TEACHING A PARENT TO TRAIN A SPOUSE IN CHILD MANAGEMENT TECHNIQUES

This study analyzed several aspects of the training of a mother and father in child management techniques for use with their 6-year-old severely developmentally delayed son. The mother received clinic training in procedures for increasing her son's independent dressing skills; subsequently, she was asked to teach the same procedures to her husband with no assistance from the trainer. For both parents, procedures were introduced sequentially across two components of parent behavior in a multiple baseline design. Examinations were made of (a) the effectiveness of initial child management training on the mother's behaviors, (b) her ability to teach the same techniques to her husband independently, (c) the generalization of both parents' skills from the training setting (a dressing task) to two untrained activities (eating and toy use), and (d) the impact of training on the child's behavior. Results showed that the mother learned to implement the trained procedures and successfully communicated them to her husband, as evidenced by substantial positive changes in both parents' behaviors after being introduced to the child management skills. Both parents showed some generalization to the untrained activities, and their written comments following training indicated they understood the procedures. Clear-cut improvements were observed in the child's attending and independent performance of dressing and toy use skills concurrent with parent training. A 2-year follow-up report indicated that both parents retained their knowledge of skills taught, continued to use the procedures, and rated the training as very helpful in teaching the child self-help skills.     

Shared minds: Effects of a mother's imitation of her child on the mother–child interaction

Children with Autistic Spectrum Disorders (ASD) have impaired social interaction right from early development. Previous studies (Dawson & Adams, 1984; Tiegerman & Primavera, 1981, 1984) have suggested that imitating children with ASD is effective in facilitating their social behaviors. The present case report, through a 6‐month intervention, investigated how a home‐based intervention of helping a mother imitate her 21‐month‐old child with ASD impacted the child's development of social communication outside the experimental settings. Our results show that the mother's imitation of her child might be associated with the development of nonverbal joint attention skills. Positive changes in the mother's emotion towards her child and the mother–child interaction also were noted and represent other important effects of parental involvement in therapeutic interventions for children with ASD.     

Training parents as behavior modifiers: self-recording of contingent attention

Two mothers of deviant young children were instructed to count their episodes of attention to appropriate child behavior in their homes, using wrist counters. Attention and appropriate child behavior were defined before counting began. Independent observations of parent-child interactions showed that, for each mother-child pair, the percentage of maternal attention given following appropriate child behavior increased, as did the child's appropriate behavior. Removal of the counters did not produce a reversal of the behaviors; instead the increased level stabilized. One mother was then instructed to count her attention to inappropriate child behavior and to decrease it. This instruction had little effect on her attention, and her child's behavior did not change. When both parents were again instructed to count their episodes of attention to appropriate behavior, further improvements in both mothers, and in their children resulted. These results were obtained despite inaccurate parent self-recording. Follow-up observations made over the next five months showed these behavioral gains to be durable. A third parent and his child were unaffected by this training procedure. Thus, there are instances in which self-recording may function as an effective and economical parent-training technique for effecting improvements in child behavior.     

A psychotherapeutic technique for mother-child intervention: A case study of a japanese down syndrome child

The purpose of this paper is to demonstrate our approach to the activation of mother-child interaction, by presenting a case study. We describe a Japanese mother's adaptation process (consisting of five stages) to her child's handicap through 6 years of continuous therapeutic support for both the mother and her child. In this particular case, the mother suffers from a mild form of cerebral palsy; therefore, the problem involves two generations, because both the mother and her child are handicapped. By analyzing the processes of this case, we also describe our method of intervention for problems in the development of multidimensional relationships. We discuss the mother's psychological maturation and the role of the therapist within the Japanese social and cultural context, under the following headings: (1) Sharing in the Mother's Ambivalence; (2) Natural Melting of the Mother's Frozen Emotional Availability; (3) Sharing in the Mother's Illusion and Disillusion; (4) Transformation of Relationships Between Family Members and Their Relationship to Society.     

Relation‐based intervention with at‐risk mothers: Outcome in the second year of life

It has been shown that the UCLA home visiting/mother–infant group intervention made a significant positive impact during the child's first 2 years of life on two indices of the mother's support and on three areas of mother–child and child development: (1) The mother's responsiveness to the needs of her child and the related development of his or her security of attachment; (2) the mother's encouragement of her child's autonomy and the related development of his or her autonomy; and (3) the mother's encouragement of her child's task involvement and the related development of his or her task orientation. By child age 2 years, the mothers experiencing the intervention, in comparison with those that did not, also used verbally persuasive as opposed to coercive intrusive methods of control and their children responded more positively to these controls. Mothers who did not experience the help of the intervention had significantly more difficulty controlling their child if it was a boy as opposed to a girl. They used the least appropriate methods of control, and the boys responded more negatively to these controls. The nature of the development of the mother's use of appropriate controls and the child's response to that control was elucidated by determining on the total sample where 12‐month antecedents influenced the indices of control either independently of or in interaction with the intervention status. The child's endurance in the test situation was an independent predictor of mother‐appropriate control and the child's positive response to that control, while the absence of maternal intrusiveness further enhanced the impact of the intervention on that control. ©2001 Michigan Association for Infant Mental Health.     

The relationship of mother–child interaction and the child's development of symbolic play

The extent to which the mother–child interactive relationship either promotes or limits a child's ability to see options or choices in the environment was investigated. It was predicted that this quality of interaction provided primarily by the mother would relate to the child's cognitive development as reflected in his or her level of symbolic play. The level and frequency of symbolic and nonsymbolic play in 30 children, ages 12 to 47 months, were coded and mothers' options‐promoting and options‐limiting behaviors were identified. Children, across this range of ages, whose mothers created an options‐promoting social context were observed engaging in more symbolic play. Nonsymbolic play, however, was not found to be significantly influenced by the mother's interactive style. A child's symbolic play marks a dynamic developmental achievement for the child, and appears to be related to the social context created by the mother's interactive style. ©2003 Michigan Association for Infant Mental Health.     

Clinical interventions in parent-infant groups around issues related to separation-individuation

Parent-child groups as an educational method in a general hospital setting provide support for parents and an environment in which they can discuss their questions about their child's development. This paper illustrates the clinical use of parent-child groups as a means of early intervention in problems that become apparent during the Separation-Individuation stages of development. We present two case studies of mother-child pairs, who have been members of the group for 2 years. The first case is a bi-racial child whose mother is struggling to deal with the child's rapprochement stage behavior. Through the oral and anal stages, conflict has grown in their relationship due to the mother's way of viewing her child, as well as her own unresolved adolescent separation difficulties. The second case is an overprotective mother whose own pathology prevented her daughter from resolving her rapprochement crisis. Interventions by the leaders as well as the group's educational method help both mother-child pairs to resolve interpersonal conflict and to continue their essentially normal development.     

Maternal satisfaction with clinic-referred children: Assessment by use of a single-subject methodology

Prior research has indicated that maternal perception of or satisfaction with their children may be predicted by factors other than the child's behavior. The present study was designed to examine this issue further by using a single-subject methodology, improving the assessment procedures utilized, and increasing the number of predictor variables. It was hypothesized that factors other than child behavior would contribute to maternal satisfaction with the child but that the particular factor would vary across mothers. Two clinic-referred children and their mothers served as subjects. Prior to, during, and after treatment, the mothers completed a daily series of questionnaires to assess satisfaction with her child, daily child behavior, maternal depression, the marital relationship, and physical health. The results indicated that maternal satisfaction and maternal report of child behavior changed with treatment. The hypothesis was confirmed as physical health for one mother and the marital relationship for the second mother combined with child behavior to predict maternal satisfaction. Correlational analyses suggested that the maternal satisfaction with the child is related more to the child's negative behavior than positive behavior. The implications of the findings and of the methodology which was employed are discussed.     

THE EFFECTS OF A CHILD'S SELF-EVALUATION PROGRAM ON COMPLIANCE WITH PARENTAL INSTRUCTIONS IN THE HOME

A self-evaluation program was implemented with a kindergarten-aged boy in the home to increase compliance with parent instructions and decrease inappropriate verbal behavior. The self-evaluation package included the child's assessing the appropriateness of his behavior in 5-min intervals, receiving chips for positive self-evaluations, and exchanging chips for a reward following experimental sessions. In a reversal design, analyses were conducted of the effectiveness of the self-evaluation program, the requisite conditions for effective child behavior change with a self-evaluation approach, and the parent's efficiency in using the self-evaluation package. The self-evaluation procedures typically resulted in increased compliant behavior and decreased inappropriate behavior, although the effects generally weakened with time. Behavioral gains were greater and better maintained when the self-evaluation procedures were preceded by a phase of external evaluation via the mother than by baseline, suggesting that self-evaluation procedures may serve more to maintain the effects of external evaluation rather than to induce their own changes. The parent generally was efficient in implementing the procedures. Research and clinical implications for using self-evaluation procedures in a home setting are discussed.     

Feeling one's way in the world: Making a life

This paper argues for the psychoanalytic relevance of the works of James Gibson and Susanne Langer in explicating the early development of the human child and makes use of this combined formulation of development to think about psychoanalytic theory and practice. From the insights of James Gibson's ecological psychology we can appreciate the embodiment and embeddedness of the child's growing mind within both her physical and social environments. Making use of Susanne Langer's concept of feeling to redefine ecological psychology's perceptual counterpart to action allows us to understand the child's seamless transition into active participation in her culture, as she learns to project her animalian capacity to feel into intersubjectively defined forms of behavior and experience with others. The paper presents a lengthy exposition of Gibson's ecological psychology, before explaining Langer's thinking and launching into the combined insights of these scholars to explicate the nature of the child's mind as she feels her way in the world and makes a life for herself within it. This is the life she will be able to remake in the embeddedness of a psychoanalytic therapeutic relationship where she can learn to feel her way in the world in a new light.     

TRAINING FAMILY THERAPISTS: AN EXPERIMENTAL ANALYSIS

This study implemented and evaluated a training program (a written manual, videotaped models, rehearsal, role plays, and performance feedback) designed to teach five subjects the skills to become effective family therapists. The study examined the therapists' use of three target behaviors: instructing, informing, and praising. The therapists, each paired with a parent and a preschool-aged child (2 1/2–4 1/2 yr old), were trained in the clinic to use, and to teach to the parents, several behavioral skills (e.g., praising, planned ignoring, and time-out) relevant to teaching children compliance to parental instructions. A multiple-baseline design across triads (therapist/parent/child) demonstrated that after the training program was instituted, the therapists increased their rates of instructing, praising, and informing the parents; all parents increased attention to compliance, decreased attention to noncompliance, and increased rates of praise to their children; and all children increased their compliance and decreased their noncompliance.     

Successful intervention with multi-problem mothers: Effects on the mother-infant relationship

A two-step model of intervention for multi-problem mothers was proposed. In order to improve mother-child interaction and later developmental outcomes, the first step is for the practitioner to help the mother change her external competencies (adult social skills) and internal perceptions (support, depression). These changes make the second step possible—the mother then can learn to foster her own child's development. The model was tested in a study of 95 multi-problem women who participated in a nursing intervention program from mid-pregnancy through the child's first birthday. The results supported the two-step model. Improvements in the mothers' external competencies were related to completion of intervention goals. These external improvements also were related to more optimal patterns of mother-child interaction during teaching and feeding episodes at 1 year. Furthermore, an especially insecure type of attachment relationship was found more frequently among the infants of mothers in the group that did not improve. Changes in internal perceptions were unrelated to intervention or interaction measures. These unexpected results suggest that the mother's internal improvements may have a more delayed or a less direct effect upon the child.     

Mother–child relationship quality from preschool to adolescence: Variation by maternal education

Using longitudinal data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (N = 1088), we examine changes in maternal perception of closeness and conflict in the mother–child relationship from the child's preschool to adolescent years, with attention to variation by maternal education. Analyses using individual growth models show that mother–child closeness increases, while mother–child conflict decreases, from preschool to first grade. From first grade to age 15, mother–child closeness decreases, while mother–child conflict increases, both gradually. The decrease in mother–child conflict from preschool to first grade and the increases in mother–child conflict from first to fifth grade, sixth grade, and age 15 are less steep for mothers with a college degree than for mothers without a college degree. These findings underscore the importance of examining changes in parent–child relationships using longitudinal data across children's developmental stages and their variations by parental social and economic status.     

Predictors of representational aggression in preschool children of low‐income urban African American adolescent mothers

Responses to five doll‐story stems thematically related to attachment experiences with the mother were videotaped in the home and used to evaluate child, maternal, and environmental predictors of representational aggression in 93 preschool children of African American women receiving public assistance who had become pregnant as teenagers. Significant correlations were found between representational aggression and child's gender (male), birth weight, maternal depressive affect, maternal educational attainment, recent employment, mother's historical residence with her own mother, and felt social support, accounting for 40% of the variance in representational aggression. A significant Felt Social Support × Gender interaction effect suggested that girls of mothers who perceive higher levels of felt social support are more likely to represent less aggression in their stories; felt social support was not associated with boys' representational aggression. A significant Felt Social Support × Employment interaction effect suggested that representational aggression is associated with lower levels of felt social support only among employed mothers. Findings suggest that different pathways exist for representational aggression in children of low‐income adolescent mothers, which nevertheless share predictors associated with poverty.     

Sex-Role Differentiation in Preschoolers: Effects of Maternal Employment

The purpose of the present study was to determine whether maternal employment affects sex-role differentiation in preschoolers, and whether this relationship varies as a function of the sex of the child, father's presence or absence, and/or the sex of the child's siblings (N = 398 boys and girls, mean age 51.2 months). The dependent measure consisted of a maximally reliable composite z score derived from five tests (Draw-A-Person, Occupational Preference, Nadleman Recall, Toy Preference, It Scale for Children). The fact of the mother working and the social status of her occupation were unrelated to sex-role differentiation, regardless of whether the child was a girl or a boy; had brothers, sisters, both, or was an only child; or came from an intact or nonintact family. However, the main effect for sex and the sex of child × sex of sibling interaction were significant.     

The Effects of Parent Training and Ritalin on the Parent-Child Interactions of Hyperactive Boys

Using a multiple baseline across subjects design, the present study assessed the effects of parent training alone and combined with methylphenidate on the social interactions of three mothers with their hyperactive boys. Two mothers received instruction in child behavior management while their sons remained off medication. Subsequently, these boys returned to medication to evaluate whether the drug further enhanced the effects of parent training. The third child received the drug treatment first and then remained on medication while his mother underwent the same parent training program. Results indicated that both treatments alone decreased the amount of commands given by the mother as well as parent ratings of deviant child behavior in the home, but produced variable improvements in child compliance to commands. More reliable improvements in child compliance to commands. More reliable improvements from each treatment occurred in the duration of compliance per command. the combination of treatments failed to produce any further improvements in mother-child interactions than that achieved by either treatment alone. Contrary to earlier research, only parent training resulted in increases in the mothers' use of positive attention following child compliance.     

Effects of parent enhancement therapy on the treatment outcome and generalization of a parent training program

The purpose of the present study was to examine the effectiveness of parent enhancement training in facilitating treatment and maintenance effects of a parent training program. Seventeen mothers and their clinic-referred noncompliant children were assigned to either a parent training alone group or a parent training plus parent enhancement therapy group. Fifteen mothers and their nonclinic children served as a quasi-control group. All clinic-referred mother-child dyads were treated individually by teaching the mother to reward compliance and other prosocial behavior and to use time-out for noncompliance. In addition, mothers in the parent training plus parent enhancement group also received treatment related to the following areas: parent's perception of their child's behavior, parent's personal adjustment, parent's marital adjustment, and parent's extrafamilial relationships. Assessment consisted of four home observations by independent observers prior to treatment, after treatment, and at a 2-month follow-up. The data indicated that the parent training plus parent enhancement therapy was more effective than parent training alone in changing child deviant behavior at posttreatment and in maintaining child compliance, child deviant behavior, parental rewards and parent contingent attention at follow-up. The control group did not change over the three assessment periods.     

TEACHING CHILD-CARE SKILLS TO MOTHERS WITH DEVELOPMENTAL DISABILITIES

The present study identified and remediated child-care skill deficits in parents with developmental disabilities to reduce their risk of child neglect. Eleven mothers with developmental disabilities who were considered by social service and child welfare agencies to be providing neglectful child care were found in baseline to have several important child-care skill deficits (e.g., bathing, diaper rash treatment, cleaning baby bottles) compared to nonhandicapped mothers. Parent training (consisting of verbal instructions, pictorial manuals, modeling, feedback, and reinforcement) resulted in rapid acquisition and maintenance of child-care skills in all mothers. Mean percentage correct scores increased from 58% in baseline to 90% in training and 91% in follow-up (M = 31 weeks). The latter two scores compare favorably to the mean score (87%) of 20 nonhandicapped mothers on the same skills. Where observable, parent training was associated with corresponding benefits to the children (e.g., elimination of diaper rash and cradle cap, increased weight gain, successful toilet training). These results indicate that parent training may be a viable option to the removal of the child from the home when parenting skill deficits place the child's well-being in jeopardy.     

The role of a parent's illness in the emotional experience of a child evidence from Klein's Narrative of a child analysis

Abstract

The analysis of Richard, described by Melanie Klein in Narrative of a Child Analysis, gives us some insight into the effect on a child of threats to the health of his parents. His mother was involved in a road accident when Richard was 2; his father collapsed during the time of the analysis when he was 10. This paper links these events with disturbances in Richard's relation to his father and to his mother, as well as with threats to his own integrity, as demonstrated in the analysis. Richard's reversal of roles with his father and mother is discussed, as are Klein's reaction to Richard's report of finding his father ‘ill and nearly fainting’ and Richard's response to her behaviour. The paper draws attention to the way in which a child's reaction to the ill health of one parent can affect relations with both parents, as well as disturbing his sense of himself.     

TRAINING PROSOCIAL BEHAVIORS TO YOUNG CHILDREN: AN ANALYSIS OF RECIPROCITY WITH UNTRAINED PEERS

We examined the effects of a social skills training package on the play behaviors of three young girls. Two children were taught to invite their peers to play and to use social amenities during their conversations with other children. A combined reversal and multiple baseline across responses design demonstrated that both children directed more social behaviors to their classroom peers after training and that these two children's play invitations were maintained in the later absence of experimental contingencies. In addition, both target children received a greater number of play invitations from their peers during the free play periods. In contrast, a third child's play invitations were not reciprocated by peers; her invitations subsequently decreased in rate after training was discontinued. An interdependent group contingency produced a reciprocal exchange of invitations between this child and her classroom peers. A reversal design demonstrated partial maintenance of subject-peer exchanges after the group intervention was discontinued. The results obtained with the three target children suggest that peer reciprocity may facilitate the maintenance of children's play invitations over time.