A review of teen-tot programs: comprehensive clinical care for young parents and their children

Comprehensive clinical programs for teenage mothers and their children, also known as teen-tot programs, have been a promising intervention to improve outcomes of teenage childbearing and parenting. However, much remains unknown regarding the efficacy of such programs. We reviewed four published evaluations of programs that provided medical care, counseling, contraception, guidance for parenting, and assistance with staying in school. The evaluations reported moderate success in preventing repeat pregnancies, helping teen mothers continue their education, and improving teen and infant health over 6 to 18 months. However, the evaluations had limitations that may have reduced or accentuated observed effectiveness. Teen-tot programs will continue to face the challenges of sustaining adequate long-term interventions and evaluations, and reducing the high attrition rate among program participants. It is concluded that increased support and funding for teen-tot programs and more complete evaluations are warranted.     

Adolescent pregnancy: implications for prevention strategies in educational settings

Over 1 million teenagers become pregnant each year in the U.S. The most alarming increases have occurred among adolescents who are younger than 15 years of age. Variables strongly associated with teen pregnancy include minority status, low socioeconomic status, low academic achievement and occupational aspirations, and growing up in a single- parent household. A majority of teenage pregnancies are unintended, and pregnancy is the largest contributor to school dropout rate for U.S. adolescent females. During pregnancy, adolescent mothers suffer higher rates of health complications, and after childbirth they receive less education, have more children, and are more likely to be dependent on welfare. Psychologists employed in educational settings are in a unique position to be involved in adolescent pregnancy prevention efforts, and schools are increasingly considered to be appropriate environments for this purpose. Progressive school-based family planning programs have been established by the St. Paul/Ramsey Medical Center in St. Paul, Minnesota, and by the Johns Hopkins University Medical Center in Baltimore, Maryland. Both programs emphasize the distribution of contraceptives. An increasing number of school programs focus their efforts on helping adolescents become more responsible in their approach to sexual relationships, though they do not distribute contraceptives. A number of innovative community-based programs have also been formed that utilize multiple strategies to provide positive alternatives to pregnancy. Before setting up teen pregnancy prevention programs, school psychologists should try to learn from the lessons offered by established programs. They should also consult with teachers, administrators, students, and parents, and they should decide what instructional approaches are appropriate for their own situations.     

Parental and family risk factors for substance use in inner-city African-American children and adolescents

The purpose of this study was to develop and test a multidimensional model of parental and family influences on risk for substance use in inner-city African-American primary grade children and their adolescent siblings. The risk factors investigated were conceptually grouped into three broad domains of family influences and the respective indices computed: parental risk attributes, family risk attributes, and parenting styles. Parenting styles were captured as indicators of a latent construct, poor parenting. In study 1, we hypothesized that the parental and family risk variables would be mediated through parenting styles to predict intentions to use drugs, actual drug use, positive drug attitudes, and negative drug attitudes in a sample of 455 inner-city African-American families and their primary-grade children. In study 2, the substance use risk model was tested on a sample of 59 adolescent sibilings to determine whether the pattern of parental and family factors that contributed to early high-risk attitudes and behaviors in children would predict drug attitudes and behaviors in teen siblings. The results confirmed our expectations that parental and family risks were important predictors of childrens' negative drug attitudes and intentions to use drugs in the future and that positive parental and family characteristics would protect against future risk by enhancing negative drug attitudes. Also, substance use attitudes and behaviors in the teen siblings were predicted primarily by family risk characteristics. The family risk index also predicted frequency of use of hard drugs, but only when mediated through poor parenting. The implications of these results for future research are discussed.     

Parenting Stress, Social Support, and Depression for Ethnic Minority Adolescent Mothers: Impact on Child Development

Rates of teenage pregnancies are higher for African American and Latina adolescents compared to their White peers. African American and Latina adolescent mothers also experience more adversities than their White peers, such as higher rates of depression, school dropout, and economic disadvantage. Furthermore, children of adolescent mothers are at higher risk for adverse development. Parenting stress and social support can impact outcomes experienced by adolescent parents and their children. The present study examined the influence of adolescent mothers’ parenting stress and perceived social support on maternal depression at baseline (6 months after birth), and its impact on infant development 1 year later (18 months after birth). Participants were 180 adolescent mothers of African American or Latino/Hispanic descent. Results suggest that higher levels of parenting stress and less perceived social support were associated with higher levels of depression in the adolescent mothers at baseline. Higher levels of maternal depression were also associated with more developmental delays in infants 1 year post-baseline. Additionally, depression mediated the relationship between parenting stress and later child outcomes. These findings highlight the importance of examining parenting factors such as parenting stress, social support, and maternal depression in ethnic minority adolescent parents, and provide valuable information regarding unique risk and protective factors associated with positive maternal outcomes for ethnic minority adolescent parents and healthy development for their children.     

The association of parenting style and child age with parental limit setting and adolescent MySpace behavior

Parent and teen MySpace user pairs completed online surveys administered in June (N = 266) and September 2006 (N = 341) to assess relationships between parenting styles and limit setting and monitoring of online behaviors, the prevalence of Internet dangers and pre-teen and teen MySpace behaviors. Cross-comparison measures of MySpace usage, parenting style, limit setting/monitoring, MySpace problems, and media perceptions were used. Parenting styles were strongly related to adolescent MySpace experiences, behaviors, and attitudes, with some age differences. Parents with older children were more likely to have Neglectful or Indulgent parenting styles and less likely to set limits on online behavior. The extent of sexual solicitation, pornography, and cyberbullying was relatively low as compared with studies asserting a high incidence of Internet-related problems. Parents' high estimates of online dangers were not matched by their low rates of setting limits and monitoring teens. Theoretical and practical perspectives of the results are offered to enhance social networking experiences for parents and their children.     

Outcomes of teen parenting programs in New Mexico

Although teen pregnancy rates in the U.S. have recently declined, the need for programs for pregnant and parenting teens remains. This report presents information from 53 programs that served pregnant and parenting teens in New Mexico between 1997 and 2000. Data on 3,194 teens, including their characteristics, the services they received, and several key outcomes, are examined. These data indicate that the programs were successful in promoting educational attainment as well as gains in employment. Prevalence of late prenatal care and low birth weight babies was lower than statewide averages, and the rate of repeat pregnancy was lower than that reported by many other programs. How these programs achieved these results is discussed.     

Professional support for adolescent mothers: Who gives it,how adolescent mothers evaluate it,what they would prefer

Forty-two adolescent mothers with 2-year-old children were questioned about their sources of social support, their satisfaction with that support, and their views about including members of their informal support network in the receipt of professional services. The results indicated that 74% of the mothers received parenting advice from some professional source, as well as from their informal support network, and that most were satisfied with their professional contacts. Nonetheless, 75% of the mothers indicated that they would like additional parenting advice from parenting classes, organized neighborhood groups, or from visiting public health nurses or other child development specialists. Ninety percent of the mothers thought it would be helpful to have members of their informal support network participate with them in the receipt of professional services, and 81% thought these individuals would be willing to do so. The implications of these findings for both future research and the design and implementation of programs directed toward adolescent parents and their children are discussed.     

Adolescent–parent attachment as a mediator of relations between parenting and adolescent social behavior and wellbeing in China

The purpose of this study was to examine links between parenting dimensions (authoritative parenting, psychological control, and parental authority) and adolescent wellbeing (self‐esteem, autonomy, and peer attachments) as mediated by parent–teen attachment, among Chinese families. The sample included 298 Chinese adolescents, ages 15–18 years (M age = 16.36, SD = .68; 60% female). The mediation model was examined using path analyses (one model with parental authority as overprotection, and one with it as perceived behavioral control). To improve model fit a direct path was added from authoritative parenting to autonomy. Authoritative parenting was positively predictive of attachment, while psychological control and overprotection (but not behavioral control) were negative predictors. In turn, adolescent–parent attachment was positively related to the three outcomes. Lastly, the model paths did not differ by adolescent gender. These findings suggest that parenting behaviors may play a crucial role in adolescent social behaviors and wellbeing via adolescent–parent attachment.     

The Effectiveness of Parenting Programs for Incarcerated Mothers: A Systematic Review

There is evidence to suggest that maternal incarceration can have negative implications for children. Children in these families can be at greater risk for conduct problems and antisocial behavior, as well as school dropout and academic failure. Institution-based parenting programs represent one means of addressing the potential negative impacts of maternal incarceration on children’s wellbeing. Through parent training programs, mothers may develop skills and strategies to help their children cope with the challenges and stressors associated with incarceration. However, it is currently unclear whether parenting programs for mothers in these facilities have a positive effect on different parenting outcomes. We conducted a systematic search of several electronic databases using key search terms and identified sixteen treatment studies. The results suggest that in the short-term, corrections-based parenting programs are associated with positive effects on parenting behavior, parenting attitudes, and parenting knowledge. However, these programs appear to have no effect on parenting stress immediately post-treatment. Implications for practice and recommendations for future research are discussed.     

The Complexity of Support: The Impact of Family Structure and Provisional Support on African American and White Adolescent Mothers' Well-Being

The importance of social support to the well-being of adolescent parents is a frequently discussed topic in the teen parenting literature. However, the meaning and conceptualization of social support varies across study and the heterogeneity within the teen parent population is often overlooked. In an effort to understand its role more precisely, the present study defined support both in terms of its structural and provision components, and examined the association of these components with both perceived psychological and behavioral measures of maternal well-being for a sample of white and African American teen mothers. Specifically, the relative contribution of household structure and provisional social support to the well-being of a sample of 107 African American and 146 white teen mothers was measured respectively. Results indicate great variability in the structural and provisional support adolescent mothers receive, regardless of race. Independent of other effects, provisional supports are more strongly associated with maternal well-being than is family structure. Further, the impact of these different types of support varies by race.     

Efficacy of a Self-Administered Home-Based Parent Intervention on Parenting Behaviors for Preventing Adolescent Substance Use

A growing body of literature suggests that parenting practices characterized by careful monitoring, firm and consistent limit setting, and nurturing communication patterns with children are protective against adolescent substance use and other problem behaviors. Family-based prevention programs that promote these behaviors can be an effective way to prevent adolescent substance use. However, low participation rates remain problematic for many such programs, particularly programs that require parents to attend scheduled meetings outside the home. The purpose of this study was to determine the efficacy of a newly developed substance use prevention program when self-administered at home by parents of middle school students. As part of a randomized trial, 338 parents of middle school students either received the parent prevention program or served as control group participants. Parents completed self-report surveys at home that assessed parenting behaviors at pre-test, post-test, and one-year follow-up time points. A series of mixed model ANCOVAs were conducted, examining the post-test and one-year follow-up means for the parent outcomes, controlling for pre-test levels on these outcomes. Analyses showed that at the post-test assessment, intervention parents reported significant increases relative to controls in appropriate role modeling, disciplinary practices, family communication, and parental monitoring skills. At the one-year follow-up assessment, intervention effects on family communication skills remained significant and effects on parental role modeling were marginally significant. This study shows that a theoretically rich prevention program can be effectively self-administered by parents at home and improve key parenting skills that have been shown to prevent adolescent substance use.     

Potential Positive and Negative Consequences of Coresidence for Teen Mothers and their Children in Adult-Supervised Households

In 1996, part of the creation of TANF (Temporary Assistance for Needy Families) required minor teen parents to live in an adult-supervised household in order to receive cash assistance. This literature review discusses the positive and negative consequences of coresidence. Research has suggested that coresidence may be beneficial for the educational and financial success of teen mothers. However, there is some evidence that coresiding teen mothers have poorer parenting skills than teen mothers who do not coreside. Implications for policy implementation are discussed. Case managers should be aware of the possible risks of coresidence and weigh these risks against potential benefits. In addition, families of teen mothers, especially grandmothers, should be included in programming and interventions in order to provide positive living environments for teen mothers and their children.     

Drop Out from Behavioral Management Training Programs for ADHD: A Prospective Study

To investigate dropout from parenting programs for disruptive behavior disorders, we followed 18 clients prospectively from the beginning of a manualized treatment program to three month follow-up. Using qualitative and quantitative methods, we then compared those who dropped out of the program with those who completed it. We found that in general, those participants who dropped out of the program were parents of children with more disturbed behavior, who perceived their children to be more difficult than others, and who experienced more subjective parenting stress. Those who dropped out were also not convinced that the strategies proposed in the program to help manage their children were useful. On the other hand, those who completed the program reported a determination to persevere with the strategies which they saw as assisting them to re-establish positive relationships with their adolescent children. The findings are discussed in the context of how manualized programs might be modified to increase retention.     

Unwanted teenage pregnancies: incidence, interpretation, and intervention.

North American and western European cultures are more permissive than they were before World War II about the increased incidence of teen sexual activity. Societies may be more open and teens are having more premarital sex than they used to, but they surely are not using contraception as often as they should. As such, there is a great deal of unintended and unwanted teenage pregnancies, especially in the US. Even the threat of contracting and/or transmitting HIV has not caused heterosexual youths to change their sexual or contraceptive behaviors. The authors conceptualize explanations for this lack of adolescent behavioral change, including procedures designed to identify deficiencies and to bring about necessary changes in contraception-relevant information, motivation, behavioral skills, and situational constraints. Examples of successful intervention programs are outlined. Sections consider the incidence of premarital intercourse, contraceptive use, and unwanted pregnancies; contraceptive neglect; unintended and unwanted pregnancies; and why teenagers have unprotected sexual intercourse. The conceptual framework of intervening to prevent unwanted teenage pregnancies is presented in sections on providing improved contraceptive information, increasing precontraceptive motivation, improving contraceptive skills, altering situational factors which inhibit contraception, and evaluation research.     

Adoption vs. parenting decisions among pregnant adolescents

The choice of adoption is rare among pregnant adolescents. This exploratory study used regression analyses to ascertain which demographic, social, and intervention variables were related to this decision. The adolescents with mothers who favored adoption and/or had few parenting peer models were more likely to choose adoption. Age, knowledge of peers who had chosen adoption, grades in school, level of involvement in a comprehensive adolescent pregnancy program, and participation in individual therapy or Decision-Making Group were not significantly related to the decision. Decision-Making Group is a once-a-week therapy session that focuses on adoption vs. parenting decisions for pregnant adolescents. Eighty-seven percent of the adolescents who participated in these sessions found them helpful. The policy implications for adolescent pregnancy programs are explored.     

Familial Influences on Dating Violence Victimization Among Latino Youth

Despite theoretical and empirical evidence suggesting that the family environment plays a central role in Latino youth development, relatively little is known about how family processes influence dating violence victimization among Latino adolescents. To address this gap in the literature, we used data from 210 Latino parents and their 13- to 15-year-old adolescents to examine associations between several different family processes, including both parenting practices (parent monitoring, parent–adolescent communication) and aspects of the family relational climate (family cohesion, family conflict, acculturation conflict) and psychological, physical, and sexual dating violence victimization. Consistent with expectations, lower levels of family cohesion and higher levels of family and acculturation conflict were associated with risk for dating violence victimization, although associations varied depending on victimization type. In contrast, neither parental monitoring nor parent–adolescent communication was significantly associated with any type of dating violence victimization. In addition, we found that parent, but not teen, Anglo-American acculturation was associated with higher dating violence victimization risk. Findings suggest that family-based dating abuse prevention programs for Latino youth should seek to increase family cohesion and decrease family conflict, including acculturation-based conflict.     

Gender Differences in the Relations among Patriarchal Beliefs,Parenting, and Teen Relationship Violence in Mexican Adolescents

Teen relationship violence is a global phenomenon associated with adverse outcomes. As in other countries, teen relationship violence is of concern in Mexico. However, few studies have examined the risk and protective factors of teen relationship violence among Mexican adolescents. This study examined whether patriarchal beliefs and exposure to authoritarian parenting among Mexican adolescents are associated with perpetration and victimization of physical and verbal-emotional teen relationship violence. Two hundred and four students (15–18 years old) from Monterrey, Mexico, completed questionnaires. Hierarchical regression analyses controlling for age revealed that among girls, authoritarian parenting was associated with physical and verbal-emotional victimization and verbal-emotional violence perpetration. Among boys, higher endorsement of patriarchal beliefs was associated with lower reports of physical perpetration and physical victimization.     

Self-Reported Parenting of Clinic-Referred and Non-referred Mexican American Mothers of Young Children

Behavioral parent training (BPT) interventions for child behavior problems have been based on decades of research that demonstrate links between particular parent behaviors and child externalizing problems. However, the majority of this research has been conducted with European-American (EA) families, and less is known about whether these findings can be generalized to Mexican Americans (MAs). In the current study, we investigated self-reported parenting practices that have been associated with externalizing behavior problems among EA families (harsh parenting, inconsistency, and low parental warmth), to determine if those practices can also differentiate MA mothers whose young children have clinically significant behavior problems from MA mothers whose children do not have behavior problems. Participants were 115 MA families with young children, 58 with a child with clinically significant behavior problems and 57 with a child in the normal range for such problems. Results indicated that MA mothers whose children have behavior problems self-reported significantly less warmth and consistency and more harsh parenting compared to parents whose children’s behavior was in the normal range. These findings indicate that parenting behaviors that are associated with externalizing behavior problems among EA families are associated with the same problems among MA families with young children, suggesting that parent training interventions designed to target these behaviors are also likely to be relevant to MA families with children in this age range. However, findings also indicate that parenting behaviors differ depending on acculturation level, suggesting that BPT programs must respond to variation in normative parenting practices for MA families.     

Adolescents’ Behaviors as Moderators for the Link between Parental Self-Efficacy and Parenting Practices

Based on theory that parents with higher levels of self-efficacy (PSE) should find it easier to parent effectively in the face of challenging child behaviors than should parents with lower levels of PSE, this study examines the link between PSE and parenting using children’s behaviors as potential moderators. Participants were 130 parents who had an older adolescent (M _age?=?17.58) in addition to the target adolescent (M _age?=?11.79), and both adolescents’ externalizing behaviors were used as moderators for the link between PSE and parenting of the target adolescent. Path analysis in Mplus showed that higher PSE was linked to more promotive parenting but only among parents who had an older adolescent with lower levels of externalizing behaviors. Among parents of adolescents with higher levels of externalizing behaviors, whose promotive parenting was significantly lower than other parents overall, PSE did not predict promotive parenting. The link between PSE and parenting did not differ depending on the target adolescents’ behavior. Findings suggest that the link between parents’ beliefs and parenting depends on the broader family context. More specifically, how PSE is linked to parenting practices depends at least partly on the experiences that parents bring from parenting an older adolescent to their interactions with a later-born adolescent. From a clinical perspective, parents might need guidance in how to think about their earlier parenting experiences when parenting a younger adolescent.     

Grandparents as family stabilizers during economic hardship in Bulgaria

T he present study of three generations' families living together during a period of marked economic dislocation investigates whether supportive grandparents can ameliorate the negative effects of economic stress on parenting and on teen outcomes. The study focuses on harsh parenting and adolescent depression, which has been shown to be especially responsive to economic stress. Three hypotheses were investigated: (1) in extended families there is a link between economic adversity and adolescent depression that is mediated by harsh parenting; (2) grandparent support diminishes the relationship between economic pressure and harsh parenting; and (3) grandparent support diminishes the relationship between harsh parenting and adolescent depression. Data were collected from a community sample of 62 extended families with an adolescent during a period of marked economic dislocation in Bulgaria. Mothers, fathers, and adolescents completed questionnaires about perceived economic pressure, parents' harsh parenting, and perceived support of grandparents. Adolescents also completed a measure of self‐reported depression. Additional interviews were conducted with every eligible family member about family relations. Results showed that even though there was significant economic stress reported by parents, adolescents reported moderate levels of depression and low levels of harsh parenting by mothers and fathers. Correlation and regression analyses revealed that whenever respondents experienced support by grandparents, it made a difference for family members. More specifically, despite economic stress, mothers who experienced the support of grandparents tended to exercise less harsh parenting practices than mothers who lacked such support. Furthermore, when grandparents were supportive, harsh parenting was not associated with adolescent depression. These findings are discussed in the light of existing studies of families under economic pressure with a special focus on extended family relations and the role of cultural context.