An integrated model for intervention with infants,preschool children,and their maltreating parents

Service delivery systems for maltreating parents need to be comprehensive, integrated, and coordinated in order to address the ecological, developmental, and psychotherapeutic needs of maltreating families. This article presents a center-based, intensive model of intervention for multiproblem, maltreating families. The program described addresses the needs of the entire family; incorporates the evaluation and treatment of the child's, as well as the parent's, development; and provides services in a multifamily group milieu. The following interventions are integrated in the treatment approach: (1) family milieu approach, (2) assistance with functioning of the “parental ego,” (3) traditional therapies, and (4) developmental-structuralist approach to parent-child interaction. Challenges encountered and solutions employed in working with maltreating families are discussed. A detailed case study is presented to illustrate the types of interventions used.     

Adoptive versus Mixed Families: Child Adjustment,Parenting Stress and Family Environment

Recent research in adoption has considered the factors and processes that underlie the adjustment of children and families. However, little research has been conducted on certain types of adoptive families, specifically on families with both adoptive and biological children often designated as mixed families. This subject is addressed by the present study which also analyzes the association between the type of adoptive family and children’s outcomes—prosocial and problem behavior—parenting stress and the relational family environment. It also examines whether children’s gender, age at adoption and the number of children in the home moderate these effects. 102 parents of adoptive children (ACF) 33 parents of both adoptive and biological children (ABCF) and 102 parents of biological children (BCF) participated in the study. Target-children were aged from 6 to 12 years. The Portuguese versions of the SDQ-P, PSI-SF and FES (Interpersonal Relationship dimension) were used. Results showed that the type of adoptive family—ACF and ABCF—significantly explained the variance of children’s behavioral problems and parenting stress. The child’s gender was shown to moderate the relationship between ACF parents and their perception of child’s prosocial behavior. The results give relevant clues as to the importance of distinct outcomes in adoptive families—ACF and ABCF—compared to families with only biological children and should, therefore, be a resource for professionals involved in the adopters’ suitability assessment and adoption intervention.     

Matching adolescents with foster mothers and fathers: An evaluation of the role of temperament

We tested the notion that better foster care adjustment would be observed when the temperaments of mothers and fathers were matched with those of adolescent foster children. We hypothesized that families in which foster parents and foster children had high (easy) scores on subscales of the Revised Dimensions of Temperament Scale (DOTS-R) would also report higher family functioning and higher foster care adjustment than parents and children from families in which one or both family members had low (difficult) scores on these scales. The hypotheses were supported when the mothers and fathers family assessments were used but rejected when the observations of the case managers and adolescents were tested. Methodological and substantive explanations for the findings are discussed and recommendation for foster care practice and continuing research are provided.     

Parent–adolescent communication in foster,inter‐country adoptive,and biological Italian families: Gender and generational differences

There is a paucity of studies aimed at comparing how parents and children in different family structures cope with the challenges posed by the adolescence transition; in particular, there are few studies aimed at comparing adoptive and foster families. In order to partially fill this gap, the principal aims of the present study were to verify whether there are differences in parent–child communication among foster, intercountry adoptive, and biological families according to the adolescents' gender, and to compare the perceptions of parents and adolescents concerning parent–child communication. Data were elaborated on two levels: a generational level (adolescent's and his/her parents' perceptions among the three family groups) and a dyadic level (mother–child and father–child perceptions). The sample was composed of 276 Italian families with adolescents aged between 11 and 17 (81 foster, 98 international adoptive, and 97 biological families). Subjects (mothers, fathers, and children) filled out a questionnaire including the Parent–Adolescent Communication Scale (Barnes & Olson, 1985 ). Results highlighted that in foster families, parent–child communication showed more difficulties from both the adolescent's and the parents' point of view. Adoptive adolescents, however, reported a more positive communication with both their parents than did their peers living in biological and foster families. At a dyadic level, some differences emerged among the three groups. In biological families, a more pronounced distance emerged between parents and children. In adoptive families, father and adolescent shared more similar perceptions, whereas a significant discrepancy emerged between mother and child. A higher level of perceptual congruence between adolescents and parents was found in foster families. Gender differences were also seen: Mothers experienced a more open communication with their children than did fathers, and adolescents, and above all females, communicated better with their mothers than with their fathers in all three family groups.     

Does Socioeconomic Status Matter for Chinese Immigrants’ Academic Socialization? Family Environment,Parental Engagement,and Preschoolers’ Outcomes

Families’ academic socialization mediates how socioeconomic status (SES) affects children’s achievement. However, little is known about whether cultural values and family cohesion could buffer negative effects of low SES. We examined parental academic socialization and children’s achievement in 220 low- and middle-SES Chinese immigrant families with four-year-olds. Low-SES parents showed less stressful family environments and stronger beliefs about parental responsibility for education. However, middle-SES parents provided more reading engagement and enrichment activities. Reading engagement and SES were significantly associated with children’s academic performance. These findings demonstrate low-SES families’ strengths but suggest the need to provide more support for such families.     

Motives for Fostering Children with Alcohol-Related Disabilities

A sample of 63 licensed foster parents was asked, “What motivates you to foster a child who has a fetal alcohol spectrum disorder?” The responses to this question were grouped together by licensed foster parents. The grouped data were subjected to multidimensional scaling and cluster analysis. Results indicated that foster parents were motivated to care for children with alcohol-related disabilities by witnessing positive changes in the children in their care, helping children focus on their strengths, using their own parenting experience, earning an income, assisting children who have disabilities, and helping children stay connected to their families and communities. Foster parents who foster children with alcohol-related disabilities foster for similar reasons to those who foster children with special needs in general. Differences between the literature on foster parent motives and study results were described. Foster parents who are caring for children with alcohol-related disabilities see their care as specialized, see their roles as long-term helpers facilitators to children, their birth families and home communities, and emphasize positive experiences of fostering.     

The Parental Reflective Functioning Questionnaire in Mothers and Fathers of School-Aged Children

Research on parental reflective functioning (PRF)—defined as parents’ capacity to comprehend the developing mind of their child, reflect upon it, and hold in mind the inner life of the child—has mostly involved mothers of infants and young children, and rarely fathers and parents of school-aged children. The present study sought to extend research on PRF by examining aspects of the construct that are still scarcely explored, such as the role of gender and attachment; to investigate whether there were differences between mothers’ and fathers’ PRF and whether there were differences in PRF related to the gender and age of the child; and, finally, to assess the association between PRF and each parent’s attachment style. The Parental Reflective Functioning Questionnaire (PRFQ) and the Attachment Style Questionnaire (ASQ) were administered to a community sample of mothers and fathers of 385 children aged 3–10 years. A multi-group factor analysis supported the hypothesized three-factor model among both fathers and mothers. Univariate and multivariate analyses of variance showed that mothers had higher levels of interest and curiosity in their children’s mental states than fathers. Parents of daughters showed higher pre-mentalizing modes than parents of sons. Parents of preschool children showed less nonmentalizing modes than parents of children aged 8–10. Correlations between PRFQ and ASQ showed that both mothers’ and fathers’ interest in thinking about their child’s internal experience and in taking the child’s perspective were correlated with higher levels of secure attachment style. Research implications are discussed.     

Latino Foster Parent Health Perceptions of Chronic Conditions: A Qualitative Exploration

Prior work using nationally representative data of children in the child welfare system suggested that Latino foster parents were less likely to identify children in their care as having chronic conditions. Hispanics comprise over one-fifth of children in foster care, the majority of whom have special health care needs, and there is a growing need to recruit qualified Latino families into the child welfare system. Little is known about Latino parents’ health perceptions regarding chronic conditions, and potential reasons for differing identification rates of children with special health care needs. We conducted 17 home-based, in-depth interviews with Latino foster parents to explore health perceptions and cultural beliefs for children in their care around the concept of chronic illness. We found that Latino foster parents’ understanding of conditions that occurred “over and over again” related to emotional and behavioral health problems. In contrast, their perception of “chronic” was associated with terminal, biological conditions that had limited treatment options, such as cancer, HIV, and hepatitis. Latino foster parents did not interpret the survey question on chronic illness as it was intended, and their view of recurrent conditions did not reflect chronic health conditions. Developing survey questions that are culturally sensitive should improve accuracy in assessing chronic health conditions for this high-risk population. Sensitivity to cultural interpretation for this high-needs population is vital to enhancing communication between families and health providers caring for children in foster care.     

Foster Families: A Systematic Review of Intention and Retention Factors

Background: Compared to residential care, family foster care is the preferable type of alternative care for neglected or abused children as it provides a familiar context that supports children’s developmental needs. New foster families are needed to care for these children. Objective: This systematic review aims to provide a critical analysis of the literature, identifying factors that explain the intention to become and to continue as a foster family. This review was performed following the PRISMA checklist and guidelines, through a search conducted in the following databases (no restrictions were made): PsycArticles, PsycInfo, Psychology and Behavioral Sciences Collection, Academic Search Complete, ERIC, Scopus, and Web of Science. Study eligibility: The review includes empirical quantitative and/or qualitative studies in English, Portuguese, and Spanish, with community and/or foster parents’ samples and explores the factors for becoming and/or retention of foster parents. Results: Forty-nine studies were included. The results revealed that the intention to become a foster parent is largely influenced by motivational factors, personal and family characteristics, individual values and beliefs, social context influences, and perceived familiarity with the child protection system. The retention of foster families is closely related to factors within the child protection system, personal or family characteristics, foster child characteristics, and placement challenges. The relationship with agencies and professional support stands out as the most important factors. Limitations and Implications: This review did not include studies focused on children with specific needs and characteristics, and future research should consider the particular challenges of fostering this group. Practice implications of these findings for the recruitment, selection, and retention of foster families will be discussed.

     

The Possibilities and Pitfalls of Talking about Conception with Donor Egg: Why Parents Struggle and How Clinicians Can Help

It can be challenging for parents to talk with their children about gamete donation. Many mothers who chose donor egg, following failed fertility treatments and/or advanced maternal age, do not talk about it with their children. Research has found significant parental anxiety, increasing with time after conception, in parents who have not told their children about their donor origins. A set of common reasons given for a reluctance to talk will be considered, along with its impact on the psychic functioning of parents and children. Talking about donor conception is not a one-time conversation but a process that will evolve over the child’s lifetime. Psychological adjustment to the choice of egg donation that can foster disclosure will be discussed, including how couples (1) accept that a donor is required; (2) imagine the donor, who is often anonymous; and (3) incorporate the choice of donor conception into daily family life. There is growing research and psychoanalytic literature on the development of children conceived with gamete donation; however, fewer families of heterosexual parents are included in these follow-up studies because of the prevalence of nondisclosure. This article considers why talking about conception with donor egg is so hard for many families and offers lines of inquiry that may be helpful to these families and the clinicians that will support them.     

The Family Environment Scale: comparison with the construct of Expressed Emotion

The Family Environment Scale (FES) was completed by parents of 30 children with conduct disorders (CD), 30 children with emotional disorders (ED), and 30 well-functioning controls. Parents were also interviewed and rated for Expressed Emotion (EE), and mothers completed the Child Behaviour Checklist (CBCL). Clinical families had significantly lower ratings of Cohesion, Expressiveness, Intellectual-Cultural and Active-Recreational Orientation. These differences were not specific to either diagnostic group. Maternal Criticism was associated with reported conflict in the CD group. The EE scales of Criticism and Warmth (absence of warmth) were correlated with child behaviour ratings in the CD group, in contrast with FES sub-scales. Maternal scores of Cohesion were significantly associated with social competence in the ED and the control group. Maternal ratings of Conflict predicted dropping-out of treatment (CD group), and ratings of Cohesion and Control had some value in predicting clinical outcome. The implications for the future use of the Family Environment Scale and other self-rated measures of family functioning are discussed.     

Parenting Intervention to Reduce Attention and Behavior Difficulties in Preschoolers: A CUIDAR Evaluation Study

In this study, we evaluated CUIDAR, a program that provides community-based 10-week parent training to reduce attention and behavior problems in preschool children. We recruited 154 predominantly low-income and Latino preschoolers and their parents to participate in this evaluation study. We collected data prior to and immediately following intervention and one year later. At the time of follow-up, we also recruited 15 parents who had initially enrolled, but never participated in the program to serve as a comparison group for a limited set of analyses. From pre to post intervention, we observed significant, positive changes in eight out of ten measured parenting behaviors. From pre intervention to follow-up, improvements in the use of transitional statements and planning ahead were significant. Children’s SDQ Total Difficulties scores significantly decreased from pre to post intervention (d = .36), and we observed significant, positive changes in all SDQ subscales. From pre intervention to follow-up, children’s SDQ Total Difficulties scores significantly decreased (d = .71) and all SDQ subscales reflected significant, positive changes. We observed no significant differences in reported barriers to participation between parents who participated in the program and those who enrolled, but never participated. Intervention gains were moderated by several factors, including history of out-of-home care and family structure. Our results should be interpreted cautiously because not all analyses included a comparison group, and a randomized trial of CUIDAR effectiveness is still needed.     

In Search of One's Past: An Identity Trip

The experience of being “cut off,” either emotionally or physically, from one's family of origin and extended families is an experience that at times confronts us all, be we the children of natural, adoptive, foster or divorced parents. The goal of this paper is to show that a person's identity is profoundly related to, and affected by, his sense of connection to his family of origin. This paper will take as its point of departure the author's story as a foster child and will describe his successful effort to get himself reconnected to his natural family. The story raises questions about the policies of foster-care agencies and, by implication, questions about adoptive agency policy. Finally, the paper may have something to say not only to family therapists and researchers but to all of us who wish to more fully “know” our parents and our extended families.     

Emotional and behavioral problems in children of depressed mothers: a school-based study in Southern Brazil

The present study aimed to verify the association between maternal depression and emotional and behavioral problems in school children in Pelotas, Southern Brazil, considering that maternal depression increases children’s vulnerability for developing psychiatric disorders. This is a cross-sectional study with a school-based sample conducted between August 2015 and November 2016 and it is part of a major project entitled ‘Healthy Childhood in Context: A Multidisciplinary Investigation’. Schoolchildren aged between 7 and 8 years and one of their respective parents or a primary caregiver were included in the study. Maternal depression was assessed using the Mini International Neuropsychiatric Interview (MINI). The presence of emotional and behavioral problems in children was verified by the Strengths and Difficulties Questionnaire (SDQ) – parents version. Children of depressed mothers exhibited higher mean scores in all SDQ domains and in the total score when compared to children of non-depressed mothers. Lower socio-economic status was also associated with higher SDQ scores. Our results showed the effects of both maternal depression and poverty on children emotional and behavioral problems, which evidence the need for child mental health preventive care, and free quality assistance for both mothers and their children.     

Do Mothers and Fathers Perceive Their Child’s Problems and Prosocial Behaviors Differently?

The aim of this study was to compare mothers’ and fathers’ ratings of their young children’s problems and prosocial behaviors using the Korean version of the Strengths and Difficulties Questionnaire (SDQ). Furthermore, the present study examined whether parental depressive symptoms were linked to agreement between mothers’ and fathers’ ratings of their young children’s behavior. The sample consisted of 302 parents whose 5-year-old children attended childcare centers in Korea. The parents completed the Korean version of the SDQ and the Center for the Epidemiological Studies of Depression short form. The results revealed that both the mothers’ and fathers’ reports moderately correlated for both boys and girls, with greater correlations for externalizing problems than for internalizing problems. Whereas there were no significant differences between mothers’ and fathers’ reports of their children’s problems, mothers reported significantly more prosocial behaviors than fathers did, regardless of the child’s gender. Polynomial regression showed that mothers’ reports were more strongly associated with fathers’ report of their children’s prosocial behavior when mothers reported lower levels of depressive symptoms. The findings provide empirical evidence that mothers and fathers reported more similarities than differences in assessing child problems. Further analyses suggest considering maternal depressive symptoms when interpreting interparental agreement on their children’s prosocial behaviors.     

Enhancing Family Resilience Through Family Narrative Co-construction

We draw upon family resilience and narrative theory to describe an evidence-based method for intervening with military families who are impacted by multiple wartime deployments and psychological, stress-related, or physical parental injuries. Conceptual models of familial resilience provide a guide for understanding the mechanics of how families respond and recover from exposure to extreme events, and underscore the role of specific family processes and interaction patterns in promoting resilient capabilities. Leading family theorists propose that the family’s ability to make meaning of stressful and traumatic events and nurture protective beliefs are critical aspects of resilient adaptation. We first review general theoretical and empirical research contributions to understanding family resilience, giving special attention to the circumstances, challenges, needs, and strengths of American military families. Therapeutic narrative studies illustrate the processes through which family members acquire meaning-making capacities, and point to the essential role of parents’ in facilitating discussions of stressful experiences and co-constructing coherent and meaningful narratives. This helps children to make sense of these experiences and develop capacities for emotion regulation and coping. Family-based narrative approaches provide a structured opportunity to elicit parents’ and children’s individual narratives, assemble divergent storylines into a shared family narrative, and thereby enhance members’ capacity to make meaning of stressful experiences and adopt beliefs that support adaptation and growth. We discuss how family narratives can help to bridge intra-familial estrangements and re-engage communication and support processes that have been undermined by stress, trauma, or loss. We conclude by describing a family-based narrative intervention currently in use with thousands of military children and families across the USA.     

Parents’ Social Status and Children’s Daily Physical Activity: The Role of Familial Socialization and Support

Physical activity is a health relevant factor, particularly in affluent societies where overweight and obesity are increasingly prevalent, even among children. Understanding the development of physical activity patterns in childhood is thus an important issue for health promotion. Following socialization theory, this study describes and explains differences in objectively measured moderate-to-vigorous physical activity (MVPA) in a socially and ethnically mixed sample of 6- to 11-year-old children in Germany. MVPA levels were objectively measured with accelerometers over the course of six consecutive days (Wednesday to Monday). Parents’ attitudes and practices as well as the family’s socio-economic status (SES) were assessed from the parents via questionnaires. Results indicate that MVPA levels of children vary with gender, but not with age and ethnicity. Moreover, parental SES, parental support for the child’s sports activities, parents’ own sport activities and the parents’ belief in sports’ capacities to foster personality development, character building and social integration significantly predict the MVPA level of children. It is concluded that interventions to promote MVPA among children need to take family interactions and lifestyles into account and should address families in socio-economically underprivileged areas.     

Immigrant Parent Legal Status,Parent–Child Relationships,and Child Social Emotional Wellbeing: A Middle Childhood Perspective

Immigrant parent legal status is an important, but understudied aspect of children’s developmental contexts that can affect their social emotional wellbeing. The present study used the Behavioral and Emotional Screening System to explore the influence of parents’ legal status on the social emotional wellbeing of 7–10 year old U.S.-born children of immigrant parents from Dominican Republic, Mexico, and Central America. Aspects of parent–child relationships, measured via the Parent–Child Relationship Questionnaire , were also explored as potential moderators. One hundred and eighty families were recruited via school and community outreach. Forty-nine percent of participating families were mixed-status. Results indicate that children in mixed-status families experience higher levels of anxiety, but lower levels of hyperactivity, and that parent–child communication moderates the relationship between parent legal status and the child’s hyperactivity. Results further indicate overall high levels of functioning among all families, regardless of parent legal status, across several domains of parent–child relationships. Findings suggest the importance of assessing for internalizing symptoms among children in mixed-status families as well as the potential for building on family strengths in the design of programs and policies to support immigrant families.     

Parent perceptions of an integrated stuttering treatment and behavioral self-regulation program for early developmental stuttering

PurposeRecent research has identified approximately half of children who stutter present with self-regulation challenges. These manifest in elevated inattentive and/or impulsive behaviours, aligned with attention deficit hyperactivity disorder (ADHD) symptoms. These symptoms have been found to influence the child’s responsiveness to their stuttering treatment, and may exacerbate the psychosocial consequences of stuttering for them and their families. Early stuttering intervention identifies parents as key agents of change in the management of their children’s stuttering. This study sought feedback from parents regarding their experiences with an integrated stuttering treatment and behavioral self-regulation program for early developmental stuttering, addressing the child’s self-regulation challenges.MethodEight parents of children who stutter who had co-occurring self-regulation challenges completed the integrated program. This incorporated the Triple P--Positive Parenting Program adapted for the developmental stuttering population, and the Curtin University Stuttering Program (CUSP). Semi-structured qualitative interviews were conducted to capture parents’ reflections on, and experiences with, the integrated program.ResultsThematic analysis identified several major themes regarding the parents’ experiences with the integrated program: emotional impact on parents, child self-regulation, link between stuttering and behaviour, parent self-regulation, impact on family dynamics, and overall positive perceptions of the integrated program. All of the parents indicated they would recommend the program to future parents of children who stutter.ConclusionThis study provides insights into parents’ perceptions regarding an integrated intervention approach for early stuttering and behavior management. It also indicates how adopting a holistic approach to stuttering intervention is positive and has social validity.