based model of intervention. Sixty-one percent of these parents had significant mental health problems prior to referral. The paper describes the sample, outlines the approach to therapy and gives a specific case example. The data post-treatment is summarized and results detailed.     

The role of risk perception in explaining parental sunscreen use

Objective: This study assessed: (1) whether risk perceptions about skin cancer were related to parent's use of sunscreen on their children; (2) which combination of assessments susceptibility and severity best explain parental sunscreen protection behaviours and (3) whether risk perceptions influence behaviour directly through intentions or through attitudes, subjective norms and self-efficacy. Design: Two longitudinal studies assessed sunscreen protection behaviours of parents for their toddlers (N?=?391) and young children (N?=?436). Main outcome measure: Parent's use of sunscreen on their children. Results: Risk perceptions correlated with future sunscreen protection behaviours of parents but were lower than those of attitude, social influence and self-efficacy. Treating susceptibility and severity as an additive function resulted in the best model fit. Risk perceptions were related with future intention and future sunscreen protection behaviour, but the effects were mediated through attitude, social influence and self-efficacy. Conclusions: Our path analyses suggest treating susceptibility and severity as an additive function. A multiplicative model without main effects - although often used - had the poorest fit. Risk perceptions influence behaviour by influencing attitudinal and self-efficacy beliefs. Addressing risk perceptions in health communication programs is relevant when the purpose is to increase awareness and to influence attitudes and self-efficacy.     

Perceiving children's behavior and reaching limits in a risk environment

The purpose of this study was to investigate the accuracy of parents' perception of children's reaching limits in a risk scenario. A sample of 68 parents of 1- to 4-year-olds were asked to make a prior estimate of their children's behavior and action limits in a task that involved retrieving a toy out of the water. The action modes used for reaching, accuracy of estimates, and error tendency were investigated. Several morphological variables, walking experience, and swimming program experience were analyzed as predictors of maximum and estimated maximum reachability. Most children sat to retrieve the toy out of the water and fell in while attempting to grasp beyond their reaching limit. Nearly 80% of the parents correctly predicted their children's behavior when the toy was unreachable. Parents were cautious in predicting their children's maximum reachability (>50% underestimates). Mothers were more accurate than fathers in estimating their children's reaching limit. The prediction of children's capabilities was based partially on body dimensions and proportions.     

The effects of a community-based literacy program on young children's language and conceptual development

Effects of a community-based literacy program on 1−, 2−, and 3-year-old children's language and conceptual development were assessed. University students were trained to teach Head Start parents effective methods for reading to their children. Families were randomly assigned to receive 18, 3, or 0 instructional visits. Results indicated that parents in the 18-instructional-visit program increased their participation in appropriate literacy behaviors such as reading to their children, teaching concepts to their children, and using the library, more than parents in the 0-instructional-visit groups. Children in the 18-instructional-visit program showed greater gains in language and conceptual development than children in the 0-instructional-visit group. Few differences were found between children in the 3-visti and 0-instructional-visit groups. Thus, only a high-intensity community-based intervention designed to train parents was effective in increasing emergent literacy in low-income ethnic children. Supported by Commission on National and Community Service grant 92HELOCA0039, the Dr. Seuss Foundation, Head Start, and the College of Sciences at San Diego State University. The authors gratefully acknowledge William A. Hillix, Leah K. Gensheimer, and Larry Fenson for their helpful reviews of drafts of this article, Florence Goldman for her training of tutors in techniques for developing emergent literacy, and the many students who assisted in the implementation and evaluation of this project.     

Telehealth parent training for a young child at risk for autism spectrum disorder

The global pandemic has highlighted the importance of telehealth to access behavioral interventions. Face-to-face parent training improves the development and behaviors of young children at risk for autism spectrum disorder (ASD). We evaluated a telehealth parent training intervention for a child at risk for ASD. Two parents identified possible early ASD symptoms in their 30-month-old son (lack of imitation, pointing, and vocal manding). Both parents simultaneously received telehealth behavioral skills training on the Parent Intervention for Children at Risk for Autism program for 1 hour per week over 29 weeks. Multiple baseline designs across parent and child behaviors showed that both parents improved their parent teaching fidelity above 80% and the child improved on all trained behaviors. This study expands the utility of telehealth behavioral parent training to young children at risk for ASD to mitigate early symptoms of ASD.     

Familial risk of early suicide: variations by age and sex of children and parents

To determine familial risk of early suicide, data on cause of death of all Dutch residents aged 20-55 years who died between 1995 and 2001 were linked to data of their parents. Men whose father died by suicide had a higher odds of suicide themselves, relative to men whose father died of other causes (Odds Ratio (OR): 2.5; 95% confidence interval: 1.8-3.6). This effect was slightly stronger in the case of mother's suicide (OR: 3.4; 2.3-5.0). The same effect was observed for women, for suicide by father (OR: 2.2; 1.3-3.7) and mother (OR: 4.6; 2.6-8.0). The odds of suicide increased with decreasing age at death of parent. Parental suicide is predictive for offspring suicide. Our data suggest that the predictive value is higher in case the mother died by suicide, particularly if the mother died by suicide at a young age.     

The Influence of Gender and Parental Attitudes on Preschool Children's Interest in Babies: Observations in Natural Settings

This paper reports on two studies of parents'observations of their preschool children's interactions with infants. In Study 1 parents observed 69 3- and 5-year-old white children with three nonsibling infants whom the children encountered during their daily lives. In Study 2 parents observed 46 3- to 6-year-old primarily white children with three nonsibling infants and completed measures of their own gender-related child-rearing attitudes.Consistent with findings from previous laboratory research, this research in naturalistic settings found girls to show more interest in, more nurturance toward,and more interaction with babies than did boys. In Study 2, children whose parents had traditional gender-stereotyped attitudes were more likely to show this gender difference than children whose parents had more egalitarian child-rearing attitudes.     

Transmission of risk factors across three generations

The present study examined the association between the parent-grandmother relationship, the parenting of toddlers, and toddlers' anger. Parent-grandmother relations were assessed when the parents were adolescents. Patient-toddler relations were examined when the toddlers were two years of age. The sample consists of 185 2-yr-old toddlers, one of the parents of each toddler, and the corresponding grandmother of each toddler. The findings support our hypothesis that there would be an indirect effect of the grandmothers' personalities and child-rearing practices on their grandchildren through the influence of the grandmothers on the parents. The influence of both the grandmothers' and the parents' smoking behaviors on the toddlers' anger was mediated by their child-rearing practices. The significance of the findings from a multigenerational study are discussed with reference to incorporating them into prevention programs. The findings are consistent with the notion of the intergenerational transmission of risk factors--from grandparents to parents to toddlers.     

Rationale and principles for early intervention with young children at risk for anxiety disorders

Anxiety disorders are one of the most prevalent categories of disorder among adults and children. Children of parents with anxiety disorders are known to be at higher risk for anxiety disorders themselves, with manifestations of this risk often appearing in toddlerhood or early childhood. Yet because affected parents are often unskilled in anxiety management, they often have difficulty in helping their young children learn to manage anxiety. Literature on the course of anxiety disorders through childhood and on effective cognitive-behavioral interventions suggests that preventive interventions even with very young children could potentially be of benefit in mitigating the course of these often debilitating disorders. This paper outlines the rationale for offering early or preventive interventions to preschool-age children at risk and their parents and discusses means of identifying children to target for intervention and the importance of parental involvement. Drawing upon the literature on parental factors in childhood anxiety disorders as well as on effective intervention strategies with preschool-age children, it delineates principles for intervention with parents and effective components of intervention with youngsters in this age range.     

Infants at risk for child abuse

Child abuse is most likely to occur when socially isolated parents react impulsively to aversive stimuli emitted by their children. Certain child signals and characteristics are aversive to adults. Infant cries are aversive to all parents, but children who are unusually irritable or whose cries are especially grating may become aversive to their parents even when they are not crying. Studies show that the cries of premature infants and the cries of babies incorrectly labelled premature are more aversive to parents, and that abusive mothers and the mothers of premature infants find cries more aversive than other mothers do. The incidence of abuse would be reduced by the availability of supportive social networks and the elimination of distorted parental expectations.     

Support reciprocity and depression among elementary school and high school students1

Abstract: This study examined the relationship between support reciprocity in friendships and depression among elementary school and high school students, taking specific account of the quality of parent‐child relationships. The participants were 340 first‐year high school students and 317 sixth‐year elementary school students, all of whom completed questionnaires measuring levels of depression and support receiving and support giving in the relationship with their best friend. In addition, high school students answered questions about their parents’ child‐rearing attitudes. Consistent with predictions, it was shown that support reciprocity correlated significantly with lower depression among high school students but not among elementary school students. Moreover, it was found that for high school students who perceived their parents as caring and affectionate, support reciprocity related significantly to lower depression but not for those who perceived their parents as distant and dismissive.     

A Meta-analytic Review of Components Associated with Parent Training Program Effectiveness

This component analysis used meta-analytic techniques to synthesize the results of 77 published evaluations of parent training programs (i.e., programs that included the active acquisition of parenting skills) to enhance behavior and adjustment in children aged 0-7. Characteristics of program content and delivery method were used to predict effect sizes on measures of parenting behaviors and children's externalizing behavior. After controlling for differences attributable to research design, program components consistently associated with larger effects included increasing positive parent-child interactions and emotional communication skills, teaching parents to use time out and the importance of parenting consistency, and requiring parents to practice new skills with their children during parent training sessions. Program components consistently associated with smaller effects included teaching parents problem solving; teaching parents to promote children's cognitive, academic, or social skills; and providing other, additional services. The results have implications for selection and strengthening of existing parent training programs.     

Multiple risk expert systems interventions: impact of simultaneous stage-matched expert system interventions for smoking, high-fat diet, and sun exposure in a population of parents.

Three stage-based expert system interventions for smoking, high-fat diet, and unsafe sun exposure were evaluated in a sample of 2,460 parents of teenagers. Eighty-four percent of the eligible parents were enrolled in a 2-arm randomized control trial, with the treatment group receiving individualized feedback reports for each of their relevant behaviors at 0, 6, and 12 months as well as a multiple behavior manual. At 24 months, the expert system outperformed the comparison condition across all 3 risk behaviors, resulting in 22% of the participants in action or maintenance for smoking (vs. 16% for the comparison condition), 34% for diet (vs. 26%), and 30% for sun exposure (vs. 22%). Proactive, home-based, and stage-matched expert systems can produce significant multiple behavior changes in at-risk populations where the majority of participants are not prepared to change.     

System functioning in families with ADHD and non-ADHD sons

Eighteen families with hyperactive 6- to 12-year-old sons and 19 families with normal 6- to 12-year-old sons were observed discussing childrearing concerns in mother-father-son triads. Parents also completed questionnaires assessing marital and parent-child relationships. Observational ratings indicated that the hyperactive sons misbehaved more and exhibited less adaptive and age-appropriate behavior than did the comparison sons. The parents' self-report data indicated that the parents of hyperactive sons spent more time discussing their sons' problems and blaming their sons for family problems relative to parents of comparison sons. The parents of hyperactive sons also reported that their sons' problems distracted them from other marital and family concerns more than did parents of comparison sons. Nevertheless, parents of hyperactive sons did not report greater marital satisfaction or a greater sense of being unified by their sons' problems. Consistent with previous findings, families of hyperactive sons also did not report or exhibit more marital conflict than did families of comparison sons. This discussion focuses on the usefulness of a systems approach for understanding the interdependence among relationships within families.     

The role of risk perception in explaining parental sunscreen use

Objective: This study assessed: (1) whether risk perceptions about skin cancer were related to parent's use of sunscreen on their children; (2) which combination of assessments susceptibility and severity best explain parental sunscreen protection behaviours and (3) whether risk perceptions influence behaviour directly through intentions or through attitudes, subjective norms and self-efficacy.

Design: Two longitudinal studies assessed sunscreen protection behaviours of parents for their toddlers (N?=?391) and young children (N?=?436).

Main outcome measure: Parent's use of sunscreen on their children.

Results: Risk perceptions correlated with future sunscreen protection behaviours of parents but were lower than those of attitude, social influence and self-efficacy. Treating susceptibility and severity as an additive function resulted in the best model fit. Risk perceptions were related with future intention and future sunscreen protection behaviour, but the effects were mediated through attitude, social influence and self-efficacy.

Conclusions: Our path analyses suggest treating susceptibility and severity as an additive function. A multiplicative model without main effects – although often used – had the poorest fit. Risk perceptions influence behaviour by influencing attitudinal and self-efficacy beliefs. Addressing risk perceptions in health communication programs is relevant when the purpose is to increase awareness and to influence attitudes and self-efficacy.     

Assessing daily management of childhood diabetes using 24-hour recall interviews: reliability and stability

Conducted 24-hr recall interviews concerning daily diabetes management with seventy-eight 6- to 19-year-old patients and their parents. Patients and parents were interviewed independently nine times over 3 months. Data obtained were used to construct 13 adherence measures. All measures yielded statistically significant estimates of parent-child concordance. Parent-child agreement was higher for weekday versus weekend behaviors and when based on nine versus three interviews. For the sample as a whole, parent-child concordance remained stable over the course of the study. Compared to the older patients, the 6- to 9-year-olds exhibited poorer parent-child agreement on measures involving time (e.g., injection and exercise-duration measures). This deficit disappeared, however, as the children became more practiced with the interview procedure. The dietary and glucose-testing measures exhibited moderate stability over the 3-month study. Lower stability estimates were obtained for the exercise and injection measures.     

Motor impairment and antisocial behavior in adolescent males at high risk for schizophrenia

A familial link between schizophrenia and antisocial behavior has been established (e.g., Silverton, 1985). This study examined this relationship in a Danish cohort. The subjects were 36 high-risk males (offspring of a schizzophrenic parent) and 36 low-risk males (offspring of parents without psychopathology). This high-risk subjects exhibited more antisocial behavior than the low-risk subjects. We tested the hypothesis of a correlation between neurointegrative deficits, as defined by motor impairment, and antisocial behavior, rated at ages 10–13, in subjects at genetic risk for schizophrenia. Path analyses were conducted from motor impairment at 1 year and motor impairment at 10–13 years to antisocial behavior separately for high-risk and low-risk subjects. Adolescent motor impairment was a significant predictor of antisocial behavior for high-risk subjects. Motor impairment at 1 year was also associated with antisocial behavior for these subjects, although the association was partly due to the indirect effects of motor impairment at 1 year on motor impairment at 10–13 years, which, in turn, was associated with changes in antisocial behavior. As predicted, none of the path coefficients nor the effect coefficient was significant for low-risk subjects.     

Interparental conflict and risk behaviors among Mexican American adolescents: a cognitive-emotional model

This study used a cognitive-emotional model to examine the relations between multiple dimensions of interparental conflict and health risk behaviors among young adolescents. Participants were 151 Mexican American adolescents and their parents. At initial individual interviews, parents reported on conflict with their spouses, and adolescents reported on their parents' conflict, their appraisals of the conflict, their emotional distress, and their acculturation level. At 6-month follow-ups, adolescents reported on their risk behaviors, including substance use and sexual activity. In general, adolescents' acculturation level was not related to their risk behaviors. More frequent conflict, more conflict about the adolescent, more adolescent involvement in the conflict, and poor conflict resolution were related to greater emotional distress. More conflict about the adolescent, mothers being more demanding/dominating during conflict, and more adolescent involvement in the conflict were related to greater risk behaviors. Adolescents' cognitions mediated the link between two dimensions of parental conflict, frequency and resolution, and emotional distress. Adolescents' emotional distress mediated the association between adolescent involvement in parental conflict and adolescents' risk behaviors.     

Relationship of personal authoritarianism with parenting styles

This research investigated the relationship between the personality construct of right-wing authoritarianism and Baumrind's 1971 proposed parenting styles of authoritarian, authoritative, and permissive parenting. 68 youth ages 12-18 along with one of their parents participated. The children rated both parents on Buri's 1991 Parental Authority Questionnaire. One of the parents responded to Altemeyer's Right-Wing Authoritarian Scale. People with higher scores on Altemeyer's scale were more likely to prefer the authoritarian parenting style as their offspring reported (r = .33). Permissive parenting correlated negatively with the measure of authoritarianism as a personality variable (r = -.56).