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Stress experienced by parents of children with cochlear implants compared with parents of deaf children and hearing children.

OBJECTIVE: To compare the stress experienced by parents of children with cochlear implants with that experienced by parents of deaf children and hearing children. STUDY DESIGN: The Parenting Stress Index and problem-oriented interviews were used with the parents of these three groups of children. RESULTS: Parents of deaf children were found to experience greater levels of stress than parents in the other two groups. CONCLUSION: Parents of children with cochlear implants experience about the same level of stress as parents of hearing children.

Child↗

Children facing the death of a parent: the experiences of a parent guidance program at the massachusetts general hospital cancer center.

Children facing the death of a parent are facing a major upheaval, a loss that will bring them emotional pain and will resonate in different ways at important points throughout their lives. Given the proper supports, most children can expect to adjust well to this enormous change and live happy,productive, and meaningful lives. Although some risk factors for poor adjustment are fixed, the parents themselves often can address others effectively. Clinicians can help the parents of these children facilitate their children's best possible adjustment by emphasizing the principles of facilitating communication, minimizing disruption, preserving family time, and at-tending to their legacy. Clinicians place their children's behaviors within the context of their developmental stage and help the parents find language and an approach that feels comfortable to them. The goal is to help parents re-locate their bearings and realize they can use the parenting skills they al-ready have. Guided by the goal of protecting their children, these parents can find purpose and strength. Reframing their circumstances as a painful and unavoidable challenge, but one that they can actively face, is organizing and fortifying for these families buffeted by loss.

Adult↗

Parents' views of teen driving risks, the role of parents, and how they plan to manage the risks.

PROBLEM: There is limited information about how parents view teen driving risks and intend to handle these risks during the licensing process, and how they will respond to graduated licensing provisions. METHODS: Parents in Connecticut were interviewed when their teens got their learner's permit. The survey was undertaken when the state did not have a midnight restriction or a passenger restriction. RESULTS: Generally, parents were well aware of teen driving risks, thought parents should be thoroughly involved in the licensing process, and plan to be active participants themselves. DISCUSSION: Parents were concerned about the risk of driving after midnight and already restrict that behavior. However, parents do not seem to see or understand the risks of having even one teen passenger in the vehicle. IMPACT ON INDUSTRY: The views and existing practices of parents need to be taken into account in deciding on the provisions of graduated licensing legislation and how to best ensure acceptance and compliance.

Accidents, Traffic↗

Pervasive developmental disorder and parental adaptation: previewing and reviewing atypical development with parents in child psychiatric consultation.

Parenting young children with pervasive developmental disorder engenders unique sustained stresses, which have been termed "burden of care." One specific source of stress for parents is the children's uneven developmental progress, in which delays and accelerations of adaptive functioning may exist side by side. This paper proposes a clinical method that may be incorporated into periodic child psychiatric consultations with parents of young children who have high-functioning autism or Asperger's disorder. Using a semistructured technique, the clinician reviews with the parents the details of the child's recent developmental course and attempts to identify emergent skills that may serve to preview upcoming developmental issues and gains. This method is aimed at enhancing parental abilities to track and anticipate developmental progress and the resultant shifts in the parent-child relationship, in order to reduce one source of sustained parental stress. Case illustrations of children ages 2-8 years old are discussed in light of recent literature on adaptive issues in families of individuals with a chronic medical or psychiatric condition and, specifically, families of children with pervasive developmental disorder.

Adaptation, Psychological↗

The power of the transmission disequilibrium test (TDT) with both case-parent and control-parent trios.

The transmission disequilibrium test (TDT) customarily uses affected children and their parents (often case-parent trios, TDTD). Control-parent trios are necessary to guard against spurious significant results due to segregation distortion but are not generally utilized in the identification of disease susceptibility loci (DSL). Controls are often easy to recruit and the TDT can easily be extended to include control-parent trios into the analyses with unrelated case-parent trios. We present an extension of the TDT (TDTDC) that incorporates unrelated cases and controls and their parents into a single analysis. We develop a simple and accurate analytical method for computing the statistical power of various TDT (e.g. the TDTD, TDTDC, TDTDC and TDTC that employ control-parent trios only) under any genetic model. We investigated the power of these TDT, and particularly compared the relative power of the TDTD and TDTDC. We found that the TDTDC is almost always more powerful than the TDTC and TDTD. The relative power of the TDTDC and TDTD depends largely upon a number of parameters identified in the study. This study provides a basis for efficient use of control-parent trios in DSL identification.

Case-Control Studies↗

Parent beliefs about infant teething: a survey of Australian parents.

OBJECTIVE: Parents ascribe many infant symptoms to teething, despite little evidence to support such an attribution. We report current parental beliefs about teething and its management in a suburban Australian setting. METHODOLOGY: A written questionnaire was given to all English-speaking parents consecutively attending infant hearing testing sessions in one Melbourne municipality between August and October 1997. Approximately 90% of Victorian infants attend these sessions. RESULTS: Parents of 92 infants (mean age 9.9 months) completed questionnaires (97% response rate). Only one believed that teething causes no problems. Most (70-85%) believed that teething causes fever, pain, irritability, sleep disturbance, mouthing/biting, drooling and red cheeks; 35-55% reported nappy rash, 'sooking', ear pulling, feeding problems, runny nose, loose stools, and infections; and a few (< 15%) reported smelly urine, constipation, colic or convulsions. Symptoms reported for a parent's own infant correlated almost perfectly with symptoms believed to be experienced by infants generally (r = 0.97, P < 0.001). Amount of infant distress when teething correlated with more 'difficult' infant temperament (r = 0.25, P < 0.05), and longer duration of symptoms per tooth correlated with parent distress (r = 0.26, P < 0. 05). Paracetamol (60%) and topical analgesia (55%) were commonly used remedies. Parents diagnose teething more by the presence of 'teething symptoms' (65%) than by palpable (43%) or visible (36%) tooth eruption. CONCLUSION: Teething is a distressing but ill-defined phenomenon reported by almost all parents of young children, and most use some form of medication to manage it. Most symptoms are minor and relate to discomfort rather than physical illness, but a substantial minority still ascribes potentially serious symptoms to teething.

Adult↗

Restricted helper function of F1 hybrid T cells positively selected to heterologous erythrocytes in irradiated parental strain mice. I. Failure to collaborate with B cells of the opposite parental strain not associated with active suppression.

Unprimed (CBA X C57BL/6)F1 lymph node T cells were transferred with sheep erythrocytes (SRC) into heavily irradiated F1 or parental strain mice and recovered from thoracic duct lymph or spleens of the recipients 5 days later. To study their helper function, the harvested F1 T cells were transferred with antigen into irradiated F1 mice plus B cells from either the two parental strains or from F1 mice. F1 T cells activated in F1 mice gave high IgM and IgG anti-SRC responses with all three populations of B cells. By contrast, F1 T cells activated in mice of one parental strain collaborated well with B cells of this strain, but poorly with B cells of the opposite strain. Active suppression was considered an unlikely explanation for this result since (a) good responses were found with F1 B cells, and (b) addition experiments showed that the poor response with B cells of the opposite parental strain (which was equivalent to that produced by unprimed F1 T cells) could be converted to a high response by a supplemental injection of F1 T cells activated in F1 mice. The phenomenon (a) was specific for the antigen used for activation (criss-cross experiments were performed with horse erythrocytes), (b) was reflected in levels of serum hemagglutinins as well as in numbers of splenic plaque-forming cells, (c) applied also to comparable activation of (DBA/2 X C57BL/6)F1 T cells, and (d) could be prevented by activating F1 T cells in mice of one parental strain in the presence of peritoneal exudate cells of the opposite parental strain. The hypothesis was advanced that F1 T cells contain two discrete subpopulations of antigen-reactive cells, each subject to restrictions acting at two different levels: (a) during T-macrophage interactions and (b) during T-B collaboration. It was suggested that when F1 T cells are activated to antigen in a parental strain environment, radioresistant macrophages activate only one of the two subgroups of T cells, and this subgroup is able to collaborate with B cells of the strain used for activation (and with F1 B cells) but not with B cells of the opposite parental strain. The other subgroup of T cells remains in an unprimed (nonactivated) state.

Animals↗

Nest predation increases with parental activity: separating nest site and parental activity effects.

Alexander Skutch hypothesized that increased parental activity can increase the risk of nest predation. We tested this hypothesis using ten open-nesting bird species in Arizona, USA. Parental activity was greater during the nestling than incubation stage because parents visited the nest frequently to feed their young during the nestling stage. However, nest predation did not generally increase with parental activity between nesting stages across the ten study species. Previous investigators have found similar results. We tested whether nest site effects might yield higher predation during incubation because the most obvious sites are depredated most rapidly. We conducted experiments using nest sites from the previous year to remove parental activity. Our results showed that nest sites have highly repeatable effects on nest predation risk; poor nest sites incurred rapid predation and caused predation rates to be greater during the incubation than nestling stage. This pattern also was exhibited in a bird species with similar (i.e. controlled) parental activity between nesting stages. Once nest site effects are taken into account, nest predation shows a strong proximate increase with parental activity during the nestling stage within and across species. Parental activity and nest sites exert antagonistic influences on current estimates of nest predation between nesting stages and both must be considered in order to understand current patterns of nest predation, which is an important source of natural selection.

Animals↗

The effects of parental divorce and parental conflict on children: an overview.

Pediatricians and other primary care professionals are frequently called upon to offer their advice concerning the psychosocial problems that families confront. Currently, one area that appears to be of great concern to parents is the effect that parental divorce has on children. However, giving advice in this area is difficult as parental divorce does not have the same effect on all children. Researchers are now beginning to identify and study numerous factors that appear to play a critical role in mediating child adjustment following parental divorce. Understanding these mediating factors will likely prove crucial when addressing questions pertaining to parental divorce. Several investigators believe that one of the most important of these mediating factors is parental conflict. This article reviews the research addressing the relationship between parental divorce, parental conflict, and child adjustment.

Adaptation, Psychological↗

Parents of adolescents: help-seeking intentions as a function of help sources and parenting issues.

This study examined the declared intentions of parents of adolescents to seek help from potential sources for a variety of hypothetical problems related to parenting. The relationship between hypothetical help-seeking and certain characteristics of the help-seeker (sex, educational level, parenting, self-confidence, birth order, and sex of the adolescent), and the source of help (natural support system, professional support system, and media); and the problem type were investigated. The research population included 187 parents of adolescents. A questionnaire was formulated for the purpose of the study which examined help-seeking from nine sources of help on eight hypothetical parenting issues. Intention to seek help was found to be a function of both the particular problem type and the potential source of help. In general, parents declared their intention to seek help from and rely on a variety of sources. It was found that parents said that they were most likely to seek help from their spouses regardless of the issue, whereas professional sources were most likely to be consulted in their area of expertise.

Adolescent↗

A videotape parent education program for abusive parents.

The San Fernando Valley Child Guidance Clinic (SFVC) offers a parent education program for abusive and high-risk-for-abuse parents. Structure and content of the program were derived from theoretical and empirical descriptions of abusive parents. The program is based on a videotape, "Hugs 'n' Kids," which consists of 13 episodes showing common problem situations between parents and their preschool children along with three or four alternative ways the situation could be resolved. Parents meet in a group and discuss one episode per week. Over 200 parents have participated to some extent, and 40 participated in pre- and posttests to assess program effectiveness. The program appears to have met its goals. Parents who completed the program demonstrated increased knowledge of alternatives to physical punishment and understanding of normal child development as well as changed attitudes toward children's misbehavior.

Adult↗

Effect of parental smoking classification on the association between parental and adolescent smoking.

Prior studies of the relationship between smoking by parents and their children have considered only current smoking by parents. In this study of 12- to 14-year-old adolescents, however, lifetime parental smoking was more strongly correlated with adolescent smoking than was current parental smoking. Indeed, lifetime parental smoking was as strongly correlated as peer smoking with adolescent smoking, and peer smoking is often considered to be the main determinant of adolescent smoking. These findings suggest that the relative role of parent smoking in adolescent smoking has been underestimated, and that new explanations for the association between parental and adolescent smoking are necessary.

Adolescent↗

Abusive parents' reports of child behavior problems: relationship to observed parent-child interactions.

PURPOSE: We evaluated the hypothesis that abusive parents' reports may exaggerate rates of child behavior problems in a clinical sample. METHOD: The association between parental ratings of behavior problems and independent observations of child behaviors was examined in a sample of 205 clinic-referred families, 58 of which had a reported history of physical abuse. RESULTS: Relative to the comparison group, parents in the abuse group reported more externalizing problems in their children after controlling for parental psychopathology, and displayed more emotionally controlling and less supportive behavior during parent-child interactions. However, there was no association between abuse history and observed child behaviors during the interaction tasks. Abuse status significantly moderated the association between parent-reported externalizing behaviors and observed demanding behavior by the child; the association was significant among comparison families, but not in the abuse group families. CONCLUSIONS: Results indicate that abusive parents may over-report externalizing behavior problems in their children.

Adolescent↗

Validity of the parenting scale for parents of children with attention-deficit/hyperactivity disorder.

The present study examined the validity of the parenting scale for parents of elementary school-aged children with attention-deficit/hyperactivity disorder (ADHD). Parents from 109 families with children who had been diagnosed with ADHD (106 mothers and 93 fathers) and from 70 families with non-problem children (69 mothers and 59 fathers) completed the parenting scale and reported on their children's behavior problems. Factor analyses revealed two interpretable factors for both mothers and fathers, corresponding to the overreactivity and laxness factors identified in previous studies of the parenting scale. Overreactivity and laxness scores were significantly higher for mothers and fathers of ADHD children than of non-ADHD children; this effect appeared to be accounted for by comorbid aggression and conduct problems among ADHD children. Results support the validity of the parenting scale for use with parents of ADHD children.

Adult↗

Parent-child interactions and child outcomes as related to gender of alcoholic parent.

Parents and children from alcoholic and non-alcoholic families (N = 137) were compared in regard to quality of interactions (using the Marital Interaction Coding System), child outcomes (using the Child Behavior Checklist), and the possible moderating effects of parenting behavior on child outcomes. Alcoholic families were subdivided by gender (father-alcoholic, mother-alcoholic, both parents alcoholic) to assess for the effect that gender of alcoholic parent has on parent-child interactions and child outcomes. Results indicated that dual and mother-only alcoholic families exhibited the most impaired interactions, although child problem behavior was not significantly different across the three groups containing one or two alcoholic parents. Furthermore, father's behavior (both alcoholic fathers and those married to an alcoholic), as compared to mother's behavior, most clearly moderated child outcomes. The possible protective effect of having a non-alcoholic mother was also indicated. Results are discussed in regard to the negative and positive effects that parents from alcoholic households can have on children.

Adolescent↗

Parental reports of changes and challenges that result from parenting a child with cancer.

Cancer in a child leads to a more stressful family life, including problems in adjusting to the situation. The aim of this study was to identify the parents' experience of problems related to their child's/adolescent's cancer and the effect of those problems on the parents' life situation. Swedish parents of 15 children and adolescents with varying diagnoses and treatments were interviewed using qualitative methods. The interview data were analyzed by two researchers using a constant comparative method. The results included eight categories of problems influencing the parents' life situation: watching our child suffer; being governed by our child's disease; behaving differently as a family member; experiencing strong feelings and reactions; trying to cope; dealing with the reactions of others; finding support from others; and evaluating the quality of care. Seven of these categories validate previously reported parental concerns, but one, evaluating the quality of care, has not been previously reported. Study findings can be used to help sensitize health care personnel to the problems experienced by parents of children and adolescents with cancer and the capacity parents have to deal with the problems.

Adolescent↗

Triple P-Positive Parenting Program: towards an empirically validated multilevel parenting and family support strategy for the prevention of behavior and emotional problems in children.

This paper outlines the theoretical and empirical foundations of a unique multilevel parenting and family support strategy designed to reduce the prevalence of behavioral and emotional problems in preadolescent children. The program known as Triple P-Positive Parenting Program is a multilevel system of family intervention, which provides five levels of intervention of increasing strength. These interventions include a universal population-level media information campaign targeting all parents, two levels of brief primary care consultations targeting mild behavior problems, and two more intensive parent training and family intervention programs for children at risk for more severe behavioral problems. The program aims to determine the minimally sufficient intervention a parent requires in order to deflect a child away from a trajectory towards more serious problems. The self-regulation of parental skill is a central construct in the program. The program uses flexible delivery modalities (including individual face-to-face, group, telephone assisted, and self-directed programs) to tailor the strength of the intervention to the requirements of individual families. Its multidisciplinary, preventive and community-wide focus gives the program wide reach, permitting the targeting of destigmatized access points through primary care services for families who are reluctant to participate in parenting skills programs. The available empirical evidence supporting the efficacy of the program is discussed and its implications for research on dissemination are discussed.

Affective Symptoms↗

Familial risk factors to oppositional defiant disorder and conduct disorder: parental psychopathology and maternal parenting.

In a sample of 177 clinic-referred children aged 7-13, an association was found between a diagnosis of conduct disorder (CD) and several aspects of family functioning: maternal parenting (supervision and persistence in discipline) and parental adjustment (paternal antisocial personality disorder and paternal substance abuse). Children with oppositional defiant disorder (ODD) were intermediate to families of children with CD and clinic control children on all variables, but differed from control children only in having a higher rate of paternal substance abuse and paternal antisocial personality disorder (APD). When both parental APD and deviant maternal parenting were entered into 2 x 2 logit-model analyses predicting CD, only parental APD was significantly associated with CD, and no interactions between parental adjustment and maternal parenting were found. The importance of these findings for understanding the etiology of CD and for disentangling correlated risk factors in future studies is discussed.

Antisocial Personality Disorder↗