Reducing conduct problems among children exposed to intimate partner violence: A randomized clinical trial examining effects of Project Support.

This study was a randomized clinical trial of Project Support, an intervention designed to reduce conduct problems among children exposed to intimate partner violence. Participants were 66 families (mothers and children) with at least 1 child exhibiting clinical levels of conduct problems. Families were recruited from domestic violence shelters. The Project Support intervention involves (a) teaching mothers child management skills and (b) providing instrumental and emotional support to mothers. Families were randomly assigned to the Project Support intervention condition or to an existing services comparison condition. They were assessed on 6 occasions over 20 months, following their departure from the shelter. Children in families in the Project Support condition, compared with those in the comparison condition, exhibited greater reductions in conduct problems. Mothers in the Project Support condition, compared with those in the comparison condition, displayed greater reductions in inconsistent and harsh parenting behaviors and psychiatric symptoms. Changes in mothers’ parenting and psychiatric symptoms accounted for a sizable proportion of Project Support’s effects on child conduct problems at the end of treatment. Clinical and policy implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-administered behavioral family intervention for parents of toddlers: Part I. Efficacy.

This study examined the efficacy of a self-administered behavioral family intervention for 126 parents of toddlers. The effects of 2 different levels of intensity of the self-administered intervention were contrasted (self-administered alone or self-administered plus brief therapist telephone assistance). The results provide support for the efficacy of the self-administered form of behavioral family intervention. There were significant short-term reductions in reported child behavior problems and improvements in maternal parenting style, parenting confidence, and anger. Families who received minimal therapist assistance made more clinically significant gains compared with families who completed the program with no therapist assistance. The intervention effects were maintained at 6-month follow-up. The implications of the findings for the population-level delivery of behavioral family interventions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A promising parenting intervention in foster care.

The purpose of this study was to evaluate the effectiveness of a 2-component intervention for biological and foster parent (pairs) to improve parenting practices, co-parenting, and child externalizing problems. Participants were biological and foster parents (N = 128) of primarily neglected children (ages 3 to 10 years) placed in regular foster homes. Biological and foster parents were randomly assigned in pairs to the intervention (n = 80) or a usual care (n = 48) condition. Intervention families received a 12-week parenting course (Incredible Years) and a newly developed co-parenting component. Key findings included significant gains in positive parenting and collaborative co-parenting for both biological and foster parents at the end of the intervention. At follow-up, intervention parents sustained greater improvement in positive parenting, showed gains in clear expectations, and reported a trend for fewer child externalizing problems. Findings supported the feasibility of offering joint parenting training to meet the needs of participating families and demonstrated that the co-parenting construct applied to families in the foster care system was amenable to intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining maternal depression and attachment insecurity as moderators of the impacts of home visiting for at-risk mothers and infants.

Home visiting programs for at-risk mothers and their infants have proliferated nationally in recent years, yet experimental studies of home visiting have yielded mixed findings. One promising strategy for explicating the effects of early home visiting is to examine moderators of program impacts. This study assessed the roles of maternal depression and attachment insecurity as moderators of the impacts of Healthy Families Alaska home visiting services for at-risk mothers and their infants. At-risk families (N = 325) were randomly assigned to home visiting or community services as usual (n = 162 and 163, respectively). Maternal depression and attachment insecurity (attachment anxiety and discomfort with trust/dependence) were measured at baseline. Maternal psychosocial and parenting outcomes were measured when children were 2 years old via maternal self-report, observation, and review of substantiated reports of child maltreatment. Maternal depression and attachment insecurity interacted in their moderation of program impacts. For several outcomes, home visiting impacts were greatest for nondepressed mothers with moderate-to-high discomfort with trust/dependence and for depressed mothers with low discomfort with trust/dependence. Implications for practice and policy are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal attributions and child oppositional behavior: A longitudinal study of boys with and without attention-deficit/hyperactivity disorder.

The authors examined changes over a 1-year period in mothers' attributions for child behavior and child oppositional behavior among 53 mothers and nonproblem sons and 44 mothers and sons with attention-deficit/hyperactivity disorder (ADHD). Boys averaged 8 years of age (SD = 11 months) at Time 1. Families were primarily of European Canadian cultural background and most were middle to upper middle class. Initial levels of child oppositionality did not predict changes in mothers' attributions over time. However, initial levels of mothers' attributions of oppositional child behavior to internal, stable, and global causes positively predicted child oppositional behavior, controlling for ADHD versus nonproblem status and the child's initial level of oppositional behavior. Although initial levels of overreactive and nonresponsive parenting also positively predicted child oppositional behavior, the contribution of mothers' attributions remained significant even with parenting variables controlled. Results suggest that mothers' attributions of child oppositional behavior to internal, stable, and global causes may contribute to maintenance of child problems over time and that these parenting cognitions have importance as intervention targets. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early intervention for parents at risk of child abuse and neglect: A preliminary investigation.

An early intervention program for young parents and children who have been identified as being at risk of child maltreatment was evaluated. Thirty mother–child dyads were randomly assigned to one of two conditions: (a) an information group offered by the child protection agency (which served as a control condition) or (b) a special program of behavioral parent training in addition to the agency group. Self-report measures indicated that significant improvements in parenting risk and child behavior problems at posttest and at 3-month follow-up were evident only for mothers who received parent training in addition to information groups. Home observation data were inconclusive, possibly due to the limited opportunities to observe behaviors of interest. Both groups showed improvements in their child-rearing environments and in their children's adaptive behaviors at follow-up. Caseworker ratings of clients' risks of maltreatment and abilities to manage their families at 1-year follow-up significantly favored the families who received parent training in addition to information. Methodological and treatment issues arising from this preliminary investigation of early intervention with diverse population of high-risk parents and children are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family-centered services: approaches and effectiveness

Much of the emphasis in the nation's system of child protection focuses on investigations to determine whether child abuse or neglect has occurred, and procedures for arranging out-of-home care for children who are not safe at home. Less attention often goes to the capacity of public and private agencies to provide services that help stressed families prevent child maltreatment before it begins, or that enable families with serious child-rearing problems to stabilize the home and provide more appropriate care for their children. This article examines the current understanding of the most promising and effective means of serving families. It highlights the family-centered service approach, which encompasses family support services for families coping with normal parenting stresses, and family preservation services designed to help families facing serious problems and possible out-of-home placement. The article explains the characteristics of family support and family preservation services, and discusses how these services are accessed and financed. It reviews available evaluation findings regarding the effectiveness of the two types of family-centered services, and considers the challenges faced when evaluating such services. Finally, the article discusses issues related to planning and service delivery, such as coordination and system reform, financing, targeting, relationships between workers and families, and efforts to strengthen entire communities.     

Six month follow-up: the crucial test of multidisciplinary developmental assessment

Participation of parents in the developmental assessment process is thought to be beneficial in promoting understanding of their child's disability, and improving consensus between parents and professionals about appropriate intervention programmes. If costly multidisciplinary assessments are to be justified, it is necessary to establish long-term benefits for the child. This highlights a need for research identifying how families use services after diagnostic assessment and what they understand to be important for their child. Poor parent-professional agreement about diagnosis may be a factor contributing to low compliance with recommendations. The major purpose of the current study was to follow-up families 6 months after developmental assessment, in order to investigate use of recommended intervention services. In addition, mothers' opinions about diagnostic findings, recommendations and early intervention services were examined. Subjects were 40 pre-school children who presented for developmental assessment, and their mothers. The majority were diagnosed with developmental problems in multiple domains. Results indicated that most mothers recalled and agreed with their child's diagnosis, but underestimated the severity of developmental delay. Families had not accessed the range of multidisciplinary intervention programmes recommended, given the complexity of their children's disabilities. Speech therapy was considered the service of highest priority by mothers, and was the treatment most frequently received. Mothers recognized a need for more therapeutic interventions for their child. An unexpected finding was the high prevalence of families who organized nonprescribed therapies. Possible explanations of the findings and implications for service delivery are discussed.     

Predicting Infant Maltreatment in Low-Income Families: The Interactive Effects of Maternal Attributions and Child Status at Birth.

Maternal attributions and child neonatal status at birth were assessed as predictors of infant maltreatment (harsh parenting and safety neglect). The population included low-income, low-education families who were primarily Hispanic. Child maltreatment during the 1st year of life (N = 73) was predicted by neonatal status (low Apgar scores, preterm status), as moderated by mothers' attributions. The highest levels of maltreatment were shown within dyads that included a mother with low perceived power and an at-risk infant. Partial support was found for maternal depressive symptoms as mediators of harsh parenting among at-risk infants. It is suggested that lack of perceived parental power constrains investment in protective relationships and fosters sensitization to potential threat. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A competency-based parent training program for child abusers.

Evaluated an intervention program for child abusers using multiple outcome criteria and extended follow-up. 16 families were given the Parent–Child Interaction Form and the Eyberg Child Behavior Inventory and were assigned to either treatment or control groups. All families were supervised by protective services, and none had requested help voluntarily. A treatment program involving group parent training in the clinic and competency-based training and rehearsal in the home was provided. Findings indicate that training abusive Ss in child-management and self-control techniques resulted in improvements in parenting skills as measured by home observations, parental reports of child-behavior problems, and caseworker reports of family problems. A 1-yr follow-up indicated that no incidences of child abuse among treatment families had been reported to or suspected by caseworkers. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reducing conduct problems among children of battered women.

This study was an experimental evaluation of an intervention designed to reduce conduct problems among children of battered women. Participants were 36 families (mothers and children) in which the mother had sought shelter because of relationship violence and had at least 1 child (4-9 years old) with clinical levels of conduct problems. The intervention consisted of 2 primary components: (a) providing instrumental and emotional support and (b) teaching child management skills to mothers. Families were randomly assigned to either the intervention condition or the existing services comparison condition and were assessed on 5 occasions over 16 months after shelter departure. Compared with families receiving existing services, children in the intervention condition improved at a faster rate, the proportion of children displaying clinical levels of conduct problems was greatly diminished, and mothers displayed greater improvements in child management skills. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child Maltreatment, Parent Alcohol- and Drug-Related Problems, Polydrug Problems, and Parenting Practices: A Test of Gender Differences and Four Theoretical Perspectives.

The authors tested how adverse childhood experiences (child maltreatment and parent alcohol- and drug-related problems) and adult polydrug use (as a mediator) predict poor parenting in a community sample (237 mothers and 81 fathers). These relationships were framed within several theoretical perspectives, including observational learning, impaired functioning, self-medication, and parentification-pseudomaturity. Structural models revealed that child maltreatment predicted poor parenting practices among mothers. Parent alcohol- and drug-related problems had an indirect detrimental influence on mothers' parenting and practices through self-drug problems. Among fathers, emotional neglect experienced as a child predicted lack of parental warmth more parental neglect, and sexual abuse experienced as a child predicted a rejecting style of parenting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Influence of Decreased Parental Resources on the Efficacy of a Responsive Parenting Intervention.

To understand whether a responsive parenting intervention for socially disadvantaged mothers was related to preintervention parenting resources, the authors examined both of these conditions as moderators of behavior change in 264 participating families (term, n = 120; very low birth weight, n = 144). Families were randomly assigned to an intervention that targeted responsive behaviors or received developmental information. Limited internal resources, particularly higher levels of anger/hostility, were related to less positive change for the broadest range of responsive behaviors for mothers in the information-only condition but not those in the intervention. Decreased social support moderated less change in provision of rich language input. A systematic session format and parent facilitator may be keys to understanding why a responsive parenting intervention can be effective in spite of limited parental resources. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fathers' participation in family research: Is there a self-selection bias?

The representativeness of fathers who participate in family research was examined among 661 families. Approximately two thirds of eligible fathers participated. Mothers' and observers' reports on families of participating and nonparticipating fathers were compared. Participating fathers underrepresented fathers with less education, later-born children, more ambivalent marriages, partners with more traditional child-rearing beliefs, families with less optimal parenting environments, and infants who were unplanned, had more difficult temperaments, and were less healthy. Also underrepresented were ethnic minority families and working-class fathers. However, no differences were found in regard to child gender, family income, mothers' psychosocial functioning, either parent's employment experiences, or child-care arrangements. Implications for the generalizability of findings and the recruitment of fathers are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A preliminary study of parental stress and child behaviour in families with twins conceived by in-vitro fertilization

This paper reports on a preliminary study of parenting quality, parental stress and child behaviour in families with twins conceived by in-vitro fertilization (IVF) in comparison with families with naturally conceived twins. No differences were found between the types of family in parenting quality or child behaviour. However, parents whose children were conceived by IVF reported greater stress associated with parenting than parents with naturally conceived twins.     

Stress-point intervention for parents of repeatedly hospitalized children with chronic conditions

Little is known about how to assist children with chronic conditions and their families cope with repeated hospitalizations. A two-group, pretest-posttest study was done to determine whether a community-based, stress-point nursing intervention for parents could decrease distress and improve child and family functioning. Fifty participants were randomly assigned to intervention or usual care control groups. The intervention focused on specific, parent-verified child and family issues. Three months after hospitalization, intervention parents had better coping and family functioning than those in the usual care group. Intervention parents' anxiety was initially higher and then lower. There were no child behavior differences between the groups after hospitalization. Intervention children had no developmental regression at 2 weeks and better developmental gains 3 months after discharge than the usual care children. Stress-point intervention for families and their children with chronic conditions improved family coping and functioning, and eliminated hospitalization-induced developmental regression.     

Coparenting, mother-infant interaction, and infant-parent attachment relationships in two-parent families.

Coparenting behavior and the quality of mothers' parenting behavior were examined in relation to parents' perceptions of their child's attachment in 60 two-parent families with 11- to 15-month-old infants (30 boys and 30 girls). Parent-child attachment was assessed using the Attachment Q-Sort. Competitive coparenting was associated with mothers' and fathers' perception of a less secure parent-child attachment relationship, whereas maternal responsiveness was associated with mothers' perception of a more secure mother-child attachment relationship. Families with mothers who were more restrictive and those with parents who were more competitive were less likely to have mothers and fathers with similar perceptions of the quality of parent-child attachment relationships. Findings support the proposal that different levels of family functioning affect the quality of parent-child relationships. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Marital conflict, maternal and paternal parenting, and child adjustment: A test of mediation and moderation.

Parenting was examined as a mediator of associations between marital and child adjustment, and parent gender was examined as a moderator of associations among marital, parental, and child functioning in 226 families with a school-age child (146 boys). Parenting fully mediated associations between marital conflict and child internalizing and externalizing behaviors. Parent gender did not moderate associations when data from the full sample or families with girls only were evaluated. Parent gender did moderate associations when families with boys were evaluated, with the association between marital conflict and parenting stronger for fathers than mothers. A trend suggested fathers' parenting may be more strongly related to internalizing behavior and mothers' parenting may be more strongly related to externalizing behavior in boys. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychometric properties of family members' reports of parental physical aggression toward clinic-referred children.

This study examined (a) differences among mothers', fathers', and children's reports of parental physical aggression toward children; (b) the reliability and validity of family members' reports of aggression using confirmatory factor analysis; and (c) the discriminant validity of the construct of mother–child and father–child aggression. Participants were 72 dual-parent families in which the parents were seeking clinical services for their children's (ages 7–9 years) conduct behavior problems. Each participant completed the parent–child version of the Conflict Tactics Scale (P-CTS). Results indicate that children reported lower levels of mother–child and father–child aggression than either mothers or fathers reported. Although the reliability (total systematic variance accounted for by observed variables) of family members' reports on the P-CTS ranged from moderate to high, convergent validity was generally low. The constructs of mother–child and father–child aggression were highly correlated but could be distinguished from each other when relationships among rater effects were considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)