Child and parent weight loss in family-based behavior modification programs.

Overweight preadolescents and parents from 76 families were assigned to 1 of 3 behavioral treatment groups: parent/child target, child target, or nonspecific target. Percent overweight changes at the end of the 8-mo treatment and 13-mo follow-up were equivalent for children in the 3 treatment groups, but parents in the parent/child group lost more weight during treatment. Weight changes for parents and children increased through the 8-mo treatment. Patterns of maintenance showed that 40% of the children were within 20% of their ideal weight by the end of treatment, achieving nonobese status. 100% of the newly nonobese children in the parent/child group maintained nonobesity during follow-up, whereas only 30% in the child-alone group and 33% in the nonspecific group maintained nonobesity. In addition, weight losses for parents and children in the same family correlated positively at the end of treatment but not at follow-up. Results suggest that parental modeling may be important during treatment, but long-term results probably are due to parental reinforcement of child self-regulation. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Child and Parent Weight Loss in Family-Based Behavior Modification Programs": Correction to Epstein et al.

Reports an error in the original article by Leonard H. Epstein, Rena R. Wing, Randi Koeske, Frank Andrasik, and Deborah J. Ossip (Journal of Consulting and Clinical Psychology, 1981, 49, 674-685). There are several errors in Table 3. The corrected table is provided. (The following abstract of this article originally appeared in record 1982-01694-001.) Overweight preadolescents and parents from 76 families were assigned to 1 of 3 behavioral treatment groups: parent/child target, child target, or nonspecific target. Percent overweight changes at the end of the 8-mo treatment and 13-mo follow-up were equivalent for children in the 3 treatment groups, but parents in the parent/child group lost more weight during treatment. Weight changes for parents and children increased through the 8-mo treatment. Patterns of maintenance showed that 40% of the children were within 20% of their ideal weight by the end of treatment, achieving nonobese status. 100% of the newly nonobese children in the parent/child group maintained nonobesity during follow-up, whereas only 30% in the child-alone group and 33% in the nonspecific group maintained nonobesity. In addition, weight losses for parents and children in the same family correlated positively at the end of treatment but not at follow-up. Results suggest that parental modeling may be important during treatment, but long-term results probably are due to parental reinforcement of child self-regulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ten-year outcomes of behavioral family-based treatment for childhood obesity.

Reports 10-yr treatment outcomes for obese children in 4 randomized treatment studies. At 10 yrs, 34% decreased percentage overweight by 20% or more, and 30% were not obese. Significant effects were observed when parents and children were targeted and reinforced for weight loss in comparison with nontargeted controls and for children given lifestyle or aerobic exercise in comparison with a calisthenics control. 34% of the variance in change in percentage overweight was predicted from sex, baseline percentage overweight, self-monitoring weight, meals eaten at home, and family and friends' support for eating and exercise. Results show long-term changes in children depend on the treatment, and evidence converges on the importance of the family and other sources of support for eating and activity change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What Gets Dad Involved? A Longitudinal Study of Change in Parental Child Caregiving Involvement.

Predictors of change in fathers' and mothers' perceptions of child caregiving involvement were examined. Middle-class 2-parent families (131 mothers and 98 fathers) with a target school-age child participated. Fathers and mothers completed annual questionnaires for 3 consecutive years. Latent growth curve modeling suggested that fathers were likely to increase their relative contribution to child caregiving over the course of 3 years when they had a greater proportion of male children in the family and when life events-particularly changes in employment and financial status-were experienced by the family. Although mothers were responsible for more of the caregiving, their relative level of involvement tended to decrease when there were no young children in the family. Two-parent families may adapt to varying family contexts and life circumstances by shifting caregiving roles and responsibilities over the course of years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Five-year follow-up of family-based behavioral treatments for childhood obesity.

This article presents the 5-year outcome of family-based behavioral treatment of obesity for 6- to 12-year-old children in 162 families across 4 treatment outcome studies. Results suggest that treatments that use (a) conjoint targeting and reinforcement of child and parent behavior or (b) reciprocal targeting and reinforcement of children and parents are associated with the best child outcomes. Predictors of child success include self-monitoring, changing eating behavior, praise, and change in parent percent overweight. Parental outcome is predicted by self-monitoring weight, baseline parent percent overweight, and participation in fewer subsequent weight control programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of diet plus exercise on weight change in parents and children.

Obese children (aged 8–12 yrs) and parents from 53 families were randomly assigned to 3 groups: diet, diet plus exercise, and no-treatment control. At 6 mo, parents and children in both treatment groups had equal and significantly better weight change than members of the control group. At 1 yr, however, parents given diet plus exercise showed better weight losses than parents given diet alone. No treatment group differences were found for children after 1 yr. Parent and child weight changes observed during the 1st 6 mo of treatment were highly correlated, but those observed during Months 6–22 were uncorrelated. Discriminant analyses showed that initial relative weight was the best predictor of 12-mo relative weight for both parents and children but that exposure to the exercise program during treatment was a predictor of maintenance of nonobesity. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonmaternal care in infancy and emotional/behavioral difficulties at 4 years old: Moderation by family risk characteristics.

The authors examined the role of familial risk and child characteristics in the association between the type of child care in infancy (maternal care [MC]) versus nonmaternal care [NMC]) and emotional/behavioral difficulties at 4 years old. Canadian families (N=1,358) with children between 1 and 12 months old were followed over 4 years. Family risks were found to moderate the association between type of child care and physical aggression. MC in infancy was associated with lower levels of physical aggression among children from a low-risk family background but not among those from a high-risk family background. The effect size was small (d=-0.16; confidence interval [CI]=-0.3, -0.01). Family risk and the sex of the child moderated the association between child care and emotional problems. MC in infancy was associated with a lower level of emotional difficulties among girls from low-risk families but not among boys or among children from high-risk families. The effect size was moderate (d=-0.44; CI=-0.65, -0.23). The study indicates that the effect of child care type in infancy varies by family and child characteristics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

American parenting of language-learning children: Persisting differences in family-child interactions observed in natural home environments.

40 families were selected to represent the range of typical American families in size, race, and SES. In data from 2? yrs of once-monthly, hour-long observations of unstructured parent–child interactions in the home, parenting was examined over 27 mo, including the time before, during, and after all the children learned to talk. 10 parent measures suggested by the literature all showed stability in expression within families across time but large differences among the 40 families. The 10 parenting variables clustered into 3 factors relating to (1) the absolute amount of parenting per hour, (2) parents' social interaction with their children, and (3) the contentative quality of the utterances parents addressed to their children. The amount of parenting per hour and the quality of the verbal content associated with that parenting were strongly related to the social and economic status of the family and the subsequent IQ of the child. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child care and mother–child interaction in the first three years of life.

Relations between nonmaternal child care and ratings of maternal sensitivity and child positive engagement during mother–child interaction at 6, 15, 24, and 36 months were examined for 1,274 mothers and their children participating in the National Institute of Child Health and Human Development(NICHD) Study of Early Child Care. In longitudinal analyses that controlled for selection, child, and family predictors, child care was a small but significant predictor of maternal sensitivity and child engagement. For the whole sample, including families who did and did not use child care, more hours of child care predicted less maternal sensitivity and less positive child engagement. For children who were observed in child care, higher quality child care predicted greater maternal sensitivity, and more child-care hours predicted less child engagement. The effects of child care on mother–child interaction were much smaller in the analytical models than the effects of maternal education but were similar in size to the effects of maternal depression and child difficult temperament. Patterns of association with child care did not differ significantly across ages of assessment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of decreasing sedentary behavior and increasing activity on weight change in obese children.

Obese children 8–12 years old from 61 families were randomized to treatment groups that targeted increased exercise, decreased sedentary behaviors, or both (combined group) to test the influence of reinforcing children to be more active or less sedentary on child weight change. Significant decreases in percentage overweight were observed after 4 months between the sedentary and the exercise groups (–29.9 vs. –23.2). At 1 year, the sedentary group had a greater decrease in percentage overweight than did the combined and the exercise groups (–28.7 vs. –20.3 and –8.7) and greater decrease in percentage of body fat (–4.7 vs. –2.3). All groups improved fitness during treatment and follow-up. Children in the sedentary group increased their liking for high-intensity activity and reported lower caloric intake than did children in the exercise group. These results support the goal of reducing time spent in sedentary activities to improve weight loss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The assessment of competence in families with a retarded child.

60 families with retarded children were divided into 3 groups, based on age of the retarded child (6–8, 12–24, and 18–21 yrs). The families were observed by trained raters and compared with nonclinical families without handicapped children. Family reports from 45-min interviews were collected regarding feelings about the family's adaptation to the child and available support systems. Results indicate that most families were functioning well overall, despite speculations in older clinical literature about chronic family dysfunction. The older the retarded child, the more competent the family pattern; families with retarded children aged 6–8 yrs (school-entry age) and male retarded children were more dysfunctional. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prenatal monitoring of ornithine transcarbamoylase deficiency in two families by DNA analysis

This study examined the variation in weight, height and body mass index of 1048 mothers living in a rural area of Bangladesh in relation to age, education, number of previous pregnancies, number of dead children, religion, family type, family size, and amount of land owned by the household. Multiple regression analysis revealed a positive relationship of education with all three variables. Moslem mothers were on average in better condition than Hindus. The number of dead children showed a negative relationship with height, weight and body mass index.     

Preschool children's social status and maternal instructions to assist group entry.

Mothers' preparatory instructions (comments, helpful advice, and suggestions) intended to assist their child in subsequently joining the play of an unknown pair of children were studied. What mothers said to their child while they actually joined in (contemporaneous instructions) was investigated, as well as their claims about the kind of feedback they would give the child after the play. Mothers of popular, rejected, and neglected children were compared. It was hypothesized that the instructions mothers gave would parallel the known group-entry behavior of these groups of children. Hypotheses were substantially supported for mothers of popular children, moderately supported for mothers of neglected children, and less supported for mothers of rejected children. The most consistent finding was that mothers of popular children were more likely to suggest a group-oriented entry strategy to their child. These results tend to support previous studies suggesting that there are links between the social behavior of parents and their children and that family experiences may be involved in the acquisition of peer relationship skills. The mechanisms by which such family influence might operate are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Child's play with adults, toys, and peers: An examination of family and child-care influences.

Toddler-age children's (11 to 30 months old) play with care-giving adults and with toys and peers was observed and rated in family day-care homes. Fifty-five children, their mothers, and family day-care home providers participated in this study. The quality of the family day-care homes was assessed with the Harms and Clifford Family Day Care Rating Scale (FDCRS) and by measures of ratio and group size. Information on family stress, social support, child-rearing attitudes, and maternal role satisfaction was reported by mothers. More nurturing and supported families were associated with higher quality child care, whereas more restrictive and stressed families were associated with lower quality child care. More restrictive and stressed families were associated with more changes in child-care arrangements. Greater numbers of child-care changes also were associated with lower levels of competent play with objects and peers. When quality of care was controlled, both more nurturing and supported families and less restrictive and stressed families were associated with higher levels of competent play with adult caregivers, peers, and objects. When family characteristics were controlled, higher quality child care was associated with more competent play with adult caregivers and with peers and objects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does Class Size in First Grade Relate to Children's Academic and Social Performance or Observed Classroom Processes?

This study evaluated the extent to which first-grade class size predicted child outcomes and observed classroom processes for 651 children (in separate classrooms). Analyses examined observed child-adult ratios and teacher-reported class sizes. Smaller classrooms showed higher quality instructional and emotional support, although children were somewhat less likely to be engaged. Teachers in smaller classes rated typical children in those classes as more socially skilled and as showing less externalizing behavior and reported more closeness toward them. Children in smaller classes performed better on literacy skills. Larger classrooms showed more group activities directed by the teacher, teachers and children interacted more often, and children were more often engaged. Lower class sizes were not of more benefit (or harm) as a function of the child's family income. First-grade class size in the range typical of present-day classrooms in the United States predicts classroom social and instructional processes as well as relative changes in social and literacy outcomes from kindergarten to first grade. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood obesity

Approximately 10% of children are obese. Twin and adoption studies demonstrate a large genetic component to obesity, especially in adults. However, the increasing prevalence of obesity over the last 20 years can only be explained by environmental factors. In most obese individuals, no measurable differences in metabolism can be detected. Few children engage in regular physical activity. Obese children and adults uniformly underreport the amount of food they eat. Obesity is particularly related to increased consumption of high-fat foods. BMI is a quick and easy way to screen for childhood obesity. Treating childhood obesity relies on positive family support and lifestyle changes involving the whole family. Food preferences are influenced early by parental eating habits, and when developed in childhood, they tend to remain fairly constant into adulthood. Children learn to be active or inactive from their parents. In addition, physical activity (or more commonly, physical inactivity) habits that are established in childhood tend to persist into adulthood. Weight loss is usually followed by changes in appetite and metabolism, predisposing individuals to regain their weight. However, when the right family dynamics exist--a motivated child with supportive parents--long-term success is possible.     

N-terminal sequence polymorphism in the coagulase gene of Staphylococcus aureus and its potential use as an epidemiological marker

OBJECTIVE: There were two main objectives of the study: (1) To assess the effectiveness of a model of family reunification which united the role of parent aide and foster parent; and (2) to determine which characteristics of the families with children in care were associated with reunification. METHOD: A multisite project known as the Shared Parenting Project recruited families from five child protection agencies to participate in a program in which foster parents became extended rather than substitute families. Families were tested before the program began on a number of sociodemographic, psychological, and family measures. The success of the program was determined by whether the child was able to return home of if the program facilitated permanency planning. The success of the project was also examined by considering the relationship between returning home and a number of risk factors measured in the families with children in care. RESULTS: Very few families who met the criteria for the project could be recruited and only 31% of the participants completed the program and returned home. The process of permanency planning was facilitated in another 50% of the cases. The more stable families with less risk factors were more likely to complete the program successfully and to have their children return home. CONCLUSIONS: The results indicate that although the treatment model has excellent potential with less at-risk families it could not meet the treatment needs of the majority of families with children in foster care in the five child protection agencies. It is recommended that this model could be most helpful offered through parent aides attached to community support agencies that could provide respite care, support, and resources to families as needed thus avoiding the child having to be placed in care.     

Mental health service use among young children receiving pediatric primary care

OBJECTIVE: To investigate the factors associated with mental health service use among young children. METHOD: Five hundred ten preschool children aged 2 through 5 years were enrolled through 68 primary care physicians, with 388 (76% of the original sample) participating in a second wave of data collection, 12 to 40 months later. Consensus DSM-III-R diagnoses were assigned using best-estimate procedures. The test battery included the Child Behavior Checklist, a developmental evaluation, the Rochester Adaptive Behavior Inventory, and a videotaped play session (preschool children) or structured interviews (older children). At wave 2, mothers completed a survey of mental health services their child had received. RESULTS: In logistic regression models, older children, children with a wave 1 DSM-III-R diagnosis, children with more total behavior problems and family conflict, and children receiving a pediatric referral were more likely to receive mental health services. Among children with a DSM-III-R diagnosis, more mental health services were received by children who were older, white, more impaired, experiencing more family conflict, and referred by a pediatrician. CONCLUSIONS: Young children with more impairment and family conflict are more likely to enter into treatment. Services among young children of different races with diagnoses are not equally distributed. Pediatric referral is an important predictor of service use.     

Home observations of mothers and sibling dyads comprised of Down's syndrome and nonhandicapped children.

Observed interaction in 31 mother–child–child triads in which 1 of the children had Down""s syndrome. Down""s syndrome siblings were all aged 18–117 mo, nonhandicapped siblings were aged 12–132 mo, and mothers were aged 30–46 yrs. Mothers were more positive and directive toward their children with Down""s syndrome but received more positive initiations from their nonhandicapped children. Significant reciprocity between mother and child was found in dyads with a handicapped child but not in dyads with a nonhandicapped child. The handicapped child""s negative behavior toward the sibling was the most important predictor of interaction across the triad. Individual differences in the social behavior of children with Down""s syndrome may have an impact throughout family systems. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trajectories of emotional well-being in mothers of adolescents and adults with autism.

Raising an adolescent or adult child with a developmental disability confers exceptional caregiving challenges on parents. We examined trajectories of 2 indicators of emotional well-being (depressive symptoms and anxiety) in a sample of primarily Caucasian mothers (N = 379; M age = 51.22 years at Time 1) of adolescent and adult children with an autism spectrum disorder (ASD; M age = 21.91 years at Time 1, 73.2% male). We also investigated within-person associations of child context time-varying covariates (autism symptoms, behavior problems, residential status) and maternal context time-varying covariates (social support network size and stressful family events) with the trajectories of emotional well-being. Data were collected on 5 occasions across a 10-year period. Average patterns of stable (depressive symptoms) and improved (anxiety) emotional well-being were evident, and well-being trajectories were sensitive to fluctuations in both child and maternal context variables. On occasions when behavior problems were higher, depressive symptoms and anxiety were higher. On occasions after which the grown child moved out of the family home, anxiety was lower. Anxiety was higher on occasions when social support networks were smaller and when more stressful life events were experienced. These results have implications for midlife and aging families of children with an ASD and those who provide services to these families. (PsycINFO Database Record (c) 2011 APA, all rights reserved)