Measuring secondhand smoke exposure in babies: the reliability and validity of mother reports in a sample of low-income families.

The reliability and validity of mother's reports of their infants' exposure to secondhand smoke (SHS) were examined in an ethnically diverse sample of low-income, low-education families (N = 141 mothers). At baseline and posttest, smoking mothers reported about their infants' SHS exposure at different locations and by different sources during the previous week. Findings show that mothers can give reliable accounts of the degree to which they contribute to their babies' SHS exposure. Mothers are able to differentiate between their own smoking behavior and the extent to which they expose their infants. Consistent with the overall exposure pattern, exposure caused by the mother and exposure occurring at home showed the strongest associations with biological and environmental measures. These findings suggest that smoking mothers can provide reliable and valid reports of the degree to which their infants are exposed to SHS.     

Asthma severity, child security, and child internalizing: using story stem techniques to assess the meaning children give to family and disease-specific events

Children with persistent asthma are at increased risk for mental health problems. Although mechanisms of effect are not yet known, it may be that children are less trusting of the family as a source of support and security when they have more severe asthma. This study tested whether asthma severity is related to children's perceptions of insecurity in the family, and whether insecurity is in turn associated with child adjustment. Children (N = 168; mean age = 8 years) completed story stems pertaining to routine family events (e.g., mealtimes) and ambiguous but potentially threatening asthma events such as tightness in the chest. Responses were evaluated for the extent to which appraisals portrayed the family as responding in cohesive, security-provoking ways. Asthma severity was assessed by both objective lung function testing and primary caregiver report. Caregivers reported child symptomatology. Beyond medication adherence, caregiver education, and child age and gender, greater asthma severity predicted more internalizing and externalizing symptoms. Greater asthma severity, assessed using spirometry (but not parent report), was related to less secure child narratives of the family, which in turn related to more child internalizing symptoms. Results suggest that asthma can take a considerable toll on children's feelings of security and mental health. Furthermore, given the difficulty in assessing young children's perceptions, this study helps demonstrate the potential of story stem techniques in assessing children's appraisals of illness threat and management in the family.     

Family climate of routine asthma care: associating perceived burden and mother-child interaction patterns to child well-being

This preliminary report links the literatures on family asthma management practices and on the characteristics of family interaction patterns thought to influence children's adjustment to a chronic physical illness. Specifically, this study of 60 families with a child with asthma examined the extent to which perceived burden of routine asthma care affected child mental health via its influence on parent-child interaction patterns. Mothers completed a measure of asthma management routine burden, mother and child were observed in a 15-minute interaction task, and children completed measures of child anxiety and asthma quality of life (QOL). Perceived routine burden significantly predicted child anxiety and QOL through its effect on mother-child rejection/criticism. The same pattern did not hold for mother intrusiveness/control. The results are discussed in terms of how overall family climate and regulation of routines affects child well-being. Implications for clinical practice and limitations of the study are provided.     

Children's cognitive ability from 4 to 9 years old as a function of prenatal cocaine exposure, environmental risk, and maternal verbal intelligence

This study examined the effects of prenatal cocaine exposure, environmental risk, and maternal verbal intelligence on children's cognitive ability. Gender and age were examined as moderators of potential cocaine exposure effects. The Stanford-Binet IV intelligence test was administered to 231 children (91 cocaine exposed, 140 unexposed) at ages 4, 6, and 9 years. Neonatal medical risk and other prenatal exposures (alcohol, cigarettes, and marijuana) were also examined for their unique effects on child IQ. Mixed models analysis indicated that prenatal cocaine exposure interacted with gender, as cocaine-exposed boys had lower composite IQ scores. Age at assessment did not moderate this relation, indicating that cocaine-exposed boys had lower IQs across this age period. A stimulating home environment and high maternal verbal IQ also predicted higher composite IQ scores. Cocaine-exposed boys had lower scores on the Abstract/Visual Reasoning subscale, with trends for lower scores on the Short-Term Memory and Verbal Reasoning subscales, as exposure effects were observed across domains. The findings indicate that cocaine exposure continues to place children at risk for mild cognitive deficits into preadolescence. Possible mechanisms for the Exposure x Gender interaction are discussed.     

Children and cigarettes: The effect of a model who quits

Twenty-six previous studies were reviewed which demonstrated a consistent link between children's smoking uptake and exposure at home to an actively smoking older family member. The present study included another variable: the family model of smoking cessation. The smoking practices, intentions, and attitudes of 344 children aged 10–14 in Western Australia were anonymously assessed. Those with ex-smokers but no active smokers at home resembled children who had never been exposed to a smoking family model in being less likely to smoke now or intend to in the future, having fewer smoking chums, and believing that cigarettes had more personal and social disadvantages than their peers who shared households with active smokers. This suggested that any pro-smoking modeling while the ex-smoker was active had been counteracted by modeling of quitting. Implications for intervention were discussed.     

Preschoolers with Asthma: Narratives of Family Functioning Predict Behavior Problems

This study tested a model predicting behavior symptoms in preschoolers with asthma. Specifically, it examined the role that asthma severity and children's representations of family functioning may play in the development of child behavior problems in a sample of 53 low-income preschoolers. The study included parent report of asthma severity and a narrative story-stem method to assess children's representations of both general and disease-specific family processes. A regression model tested the inclusion of both types of family processes in predicting child internalizing and externalizing behavior. Disease severity and children's family narratives independently predicted children's behavior over and above the combined effects of demographic variables including child age, socioeconomic status, and family structure. Although children's narratives about general family functioning predicted children's behavior, narratives about family response to asthma symptoms did not. Findings support that both disease severity and family functioning are important considerations in understanding children's behavior problems in the context of asthma. Clinical applications of findings may include: (1) Informing family based-assessments to incorporate children's narratives, and (2) A focus on reducing asthma symptoms and strengthening family functioning to prevent or address child behavior problems.     

Prevalence of Children's Exposure to Domestic Violence and Child Maltreatment: Implications for Prevention and Intervention

The purpose of this paper is to review research on the prevalence of children's exposure to domestic violence, to consider the available literature on the co-occurrence of domestic violence and child maltreatment, and to gain more understanding about the impact of exposure on children. There is clear evidence indicating that both severe and moderate violence occurs frequently in homes among family members and that children are exposed to this violence. However, because of differing definitions of what constitutes domestic violence and variability in research methodologies for collecting the data, there are significant discrepancies in prevalence reports across studies. Of great concern is the immediate impact on the children and the long-term consequences for their later relationships. Fewer studies have been done on the co-occurrence of domestic violence and child maltreatment. However, it is likely that children who live in homes where domestic violence occurs are more likely to be abused and neglected. On the basis of available research, there is little doubt that vast numbers of children are exposed to domestic violence and that children's responses vary widely depending on their risk and vulnerability, as well as the structure of their environments. A developmental risk and protective factors framework will be used to integrate the information on children's exposure to violence.     

Children growing up in a violent community: The role of the family

This review evaluates empirical reports of relations among exposure to violence in the community, dimensions that characterize families and parenting, and the distress and maladjustment of children and adolescents. Family functioning variables that have been examined in relation to community violence exposure include family conflict and violence, social support, structure and cohesion, parenting practices, maternal distress, and sociodemographic characteristics. Evidence is reviewed for three hypotheses regarding family dimensions: (1) that they are associated with children's community violence exposure in bivariate relations, (2) that they moderate relations between community violence exposure and child outcomes, and (3) that they mediate relations between community violence exposure and child outcomes. Following the empirical review, theoretical and methodological gaps in the literature are identified; guidelines are proposed for ecologically valid family-based research on community violence.     

A genetically informed study of associations between family functioning and child psychosocial adjustment

Research has documented associations between family functioning and offspring psychosocial adjustment, but questions remain regarding whether these associations are partly due to confounding genetic factors and other environmental factors. The current study used a genetically informed approach, the Children of Twins design, to explore the associations between family functioning (family conflict, marital quality, and agreement about parenting) and offspring psychopathology. Participants were 867 twin pairs (388 monozygotic; 479 dizygotic) from the Twin and Offspring Study in Sweden, their spouses, and children (51.7% female; M = 15.75 years). The results suggested associations between exposure to family conflict (assessed by the mother, father, and child) and child adjustment were independent of genetic factors and other environmental factors. However, when family conflict was assessed using only children's reports, the results indicated that genetic factors also influenced these associations. In addition, the analyses indicated that exposure to low marital quality and agreement about parenting was associated with children's internalizing and externalizing problems and that genetic factors also contributed to the associations of marital quality and agreement about parenting with offspring externalizing problems.     

Everyday Marital Conflict and Child Aggression

Children's immediate aggressive responding to exposure to marital conflict was examined. Participants were 108 families with 8- to 16-year-old children (53 boys, 55 girls), with diary records of children's reactions to marital conflict in the home completed by 103 mothers (n = 578 records) and 95 fathers (n = 377 records) during a 15-day period. Child responses to analog presentations of marital conflict tactics were also obtained. Exposure to destructive conflict tactics and negative parental emotionality increased the likelihood of aggressive behavior in children when they witnessed marital conflict, whereas constructive conflict tactics and positive parental emotionality decreased the probability of aggression. Conflict topics presumed to be threatening to the child (child- or marital-related) also heightened the likelihood of aggression. Aggressive responding to conflict in both home and laboratory predicted externalizing behavior problems. Fathers' and mothers' separate diary reports, and child responses to analog presentation of conflict, provided generally consistent findings. An exposure hypothesis for marital conflict as an influence on child aggression is discussed.     

Teachers' knowledge of children's exposure to family risk factors: accuracy and usefulness

Teachers' knowledge of children's exposure to family risk factors was examined using the Family Risk Factor Checklist-Teacher. Data collected for 756 children indicated that teachers had accurate knowledge of children's exposure to factors such as adverse life events and family socioeconomic status, which predicted children's mental health problems at 1 year follow-up. For children at high teacher-rated risk, odds ratios ranged from 3.04 to 7.46, after adjusting for prior mental health problems. Teachers had poor knowledge of internal family functioning, such as conflict, parenting practices, or parental drug abuse. The findings suggest that asking teachers to report children's exposure to particular family risk factors is a feasible method for identifying children for selective interventions, but improved family-school communication may further enhance this process.     

Trajectory of Adolescent Obesity: Exploring the Impact of Prenatal to Childhood Experiences

This study examined longitudinal associations of prenatal exposures as well as childhood familial experiences with obesity status from ages 10 to 18. Hierarchical generalized linear modeling was applied to examine 5,156 adolescents from the child sample of the 1979 National Longitudinal Survey of Youth. Higher maternal weight, maternal smoking during pregnancy, lower maternal education, and lack of infant breastfeeding were contributors to elevated adolescent obesity risk in early adolescence. However, maternal age, high birth weight of child, and maternal annual income exhibited long-lasting impact on obesity risk over time throughout adolescence. Additionally, childhood familial experiences were significantly related to risk of adolescent obesity. Appropriate use of family rules in the home and parental engagement in children’s daily activities lowered adolescent obesity risk, but excessive television viewing heightened adolescent obesity risk. Implementation of consistent family rules and parental engagement may benefit adolescents at risk for obesity.     

Designing a behavioral program for a barrio in Tegucigalpa, Honduras

Health in Housing initiated a behavioral program of education and skills training for children and adults in a community of 30,000 persons living in substandard conditions in Tegucigalpa, Honduras. To measure achievement in the long-range project, 21 families of Flor del Campo participated in a preliminary three-part survey of their (a) health, (b) housing and the environment, and (c) family history. Doctors, designers, and educators worked with Honduran personnel in the first survey. Following functional analyses of the home and surrounding environment and the physical status of the individuals living there, procedures provide the family with treatment and training for home and environment improvement. Graphic, verbal, and numerical data, incorporated into a master computerized system, record events of each family member: training programs experienced, health care delivery courses taken, medical treatments, growth of children, literacy changes, educational courses completed, kinds and amounts of foods eaten, household and building materials purchased. Ongoing functional analysis and a long-range evaluation are made of the progress of each participating individual in a family. Teams revisit each house to observe and record any changes in the physical and environmental facility and the health and life-styles, and to report any indications of new health problems or recurrences.     

The effect of family variables on child weight change

Previous research has shown that family size, the number of obese persons living at home, and parental weight influence the development of childhood obesity. Our study reports the relevance of these factors to child weight loss during a 1-year treatment period. Multiple linear regression procedures showed that the amount of relative weight change was related to initial treatment success, the number of children in the family, and the gender of the child. Children who were more successful lost more weight initially, had fewer siblings, and were female. These results suggest that family size may interact with treatment to determine weight change. The effects of family size on outcome may be operating simply by reducing the amount of time that a parent has to spend with the child in promoting behavior change. Likewise, increased family size may be operating as a stressor, reducing the effectiveness of parents in effectively managing their children.     

Psychological effects of custody disputes on children

This two-group, repeated measures examination of the psychological impact of child custody contests on children reports a subset of data from an ongoing longitudinal study of 95 children and their parents from 43 divorcing families. The authors report clinical observations concerning children's experience of custody litigation, as well as comparisons of baseline and post-test responses of contested and uncontested groups on measures of locus of control, separation anxiety and family concept. Contested children exhibited significantly greater internality of control orientation than the normative sample. Contested children's test scores also suggested significantly less separation anxiety and significantly more positive family concept than the uncontested group at post-test. The implications of these unanticipated findings are discussed.     

Children Exposed to Domestic Violence and Child Abuse: Terminology and Taxonomy

Three definitional issues regarding children exposed to domestic violence are examined. First, the multiple ways in which a child can be exposed to violence is discussed. A taxonomy of 10 types of exposure is proposed. Nine key characteristics of domestic violence, as they relate to children and children's exposure, are then outlined. The third issue addressed concerns why children who are exposed to domestic violence can be considered victims of child maltreatment. These children, by nature of their experience in the home, are psychologically maltreated and are also at high risk for physical abuse and some risk for sexual abuse. Empirical questions concerning these definitions and taxonomies and their interrelations are discussed.     

I don't think that's what really happened: the effect of cross-examination on the accuracy of children's reports

In the courtroom, child witnesses must undergo cross-examination. Prior research has shown that children change their original testimony under cross-examination, but the effect of these changes on the accuracy of children's testimony is unknown. The authors examined the effect of cross-examination on the accuracy of 5- and 6-year-old children's (N=46) reports of a contrived event. Consistent with prior research, children made changes to their original responses during cross-examination. Furthermore, these changes occurred irrespective of original accuracy. Finally, prior exposure to misleading information did not affect children's responses to cross-examination. Even children with no prior exposure to misinformation altered their original responses, decreasing their ultimate levels of accuracy. These findings demonstrate that cross-examination style questioning is inappropriate for young children.     

Community violence, family conflict, and preschoolers' socioemotional functioning

This study examined the relations among family conflict, community violence, and young children's socioemotional functioning and explored how children's social cognition and mothers' psychological functioning may mediate the outcomes associated with this exposure. Mothers of 431 Head Start preschoolers completed questionnaires about their family demography, exposure to community violence, family conflict, and children's distress symptoms. Children were administered a social cognition assessment, and teachers rated their behavior. Results showed that mothers' reports of children's co-witnessing of community violence were positively associated with police department crime rates, children's distress symptoms, and teachers' ratings of aggression. A path analysis revealed that children's social awareness and mothers' depressive symptoms partially mediated the effects of community violence and family conflict on outcomes for children.     

Family processes as pathways from income to young children's development

A variety of family processes have been hypothesized to mediate associations between income and young children's development. Maternal emotional distress, parental authoritative and authoritarian behavior (videotaped mother-child interactions), and provision of cognitively stimulating activities (Home Observation for Measurement of the Environment [HOME] scales) were examined as possible mediators in a sample of 493 White and African American low-birth-weight premature infants who were followed from birth through age 5. Cognitive ability was assessed by standardized test, and child behavior problems by maternal report, when the children were 3 and 5 years of age. As expected, family income was associated with child outcomes. The provision of stimulating experiences in the home mediated the relation between family income and both children's outcomes; maternal emotional distress and parenting practices mediated the relation between income and children's behavior problems.     

Children's living arrangements following separation and divorce: insights from empirical and clinical research

When parents separate, children typically enter into new living arrangements with each parent in a pattern determined most often by one or both parents or, failing private agreement, as a result of recommendations and decisions by lawyers, therapists, custody evaluators, or family courts. Most of these decisions have been based on cultural traditions and beliefs regarding postseparation parenting plans, visitation guidelines adopted within jurisdictions, unsubstantiated theory, and strongly held personal values and professional opinions, and have resulted since the 1960s in children spending most of their time with one residential parent and limited time with nonresident, or "visiting," parents. A large body of social science and child development research generated over the past three decades has identified factors associated with risk and resiliency of children after divorce. Such research remains largely unknown and untapped by parents and professionals making these crucial decisions about children's living arrangements. This article highlights empirical and clinical research that is relevant to the shape of children's living arrangements after separation, focusing first on what is known about living arrangements following divorce, what factors influence living arrangements for separated and divorced children, children's views about their living arrangements, and living arrangements associated with children's adjustment following divorce. Based on this research, it is argued that traditional visiting patterns and guidelines are, for the majority of children, outdated, unnecessarily rigid, and restrictive, and fail in both the short and long term to address their best interests. Research-based parenting plan models offering multiple options for living arrangements following separation and divorce more appropriately serve children's diverse developmental and psychological needs.