From Boys Town to Oliver Twist: Separating fact from fiction in welfare reform and out-of-home placement of children and youth.

Recent debate following the suggestion to place children of "welfare mothers" in "orphanages" illustrates the need to evaluate the relative goodness of residential care and to examine many of the basic assumptions underlying current welfare reform proposals. Nearly half a million children and youth are currently in government-funded out-of-home care in the United States. As custodians of this challenging population, child and youth care workers are neither parents nor therapists, but appear to perform both of these roles as "therapeutic parents." Two comprehensive and mature literatures—common factors of therapist efficacy and parental correlates of offspring psychopathology—provide theoretical and empirical support for this model of child and youth care. Current welfare reform proposals are evaluated in the context of the therapeutic parent model; assumptions about welfare mothers are also examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Music for sleep disturbance in the elderly

The purpose of this exploratory study was to examine issues reported by natural and foster parents when caring for a child 3 years of age or younger with vertically transmitted HIV-disease. Issues common to both groups, and specific to the natural and foster parents were explored. The issues discussed by the natural mothers included guilt, their relationship with their infected child, and the effects of their HIV infection on their family. Issues discussed by foster mothers included their decision to foster a HIV-positive child, characteristics of their HIV- positive foster children, fears of transmission, and the effect of the HIV-positive foster child(ren) on their natural family. Issues common to both sets of mothers include disclosure, support, preparation for the HIV-positive child's death, and life in general. The experiences of these families are important to describe in order for pediatric nurses to give accurate, sensitive, and culturally appropriate care.     

Behavior problems among young children in low-income urban day care centers

The purposes of this study were to describe: (a) the frequency and correlates of behavior problems among a sample of 2- and 3-year-old children from low-income families as seen by their parents and day care teachers, (b) the degree to which parents and teachers agree about the children's behavior problems in their respective contexts, and (c) family characteristics that distinguish toddlers with behavior problems both at home and at day care from the rest of the sample. Parents of 133 toddlers from 10 Chicago day care centers completed measures of child behavior problems, child behavioral intensity, parenting self-efficacy, discipline strategies, and stress. Children's day care teachers also completed a measure of child behavior problems. Parent-reported behavior problems were associated with higher child behavioral intensity, greater parent stress, lower self-efficacy, and discipline strategies characterized by irritability, coercion, and inconsistency. Parent and teacher ratings on child behavior were correlated for boys' behavior problems only. Parents reported more child behavior problems than teachers. Approximately 8% of the children were rated as having behavior problems at home and at day care. Although most of the children are functioning well, many of these parents and toddlers are engaged in highly stressful and coercive relationships.     

Families of the baby boom: Parents' division of labor and children's adjustment.

Assessed lesbian couples' division of labor, their satisfaction with division of labor and with their relationships, and their children's psychosocial adjustment. The 26 participating families were headed by lesbian couples, each of whom had at least 1 child between 4 and 9 yrs of age. Parents' relationship satisfaction was generally high but was unrelated to measures of parental division of labor or of children's adjustment. Although both parents reported sharing household tasks and decision making equally, biological mothers reported greater involvement in child care, and nonbiological mothers reported spending longer hours in paid employment. Parents were more satisfied and children were more well-adjusted when labor involved in child care was more evenly distributed between the parents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Illness and injury in family day care: a seasonal survey

Many mothers with children under age 6 are employed and it is not usually feasible for a parent to stay home with a child who is mildly ill. Such ill children likely remain in child day care programs. The extent to which this occurs and the management of these children in family day care was studied. Over the course of a year, 1 to 3 visits were made to 714 family day care homes in order to survey providers. With enrollments ranging between 0 and 18 children per day care home at the time of each visit, information on 3,630 "child enrollment days" was collected. The median age of children in care was 2 years. An average of 16% of all children were ill on any one day (with seasonal variation); 1% were injured. Of ill children, 82% attended day care that day, 49% had contacted a physician about that illness, and 28% were administered a medication at the day care setting. Twenty-one percent of children receiving medication in day care had no contact with a physician for that illness. These data show that mild childhood illnesses are routinely managed by child day care providers. Physicians who traditionally limit their illness-management education to parents need to recognize the health education and consultation needs of day care providers.     

The parent-nurse relationship from the perspective of parents of children with cancer

Research to date has overlooked the specific relationship between parents and nurses, particularly in the context of family-centered care for a hospitalized child with cancer. The purpose of this study was to describe how parents perceive the relationship with the pediatric staff nurse necessitated by the hospitalization of their child with cancer. Using a symbolic interactionist framework and a modified grounded theory methodology, this study explored the parent-nurse relationship when a child with cancer is hospitalized. A purposive, theoretical quota sampling method was used to recruit 16 parents. Both parents' and nurses' care were examined from the parents' perspectives; mothers and fathers were interviewed separately. Analysis of the data led to the development of a substantive theory describing parent care (Making it Better), nursing care (Going Through the Motions, Caring Incompletely and Caring Completely), and the parent-nurse relationship (Working Together). Conditions influencing the care provided by parents and nurses and in turn the parent-nurse relationship were also identified. This research describes strategies nurses use to enhance the family-centered care they provide and reveals the effect nursing care has on parents' hospital experiences. Recommendations are made for nursing research, practice, and education.     

Gender-role attitudes and behavior across the transition to parenthood.

On the basis of social structural theory and identity theory, the current study examined changes in gender-role attitudes and behavior across the first-time transition to parenthood and following the birth of a second child for experienced mothers and fathers. Data were analyzed from the ongoing longitudinal Wisconsin Study of Families and Work. Gender-role attitudes, work and family identity salience, and division of household labor were measured for 205 first-time and 198 experienced mothers and fathers across 4 time points from 5 months pregnant to 12 months postpartum. Multilevel latent growth curve analysis was used to analyze the data. In general, parents became more traditional in their gender-role attitudes and behavior following the birth of a child, women changed more than men, and first-time parents changed more than experienced parents. Findings suggest that changes in gender-role attitudes and behavior following the birth of a child may be attributed to both the process of transitioning to parenthood for the first time and that of negotiating the demands of having a new baby in the family. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Popular primers for parents.

Notes that we are witnessing a proliferation of parenting "primers" as Dr. Spock is joined by a host of other child-care "experts." The present paper examines the extent and characteristics of the audience for these practical child-care manuals by integrating information from 4 of the author's studies. Data are presented from (a) a survey of 100 child-care publications, (b) the responses of 48 parents to a questionnaire about sources of child-care advice, (c) the questionnaire responses of 60 readers of parenting books owned by a public library, and (d) interviews with 104 mothers participating in a larger study of child-care. Results indicate that the publication and the reading of this literature have increased over the past several decades. Almost all parents read at least one such book, and a substantial proportion read more than 5. Those who read the most books are relatively young, worried about being parents, and isolated from family sources of child care. Although the number of books parents read is related to their education, it is not related to occupation. The characteristics and reactions of parents reading child-care books are discussed (a) in the context of current social conditions that may increase reliance on "expert" advice about child care, and (b) in light of the goals and shortcomings of the advice that is offered. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children of substance abusers: the life experiences of children of opiate addicts in methadone maintenance

We interviewed 70 substance abusers in methadone maintenance treatment regarding the life experiences of their 188 children. Sixty-four percent of the mothers reported using psychoactive drugs during their pregnancies. Eighty percent of parents reported an arrest during the time the child was growing up, 34% reported receiving treatment for an emotional disorder, and 14% were hospitalized. Four percent of the parents reported that their children had been placed in adoptive care, 9% in foster care, and 1% had a child in a group home. Forty-one percent of the parents reported that at least one of their children repeated a grade in school, 19% were involved in truancy, and 30% had been suspended from school. Twenty percent of parents reported their children's involvement with the law, and 17% reported drug or alcohol use. Problems with the law correlated highly with 1) being held back a grade, 2) truancy, 3) suspension from school, 4) expulsion from school, and 5) treatment for alcohol or drug abuse.     

Paternal influences and the father's role: A personal perspective.

Briefly reviews research and theory concerning the role of the father in child development and presents a personal perspective that sees some long-established attitudes toward child care changing. Traditionally, major responsibility for childrearing has been assumed by women. Studies show, however, that most infants become attached to both their parents, although most turn to their mothers when distressed. With older children, fathers appear to have their greatest influence on sex role development. The type and extent of their impact varies depending on the quality of the father–child relationships. Recent trends indicate an increasing involvement of fathers in child care. These trends will increase paternal contributions to the socialization process. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stillbirth is no longer managed as a nonevent: a nationwide study in Sweden

BACKGROUND: Giving birth to a stillborn child is a tragedy. The aim of this study is to investigate the meeting of mothers with their stillborn children and the women's experiences of support during and after the delivery. METHODS: In a nationwide study in Sweden, data from 636 women who gave birth to a stillborn or live baby were collected by means of an anonymous postal questionnaire in 1994. RESULTS: Among the 314 women who gave birth to a stillborn child, nearly every mother had seen her child, and 80 percent had carressed her baby. More than 90 percent of the mothers stated that the medical staff showed respect, and about 80 percent of the mothers stated that staff exhibited tenderness toward their dead children. The mother's assessment of respect and tenderness to her child by medical staff was almost identical between stillbirths and live births. Nearly 70 percent of the women reported that the hospital had good routines to support mothers of stillborn children. Feelings of sadness and having been deeply hurt or angered by the medical staff's behavior were reported by 37 percent of the women. A difficult balance is still to be achieved between women being forced to encounter the baby when not yet ready versus others who wish the staff had given more encouragement. The value of properly taken photographs is described. CONCLUSIONS: Treating stillbirth as a nonevent has been largely, if not entirely, abandoned in Sweden. Most mothers of a stillborn child experience that the medical staff treat their dead children appropriately.     

Parenting children with anorectal malformations: implications and experiences

Parents play a crucial role in the life of a child suffering from an anorectal malformation (ARM), since their guidance contributes to the degree to which the child learns to cope with his or her disability. We investigated whether they experience stress in parenting such a child and also attempted to identify somatic or behavioral characteristics in the child that influence the stress of parenting. The parents of 109 children (69 males, 40 females; median age 5.9 years, range 1-18 years) with an ARM (58 low, 10 intermediate, 41 high) were studied. The Nijmegen Questionnaire on Child-rearing Situations (NQCS) was used to investigate the existing parenting situation. Behavioral characteristics of the children were studied by means of the Child Behaviour Checklist (CBCL) and the Teacher Report Form (TRF). In a semi-structured interview, we investigated how parents experienced the implications of the disability in everyday life with their child. Our study showed that as far as the perception of parenting stress is concerned, parents of children with an ARM do not differ from those with healthy primary-school children. Within the group of parents with ARM-afflicted children, the parents of older, incontinent children experienced relatively more stress, especially when the child concerned was male. With regard to the children's behavior, the parents and teachers under investigation did not report a higher than normal incidence of deviant behavior. However, when individual parents observed difficult behavior in their child, they found it harder to deal with than the incontinence for feces. Regarding the implications of the disorder for their everyday lives, parents were concerned and indicated a need for specific counselling. We conclude that having a child with a somatic affliction, in this case an ARM, does not automatically imply that the parents experience child-rearing problems. However, certain groups of parents are more at risk, i.e., parents with older, incontinent sons and parents with children exhibiting behavioral problems. In addition, our study shows that parents do have difficulties in coping with the implications of the disorder and express a need for support. We feel that patient care can be improved if aid is tailored to these specific problems.     

Attitudes to the use of dummies in New Zealand; a qualitative study

AIMS: To explore experiences with, and attitudes to, the use of dummies (pacifiers). METHODS: Seven focus group discussions were held with groups of mothers and of health professionals. RESULTS: Most mothers and health care workers had a generally negative view of dummy use. This related particularly to dislike of toddlers with them and practical issues such as getting lost or dirty. All would allow their use in a very unsettled baby. No mothers had personally experienced problems with breastfeeding due to the use of a dummy, but concern about this possibility was expressed by some health care workers. Recommendations varied about the length of time that dummies need to be avoided. CONCLUSIONS: Mothers in New Zealand use dummies selectively for their infants and were concerned with issues of weaning the baby from the dummy, keeping it clean and not losing it. In analysing the relationships between dummy use and breastfeeding it is important to take into consideration the context of dummy use.     

Disruptive behavior disorder and intergenerational attachment patterns: A comparison of clinic-referred and normally functioning preschoolers and their mothers.

This study examined linkages between child disruptive behavior disorder ( DBD), quality of mother-child interactions, and mothers' recollections of and attitudes toward their own parents. Twenty-five preschool boys referred to a psychiatric clinic were matched with normally functioning boys. Mothers and sons were videotaped during a separation-reunion sequence, the Adult Attachment Interview was administered to mothers, and mothers completed questionnaires assessing family environment. Mothers of boys with DBD described relationships with their own parents less coherently than comparison mothers did, indicating less secure representations of attachment. Maternal and child attachment classifications were concordant. Log-linear analyses suggested that the influence of maternal representation of attachment on disruptive behavior problems was secondary to the quality of mother-child interaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An investigation into the feasibility of parental participation in the nursing care of their children

Family-centred care has been recognized as a basic tenet of paediatric nursing for some time because it is believed that children benefit from the continuous presence of their patents. It is for this reason that the concept of care by parents has evolved. Although such a philosophy is beneficial for the child, it has undoubtedly evolved due to low staffing levels, and in such an environment the guidelines for safe practice are easily called into question. In the wake of a new paediatric oncology ward, it was decided to consider instituting care by parents. In an effort to do this in a structured way, it was decided to make our practice research based. A teaching tool was formulated and five mothers who presented consecutively to the paediatric oncology ward were taught how to administer intravenous antibiotics to their child. Mothers' views on the teaching programme were sought using taped interviews, and the data were analysed using grounded theory. This methodology allowed a theoretical framework based on realistic data to emerge, and the resultant themes provided a valuable insight into mothers' views on the subject. It emerged that nurses' attitudes towards care by parents require clarifying and that changes need to take place if this concept is to be taken on board. Negotiation to allow mutual understanding between parents and nurses is essential to the successful implementation of such a scheme.     

Infantile colic as maternal reason of consulting a pediatrician: characteristics of mother and child

About 10-20% of infants under four months of age suffer from infantile colic (IC), an excessive screaming behaviour caused by multiple factors. WESSELS et al. (1954) definition is that babies in usually good health and nutritional condition are screaming/whining more than three hours daily, more than three days weekly for no apparent reasons. The question is whether/in what way daily routines of infants concerned differ from normal infants. Mothers of colicky infants (n = 25) and mothers in a control group (n = 25) record characteristics of the mother/child relationship, their assumptions why the child is screaming, care and attention they provide and babies' reactions. For seven days the mothers kept a diary about the babies' behaviour and worked on questionnaires concerning social support received, depressant effects and exhaustion. Interviews about the extent of care provided as well as personal thoughts and emotions were conducted. The "colic group" formed two subgroups: one fulfilling Wessels criteria (Wessel-Koliker; WK), the other more conforming with the "control group" babies though mothers complained about screaming (Non-Wessel-Koliker; NWK). "Colic group"-babies received more attention and care (compared to the "control group" babies), attempts to calm them down frequently failed and mothers in this group reacted less promptly to their babies' screaming. "NWK-group"-mothers strongly tend to attribute the babies' screaming to "meteorism" or "discontent". No differences existed between groups concerning social support, depressant effects and exhaustion. There is a risk that the colic may negatively influence the mother/child interaction beyond three months.     

Revising and validating the random search model for competitive search

The aim of the present study is a comparison of family relations in families with an obese adolescent and families with a normal-weight adolescent. Particularly, we studied the parents' and children's perceptions of some crucial areas of their relationship, e.g., communication, support, and some factors of "psychosocial risk" for the adolescents. We compared 30 family triads each with an obese child and 30 family triads each with a normal-weight child. We used a questionnaire aimed to evaluate some crucial variables of family functioning such as communication, family climate, support and satisfaction. A multivariate analysis of variance yielded no difference between obese and nonobese adolescents concerning communication with their mothers and fathers and concerning support given and received from them. In particular, analysis indicated no difference between parents of obese adolescents and parents of normal-weight adolescents regarding openness and problems in communication. As a protective factor against psychosocial risk, in both the samples the relationship with the mother arises as relevant, but, for the nonobese adolescents, both support and communication with this parent were important, whereas for the obese adolescents only support seemed to be really important. The results are discussed with respect to this approach which considered the family as the unit of analysis both from a theoretical and a methodological point of view.     

The mother's psychophysiological reactions to contrasting affective expressions by her own and an unfamiliar infant.

Investigated mothers' autonomic reactions to their own infants' emotional states. 17 mothers of 5-mo-olds viewed 2 landscape scenes and 4 types of videotaped segments depicting their own baby and an unfamiliar baby smiling or crying. Each episode was presented for 3 consecutive 10-sec trials, and order of stimulation was varied systematically. Initial presentations of Ss' own infants evoked cardiac acceleration and large skin conductance responses (SCRs), whereas cardiac deceleration and smaller SCRs were evoked by the unfamiliar infant crying. Episodes displaying the strange infant smiling and landscapes yielded nonsignificant trends toward cardiac deceleration and still smaller SCRs. Results indicate that mothers react with excitement to images of their own child and with patterns characteristic of environmental intake or orientation when viewing unfamiliar infants. Because parent–child relations are considered transactional, physiological indices of maternal responsiveness to infant behaviors are useful as potential predictors of developmental outcome. Hence, it is concluded that the findings that mothers display differential physiological reactions to their own and unfamiliar infants are especially promising. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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.     

Mealtime behavior and parent-child interaction: a comparison of children with cystic fibrosis, children with feeding problems, and nonclinic controls

Examined the role of family interaction factors in dietary compliance problems reported by parents of children with cystic fibrosis (CF). The family mealtime interactions of children with CF, children with feeding problems and nonclinic controls were observed, and parents monitored children's eating behavior at home. Parents of children with CF reported more concern about feeding problems and recorded more disruptive mealtime behavior than parents of nonclinic children. Observational data showed children with CF to display overall rates of disruptive mealtime behavior not significantly different from either comparison group. Mothers of children with CF were observed to engage in higher rates of aversive interaction with their child than did mothers of nonclinic controls. Fathers of children with CF reported lower marital satisfaction than fathers of controls. Both mothers and fathers of children with CF reported lower parenting self-efficacy than non-CF families. Clinical implications are discussed.