Pediatric Whole Exome Sequencing: an Assessment of Parents’ Perceived and Actual Understanding.

Whole exome sequencing (WES) is an integral tool in the diagnosis of genetic conditions in pediatric patients, but concerns have been expressed about the complexity of the information and the possibility for secondary findings that need to be conveyed to those deciding about WES. Currently, there is no validated tool to assess parental understanding of WES. We developed and implemented a survey to assess perceived and actual understanding of WES in parents who consented to clinical WES for their child between July 2013 and May 2015. Fifty-three eligible surveys were returned (57% response rate). Areas with both low perceived and actual understanding about WES included how genes are analyzed and lack of protection against life insurance discrimination. Parents also had low actual understanding for two questions related to secondary findings – reporting of secondary findings in a parent (if tested) and whether secondary findings can be related to traits such as height and hair color. Further work to develop a validated tool to assess understanding of WES would be beneficial as WES is integrated more frequently into clinical care.     

Intergenerational Transfers: Associations with Adult Children’s Emotional Support of Their Parents

This study investigates how different factors in regard to intergenerational relationships are associated with emotional support given by adults to their parents. The analysis focuses on adult children and their parents in a representative German sample. Data were obtained from the second wave of the German Family Panel (pairfam) consisting of 2064 women and 1841 men. Results show that transfer of emotional support by the adult children was especially associated not only with received emotional support from parents, but also with affection, conflicts, and expectations concerning parents. A moderator analysis focuses on gender and showed differences for the association between given support by adults and conflicts between mothers and fathers. For the offspring, no gender effects were found.     

Newborn Screening for Cystic Fibrosis: Parents’ Preferences Regarding Counseling At the Time of Infants’ Sweat Test

Newborn screening (NBS) protocols for cystic fibrosis (CF) are the first regional population-based programs to incorporate DNA analysis into their procedures. Research about these programs can inform policy and practice regarding how best to counsel families with abnormal NBS results. The grounded theory method guided interviews with 33 families whose infants had abnormal CF NBS results. A dimensional analysis of these interviews provided a theoretical framework describing parents’ preferences regarding counseling during their infant's sweat test appointment. This framework describes the contexts and characteristics of the two main dimensions of parents’ preferences: factual information and emotional support. Factual information included learning about the probability of a CF diagnosis, CF disease facts, sweat test procedure, and CF genetics. Social support consisted of offering parents a choice about the timing and amount of CF information, showing empathy for their distress, instilling hope, personalizing counseling, and providing hospitality. This framework also explains the consequences of counseling that matched versus mismatched parental preferences in these domains. Counseling that matched parents preferences reduced parents’ distress while mismatched counseling tended to increase parents’ worry about their infant.     

Adolescents’ Attachment to Parents and Peers: Links to Young Adulthood Friendship Quality

Few studies have been carried out on emerging adults’ friendships and on their developmental roots. Research suggests that in adolescence, both attachment to parents and attachment to peers play a role in future socio-emotional development. The aim of the present study was to compare attachment in these two types of relationships in adolescence according to gender and test whether they respectively predicted the perception of best friendship in early adulthood. A sample of 83 participants (49 girls) was seen in early adolescence (M?=?13.66 years, SD?=?0.64) and 7 years later (mean age?=?21.15 years, SD?=?0.83). At T1, participants completed the Inventory of Parent and Peer Attachment, which measures attachment using three subscales (communication, alienation and trust) and one global security score. At T2, they completed the McGill Friendship Questionnaire. Results show that in adolescence, boys report higher security with parents compared to peers (mainly due to better communication), unlike girls who obtain higher scores with peers. Longitudinal findings reveal that alienation in the relation with parents is what best predicts friendship quality in early adulthood. These findings underline the specific internal working models at play in socio-emotional development and the way gender differences evolve from adolescence to early adulthood.

     

Parents’ Attachment Styles and Adolescents’ Regulatory Emotional Self-efficacy: The Mediating Role of Adolescents’ Attachment to Parents in China

Guided by attachment theory, this longitudinal study examined the mediating role of parent-adolescent attachment on the relation between parents’ attachment styles and adolescents’ regulatory emotional self-efficacy (RESE, including managing negative affect and expressing positive affect). Five hundred seventy-three Chinese junior high school students (46% male; aged 11–14 years, M = 12.76 years, SD = 0.74) completed measures of RESE at T1, parent-adolescent attachment at T2 (six months later), and RESE at T3 (another six months later), while 573 students’ parents (one student only has a parent, 241 fathers and 332 mothers) completed measures of adult attachment styles (anxiety and avoidance) at T1. Results from structural equation modeling indicated that father-adolescent attachment mediated the association between fathers’ attachment anxiety and adolescents’ self-efficacy beliefs in managing negative affect, while mother-adolescent attachment marginally mediated the relation between mothers’ attachment anxiety and adolescents’ self-efficacy beliefs in managing negative affect and expressing positive affect. These findings suggest that parents’ attachment anxiety could predict their children’s attachment to parents, in turn, impacting their children’s regulatory emotional self-efficacy.

     

Parent-Professional Codevelopment of a Tool to Stimulate Children’s Development at Home: The TRIAGE Method

Journal of Child and Family Studies - Children from families with low income are at an increased risk of developmental delays. While early interventions are effective in supporting the development...     

Accompanied Visits as a Tool to Understand Visitors’ Experiences: A Critical Reflection and Proposed Typology

Accompanied visits are commonly used to capture visitors’ spontaneously occurring activities, conversations, and views. However, there is limited reflection on how to implement and analyze accompanied visits, and their use is under-theorized. This article draws on three uses of accompanied visits: in a small gallery, a botanic garden, and a science museum. It describes and critically reflects on the methods used for these visits. Overall, it is argued that although accompanied visits can offer valuable insights into visitors’ views and experiences, it is important to conceptualize them to shape academic discussions and longer-term improvements to museum practice and visitor experience. The article provides a typology of accompanied visits that is based on an ethnographic approach and that shows the benefits and drawbacks of different types of accompanied visits. The typology provides the necessary structure for accompanied visits to understand current audiences and possibly to increase the number and diversity of future audiences.     

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.     

Conscious Parenting: A Qualitative Study on Swedish Parents’ Motives to Participate in a Parenting Program

Triple P is a parenting program that aims to prevent behavioral, emotional, and developmental problems in children. Because Triple P is a new parenting program in Sweden, it is important to see how parents felt about the intervention. The aim of this study was to find out why parents of preschool children chose to participate in Triple P in Sweden, what they thought of the Triple P curriculum, and how the program related to their parenting philosophy in general. This is a qualitative study using semi-structured interviews with seven mothers and three fathers who participated in Triple P. The interviews were transcribed verbatim and were analysed using Malterud’s method of Systematic Text Condensation. Parents chose to participate in Triple P for several reasons: they wanted to learn more about the intervention; they had specific problems that they sought help for; or they felt encouraged to participate due to advertisements and recommendations from friends. Of the Triple P curriculum, the participants especially enjoyed the “directed discussion” technique, the positive reinforcement sections, and the instructions on how to communicate effectively with their child by staying calm, close, and maintaining eye contact. It was important for many of the parents to feel validated and respected, and they liked having discussions with the preschool teacher rather than being told what to do. Parents in this Swedish sample generally liked and selectively used the strategies they learned from participating in Triple P, depending on how well these fit with their own parenting experiences and philosophy.     

Neighborhood Risk and Interpersonal Support as Predictors of Parents’ Sense of Community

Parents’ sense of community (SOC) may ease the impact of neighborhood risk on children’s outcomes, but not all parents feel part of a trusted community. In this study, we examined whether parents’ ratings of neighborhood risk and interpersonal support were related to their SOC, and whether interpersonal support moderated the relationship between neighborhood risk and parents’ SOC. Participants included 161 parents (M?=?40.25 years; 92.3% female) of minor children who were enrolled in youth mentoring programs. Results indicated that greater interpersonal support and less neighborhood risk was associated with parents’ SOC. Post-hoc analyses showed that living in a neighborhood with gangs and illegal drugs, but not residential instability or living in public housing, was a salient risk factor for lower SOC. Contrary to our prediction, interpersonal support did not moderate the link between neighborhood risk and parents’ SOC. These findings may inform interventions designed to bolster parents’ connectedness to community and ability to promote children’s positive development.

     

Parents’ Intelligence Mindsets Relate to Child Internalizing Problems: Moderation Through Child Gender

Parental belief systems can strongly influence children’s affect, behavior, and mental health. However, associations between specific kinds of parental beliefs and children’s mental health have not been thoroughly explored. One relevant belief system is parental intelligence mindset: beliefs about the malleability of intelligence. Children of parents who view intelligence as static (known as a fixed intelligence mindset), rather than malleable through effort (known as a growth intelligence mindset), experience more academic, self-regulatory, and motivational difficulty. However, associations between parental intelligence mindset and child mental health problems are unclear. Accordingly, we tested whether parents’ intelligence mindsets related to internalizing problems in their children (N?=?131, ages 5–8). Overall, parents with stronger fixed intelligence mindsets had children with greater internalizing problems, particularly social anxiety (characterized by fear of negative evaluation). Results further revealed that parents’ fixed intelligence mindsets were associated with overall internalizing problems and depressive symptoms in boys, but not girls. Results are the first to suggest and parse direct links between parents’ intelligence mindsets and youth internalizing problems.     

Parents’ observed responses to children’s emotional distress: Relations with social competence in preschool

Although affective interactions in the family are important for development, home observational data are sparse. We replicated and extended one such study, Roberts & Strayer (1987, Developmental Psychology, 23, 415). Interactions in 33 two-parent families (mean child age = 4.8 years; 48% girls) were observed for four evenings, from suppertime until the child settled for the night. Parents completed the Child Rearing Practices Q-sort. Peer interactions and friendship networks in preschool were observed over four days. Teachers and observers completed the Preschool Behavior Q-Sort. Based on Q-rated peer competence and aggression, three expected groups of children were identified, one of them high on both aggression and peer competence. Although socially active and accepted by peers, they were, compared with other children, less cooperative with adults, less prosocial with peers, more impulsive, less achievement oriented, less purposive, and less happy (mean η² = .52). Parenting, especially observed impatience, threats, and use of force when children were emotionally distressed, showed important differences across groups.     

Adrenal Insufficiency in Young Children: a Mixed Methods Study of Parents’ Experiences

Research into adrenal insufficiency (AI) and congenital adrenal hyperplasia (CAH) in children has focused largely on clinical consequences for patients; and until recently, the wider experience of the condition from the perspective of other family members has been neglected. In a mixed methods study, we captured the experiences of parents of young children affected by AI/CAH, including their views on the psychosocial impact of living with and managing the condition. Semi-structured interviews were carried out in the UK and an online survey was developed, translated and disseminated through support groups (UK and the Netherlands) and outpatient endocrinology clinics (Germany). Challenges associated with diagnosis, treatment, support and the future were identified. For UK parents, the diagnosis period was characterised by a lack of awareness amongst healthcare professionals and occurrences of adrenal crisis. Parents reported burden, anxiety and disruption associated with the intensive treatment regimen. Parents adjusted and gained confidence over time yet found delegating responsibility for medication difficult and worried about the future for their child. Access to psychological support and contact with other families was reported as highly beneficial. The findings of the study provide critical context for future studies and for informing how parents and families can be better supported. Prenatal genetic counselling for parents who already have an affected child will include an explanation of recurrence risk but should also focus on providing information and reassurance about diagnostic testing and care for their newborn.     

Pascal’s Wager: a Reason to Hesitate

Philosophia - One version of Pascal’s Wager says we should commit to, or cultivate belief in, whatever religion we think is most likely to bring us eternal joy. I pose a reductio for this...     

Parents’ influence on the development of their children’s ethnic intergroup attitudes: a longitudinal analysis from middle childhood to early adolescence

This study investigated to what extent parents’ intergroup attitudes influence the development of their children’s ethnic intergroup attitudes (i.e., ingroup bias), and which socialization factors moderate this influence. We report on a four-year longitudinal study of 213 children (M_age = 7.94) and their parents conducted in Eastern Germany. Findings showed significant interindividual differences in children’s developmental trajectories, which could, in part, be explained by child gender, socio-economic status and parental attitudes. The influence of parents’ intergroup attitudes was moderated by parenting style and parental similarity in attitudes both of which, our findings suggest, can make the transmission of parental attitudes more likely.     

The Family Cycle: An Activity to Enhance Parents’ Mentalization in Children’s Mental Health Treatment

This article introduces the Family Cycle, a therapeutic activity informed by attachment theory, family systems theory, and current literature on reflective functioning. The Family Cycle helps clinicians and families create a narrative about a child’s psychopathology that considers complex trauma and/or adverse childhood experiences. It reframes observable dysfunctional phenomena as behavioral sequelae of more deeply rooted emotional loss. After the theoretical underpinnings of the Family Cycle are laid out, we describe the implementation of the Family Cycle within the context of an intensive home-based, family-focused intervention created at the Yale Child Study Center, the Intensive In-Home Child and Adolescent Psychiatric Service (IICAPS). The Family Cycle provides a teachable clinical framework to facilitate the treatment of families with complex, multigenerational trauma.