Relations between Parenting Stress,Parenting Style,and Child Executive Functioning for Children with ADHD or Autism

Relations among parenting stress, parenting style, and child executive functioning for children with disabilities are not easily teased apart. The current study explored these relations among 82 children and adolescents age 7–18: 21 with attention deficit/hyperactivity disorder, 33 with autism spectrum disorder, and 28 typically developing. Results indicated that children with attention deficit/hyperactivity disorder or autism spectrum disorder had more executive functioning deficits, and their parents reported more parenting stress and a greater use of permissive parenting, compared to typically developing children. In general, increased parenting stress was associated with greater use of authoritarian and permissive parenting styles, as well as more problems with behavior regulation for children. Authoritarian and permissive parenting styles were associated with poorer child executive functioning. Child diagnostic group (attention deficit/hyperactivity disorder, autism spectrum disorder, typically developing) moderated relations between parent stress and child functioning, and between parenting style and child functioning. Implications for intervention with families of children with disabilities are discussed.     

Association of social-environmental factors with cognitive function in children with sickle cell disease

The aim of this study was to examine the relationship between cognitive function in pediatric sickle cell disease (SCD) patients and mothers’ reports of social-environmental stress, depressive symptoms, and parenting. A total of 65 children with SCD completed comprehensive neuropsychological testing to assess several domains of cognitive functioning, including general intellectual ability, academic achievement, and executive function. Mothers reported on demographics, social-environmental stress, depressive symptoms, and parenting. As predicted, children with SCD significantly underperformed relative to normative data on measures of cognitive function. Associations between maternal social-environmental stress, maternal depressive symptoms, and parenting were mixed. The results show partial support for the hypothesis that greater stress and depressive symptoms and less positive parenting are associated with poorer cognitive function in children with SCD. Linear regression analyses showed that maternal financial stress was the strongest predictor across all domains of cognitive function. The findings replicate and extend past research, reaffirming that children with SCD are at risk for cognitive impairment across multiple domains. Additionally, social-environmental stress, particularly financial strain, is linked to mothers’ depressive symptoms and parenting behaviors as well as children’s cognitive function. Future studies using direct observations of parenting behaviors are needed. These findings, along with recent research on parenting interventions, may inform the development of concrete, teachable parenting and coping skills to improve cognitive functioning in children with SCD.     

Coping and care-related stress in parents of a child with autism spectrum disorder

Background and Objectives: Parenting a child with Autism Spectrum Disorder (ASD) is challenging and can result in elevated levels of parenting stress. This study investigated the relationship between parent-ratings of their child’s ASD symptoms and two conceptually different measures of parenting stress: One specific to the ASD context and the other a general stress measure applicable to the broader caregiving context. Additionally, the influence of coping style on the relationship between child’s ASD symptoms and parenting stress was investigated.

Design and Methods: Using an internet survey, parents (N?=?178) caring for a child with ASD reported on coping strategies, completed two measures of parenting stress, and assessed their child’s ASD symptoms.

Results: Parenting stress increased with severity of the child’s ASD symptoms, but the strength of this relationship depended on whether a general or disorder-specific measure of parenting stress was used. Regression analyses indicated that some coping strategies moderated the impact of ASD symptom severity on the parent’s care-related stress, but moderation depended on how stress was conceptualized.

Conclusion: This study reinforces the importance of identifying the coping strategies of parents of children with developmental disorders, and highlights the consequences of using different conceptual approaches to measure parenting stress.     

Maternal positive parenting style is associated with better functioning in hyperactive/inattentive preschool children

Many preschoolers are highly inattentive, impulsive, and hyperactive; but only some are impaired in their functioning. Yet factors leading to functional impairment, above and beyond the severity of inattentive and hyperactive symptoms, have not been systematically examined. This study examined a model suggesting that after controlling for attention‐deficit/hyperactivity disorder (ADHD) symptom severity, child temperament is uniquely associated with parenting stress; that parenting stress affects parenting style, above and beyond child characteristics; that parenting style is related to the level of child impairment, above and beyond the effects of child symptoms, temperament, and parenting stress; and finally that parenting style moderates the relationship between ADHD symptom severity and child functioning. Child measures included parent‐ and teacher‐rated ADHD symptom severity, teacher‐rated temperament, and clinician‐rated functioning in a sample of 138 inattentive/hyperactive preschoolers. Maternal self‐ratings of parenting style and parenting stress were obtained. Analyses indicated that, after controlling for symptom severity, child temperament was related to maternal parenting stress, which was additionally related to both maternal parenting style and child functioning. Maternal positive parenting style moderated the relationship between ADHD symptom severity and child impairment, indicating that a positive parenting style plays a protective role in the functioning of hyperactive/inattentive preschoolers. Copyright © 2010 John Wiley & Sons, Ltd.     

A longitudinal investigation of children internationally adopted at school age

Most existing research on children adopted internationally has focused on those adopted as infants and toddlers. The current study longitudinally tracked several outcomes, including cognitive, behavioral, emotional, attachment, and family functioning, in 25 children who had been internationally adopted at school age (M = 7.7 years old at adoption, SD = 3.4, range = 4–15 years). We examined the incidence of clinically significant impairments, significant change in outcomes over the three study points, and variables that predicted outcomes over time. Clinically significant impairments in sustained attention, full-scale intelligence, reading, language, executive functioning, externalizing problems, and parenting stress were common, with language and executive functioning impairments present at higher levels in the current study compared with past research focusing on children adopted as infants and toddlers. Over the three study points, significant improvements across most cognitive areas and attachment functioning were observed, though significant worsening in executive functioning and internalizing problems was present. Adoptive family-specific variables, such as greater maternal education, smaller family size, a parenting approach that encouraged age-expected behaviors, home schooling, and being the sole adopted child in the family were associated with greater improvement across several cognitive outcomes. In contrast, decreased parenting stress was predicted by having multiple adopted children and smaller family sizes were associated with greater difficulties with executive functioning. Child-specific variables were also linked to outcomes, with girls displaying worse attachment and poorer cognitive performance and with less time in orphanage care resulting in greater adoption success. Implications for future research and clinical applications are discussed.     

Parenting stress in parents of children with attention-deficit hyperactivity disorder and parents of children with learning disabilities

Parenting a child with ADHD can challenge parenting resources and coping. Increasingly, researchers are examining the relationship between the behavior of the child with ADHD and family functioning. While studies have shown inceased parenting stress in parents of children with ADHD, these studies have compared children with ADHD to non-disabled children. This study compares reports of parenting stress among mothers of children with ADHD, mothers of children with learning disabilities and mothers of non-referred children. Results showed that parenting stress was highest for mothers of children with ADHD. Increased parenting stress was associated with child characteristics and, in particular, with externalizing behavior problems.     

Bidirectional Relationships Between Parenting Stress and Child Coping Competence: Findings From the Pace Study

The present study was designed to evaluate the bidirectional relationships between parenting stress and child coping competence. Data from a diverse sample of 610 parents enrolled in the parenting our children to excellence program was used to evaluate whether parenting stress negatively contributes to affective, achievement, and social coping competence in preschoolers, as well as whether child coping competence predicts parenting stress; after accounting for child disruptive behavior. Results from cross-lagged panel analyses demonstrated a bidirectional relationship, such that parenting stress predicted later child coping competence and child coping competence predicted later parenting stress. Assessment of ethnicity differences indicated that child coping continues to have a long-term impact on parenting stress, regardless of parent ethnicity. The same relationship did not hold for earlier parenting stress on later child coping competence, however, indicating a bidirectional relationship for African American families, but not for their European American counterparts. The relationship between parenting stress and child coping competence is discussed with respect to their conceptual and clinical implications. Suggestions for parent training intervention and prevention programs are given.     

Caregivers's Stress Secondary to Raising Young Children with HIV Infection: A Preliminary Investigation

This study examined the impact of caring for a child with HIV infection on biological mothers (also infected with HIV), familial caregivers, and foster mothers. Levels of reported parenting stress, emotional functioning, the impact of the child's illness, and coping strategies utilized were compared. Participants were 35 female caregivers of young children (birth to 5 years) with HIV infection. Demographic variables reflected group differences: biological mothers were younger, foster mothers had greater monthly income, and children who were living with relatives were older. Group differences were noted with regards to parent related stress, anxiety, and depression with foster mothers reporting lower levels. The types of coping strategies utilized were generally similar across groups. Results suggest that young, biological caregivers of children with HIV infection may benefit from careful assessment with regard to their need for psychological intervention.     

Early parent-child relations and family functioning of preschool boys with pervasive hyperactivity

This study examined the quality of parent–child relationships and family functioning of preschool children with early onset hyperactivity by comparing a community sample of 33 pervasively hyperactive preschool boys with a comparison sample of 34 boys. Mothers and children were assessed at home on a range of interview, parent questionnaire, and observational measures of parenting and family functioning. Results of the study showed that higher rates of reported lax disciplinary practices, less efficient parental coping, lower rates of father–child communication, and less synchronous mother–child interactions were significantly associated with hyperactivity following statistical adjustment for the effects of conduct problems and other confounding factors. The best parenting predictor of hyperactivity was maternal coping. The present findings suggest that the way in which parents interact with their preschool children may make a unique contribution to the development and ongoing behavioral difficulties experienced by children with pervasive hyperactivity. Findings also highlight the importance of considering the role of fathers in the behavioral development of boys with early tendencies to hyperactive and distractible behavior problems.     

Family Cohesion and Health-Related Quality of Life of Children with Type 1 Diabetes: The Mediating Role of Parental Adjustment

Despite the increasing number of studies on the health-related quality of life (HRQOL) of children with type 1 diabetes (T1D), little is known about the influence of family and parental factors on this outcome. This study aimed to explore whether family cohesion and children’s HRQOL were connected through three indicators of parental psychological adjustment (parenting stress, depressive symptoms, and anxious symptoms) as well as whether these links varied according to the child’s age. Levels of family cohesion, parenting stress, and depression/anxiety symptoms of parents of children with T1D and parents of healthy children were compared. The sample included 88 child–parent dyads composed of children/adolescents (8–18 years old) with T1D and one of their parents and 121 dyads composed of healthy children/adolescents and one of their parents. The parents completed self-report measures of family cohesion, parenting stress, and emotional adjustment, and the children completed measures of HRQOL. Testing of the hypothesized moderated mediational model showed that higher HRQOL ratings in children were associated with higher levels of cohesion through lower levels of parental stress, regardless of the child’s age. Parents of children with T1D perceived less cohesion and felt more anxiety and stress about parenting tasks compared to parents of healthy children. Our findings suggest that parents of children with T1D are at an increased risk of psychological maladjustment. Moreover, this study highlights the interrelation between family/parental functioning and child adjustment and makes an innovative contribution by identifying a mechanism that may account for the link between family and child variables.     

Early childhood cortisol reactivity moderates the effects of parent–child relationship quality on the development of children's temperament in early childhood

Positive parenting has been related both to lower cortisol reactivity and more adaptive temperament traits in children, whereas elevated cortisol reactivity may be related to maladaptive temperament traits, such as higher negative emotionality (NE) and lower positive emotionality (PE). However, no studies have examined whether hypothalamic‐pituitary‐adrenal axis activity, as measured by cortisol reactivity, moderates the effect of the quality of the parent–child relationship on changes in temperament in early childhood. In this study, 126 3‐year‐olds were administered the Laboratory Temperament Assessment Battery (Lab‐TAB; Goldsmith et al., 1995) as a measure of temperamental NE and PE. Salivary cortisol was collected from the child at 4 time points during this task. The primary parent and the child completed the Teaching Tasks battery (Egeland et al., 1995), from which the quality of the relationship was coded. At age 6, children completed the Lab‐TAB again. From age 3 to 6, adjusting for age 3 PE or NE, a better quality relationship with their primary parent predicted decreases in NE for children with elevated cortisol reactivity and predicted increases in PE for children with low cortisol reactivity. Results have implications for our understanding of the interaction of biological stress systems and the parent–child relationship in the development of temperament in childhood.     

Expressed Emotion,Parental Stress,and Family Dysfunction Among Parents of Nonclinical Italian Children

Expressed emotion (EE) is an index of the amount of emotion typically displayed by a family member or caretaker characterized by high emotional involvement, hostility or criticism. The aims of the current study were (a) to examine EE, stress and helplessness in childcare, and family functioning in mothers and fathers of elementary and junior high school children without clinical mental health problems living in a “nonclinical” family context; (b) to assess relationships between child age, gender, socio-economic status and EE; and (c) to investigate whether there are some factors—in a “normal family” context—that play a crucial role in the quality of EE. EE, assessed using the Five Minute Speech Sample (FMSS), and questionnaires assessing parenting alliance, family functioning, parenting stress index, and the parent’s state of helplessness in caring for the child were completed by a community-based Italian sample of mothers and fathers of children (N = 381) aged 6–14 years (M = 9.8, SD = 2.25). As expected, low rates in all FMSS variables were found for mothers and fathers, without significant differences between them. Mothers and fathers who showed high EE scores reported higher family non-adaptive functioning. Mothers also reported higher parental stress and higher Helplessness in caring for the child. Mothers’ stress and fathers’ reports of higher family non-adaptive functioning were the most consistent predictors of EE. Further research is needed to highlight associations between EE and family functioning.     

Mentoring Youth with Psychiatric Disorders: The Impact on Child and Parent Functioning

ABSTRACT

This study examined the effectiveness of a behavioral mentoring program aimed at serving youth with psychiatric disorders. Participants included 30 youth (8–12 years old) receiving services in a mentoring program for a mental health population and 30 wait-listed youth and their maternal caregivers. Participating in mentoring services was related to higher family functioning across a number of domains including child behavior, parenting stress, perceived parent social support, and perceived parent-child relationship quality. As predicted, parenting stress mediated the relationship between mentoring and children's externalizing behavior problems. Results suggest that mentoring services may be a useful adjunct service for highly stressed families with children with emotional and behavioral disorders.     

Effectiveness of therapeutic and behavioral interventions for parents of low‐birth‐weight premature infants: A review

Premature birth has been associated with a number of adverse maternal psychological outcomes that include depression, anxiety, and trauma as well as adverse effects on maternal coping ability and parenting style. Infants and children who were premature are more likely to have poorer cognitive and developmental functioning and, thus, may be harder to parent. In response to these findings, a number of educational and behavioral interventions have been developed that target maternal psychological functioning, parenting, and aspects of the parent–infant relationship. Since the last comprehensive review of this topic in 2002, there have been a significant number of developments in the quality of the studies conducted and the theoretical models that address the experience of parents of premature infants. In the current review, 18 new interventions were identified and grouped into four categories based on treatment length and the target of the intervention. Findings suggest a trend toward early, brief interventions that are theoretically based, specifically target parent trauma, and utilize cognitive behavioral techniques. Although it is difficult to generalize study findings, conclusions from the review suggest that targeted interventions may have positive effects on both maternal and infant outcomes.     

Cumulative parenting stress across the preschool period: relations to maternal parenting and child behaviour at age 5

Despite increasing interest in the effects of parenting stress on children and families, many questions remain regarding the nature of parenting stress and the mechanism through which stress exerts its influence across time. In this study, cumulative parenting stress was assessed across the preschool period in a sample of 125 typically developing children and their mothers. Indices of parenting stress included both major life events stress‐assessed annually from age 3 to 5, and parenting daily hassles assessed every 6 months across the same period. Naturalistic home observations were conducted when children were age 5, during which measures of parent and child interactive behaviour as well as dyadic pleasure and dyadic conflict were obtained. Mothers also completed the CBCL to assess children's behaviour problems. Results indicated that parenting daily hassles and major life stress are relatively stable across the preschool period. Both cumulative stress indices also proved to be important predictors of parent and child behaviour and dyadic interaction, although the predictions were somewhat differential. Despite meaningful relations between the stress factors and child well being, no evidence was found to support the premise that parent behaviour mediates the association between parenting stress and child outcomes. Results are discussed within a developmental framework to understand the stability and complexity of cumulative stress associations to early parent–child relationships. Copyright © 2005 John Wiley & Sons, Ltd.     

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.     

Executive functions in early childhood: The role of maternal and paternal parenting practices

We investigated the association between mothers' and fathers' harsh parenting and sensitive parenting practices and child's executive functions (EF) in early childhood in 607 families. We focused on three broad dimensions of child EF: Emergent metacognition, inhibitory self‐control, and flexibility measured with the parent‐reported Behavior Rating Inventory of Executive Function‐Preschool Version. Less sensitive parenting of the mother and harsher parenting of the father were related to lower scores of emergent metacognition and inhibitory self‐control. Parenting was not associated with child flexibility. This study extends previous research on the association between parenting and EF by the focus on the role of the father and demonstrates independent effects of mother and father on child EF.     

Improved Parental Emotional Functioning After Circle of Security 20-Week Parent–Child Relationship Intervention

This study examined the effectiveness of the attachment-based Circle of Security 20-week intervention (COS) in improving parent emotional functioning in 83 families referred to a community clinical service with concerns about their young children’s behavior. Parenting stress and parent psychological symptoms were assessed pre and post intervention and mixed design repeated measures ANOVAs were used to assess change. Severity of presenting problems was considered as a moderator. Results showed clinically significant improvements in both aspects of parent emotional functioning, with changes accounted for by for those with more severe problems at the outset. Improvements for parents were associated with improved child behavior and more positive parent representations of the child and of parenting capacity. Findings suggest the intensive COS intervention is effective in reducing parenting stress and psychological symptoms in parents of children from aged 1–7 years. Questions remain about the mechanisms of change and the direction of effects.     

Long-term executive function deficits in children with traumatic brain injuries: assessment using the Behavior Rating Inventory of Executive Function (BRIEF).

Long-term deficits in executive functions following childhood traumatic brain injuries (TBI) were examined using the Behavior Rating Inventory of Executive Function (BRIEF). Parents completed the BRIEF approximately 5 years postinjury as part of a prospective study of children injured between the ages of 6 and 12. The children were between 10 and 19 years of age at the time of the assessment, and included 33 with severe TBI, 31 with moderate TBI, and 34 with orthopedic injuries. Parents also rated children's adaptive functioning and completed several other measures of parent and family functioning. Children were administered a neuropsychological test battery that included several measures of executive functions. The groups displayed a significant linear trend in BRIEF scores, with the largest deficits in executive functions reported in children with severe TBI. BRIEF scores were related consistently across groups to a test of working memory, but not to other neuropsychological measures. BRIEF scores also predicted children's adaptive functioning and behavioral adjustment, as well as parent psychological distress, perceived family burden, and general family functioning. The findings indicate that TBI results in long-term deficits in executive functions that are related to children's psychosocial outcomes, as well as to parent and family functioning.     

Childhood Adversity and Children’s Academic Functioning: Roles of Parenting Stress and Neighborhood Support

Existing research has shown that adverse childhood experiences from family instability and lack of safety increase children’s risk for poor academic functioning. A recent conceptual framework, however, has emphasized the need to investigate how parenting might mediate while community context might moderate the association between childhood adversity and children’s cognitive development. In the current study, we tested the roles of parenting stress and neighborhood support in the association between cumulative childhood adversity and children’s current academic functioning. We conducted a secondary data analysis on the subsample of school-aged children (i.e., 6–17 years old; N?=?65,680) from the 2011–2012 United States National Survey of Children’s Health (NSCH). The parent provided telephone survey data on six types of adversity (e.g., parent’s divorce) that the target child experienced, parenting stress, neighborhood support, as well as the child’s academic functioning. Controlling for the child’s age, gender, ethnicity, and the parent’s education level, structural equation modeling (SEM) revealed a significant moderated mediating effect: parenting stress partially mediated the association between history of childhood adversity and children’s current academic functioning (β?=??1.760, p?<?0.001), while neighborhood support moderated the association between parenting stress (β?=?0.492, p?<?0.001) and academic functioning.