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PubMed2004

Parent-child dyadic mutuality and child behavior problems: an investigation of gene-environment processes.

BACKGROUND: Parent-child mutuality is comprised of emotional reciprocity, co-responsiveness, and cooperation, which together represent aspects of co-regulation of emotion and behavior that may be important in the etiology of children's behavior problems. Furthermore, individual differences in children's mutuality and behavior problems involve transactions between genetic and environmental influences. Behavioral genetic designs are useful for elucidating these processes. METHODS: The sample included 396 children in adoptive families (53% female, age M = 8.16 years), of whom 244 were siblings (122 pairs). All of the siblings were genetically unrelated. In some families, one child was adopted but the other child was a biological child of the adoptive parents. We observed mother-child dyadic mutuality (a composite score including responsiveness, interaction reciprocity, and cooperation) during videotaped in-home observations. In addition, child behavior problems were assessed and represented as a composite score including observers' ratings of noncompliance, and parents' ratings of aggression and conduct problems. RESULTS: Greater mutuality was associated with lower levels of child behavior problems, both between families and within families (i.e., sibling differences). The sibling intra-class correlation for mutuality with the same parent was near zero in this sample of genetically unrelated siblings. The correlation between child behavior problems and dyadic mutuality did not vary as a function of mother-child genetic similarity. CONCLUSIONS: Mother-child mutuality is child specific within families, a finding that is consistent with theories regarding bi-directional parent and child effects in socialization. In addition, there was no evidence of passive gene-environment correlation, suggesting that the link between lower levels of maternal mutuality and higher levels of child behavior problems is not only reflecting overlapping genetic influences on parent and child behavior.

Child↗
PubMedDate not supplied

Child care and children's peer interaction at 24 and 36 months: the NICHD study of early child care.

Data from the National Institute of Child Health and Human Development Study of Early Child Care were examined to determine how children's experiences in child care were related to peer competence at 24 and 36 months of age, after controlling for the effects of family and child characteristics. Peer competence was assessed using mother and caregiver ratings as well as observations of children with their peers in child care, and at 36 months from observations of dyadic play with a familiar peer. Consistent, albeit modest, relations were found between child-care experiences in the first 3 years of life and children's peer competencies. Positive, responsive caregiver behavior was the feature of child care most consistently associated with positive, skilled peer interaction in child care. Children with more experience in child-care settings with other children present were observed to be more positive and skilled in their peer play in child care, although their caregivers rated them as more negative with playmates. Children who spent more hours in child care were rated by their caregivers as more negative in peer play, but their observed peer play was not related to the quantity of care. Child-care experiences were not associated with peer competence as rated by mothers or as observed in dyadic play with a friend. Maternal sensitivity and children's cognitive and language competence predicted peer competence across all settings and informants, suggesting that family and child-care contexts may play different, but complementary roles in the development of early emerging individual differences in peer interaction.

Adult↗
PubMed2006

State child care regulations regarding infant sleep environment since the Healthy Child Care America-Back to Sleep campaign.

BACKGROUND: Despite overall decreases in sudden infant death syndrome deaths and prone sleeping, the proportion of sudden infant death syndrome deaths that occurs in child care settings has remained constant at approximately 20%. In 2003, the American Academy of Pediatrics' Healthy Child Care America program launched its own Back to Sleep campaign to promote the Back to Sleep message for those who care for young children. OBJECTIVES: The purpose of this study was to evaluate the effectiveness of the first 2 years of the Healthy Child Care America-Back to Sleep campaign in improving child care regulations by assessing the inclusion of the elements of a safe sleep environment in the individual state regulations for child care centers and family child care homes. METHODS: We examined regulations available in October 2005 for licensed child care centers and family child care homes in the 50 states and the District of Columbia for specific regulations pertaining to (1) sudden infant death syndrome risk-reduction training for child care providers, (2) infant sleep position, (3) crib safety, (4) bedding safety, (5) smoking, and (6) provision of information about sleep positioning policies and arrangements to parents before the infant is enrolled in child care. RESULTS: Since 2003, when the Healthy Child Care America-Back to Sleep campaign began, 60 of the 101 state regulations for either child care centers or FCCHs have been revised. More than half of these regulations written since 2003 mandate a nonprone sleep position and restrictions on soft bedding in the crib, and the change in these regulations since 2003 is statistically significant. However, of the 101 existing state regulations, only 49 require that infants sleep nonprone, 18 mandate sudden infant death syndrome training for child care providers, 81 have > or = 1 crib safety standard, and 43 restrict soft bedding in the crib. Only 4 regulations require that parents be provided with sleep policy information. CONCLUSIONS: The initial 2 years of the Healthy Child Care America Back to Sleep campaign have been successful in promoting safe infant sleep regulations. Efforts must continue so that safe sleep regulations exist in all jurisdictions.

Bedding and Linens↗
PubMed2001

Predictors of maternal child-feeding style: maternal and child characteristics.

We investigated relationships among maternal and child characteristics, and two aspects of maternal child-feeding styles that may place daughters at risk for developing problems with energy balance. Participants included 104 overweight (BMI> or =25) and 92 non-overweight (BMI<25) mothers and their 5-year-old, non-Hispanic, White daughters. Child-feeding styles included (a) restriction of daughters' intake of energy-dense snack food, and (b) pressure to eat more food. Predictors of child-feeding styles included measures of (1) maternal investment in weight and eating issues, including dietary restraint and weight concern, (2) child adiposity, (3) maternal perceptions of the child as underweight or overweight, and (4) maternal concern for child weight. Mothers reported using more restrictive feeding practices when they were invested in weight and eating issues, when they perceived daughters as overweight, when they were concerned about daughters' weight, and when daughters were heavier. Mothers reported using more pressure in child feeding when daughters were thinner, and when mothers perceived daughters as underweight. Further analyses examined whether relationships among child-feeding styles were different for overweight and non-overweight mothers. Overweight mothers' child-feeding styles appeared to be influenced by observable child weight characteristics, concerns for the child's weight status, and mothers' own history of overweight. Non-overweight mothers' child-feeding styles appeared to be influenced by distorted perceptions of and concerns for children, as well as distorted self-perceptions.

Adult↗
PubMed2006

Child-directed interaction: prediction of change in impaired mother-child functioning.

The first phase of parent-child interaction therapy (PCIT), called child-directed interaction, teaches parents to use positive and differential social attention to improve the parent-child relationship. This study examined predictors of change in mother and child functioning during the child-directed interaction for 100 mother-child dyads. The children were 3-6-years-old and diagnosed with oppositional defiant disorder. After establishing that significant improvements occurred in mother report of child disruptive behavior, parenting stress, and parenting practices, these three variables were combined to form a latent impaired mother-child functioning construct. Structural equation models were examined using maternal demographic and psychosocial variables as predictors of impaired mother-child functioning before and after the child-directed interaction. Mothers' self-reported daily hassles and depressive symptomatology predicted 74% of variance in impaired mother-child functioning before treatment. Mothers' report of social support predicted impaired mother-child functioning after the child-directed interaction, with 57% of the variance accounted for in this longitudinal model. These findings suggest the importance of improving maternal social support during the initial phase of PCIT.

Attention Deficit and Disruptive Behavior Disorder↗
PubMed1983

Fatal child abuse in Georgia: the epidemiology of severe physical child abuse.

Decisions about the occurrence of child abuse are increasingly difficult to make because concepts of what qualifies as reportable child abuse may be broadening. We examined this question by comparing 51 fatal child abuse cases occurring in Georgia between July 1975 and December 1979 to non-fatal cases and to the Georgia population. Overall rates of fatal child abuse were higher for male perpetrators compared with female and black perpetrators compared with white. However, the latter finding varied with economic and geographic status. The highest child abuse fatality rates were found in poor, rural, white families (3.3/100,000 children) and in poor, urban, black families (2.4/100,000 children). Risk factors for fatal abuse included early childhood (RR 6:1), parental teenage childbearing (RR 4:1), and low socioeconomic status. These characteristics were similar to those of the severe child abuse cases noted in the early child abuse literature. Non-fatal cases did not clearly share these risk factors. Severe abuse, here represented by fatal cases, is a distinct subset of reported child abuse, but characteristics associated with it are frequently attributed to all reportable child abuse. Medical personnel should be aware that they cannot rely on the presence or absence of these characteristics in screening for risk of reportable child abuse. Child abuse research should use restricted, stated case definitions. When intervention and prevention programs are being organized, they should not generalize research findings to all forms of child abuse.

Adolescent↗
PubMed1996

What can child homicide rates tell us about the effectiveness of child welfare services?

This paper examines the methodological problems involved in using child homicide rates as measures of the success or failure of child protection efforts. A comprehensive review of child homicide research identifies three major methodological issues: (1) The classification of child deaths as homicides is unreliable; (2) child homicides may not generally represent the endpoint of a continuum of violence ranging from inadequate parenting to maltreatment to death; and (3) child homicides are not frequent enough occurrences to effectively measure the impact of child welfare services and policies. We conclude that while improved reporting and classification procedures may lead to some useful avenues for research, relying on child homicide statistics to evaluate child welfare services may contribute to further narrowing the scope of child welfare by stressing procedures geared primarily to preventing child homicides. Child welfare services need to develop outcome measures that tap the broader mandate of improving the circumstances and well-being of children.

Adolescent↗
PubMedDate not supplied

Mothers' perceptions of child care assistance: the impact of a child's disability.

OBJECTIVE: This study examined and compared mothers' perceptions of child care assistance provided by fathers and other caregivers. Awareness of child care division of labor will assist occupational therapists in addressing the needs of children with disabilities within the family context. METHOD: One hundred and thirty-five mothers living in two-parent households kept a time diary of their daily activities for 7 consecutive days using the Caregiver's Activity and Recording of Events Inventory and estimated the percentage of child care their partners performed, the amount of child care their partners performed, and their satisfaction with this division of labor. One third of the women had children with multiple disabilities, one third had children with Down syndrome, and one third had children who were typically developing. RESULTS: The majority of mothers in all three groups perceived that they were responsible for the majority of child care. There were no significant differences between groups in terms of mothers' perceptions of the amount of child care provided by fathers and other caregivers, including relatives, childsitters, nurses, school personnel, and neighbors. However, there were wide variations among families concerning child care arrangements and division of labor. Seventy-five percent of mothers indicated that they were satisfied with the division of child care labor between mothers and fathers, and no significant correlation was found between perceived percentage of child care performed and satisfaction with the division of labor. CONCLUSION: Mothers in this study were responsible for the majority of child care whether their child had a disability. The variation in number of hours that others spent performing child care activities within individual families suggests that there is no "best" or typical pattern. Occupational therapists need to collaborate with families to determine a system of accommodations to manage their daily routine that most effectively meets the family's needs.

Adult↗
PubMed2003

Maternal-child feeding patterns and child body weight: findings from a population-based sample.

BACKGROUND: Certain mother-child feeding patterns (MCFPs) may promote childhood obesity and/or disordered eating. OBJECTIVES: To assess the demographic correlates of MCFPs and to test whether differences in MCFPs are associated with child body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) z scores in a population-based study. DESIGN: A secondary analysis of the National Longitudinal Survey of Youth main and child cohorts was conducted on more than 1000 Hispanic, African American, and non-Hispanic/non-African American children, aged 3 to 6 years. The MCFPs were measured by means of 3 interview questions probing mother-allotted child food choice, child compliance during meals, and child obedience during meals. RESULTS: Mothers of non-Hispanic/non-African American children allotted greater food choice than mothers of African American or Hispanic children. Maternal BMI and other demographic measures were unrelated to MCFPs. The lowest levels of mother-allotted child food choice and child eating compliance were associated with reduced child BMI, with mean BMI z scores of -0.36 and -0.41, respectively. Effect sizes were small, however, and MCFPs did not discriminate children who were overweight or at risk for being overweight from children who were not (P>.05). CONCLUSIONS: Feeding strategies providing the least child food choice were associated with reduced child BMI. However, MCFPs did not relate to child overweight status.

Analysis of Variance↗
PubMed2006

Interactions between child and parent temperament and child behavior problems.

OBJECTIVE: Few studies of temperament have tested goodness-of-fit theories of child behavior problems. In this study, we test the hypothesis that interactions between child and parent temperament dimensions predict levels of child psychopathology after controlling for the effects of these dimensions individually. METHODS: Temperament and psychopathology were assessed in a total of 175 children (97 boys, 78 girls; mean age, 10.99 years; SD, 3.66 years) using composite scores from multiple informants of the Junior Temperament and Character Inventory and the Achenbach System of Empirically Based Assessment. Parent temperament was assessed using the adult version of the Temperament and Character Inventory. Statistical analyses included multiple regression procedures to assess the contribution of child-parent temperament interactions after controlling for demographic variables, other types of child psychopathology, and the individual Temperament and Character Inventory and Junior Temperament and Character Inventory dimensions. RESULTS: Interactions between child and parent temperament dimensions predicted higher levels of externalizing, internalizing, and attention problems over and above the effects of these dimensions alone. Among others, the combination of high child novelty seeking with high maternal novelty was associated with child attention problems, whereas the combination of high child harm avoidance and high father harm avoidance was associated with increased child internalizing problems. Many child temperament dimensions also exerted significant effects independently. CONCLUSIONS: The association between a child temperament trait and psychopathology can be dependent upon the temperament of parents. These data lend support to previous theories of the importance of goodness-of-fit.

Age Factors↗
PubMedDate not supplied

Child abuse quilts: revealing and healing the pain of child abuse.

According to the recent government report, Child Maltreatment 1997: Reports From the States to the National Child Abuse and Neglect Data System, almost 3 million reports of child abuse and neglect were filed in the United States in 1997. The number of substantiated or indicated maltreatment cases decreased from more than 1 million child victims in 1996 to about 984,000 in 1997. More than half of the reports involved neglect, about one-fourth involved physical abuse, and 12% included sexual abuse, and an estimated 1,197 fatalities resulted from child maltreatment in 1997. In response to the issue of child maltreatment, the Child Abuse Quilts Project was conceived. At least 28 quilts were made for this project, visually addressing the subject of child abuse, child abuse prevention, and violence against children. Mary Beth Goodman, curator of the quilt exhibit says, "The quilters put these quilts before you, not to make you turn away from their quilts in distaste, but to make you think about child abuse and its impact on the child, the survivor, the family, the community. Change comes slowly, heart by heart. We hope that each person who sees these quilts with [be]... re-awakened to the tragedy of child abuse and resolved to prevent it" Ten of these quilts are displayed here; all 28 are displayed on the Internet at members.tripod.com/mbgoodman/ caqpics/caqindex.html.

Child↗
PubMedDate not supplied

Alternate child care, history of hospitalization, and preschool child behavior.

BACKGROUND: With more single mothers entering the workforce due to welfare reform efforts, more hospitalized children from single-parent families will have experienced alternate child care arrangements where routine care is provided by adults other than the child's mother. OBJECTIVES: To investigate with secondary analysis of data whether experience with alternate child care has a moderating effect on the relationship between hospitalization and behavior of preschool children living in female-headed single-parent families. METHOD: A sample of 60 preterm and 61 full-term children who were 3, 4, or 5 years old was recruited for the larger longitudinal study. Behavior problems were measured with the Child Behavior Checklist. History of hospitalization and alternate child care arrangements were measured with the Life History Calendar. RESULTS: Preschool children who experienced hospitalization without alternate child care experience had more somatic complaints, but those with both hospital and alternate child care experience had fewer aggressive behaviors than other children. For children with a history of hospitalization, aggressive behaviors decreased as the proportion of the child's life in alternate child care increased. CONCLUSIONS: Experience with alternate child care may ameliorate some of the negative effects of hospitalization, and potentially other novel and negative experiences, for preschool children. This could be due to child care providing positive experiences with separation from the mother, a peer group with which to talk about the novel experience, or actual instruction about the novel experience.

Adult↗
PubMed2002

Caretaker-child concordance for child's exposure to violence in a preadolescent inner-city population.

BACKGROUND: Effective screening for exposure to violence (ETV) in the pediatric setting depends on informant reliability and recognition of patients at increased risk. Pediatricians screening for children's ETV often rely on parent reporting. HYPOTHESIS: That there would be poor caretaker-child concordance given that children would report events occurring outside the home not witnessed by the caretaker and that ETV would be higher among immigrant families. OBJECTIVES: To examine concordance between caretaker and child self-report of the child's ETV in a preadolescent population and to explore factors related to increased risk. DESIGN: Community-based survey. SETTING: Urban community health center. PARTICIPANTS: One hundred sixty-five caretaker-child pairs. METHODS: The ETV was assessed by means of a standardized interview questionnaire on location and frequency of ETV. A Rasch model was used to develop summary scores of ETV (frequency and severity). RESULTS: Caretaker-child concordance on reports of child's ETV was poor. The kappa statistics ranged from -0.04 for seeing someone knifed to 0.39 for witnessing a shooting. Children reported ETV more often in their neighborhood or at school, whereas caretakers reported more events near or at home. Univariate predictors of child's self-reported ETV were female sex (beta +/- SE, -10.1 +/- 4.6; P =.03) and caretaker being divorced (beta +/- SE, 12.6 +/- 6.0; P =.04). In multivariate analyses, country of origin predicted child's ETV, adjusting for child's age and sex, and caretaker educational status and marital status. CONCLUSIONS: Caretakers and their children have poor agreement on reports of the child's ETV. Intervention strategies around ETV should include assessment of the child independent of caretaker report for preadolescents. Screening may be more effective if pediatricians are aware of factors related to increased risk, including immigration status and caretaker marital status.

Adolescent↗
PubMedDate not supplied

Planning for health promotion in low-income preschool child care settings: focus groups of parents and child care providers.

OBJECTIVE: To identify potentially successful strategies, barriers, and facilitators for health promotion in preschool child care settings. METHODS: We conducted 6 focus groups including each of the following: parents of children attending child care centers and home-based family child care (2 in English, 1 in Spanish) and directors of child care centers and family child care providers (2 in English, 1 in Spanish). Systematic thematic analysis was conducted to generate themes to address study questions. RESULTS: A total of 24 parents and 45 child care providers, serving predominantly urban, low-income children in Boston, participated. Parents and child care providers agreed that in-person group discussions would be the most effective strategy for providing health education information to parents. Several barriers that could affect implementation emerged. First, some providers expressed frustration toward parents' attitudes about child safety and health. Second, there was diversity of opinion among providers on whether conducting health promotion activities was consistent with their training and role. In addition, literacy, language, and cultural barriers were identified as potential barriers to health promotion in child care. CONCLUSIONS: In order to be successful, health promotion strategies in child care settings will need to overcome tensions between providers and parents, allow professional growth of child care providers to serve in a health promotion role, and better integrate external health resources and personnel. Group sessions and peer learning opportunities that are culturally and linguistically sensitive are potentially successful strategies for implementation of health promotion interventions for many parents.

Administrative Personnel↗