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.     

Temperament as Risk and Protective Factors in Obesogenic Eating: Relations Among Parent Temperament,Child Temperament,and Child Food Preference and Eating

Children’s food preferences and eating behaviors have implications for their health and weight status, serving as risk or protective factors for obesity. Although parent and child factors influence children’s eating, few studies have examined parent and child temperament simultaneously in relation to child food preference and eating behaviors. The authors addressed this research gap. Participants were 115 ethnically diverse children between 4 and 6?years old and their parents. Measures included parental temperament traits, parental anxiety, child temperament traits, and child food preference and eating behaviors observed using a laboratory procedure. Results show that children preferred candies over grapes, and that aspects of both child and adult temperament were related to child eating behaviors. Child surgency was linked to eating more candies, while child effortful control was linked to eating more grapes. Parent effortful control was related to children’s preference toward grapes. No relations were found between child eating behaviors and child or parent negative affectivity and parental anxiety. Overall, findings suggest that highly impulsive and poorly self-regulated children may be at risk for obesogenic eating habits.     

Factors Associated with 3-Year Stability and Change in Parenting Behavior of Abusive Parents

We sought to examine the stability of parenting behaviors among physically abusive parents in the 3-year period between their children’s preschool and first grade years. The second purpose of the study was to identify factors that predicted the levels and rates of change in parenting behaviors. 54 parent/child dyads were recruited following substantiated physical abuse of the child and were assessed in preschool, kindergarten, and first grade. Parenting behaviors were measured by observations during Parent–Child Interactions, self-reports from parents, and child reports using a puppet interview. Potential predictors of stability and change examined were demographic factors (SES, child gender, and ethnicity) and parent characteristics (depressive symptomatology, perceptions of child behavior problems, and life stress). Multilevel modeling indicated significant fluctuations in parenting among abusive parents, and these fluctuations were generally attributable to within-person rather than between-person differences. Linear change over time was evidenced in observed positive regard, flat affect, sensitivity, and child-reported structure; changes generally were in the direction of deterioration of parenting over time. Parents’ perceptions of the severity of their children’s behavior problems predicted changes over time in parenting behaviors related to intrusiveness and structure in the home. Demographic factors and parental depression predicted change in select parenting behaviors. Overall, findings indicate instability in parenting during the developmental transition to kindergarten and wide individual differences in patterns of change in parenting. Further, parenting behavior tends to deteriorate rather than improve following substantiation of physical abuse by the child protection system.     

Effects of PMTO in Foster Families with Children with Behavior Problems: A Randomized Controlled Trial

The present randomized controlled trial examined the effectiveness of Parent Management Training Oregon for foster parents with foster children (aged 4–12) with severe externalizing behavior problems in long-term foster care arrangements. Foster children’s behavior problems are challenging for foster parents and increase the risk of placement breakdown. There is little evidence for the effectiveness of established interventions to improve child and parent functioning in foster families. The goal of Parent Management Training Oregon, a relatively long and intensive (6–9 months, with weekly sessions) parent management training, is to reduce children’s problem behavior through improvement of parenting practices. We specifically investigated whether Parent Management Training Oregon is effective to reduce foster parenting stress. A significant effect of Parent Management Training Oregon, compared to Care as Usual was expected on reduced parenting stress improved parenting practices, and on reduced child behavior problems. Multi-informant (foster mothers, foster fathers, and teachers) data were used from 86 foster families (46 Parent Management Training Oregon, 40 Care as Usual) using a pre-posttest design. Multilevel analyses based on the intention to treat principle (retention rate 73?%) showed that Parent Management Training Oregon, compared to Care as Usual, reduced general levels of parenting stress as well as child related stress and parent-related stress (small to medium effect sizes). The clinical significance of this effect was, however, limited. Compared to a decrease in the Care as Usual group, Parent Management Training Oregon helped foster mothers to maintain parental warmth (small effect size). There were no other effects of Parent Management Training Oregon on self-reported parenting behaviors. Child behavior problems were reduced in both conditions, indicating no additive effects of Parent Management Training Oregon to Care as Usual on child functioning. The potential implication of reduced foster parenting stress for placement stability is discussed.     

The Impact of Parent Empowerment in Children’s Mental Health Services on Parenting Stress

Emotional and behavioral (EB) problems in children are associated with increased perceptions of strain in parenting. Among children receiving services, parenting stress has been linked to initiating services for their children, and may strain the relationship between parent and child. In contrast, parental engagement and empowerment in services is an important quality indicator for positive treatment outcomes. However, no known studies have examined the association between parent empowerment in their child’s services and their perceptions of stress related to parenting a child with significant mental health needs. Further, no studies have explored whether empowerment moderates the relationship between the child’s symptoms and parental perceptions of stress. The current study examined the impact of child EB problems and parent empowerment on parenting stress. Among a sample of 525 parents of children receiving school-based services for disruptive behavior disorders, child EB problems significantly predicted parenting stress. Parent empowerment also correlated with lower parenting stress, as hypothesized. Although parent empowerment was not found to moderate the relationship between child symptomatology and parenting stress, the relationship between parent empowerment and parenting stress differed based on child gender and age. Parent empowerment was associated with lower parenting stress more for parents of females and younger children than for parents of males and older children.     

Parent–child interactions during traditional and interactive media settings: A pilot randomized control study

Parent–child interactions are pivotal for children's socioemotional development, yet might suffer with increased attention to screen media, as research has suggested. In response, we hypothesized that parent–child play on a tablet computer, as representative of interactive media, would generate higher‐quality parent–child interactions than toy play or watching TV . We examined the emotional availability of mothers and their 2‐year‐old child during the previous three contexts using a randomized crossover design (n = 22) in a laboratory room. Among other results, mothers were more sensitive and structuring during joint gaming on a tablet than when engaged in toy play or watching TV . In addition, mothers were more hostile toward their children during play with traditional toys than during joint tablet gaming and television co‐viewing. Such findings provide new insights into the impact of new media on parent–child interactions, chiefly by demonstrating that interactive media devices such as tablets can afford growth‐enhancing parent–child interactions.     

“It Depends on What You Mean by ‘Disagree’”: Differences between Parent and Child Perceptions of Parent–Child Conflict

We examined a new structured interview of parent?Cchild conflict that assesses parent and child perceptions of behavioral conflict about daily life topics (e.g., doing chores, homework), and whether discrepancies exist on beliefs about these topics. In a sample of 100 parents and children ages 10 to 17?years (M?=?13.5?years, 52 males, 57?% African-American), informants could reliably distinguish between perceived behavioral conflicts and perceived discrepant beliefs about topics. These scores were also significantly related to questionnaire reports of parent?Cchild conflict. Parent and child questionnaire reports did not significantly differ, yet on the structured interview, parents reported significantly greater levels of perceived conflict and discrepant beliefs relative to child reports. Additionally, structured interview reports of conflict demonstrated incremental validity by relating to child self-reports of delinquent behaviors, when accounting for questionnaire conflict reports. The findings have implications for increasing understanding of the links between parent?Cchild conflict and psychosocial outcomes.     

Parent–Child Synchrony in Children with Oppositional Defiant Disorder: Associations with Treatment Outcomes

Oppositional defiant disorder (ODD), characterized by angry/irritable mood, and argumentative/defiant behavior, is associated with significant negative outcomes in childhood and beyond. Researchers posit that these behaviors arise from poor parenting and/or an incompatibility between characteristics of the child and the child’s parents, resulting in strained interaction styles. The present study examines parent–child synchrony, the inverse of parent–child incompatibility as a predictor of children’s emotional lability, aggression, and overall functioning following psychosocial treatment. Participants were 75 treatment-seeking families with children diagnosed with ODD (46 boys). Families received one of two empirically supported treatments for ODD (Parent Management Training or Collaborative and Proactive Solutions). Findings indicated that pre-treatment parent–child synchrony was associated with decreased emotional lability and aggression following both treatments, as well as improvement in overall functioning, irrespective of treatment condition. These results reflect the importance of parent–child relations at the onset of treatment in predicting response to treatment and suggest potential treatment targets within parent–child relationships.     

Relationship Quality among Chronically Ill Children and their Parents

The present study examined the quality of parent–child relationships as reported by 383 parents of chronically ill children. The medical condition category, child’s mobility, education type and childcare assistance were examined. Parents answered the Parent–Child Relationship Inventory (PCRI). In addition, 45 parents of chronically ill children were interviewed. The results indicated a significant difference in most aspects of the PCRI (limit setting, promotion of autonomy, communication, satisfaction and involvement) across medical condition categories. Further child variables (mobility, assistance and education type) had an effect on the PCRI subscales as well. Interview analysis revealed a difference in the reported quality of parent–child relationships between medical conditions categories. Parents of mentally ill children primarily felt anger and guilt in their relationship with their ill children, whereas parents of children with cancer and autoimmune disease primarily felt depressed. Our results suggest the need for further study of parent–child relationships in and between different chronic childhood medical conditions in an attempt to address parents’ and children’s needs in an optimal way.     

Fathers as Intervention Agents for Their Children with Developmental Disabilities

ABSTRACT

Parent training aimed at aiding children to overcome social and behavioral problems is an area that has continued to gain attention and support. Very little of the current research has been with developmentally disabled children, the focus of this study. Additionally, for most parent training programs, “parents” actually refers to mothers. In this study three fathers and their developmentally disabled children, who ranged in age from 2 years 10 months to 4 years 5 months, were studied. A multiple baseline across fathers' behaviors was utilized for participants to evaluate effects of parent training on fathers' target behaviors. Child compliance and inappropriate behaviors were also addressed. Parent training resulted in desirable changes on a range of target behaviors. The implications of these findings are discussed.     

A Glimpse into Co-Occupations: Parent/Caregiver's Support of Young Children's Playfulness Scale

Cooperative play between parents/caregivers and children is a positive and significant contributor to the development of children’s emotional, social, and cognitive skills and may set the stage for the formation of co-occupations. This article discusses the rationale for the development of Parent/Caregiver’s Support of Young Children’s Playfulness (PSYCP), an assessment that is based on children’s play and playfulness, adult’s playfulness, and parent–child interaction. The use of the PSYCP to assess co-occupations will allow therapists to identify the specific behaviors that either hinder or support playfulness and mutual play.     

Depressive Symptoms among Children with ODD: Contributions of Parent and Child Risk Factors in a Chinese Sample

Oppositional Defiant Disorder (ODD) is a developmental disorder characterized by serious and persistent social impairment, especially stressful interactions with parents. Although previous studies demonstrated associations between parent mental health and children’s ODD symptoms, less attention has been paid to integrating both parent and child risk factors. The purpose of the current study was to investigate the associations among parent emotion regulation, child emotion regulation, parental depression, and child depression in Chinese children with ODD. A total of 234 children with ODD ranging in age from 6 to 13 years, along with their fathers or mothers, completed questionnaires. Results indicated that: (1) Parent emotion regulation, parental depression and child emotion regulation were significantly correlated with children’s depressive symptoms. (2) Parent emotion regulation was related to children’s depression indirectly through parental depression and child emotion regulation. (3) Child emotion regulation fully mediated the relationship between parent emotion regulation and child depression, and also fully mediated the relationship between parental and child depression. These findings highlight the need to improve parent emotion regulation and pay attention to parental mental health, because both risk factors may exacerbate their children’s emotion regulation difficulties and further associate the high level of depressive symptoms among children with ODD.     

Psychometric Evaluation of the Parent Anger Scale

This study assessed the factor structure and psychometric properties of the Parent Anger Scale in a sample of 326 parents of children ages 2–18 years. Exploratory factor analysis identified a two-factor solution: parent anger experience and parent anger expression. Subscales based on the items of each factor demonstrated excellent internal consistency and concurrent validity with measures of other negative affect and parent discipline. The Parent Anger Scale subscales also evidenced incremental validity, predicting discipline behaviors uniquely above that predicted by parents’ general anger and general anxiety. Specifically, analyses indicated that the Parent Anger Scale experience and expression scores were each unique predictors of inconsistent and punitive parental discipline after controlling for the influences of general anger and anxiety. However, only the Parent Anger Scale expression score had a significant incremental effect in negatively predicting positive parenting above the effects of parents’ general anger and anxiety. Results suggest that the Parent Anger Scale is a valid and useful measure for assessing anger specific to the parent-child context. However, additional research exploring the factor analytic structure and predictive value of the Parent Anger Scale in a clinical sample is needed.     

Parenting Behaviors and Childhood Anxiety: A Psychometric Investigation of the EMBU-C

Parent rearing behaviors, including both behavioral modeling and parent–child interactions, are associated with anxiety in children. Patterns of overprotection or rejecting behavior from parents may lead children to develop behavioral avoidance, lower self-confidence, and higher symptoms of anxiety. Additional research is needed to further elucidate the role that parenting behavior plays in the development of childhood anxiety. Unfortunately, few measures of parenting behavior exist. The EMBU-C is a 40-item child-report measure of these behaviors, but empirical data supporting the psychometric properties of the EMBU-C are limited. The current investigation examined the psychometric properties of the EMBU-C in the context of childhood anxiety. Participants were 213 children with an anxiety disorder and 150 recruited from the community (all aged 8–13 years). Overall, the EMBU-C demonstrated promising psychometrics. In terms of convergent validity, parent rearing behaviors described on the EMBU-C were significantly related to children’s anxiety symptoms, anxiety-related disability, parenting stress, family functioning and children’s externalizing behaviors. Further, the overprotection and anxious-rearing subscales discriminated between clinical and community participants. Finally, parental overprotection significantly predicted increases in child anxiety and anxiety-related disability 1 year later. Thus, the EMBU-C appears to have value as a clinical tool for assessing parental factors that may contribute to anxiety in children. Recommendations for further item development and measure improvement are offered.     

Brief Behavioral Intervention for Young Children with Disruptive Behaviors

Parent reported behavioral difficulties in young children are relatively common. Without adequate intervention, some children will later present with more severe problem behaviors. Parent management training is one of the best methods of treatment for behavior problems; however, existing treatments can be lengthy and difficult to conduct outside of a research setting. The Brief Behavioral Intervention was designed as a briefer version of a manualized parent management training treatment package. Thirty-one parents of children aged 2–6.5 presenting with behavior problems were included in this initial study of treatment effectiveness. Based on parent and teacher report, treatment was effective in a mean of 7.2 sessions.     

Therapist Focus on Parent Involvement in Community-Based Youth Psychotherapy

Parent involvement in the treatment of childhood disruptive behavior problems is a critical component of effective care. Yet little is known about the amount of time therapists are involving parents in treatment and factors that predict therapists' efforts to involve parents in routine care. The purpose of this study is to examine therapists' within-session involvement of parents in community-based outpatient mental health treatment. The data are from a larger longitudinal observational study of psychotherapy for children ages 4-13 with disruptive behavior problems and include videotaped psychotherapy sessions coded for the therapeutic strategies delivered as well as measures of child, parent/family, and therapist characteristics at baseline. Parent involvement is defined as the proportion of time in the session that therapists direct treatment strategies towards parents. Results indicated that therapists directed treatment strategies towards parents an average of 44% of the time within a session. Multilevel modeling was used to examine client-level (child, parent, and family functioning) and provider-level (therapist experience and background) predictors of parent involvement. Therapists involved parents more when the child had higher levels of behavior problems, when the parent reported higher levels of internalized caregiver strain, and when the therapist was more experienced. The results highlight potential areas to target in efforts to increase parent involvement, including training less experienced therapists to increase their focus on directing strategies towards parents.     

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.     

Utilizing Benchmarking to Study the Effectiveness of Parent–Child Interaction Therapy Implemented in a Community Setting

Benchmarking is a program evaluation approach that can be used to study whether the outcomes of parents/children who participate in an evidence-based program in the community approximate the outcomes found in randomized trials. This paper presents a case illustration using benchmarking methodology to examine a community implementation of Parent–Child Interaction Therapy (CI-PCIT) utilized as a child maltreatment prevention effort. Data were collected from 83 parent–child dyads. Change scores were compared to treatment and control effect sizes aggregated from the PCIT literature. Pre-post results indicated significant positive changes in child behavior for CI-PCIT completers. Benchmarking analyses revealed that parents who completed CI-PCIT reported significantly greater positive child outcomes than the aggregate control group benchmark, and significantly less than observed in the treatment benchmark. A summary of decision points and implications for utilizing this methodology in the child maltreatment field are postulated.     

Family Communication Patterns,Discourse Behavior,and Child Television Viewing

This study investigated the relationship between the Family Communication Patterns (FCP) Inventory and parent-child discourse, the effect of FCP scores on child compliance, and the effect of parent discourse strategies on child compliance. Parents and children did not appear to agree about the norms in their family and appeared to be using different instances of discourse to draw conclusions about their family. For parents, control orientation was related to controlling verbal strategies; for children, control was related to global negative affect. Communication orientation was related to information sharing for parents but to fewer parental commands for children. In addition, greater control orientation resulted in less compliance. Parent discourse strategies also were related to child compliance. Younger children were more compliant when parents used directive language coupled with positive affect, but older children were less compliant in response to this verbal strategy.     

Parent stress and coping in relation to child ADHD severity and associated child disruptive behavior problems.

Examined parent role distress and coping in relation to childhood attention deficit hyperactivity disorder (ADHD) in mothers and fathers of 66 children age 7 to 11 (42 boys, 24 girls; mean age = 10.2). Parents of children with ADHD combined and inattentive subtypes expressed more role dissatisfaction than parents of control children. Parents of ADHD combined and inattentive type children did not differ significantly in levels of distress. For mothers, child inattention and oppositional-conduct problems but not hyperactivity contributed uniquely to role distress (dissatisfaction related to parenting or parenting performance). For fathers, parenting role distress was associated uniquely with child oppositional or aggressive behaviors but not with ADHD symptom severity. Parent coping by more use of positive reframing (thinking about problems as challenges that might be overcome) was associated with higher role satisfaction for both mothers and fathers. Community supports were associated with higher distress for mothers only.