Positive parenting of children with developmental disabilities: a meta-analysis

Parenting Behaviors and Parental self-efficacy: A comparative study of parents of children with intellectual disabilities and typically developing children

Purpose: The aim of this study was to investigate the parenting behaviors and parental self-efficacy of parents of typically developing and child with an intellectual disability, considering their children's groups of with or without intellectual disability and other relevant variables. The study involved 1194 parents with children aged 3-6 years, of whom 521 parents had children with intellectual disabilities and the remaining 673 parents had typically developing children. Method: The data collection instruments used in this study were the Parental Behavior Scale Short Form and Parental Efficacy Scale. A t-test was used to compare parenting behavior and parental efficacy according to the child with or without an intellectual disability. In addition, MANOVA was used to compare parenting behavior and parental efficacy in relation to parents' level of education and to examine the possible interaction effect between these two independent variables. Results: The findings indicate that parents of typically developing children exhibit more positive parenting behaviors than parents of children with intellectual disabilities. However, the negative parenting behaviors of both groups were similar. In terms of parenting self-efficacy, parents of children with intellectual disabilities display higher self-efficacy than parents of typically developing children. The study also investigated whether there was a common effect in relation to child with or without an intellectual disability and parental education level, but no common effect was observed. Conclusion: Positive parenting behaviors and parental self-efficacy differed according to whether child with or without an intellectual disability.

Profiles of the parenting experience in families of autistic children

LAY ABSTRACT

Research shows that parents of autistic children, on average, are stressed; however, there is likely an array of factors that characterize the parenting experience in the context of autism other than stress. Understanding the diversity in the parenting experiences of both mothers and fathers of autistic children is important in the development of family-based intervention. A total of 188 co-habiting couples with an autistic child described their parenting experiences using a series of questionnaires examining their feelings of stress, parenting competence, and parenting attitudes and behaviors. We then sorted responses into profiles-three for mothers and four for fathers. We found that children of parents who reported the least amount of stress, highest feeling of competence, and use of responsive and directive parenting strategies (the Adaptive profile) had children with the least severe behavioral problems and autism symptoms. It was not necessary for both parents to be in the Adaptive category for child emotional and behavioral problems to less severe. We found that children did just as well when one parent was Adaptive compared with when both parents fell into this category.

Meta-Analyses of the Relationships between Family Systems Practices, Parents' Psychological Health, and Parenting Quality

(1) Background: Family systems theories include assertations that both personal and environmental factors are determinants of parents' psychological health, well-being, and parenting quality. Applied family systems theories focus on determinants that can be operationalized as intervention practices. The analyses described in this paper focused on the direct and indirect effects of four family systems practices (family needs, resources, supports, and strengths), parents' psychological health (depression, well-being, etc.), and parenting quality (parenting beliefs, involvement, and practices) in families of children with identified disabilities, medical conditions, or at-risk conditions for poor outcomes; (2) Methods: Data from previously completed meta-analyses of the relationships between family systems practices and parents' psychological health outcomes and parenting quality outcomes were reanalyzed. Next, a meta-analysis of the relationships between parents' psychological health and parenting quality was completed to identify which predictors were related to which parenting quality outcomes. Both main effects and mediated effects were examined; (3) Results: The four family systems practices were each related to six different psychological health measures and three parenting quality measures. The six different parental psychological health measures were also related to the three parenting quality measures. The relationships between family systems practices and parenting quality were partially mediated by parents' psychological health; (4) Conclusions: The effects of family systems practices and parents' psychological health on parenting quality were primarily direct and independent. The relationships between family systems practices and parenting quality were partially mediated by parents' psychological health. Future research should focus on the identification of other mediator variables found to be important for explaining the indirect effects of family systems practices measures on parenting beliefs, behavior, and practices.

Factors related to parenting styles of Chinese mothers of children with and without intellectual disability

BACKGROUND

Parenting styles play a crucial role in children's development. However, approaches to parenting children with intellectual disability (ID) beyond Western cultures have been underexamined. This study compared the self-reported parenting styles of Chinese mothers of children with and without ID and examined some factors that might be related.

METHODS

Chinese mothers of children with ID (n = 173) and mothers of typically developing children (n = 119) completed measures of their parenting style, parenting stress, parenting sense of competence and family support.

RESULTS

Both groups endorsed similar levels of authoritative parenting, but mothers of children with ID were more likely to report adopting strategies aligned with authoritarian parenting. For mothers in the ID group, family support moderated the effects of parenting stress and parenting sense of competence on authoritative parenting. Parenting stress and parenting sense of competence, respectively, predicted authoritarian parenting for mothers of children with and without ID.

CONCLUSIONS

This study highlights the importance of reducing parenting stress, strengthening parenting sense of competence and providing family support in order to promote optimal parenting styles for Chinese mothers of children with ID.

Association between Mothers' Emotional Problems and Autistic Children's Behavioral Problems: The Moderating Effect of Parenting Style

Mothers' emotional problems are associated with autistic children's behavioral problems. We aim to test whether parenting styles moderate associations between mothers' mood symptoms and autistic children's behavioral problems. A sample of 80 mother-autistic child dyads were enrolled at three rehabilitation facilities in Guangzhou, China. The Social Communication Questionnaire (SCQ) and the Strengths and Difficulties Questionnaire (SDQ) were used to collect the autistic symptoms and behavioral problems of the children. Mothers' depression and anxiety symptoms were measured using the Patient Health Questionnaire 9 (PHQ-9) and the General Anxiety Disorder 7-item (GAD-7) scale, respectively, and parenting styles were measured using the Parental Behavior Inventory (PBI). Our results show that mothers' anxiety symptoms were negatively associated with their children's prosocial behavior scores (β = -0.26, p < 0.05) but positively related to their social interaction scores (β = 0.31, p < 0.05). Supportive/engaged parenting styles positively moderated the effects of mothers' anxiety symptoms on their prosocial behavior score (β = 0.23, p = 0.026), whereas hostile/coercive parenting styles had a negative moderation (β = -0.23, p = 0.03). Moreover, hostile/coercive parenting styles positivity moderated the effects of mothers' anxiety symptoms on social interaction problems (β= 0.24, p < 0.05). The findings highlight, where mothers adopted a hostile/coercive parenting style while experiencing high anxiety, their autistic child may have more serious behavioral problems.

Relations between Positive Parenting Behavior during Play and Child Language Development at Early Ages

Parental behavior in interactions with children has been related to child language development. Our study contributes to the literature about relations between the characteristics of parent–child interactions during play and a child’s language development in typically developing children at early ages, with data from mothers and fathers from the same families in Spain. Our aim was to analyze the relation between positive parenting behaviors assessed with the Spanish version of the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO) and child language development assessed with the Bayley-III scales. We controlled for some sociodemographic variables. The participants were 90 children aged 15–31 months and their mothers and fathers. Bivariate analysis showed significant positive relations between mothers’ responsive, encouraging and teaching behaviors and a child’s language scores. Relations were found between fathers’ encouraging and teaching behaviors and a child’s language. Regression models indicate that maternal and paternal encouraging behaviors predicted 18% of the variability in the child’s receptive language, and maternal responsive and teaching behaviors predicted 16% of the variability in the child’s expressive language and total language scores. The study provides new data that support the relevance of positive parental behaviors to improve a child’s linguistic development.

Factors Associated with Behavioral Disorders in Children with Congenital Zika Syndrome and Their Families—A Cross-Sectional Study

The Zika virus was responsible for an outbreak between 2015 and 2016 in Brazil: an alarming public health problem of international relevance. The Congenital Zika Syndrome (CZS) is often associated with manifestations that are responsible for cognitive and motor development delays and behavioral disorders. Thus, we aimed to characterize the clinical-epidemiological and familial context of those children and to identify factors associated with the risk of behavioral disorders using the Survey of Well-Being of Young Children questionnaire (SWYC). In total, 52 children diagnosed with CZS were evaluated. Logistic regressions were employed to assess predictive variables for behavioral alteration. Eighteen (35%) of the children presented a risk of behavioral alteration. Children born normocephalic were 36-fold more likely to present behavioral alteration (95% CI: 3.82 to 337.92, p = 0.002). Children with hearing and visual impairments showed reduced risks. In total, 35% percent of families reported food insecurity and 21% were at risk for maternal depression. Our findings suggest better social interactions and conditions to externalize reactions for children with CZS born normocephalic. The continuous assessment of these children and families may identify conditions associated with behavioral alteration and psychosocial vulnerabilities that help in decision-making, therefore optimizing patient–family interactions.

Marital satisfaction, parenting styles, and child outcomes in families of autistic children

Theory and research on the general population suggest that parents' marital relationship quality is associated with children's emotional and behavioral functioning directly, as well as indirectly, by affecting parenting attitudes and behaviors. However, little has been done to investigate the potential connection among parent marital satisfaction, parenting styles, and outcomes for autistic children. Using longitudinal data collected from 188 couples parenting an autistic child, this study tested the time-ordered indirect effect of parent marital satisfaction (assessed at Time 1) on the internalizing and externalizing symptoms (assessed at Time 3) of autistic children (originally aged 5-12 years) via parenting styles (assessed at Time 2) using actor-partner interdependence modeling extended to mediation. Results indicated that a lower level of marital satisfaction at Time 1 predicted impaired child outcomes at Time 3 via its impact on parenting style at Time 2. For both parents, lower marital satisfaction predicted more child externalizing symptoms via reports of more authoritarian parenting style. Lower marital satisfaction in mothers at Time 1 was also associated with higher levels of child internalizing symptoms at Time 3 via increased authoritarian parenting in mothers. No partner effects were found. A family-wide approach that includes support for the parent marital relationship, which may have downstream effects on parenting, is important for promoting optimal emotional and behavioral health in autistic children.

Maternal perception of spousal support in raising children with developmental disability in the context of family and child variables

OBJECTIVE

The purpose of this study was to examine the relationship between the variables of mental, physical, and emotional problems in children with developmental disabilities (DDs) and the spousal support perceived by the mothers of those children.

METHODS

One hundred forty-three children diagnosed with autism spectrum disorder (ASD, n:43), intellectual disability (ID, n:28), cerebral palsy (CP, n:47), or Down syndrome (DS, n:25) were included in this study. The support that mothers received from their spouses was evaluated using the Spousal Support Scale (SSS). Aggressive behavior in the children was evaluated using the anger-aggression subscale of the Social Competence and Behavior Evaluation Scale (SCBE-30). The data obtained were then subjected to statistical comparisons.

RESULTS

Multiple comparisons revealed no significant difference between the DD diagnosis groups (ID, CP, ASD, and DS) in terms of spousal support or spousal support sub-dimension scores (p > 0.05). Significant negative correlation was found between anger-aggression subscale scores and SSS sub-parameters (emotional support r = -0.315 p < 0.001, financial and informational support r = -0.285 p < 0.001, appreciation r = -0.299 p < 0.001, social support r = -0.381 p < 0.001, and spouse support score r = -0.389 p < 0.001).

CONCLUSION

Children's anger-aggression levels were adversely affected by a lack of spousal support for their mothers.

Supporting Parenting at Home-Empowering Rehabilitation through Engagement (SPHERE): study protocol for a randomised control trial

INTRODUCTION

Infants with neurodevelopmental disabilities (NDs) show emotional, cognitive and sociointeractive dysregulation dramatically impacting on caregiving behaviour. Early video-feedback interventions (VFIs) are effective in promoting sensitive parenting, which in turn supports infants' development, even in case of ND. In the light of limited resources of the healthcare systems, technological advances in telemedicine may facilitate the delivery of VFI to a greater number of families of infants with ND. To date, no study has implemented a telemedicine VFI (TVFI) for families of infants diagnosed with ND.

METHODS AND ANALYSIS

The Supporting Parenting at Home-Empowering Rehabilitation through Engagement project is a randomised controlled trial aimed at assessing the effectiveness of an early family-centred TVFI parenting support on dyads with infants diagnosed with ND. It includes two arms (TVFI vs Booklet Psychoeducational Intervention) and three assessment phases: T0, baseline; T1, immediate postintervention; T2, 6-month follow-up.

ETHICS AND DISSEMINATION

This study is funded by the Italian Ministry of Health and was approved by the Ethics Committee (Pavia). Results will be published in peer-reviewed journals and presented at national and international scientific conferences.

TRIAL REGISTRATION NUMBER

The study protocol has been also registered on NIH Clinical Trials (protocol code NCT04656483; Pre-results).

Associations Between Neonatal Brain Structure, the Home Environment, and Childhood Outcomes Following Very Preterm Birth

Background

Very preterm birth is associated with an increased risk of childhood psychopathology and cognitive deficits. However, the extent to which these developmental problems associated with preterm birth are amenable to environmental factors or determined by neurobiology at birth remains unclear.

Methods

We derived neonatal brain structural covariance networks using non-negative matrix factorization in 384 very preterm infants (median gestational age [range], 30.29 [23.57–32.86] weeks) who underwent magnetic resonance imaging at term-equivalent age (median postmenstrual age, 42.57 [37.86–44.86] weeks). Principal component analysis was performed on 32 behavioral and cognitive measures assessed at preschool age (n = 206; median age, 4.65 [4.19–7.17] years) to identify components of childhood psychopathology and cognition. The Cognitively Stimulating Parenting Scale assessed the level of cognitively stimulating experiences available to the child at home.

Results

Cognitively stimulating parenting was associated with reduced expression of a component reflecting developmental psychopathology and executive dysfunction consistent with the preterm phenotype (inattention-hyperactivity, autism spectrum behaviors, and lower executive function scores). In contrast, a component reflecting better general cognitive abilities was associated with larger neonatal gray matter volume in regions centered on key nodes of the salience network, but not with cognitively stimulating parenting.

Conclusions

Our results suggest that while neonatal brain structure likely influences cognitive abilities in very preterm children, the severity of behavioral symptoms that are typically observed in these children is sensitive to a cognitively stimulating home environment. Very preterm children may derive meaningful mental health benefits from access to cognitively stimulating experiences during childhood.

Practitioner's review: medication for children and adolescents with autism spectrum disorder (ASD) and comorbid conditions

Alleviating the multiple problems of children with autism spectrum disorder (ASD) and its comorbid conditions presents major challenges for the affected children, parents, and therapists. Because of a complex psychopathology, structured therapy and parent training are not always sufficient, especially for those patients with intellectual disability (ID) and multiple comorbidities. Moreover, structured therapy is not available for a large number of patients, and pharmacological support is often needed, especially in those children with additional attention deficit/hyperactivity and oppositional defiant, conduct, and sleep disorders.

Parental Self-Efficacy and Behavioral Problems in Children with Autism During COVID-19: A Moderated Mediation Model of Parenting Stress and Perceived Social Support

PURPOSE

COVID-19 pandemic has been verified as a public health emergency of international concern. During the special period, the health of vulnerable groups, such as children with autism, should be concerned. Some studies have been carried out to investigate the behavioral problems of children with autism during the COVID-19, but underlying mechanisms behind it is not clear. This study examines the role of parenting stress as a mediator in the relationship between parental self-efficacy and behavioral problems in Chinese children as well as the role of perceived social support as a moderator for this mediation effect.

METHODS

A total of 439 parents of children with autism (mean age=40.17, SD=5.26) were surveyed and completed five questionnaires (Conners Parent Symptom Questionnaire, Parental Self-Efficacy Questionnaire, Parenting Stress Index-Short Form 15, Perceived Social Support Questionnaire, and Neuroticism Extraversion Openness Five Factor Inventory). The statistical analyses were conducted by SPSS 26.0 and SPSS PROCESS macro.

RESULTS

Controlling for neuroticism, which is highly associated with psychological changes in parents, the study found that parental self-efficacy was significantly and negatively correlated with behavioral problems in children with autism. In addition, the relationship between parental self-efficacy and behavioral problems was mediated by parenting stress. Furthermore, parenting stress moderated the indirect relationship between parental self-efficacy and behavioral problems via perceived social support.

CONCLUSION

These results provide direct evidences for the inextricable relationship between family, social factors and behavioral problems of children with autism. It suggest that improving perceived social support to enhance parental self-efficacy is critical to buffering against parenting stress and stabilizing children with autism during the COVID-19 pandemic.

Parent-Mediated Interventions for Infants under 24 Months at Risk for Autism Spectrum Disorder: A Systematic Review of Randomized Controlled Trials

Prodromal symptoms of Autism Spectrum Disorder (ASD) have been detected within the first year of life. This review evaluated evidence from randomized controlled trials (RCTs) of parent-mediated interventions for infants under 24 months who are at risk for ASD. Electronic databases, including grey literature, were searched up till November 2019. Seven RCTs were identified. There was substantial heterogeneity in recruitment, outcome measures and effect size calculations. Interventions did not reduce the risk of later ASD diagnosis and post-intervention effects on infant outcomes were inconsistent, with five studies reporting significant improvements across both treatment and control groups. Moderate level of evidence of intervention effects on parental interaction skills and the small number of RCTs, and significant limitations restrict generalizability across studies.

Positive parenting and its mediating role in the relationship between parental resilience and quality of life in children with developmental disabilities in Java Island, Indonesia

BACKGROUNDS

Developmental disabilities exert severe physical, cognitive and social-emotional consequences, such as low quality of life, not only on children but also on their families. However, the extent of the effect of such consequences on quality of life is partially dependent on how parents address the situation.

AIMS

The study aimed to examine whether positive parenting mediates the link between parental resilience and quality of life of children with a developmental disability in Indonesia.

METHODS AND PROCEDURES

Data were derived from a three-wave longitudinal study on 497, 224 and 209 families in waves one, two and three, respectively. The study determined parental resilience by assessing the knowledge of parents about the characteristics of their child, perceived social support and positive perception of parenting. Quality of life consisted of five aspects: material well-being, communication and influence, socio-emotional well-being, development and activity. Positive parenting was assessed through observed levels of support, encouragement and praise.

CONCLUSIONS AND IMPLICATIONS

The results demonstrated that positive parenting mediated the impact of positive perception of parenting on quality of life. This finding implies that positive perception and positive parenting should be encouraged when families with children with developmental disabilities receive care or support.

Parental styles and attitudes of fathers of children and adolescents with intellectual disability: Do parental styles and attitudes impact children's adaptive behaviour?

BACKGROUND

There is little literature that has explored the paternal role among children with intellectual disabilities. The aim of the study is to characterise parental attitudes and styles of fathers of children with intellectual disabilities, and to analyse their relation to the children's adaptive behaviour.

METHOD

Eighty-three families (fathers and mothers) answered self-report questionnaires, which assessed parenting styles and attitudes, as well as an adaptive behaviour questionnaire about their children with intellectual disabilities between 4 and 18 years of age.

RESULTS

Both parents have a tendency towards an authoritative style of parenting. Fathers (versus mothers) perceive greater parental support but are less involved in their children's lives. Among fathers, the authoritative style was a significant contributor to the child's adaptive behaviour, above and beyond the mother's contribution.

CONCLUSIONS

Studies about parenting should include both mothers and fathers, as paternal parenting styles and attitudes are related to children's adaptive behaviour.

Quality of Life Among Malaysian Parents with Autism Spectrum Disorder Child: The Double ABCX Model Approach

This paper reported the quality of life (QoL) of 260 Malaysian parents with autism spectrum disorder (ASD) and factors which influencing it. About half of these parents reported to having good QoL. The factors identified in the double ABCX model showed that perceived social support and sense of coherence (SOC) were mediated by coping strategies and had a positive direct and indirect effect on parents' QoL. These finding reiterate the importance of social support, coping skills, and strong SOC reflection skills in influencing the QoL of parents with ASD child. We therefore suggest parents to utilize the widely available social and organization supports to gain good QoL, which is also important for the wellbeing of their child.

The role of parental playfulness as a moderator reducing child behavioural problems among children with intellectual disability in Israel

BACKGROUND

Playfulness is well known to be vital for child development. However, not much is known regarding parental playfulness. We set out to investigate the role of parental playfulness in children with intellectual disabilities (ID) and typical development (TD) living in Israel. Specifically, we examined 1) differences in parental playfulness between groups and 2) parental playfulness as a moderator in the link between developmental status and behavioural problems (BP).

METHOD

One hundred forty-two families living in Israel and their children (48 % with ID) aged 4-7 years participated in the study. Parent-child play interaction was videotaped and coded for parental playfulness. Parents reported on child BP using the CBCL questionnaire.

RESULTS

Parents in the ID group showed lower levels of playfulness compared to parents in the TD group. Father's playfulness acted as a moderator in the link between developmental status and child BP.

CONCLUSIONS

These results highlight the unique role of father's playfulness in the developmental status of a child diagnosed with ID.

Parenting styles, parenting stress, and behavioral outcomes in children with autism

Being in a caregiver role for a child with autism spectrum disorder (ASD) brings a unique set of stressors and challenges to the entire family unit. This study examined a model hypothesizing that (a) parenting stress and the parenting style used by the parents of a child with ASD are correlated; (b) ASD severity, parenting stress, and parenting style uniquely explain the variance in the presentation of internalizing and externalizing symptoms among children with ASD; and (c) parenting style moderates the association between ASD severity and the presentation of internalizing and externalizing behaviors after controlling for specific demographic variables. A group of online participants were recruited through personal contacts, social media, and Amazon’s Mechanical Turk. The group of subjects, made up of 70 primary caregivers of children ages 3 to 18 years diagnosed with ASD, completed a self-report measure. Statistical analyses revealed that ASD severity and parenting style contributed to externalizing behaviors but did not have a significant impact on internalizing behaviors. Parenting stress was the primary predictor of both internalizing and externalizing child behaviors. Parenting style was not related to the stress level of parents of children with ASD and was not found to moderate the relationship between ASD severity and internalizing and externalizing behaviors. Implications for future research and clinical practice are discussed, highlighting the importance of reducing parenting stress and providing parent training to promote positive parenting styles for children with ASD.

Parenting behaviors of mothers and fathers of young children with intellectual disability evaluated in a natural context

The aims of this study were to analyze the interactions of mothers and fathers with their children with intellectual disabilities, focusing on certain parental behaviors previously identified as promoting child development, and to explore the relations between parenting and some sociodemographic variables. A sample of 87 pairs of mothers and fathers of the same children were recruited from Early Intervention Centers. The children (58 male and 29 female) were aged 20–47 months. Most of the families (92%) were from the province of Barcelona (Spain), and the remaining 8% were from the other provinces of Catalonia (Spain). Parenting behaviors, divided into four domains (Affection, Responsiveness, Encouragement, and Teaching) were assessed from self-recorded videotapes, in accordance with the validated Spanish version of the PICCOLO (Parenting Interactions with Children: Checklist of Observations Linked to Outcomes). Parents were administered a sociodemographic questionnaire. The results revealed strong similarities between mothers’ and fathers’ parental behaviors. Mothers and fathers were more likely to engage in affectionate behavior than in teaching behavior. Only maternal teaching presented a significant positive relation to the child’s age. With respect to the child’s gender, no differences were observed in mothers’ parenting. Conversely, fathers scored significantly higher in Responsiveness, Encouragement and Teaching (and had higher total parenting scores) when interacting with boys. The severity of the child’s ID had a statistically significant effect only on fathers’ Teaching, which showed lower mean scores in the severe ID group than in the moderate and mild ID groups. Teaching also presented a significant positive relation to mother’s age, but father’s age was not related to any parenting domain. Mothers with a higher educational level scored significantly higher in Encouragement and Teaching, and the fathers’ educational level was not significantly related to any parenting domain. Mothers’ and fathers’ Teaching, and fathers’ Responsiveness, Encouragement and total parenting scores, presented a significant positive relation to family income. Finally, mothers spent more time in childcare activities than fathers, particularly on workdays. Our main conclusion is that mothers and fathers show very similar strengths and weaknesses when interacting with their children with intellectual disabilities during play.

Do beliefs influence posttraumatic growth in fathers of children with intellectual disabilities?

BACKGROUND

Although facing a child's intellectual disability (ID) is considered to threaten paternal psychosocial wellbeing, in recent years there has also been a burgeoning interest in positive contributions of raising children with ID, including posttraumatic growth (PTG) in parents.

METHOD

142 fathers of children with ID completed Polish versions of three inventories: The Post-traumatic Growth Inventory (PTGI), Basic Hope Inventory (BHI), and General Self-Efficacy Scale (GSES). The average child's age was 11.06 (range: 7-13 years). The stages of the analysis included: descriptive statistics for posttraumatic growth (PTG), basic hope (BH), and self-efficacy (GSE), correlation analysis and the Preacher and Hayes procedure of bootstrapping to test whether GSE mediates the relationship between BH and PTG.

RESULTS

85.91 % of fathers of children with ID experience average or high levels of PTG with the highest scores in its two dimensions: greater appreciation of life, and positive changes in relations with others. PTG is significantly negatively related to a child's age. GSE is a significant mediator of the relationship between BH and PTG (total score and all dimensions).

CONCLUSION

The importance of beliefs for experiencing positive changes as a result of raising a child with disability may be useful in therapeutic and supportive activities offered to fathers who experience difficulties in fulfilling their paternal role.

Parental behavior and child interactive engagement: a longitudinal study on children with a significant cognitive and motor developmental delay

Knowledge on the long-term interactive interplay between children with a significant cognitive and motor developmental delay and their parents is very scarce. We aimed to characterize the (in)variability and potential mutual influence of parent's interactional style and child interactive engagement throughout early childhood. Every six months over the course of two years, thirty-five parent-child dyads (children aged 6-59 months) living in Flanders (Belgium) or the Netherlands were video-taped during a 15-minute unstructured play situation. Video-taped observations were scored using the Child and Maternal Behavior Rating Scales. No consistent group-level trend was found. Within singular interactions, parent's responsive behavior and child interactive engagement (attention and initiation) seem to be strongly related. Initial child initiation seems to positively predict parents' achievement orientation and directive behavior two years later. Parental responsiveness might be an effective interactional strategy to increase child engagement and higher levels of engagement in children possibly can facilitate parental responsiveness within a concrete interaction. The more initiative children show, the more parents might have hope for developmental benefits resulting from a directive/achievement oriented approach. Further research is warranted applying more differentiated and dynamically evaluated outcome measures and a longer follow-up time frame, with specific attention to inter-individual differences.

Early Parenting Intervention - Biobehavioral Outcomes in infants with Neurodevelopmental Disabilities (EPI-BOND): study protocol for an Italian multicentre randomised controlled trial

INTRODUCTION

Neurodevelopmental disability (ND) represents an adverse condition for infants' socio-emotional and behavioural development as well as for caregiving (eg, parental sensitivity) and mother-infant interaction. Adverse exposures are associated with altered neuroendocrine hormones concentrations (eg, oxytocin and cortisol) and epigenetic regulation (eg, methylation of stress-related genes), which in turn may contribute to less-than-optimal mother-infant interaction. Parental sensitivity is a protective factor for childrens' development and early parental interventions (eg, video-feedback intervention) can promote parental caregiving and better developmental outcomes in children. The present multi-centric and longitudinal randomised controlled trial aims to assess if and to which extent early VFI could benefit both infants and mothers in terms of behavioural outcomes as well as neuroendocrine and epigenetic regulation.

METHODS AND ANALYSIS

Dyads will be randomly assigned to the video-feedback Intervention Group or Control Group ('dummy' intervention: telephone calls). Infants with ND aged 3 to 18 months will be recruited from three major child neuropsychiatric units in northern Italy. A multi-layer approach to intervention effects will include videotapes of mother-infant interaction, maternal reports as well as saliva samples for hormones concentrations and target-gene methylation analysis (eg, BDNF, NR3C1, OXTR and SCL6A4) that will be obtained at each of the four assessment sessions: T₀, baseline; T₁, post-intervention; T₂, short-term follow-up (3 month); T₃, long-term follow-up (6 month). Primary effectiveness measures will be infant socio-emotional behaviour and maternal sensitivity. Neuroendocrine hormones concentrations and DNA methylation status of target genes will be secondary outcomes. Feasibility, moderation and confounding variables will be measured and controlled between the two groups.

ETHICS AND DISSEMINATION

Ethics approval has been obtained in all three participating units. Results of the main trial and each of the secondary endpoints will be submitted for publication in peer-reviewed journals and international conferences.

TRIAL REGISTRATION NUMBER

NCT03853564; Pre-results.

Evidence and Open Questions for the Use of Video-Feedback Interventions With Parents of Children With Neurodevelopmental Disabilities

The Video-Feedback Intervention (VFI) is a technique aimed at promoting positive parenting that has been found to be supportive of child development and parent-child interaction in different at-risk and clinical populations. The application of VFI with parents of children with neurodevelopmental disabilities (ND; e.g., cerebral palsy, sensory and/or psychomotor delay, and genetic syndromes) is growing. Nonetheless, no systematic review is currently available documenting whether this type of intervention improves children's developmental outcomes (e.g., behavioral stability and cognitive abilities), parental caregiving skills (e.g., responsive parenting), and parental emotional well-being (e.g., depressive symptomatology). In the present mini-review, 212 VFI records were retrieved from three databases (i.e., PubMed, Scopus, and Web of Science), and 10 papers were finally included. Abstracted information included age, diagnosis, methodological aspects (timing, setting, and themes), and child/parent outcomes. Significant improvements from pre- to post-VFI were observed in all studies. Specifically, the VFIs were significantly associated with better children developmental outcomes and parental caregiving skills. Inconsistent findings emerged for the VFI effects on parental emotional well-being. Overall, the current mini-review supports the potential effectiveness of parent-focused VFI interventions for parents of children with ND, despite the presence of open questions that need to be addressed in future clinical trials.

Alexithymia, Not Autism Spectrum Disorder, Predicts Perceived Attachment to Parents in School-Age Children

Alexithymia is defined as a limited ability in the cognitive processing of emotions. Literature suggested its negative influence on interpersonal relationship, documenting elevated alexithymia in individuals with Autism Spectrum Disorder (ASD) compared to control groups. However, the study of alexithymia in school-age children with ASD remains largely unexplored as well as its effect on specific child socioemotional outcomes such as quality of attachment relationships. This study examines alexithymia and perceived attachment to parents in twenty-four children with ASD (without intellectual disability) and 24 typically developing (TD) children (mean age 10 years) using the self-reported Alexithymia Questionnaire for Children (AQC) and the Inventory of Parent and Peer Attachment (IPPA). Measures of family SES as well as child intelligence were collected. Data revealed that ASD children showed higher levels of Alexithymia compared to TD group. In addition, 21% of participants with ASD exceed alexithymia categorical cut-off. By contrast, no difference emerged in the perception of attachment to parents. Moreover, alexithymia, but not ASD status, was found to predictive of child perception of attachment to parents. We observed no significant effect of child age and verbal IQ. Our findings showed that alexithymia was more common in children with ASD, whereas attachment was similar between groups. Difficulties in identifying and describing one's own feelings may hinder the construction of a positive representation of parent-child attachment relationship regardless of child clinical status. Thus, alexithymia seems to play a key role on the way school-age children with and without ASD perceive their relationship with their parents.

Caregiving experiences and expectations of parents with in-school children with intellectual disability in Ghana

BACKGROUND

The literature suggests that there are challenges faced by parents of children with intellectual disabilities (ID), which have resulted in calls for support services to be made available to parents and their children with ID. Although regular schools in Ghana are unable to admit students with ID, it is believed that special schools have the necessary facilities to support parents and their children with ID. However, little has been documented on the experiences and expectations of parents whose children with ID are enrolled in a special school.

METHOD

In this qualitative study, one-on-one semi-structured interviews were conducted with purposively recruited parents (n = 20) from the second most populous city in Ghana to explore their caregiving experiences and expectations regarding the education of their school-going children with ID.

RESULTS

Although the parents acknowledged that access to education has some benefits, such as the protection of their children with ID from negative societal attitudes and a reduction of their caregiving burden, they had low expectations for their children's education. Furthermore, the parents encountered considerable challenges in catering for their children with ID, such as financial problems and limited access to caregiving skills.

CONCLUSION

There is a need to intensify efforts at public education in relation to disability acceptance as well as to develop formidable social support systems.

Demographic and Parental Factors Associated With Developmental Outcomes in Children With Intellectual Disabilities

The aim of the study was to examine the relation between demographic variables, parental characteristics, and cognitive, language and motor skills development in children with intellectual disabilities (ID). A sample of 89 children with ID, aged 20-47 months, completed the Bayley Scales of Infant Development to measure cognitive, motor, and linguistic development. Parents were administered questionnaires about demographic information and parental anxiety, depression, parental stress, conjugality and familial functioning. Parenting behaviors (affection, responsiveness, encouragement, and teaching) were observed using the Spanish version of PICCOLO (Parenting Interactions with Children: Checklist of Observations Linked to Outcomes). A bivariate analysis showed that cognitive development in infants was significantly related to the mother's and father's responsiveness, and to the father's teaching scores. Infant language development was related to a variety of maternal factors (educational level, anxiety, depression, maternal responsiveness) and to the father's teaching scores. None of the factors were statistically related to child motor development. A multivariate regression analysis indicated that children's cognitive development can be predicted by a linear combination of maternal responsiveness and paternal teaching scores. Language development can be predicted by a linear combination of maternal anxiety and responsiveness, and paternal teaching scores. The present study provides evidence of the importance of paternal involvement for cognitive and language development in children with intellectual disabilities, and contributes to the increasing literature about fathering. Gaining knowledge about parental contributions to children's development is relevant for improving positive parenting in early intervention programs.

Barriers to accessing mental health treatment for parents of children with intellectual disabilities: a preliminary study

Purpose: Parents of children with intellectual disability often experience heightened levels of psychological distress compared to parents of typically developing children due to increased parenting demands. Given these demands, parents may also have difficulty accessing mental health treatment for themselves. This research investigated whether parents of children with intellectual disability experience barriers in accessing mental health treatment for themselves related to the increased parenting demands of having a child with an intellectual disability.Materials and methods: 80 parents of children with intellectual disability were surveyed about barriers to accessing mental health treatment for themselves and interest in an e-treatment.Results: Parents who experienced mental health difficulties were more likely to experience barriers in accessing treatment. For parents who had experienced mental health difficulties, cost, arranging childcare, and availability of providers were significant barriers to accessing treatment. Older participants were less likely to report cost as a barrier. Participants with higher incomes were less likely to report work scheduling as a barrier. Participants reported interest in an e-treatment, with younger participants more likely to express interest.Conclusions: These preliminary findings suggest that parents of children with intellectual disability experience barriers to accessing treatment. Research directions include developing e-treatments for these carers.Implications for rehabilitationHaving a child with an intellectual disability is associated with increased parenting demands, and significant stress for parentsThe results of this survey suggest that for parents who are experiencing mental health difficulties, cost, arranging childcare and availability of providers may act as barriers to accessing treatment for their own mental health concernsRehabilitation professionals can assist parents in addressing these barriers and encourage parents to seek treatment for themselves by offering flexibility in appointment times, reduced cost services and options for childcareAccessible and affordable treatment options, such as e-treatments may further assist these parents in accessing care for themselves.

Maternal Stress and the Functions of Positivity in Mothers of Children with Intellectual Disability

Although mothers raising children with Intellectual Disability (ID) report poorer mental health than parents raising typically developing children, they also report feelings of positivity; both generally and specific to their child. To date little is known about the function of maternal positivity thus, we explored the putative compensatory and protective functions of maternal positivity, within both a cross-sectional and one-year longitudinal framework that examined the relationship between children's behaviour and mental health problems with maternal mental health problems. Participants included 135 mothers of children with severe ID who were between 3 and 18 years of age. Multiple linear regression models investigated the potential function of maternal positivity. At a cross-sectional level, maternal positivity was found to be a significant independent predictor of maternal stress and moderated the impact of child behaviour problems on maternal parenting stress. Longitudinally, maternal positivity did not have a direct effect on later parenting stress nor function as a moderator. Findings from our cross-sectional analysis are consistent with the view that positivity serves a compensatory function. Further exploration is needed to understand the longitudinal function of maternal positivity.

Parenting practices of Singaporean mothers of children with ADHD

Objectives:

We wanted to determine: (1) whether ADHD symptoms were more common in mothers of children with ADHD; (2) whether mothers of children with ADHD differed in their parenting strategies; and (3) whether there was a difference in care-giving arrangements for children with ADHD and without ADHD. This was done by comparing mothers of children with ADHD with mothers of children without ADHD in Singapore.

Methods:

Mothers of children with ADHD ( n=46) and mothers of children without ADHD ( n=45) completed the Conners’ Parent Rating Scale-Revised, the Conners’ Adult ADHD Rating Scale-Self Report and the Alabama Parenting Questionnaire.

Results:

Mothers of children with ADHD did not report higher levels of current ADHD symptoms compared with the control group. However, they did use less adaptive parenting strategies. There were also no differences in the reported behaviours of children cared for by a paid worker and those cared for by mothers.

Conclusions:

Data support the Singapore Clinical Guidelines recommendations for the promotion of parenting skills, and referral to parenting programmes for parents of children with ADHD. The promotion of parenting skills and referral to parenting programmes for mothers of children with ADHD might include the option of electronic forms of programme delivery. The model of using paid help in the home, which is commonplace in Singapore, does not seem to disadvantage children with ADHD.

Family management of childhood chronic conditions: Does it make a difference if the child has an intellectual disability?

The purpose of this analysis was to assess the applicability of the Family Management Measure (FaMM) to families in which there was a child with an intellectual disability versus a chronic condition. Drawing on data from 571 parents of children with a chronic physical condition and 539 parents of children with Down syndrome, we compared the two groups across the six FaMM scales. After accounting for the covariate effects of race, ethnicity, family income, and child age, we found significant differences in four of the six FaMM scales, with parents of children with Down syndrome reporting a significantly more positive view on the Condition Management Effort and View of Condition Impact scales and a significantly less positive view on the Child's Daily Life and Condition Management Ability scales than parents of children with a chronic physical condition. There were no significant differences between groups on the Family Life Difficulty and the Parental Mutuality scales. The analysis provided evidence of the applicability of the FaMM for studying families in which there is a child with Down syndrome and its utility in identifying the common and unique challenges of family management between the groups.

Exploring parental behavior and child interactive engagement: A study on children with a significant cognitive and motor developmental delay

BACKGROUND AND AIMS

Parenting factors are one of the most striking gaps in the current scientific literature on the development of young children with significant cognitive and motor disabilities. We aim to explore the characteristics of, and the association between, parental behavior and children's interactive engagement within this target group.

METHODS AND PROCEDURES

Twenty-five parent-child dyads (with children aged 6-59 months) were video-taped during a 15-min unstructured play situation. Parents were also asked to complete the Parental Behavior Scale for toddlers. The video-taped observations were scored using the Child and Maternal Behavior Rating Scales.

OUTCOMES AND RESULTS

Low levels of parental discipline and child initiation were found. Parental responsivity was positively related to child attention and initiation.

CONCLUSIONS AND IMPLICATIONS

Compared to children with no or other levels of disabilities, this target group exhibits large differences in frequency levels and, to a lesser extent, the concrete operationalization of parenting domains. Further, this study confirms the importance of sensitive responsivity as the primary variable in parenting research.

Social-emotional competences in very young visually impaired children

Social-emotional competences are an important developmental domain for children with a visual impairment (VI). Therefore, early diagnosis in this regard is needed to ensure that VI children receive appropriate support. In this study, we used two preliminary German versions of the Infant–Toddler Social Emotional Assessment (ITSEA) and the Social-Emotional Assessment/Evaluation Measure (SEAM) to assess social-emotional competences in 92 VI infants and toddlers aged 12–36 months. Our results indicate that both instruments provide valid, reliable data and are suitable for use in practice. The results still reveal that understanding the emotions of other persons, paying attention to things around them and engaging with their environment, in addition to relating to other peers, seem to be the most important challenges for early intervention in VI toddlers. An additional disability is yet another condition that poses a specific challenge for VI education. The data also corroborate well-known findings from other research on the education of children with different conditions; in particular, the role of parental responsivity for the development of social-emotional competences is confirmed. Overall, the results suggest that the two instruments employed provide important information for educational practice, but further research is needed to demonstrate their full value.

The effect of parent education program for preschool children with developmental disabilities: A randomized controlled trial

AIM

This study aimed to evaluate the efficacy of a parent education program, the Happy Parenting program, for Chinese preschool children with developmental disabilities.

METHODS

This study adopted randomized controlled trial design without blinding. Participants were randomized into intervention group (n=62) who were offered the Happy Parenting program delivered by educational psychologists and trainee educational psychologists, and a control group (n=57) who were offered a parent talk after the intervention group had completed treatment. Parent participants were requested to complete questionnaires on their children's behavior, their parenting stress, and discipline strategies.

RESULTS

Analysis was by intention-to-treat. The results indicated significant decrease in child problem behaviors, parenting stress and dysfunctional discipline strategies in the intervention group at post-intervention.

CONCLUSION

This study provided promising evidence on the effectiveness of a parent education program, the Happy Parenting program, for Chinese preschool children with developmental disabilities.

Neuropsychological late effects of treatment for acute leukemia in children with Down syndrome

BACKGROUND

Children with Down syndrome (DS) have an elevated risk of developing acute leukemia, but little is known about treatment-related neuropsychological morbidity because they are systematically excluded from research in this area. The current study investigated neuropsychological outcomes in children with DS treated for acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML) compared to children with DS with no history of cancer.

PROCEDURE

Participants were 4 to 17 years of age at testing and were administered measures of intelligence, academic achievement, language, visual-motor and fine-motor skills, and adaptive function. Patients had been off treatment for at least 2 years.

RESULTS

The AML group (N = 12) had significantly lower verbal intelligence and receptive vocabulary compared to controls (N = 21). By contrast, the ALL group (N = 14) performed significantly worse than controls on measures of verbal intelligence, spelling, receptive and expressive vocabulary, visual-motor skills, and adaptive function.

CONCLUSIONS

Patients with DS treated for AML may have specific post-treatment morbidity in verbal function, whereas those treated for ALL have broader morbidity affecting multiple neuropsychological domains and overall adaptive function. We hypothesize that the broader impairment profile of ALL survivors may be related to a combination of the longer duration of central nervous system-directed treatment for ALL compared to AML and the concomitant limited access to intervention opportunities during active treatment.

Exploring the beliefs of Japanese mothers caring for a child with disabilities

The purpose of this study was to describe the beliefs of Japanese mothers caring for a child with disabilities to advance knowledge about beliefs of Japanese families experiencing illness. A semistructured interview was conducted with eight mothers who had a child with disabilities (physical, intellectual, and/or developmental). The interview invited their reflections about "mutual thoughts of family members" and family relationships in the context of daily life of caring for a child with disabilities. Data were qualitatively analyzed inductively and deductively and compared with the Common Tentative Framework of Japanese Family Beliefs developed from previous research. The analyses highlighted new understandings of the influence of Japanese cultural and societal beliefs on the family's experience of having a child with disabilities. Clinical implications are discussed and directions for future research suggested.

Longitudinal models of socio-economic status

Parenting research is frequently conducted without a thorough examination of socio-economic characteristics. In this study, longitudinal observations of positive parenting were conducted across six time points. Participants were 219 mothers of children with and without developmental delays. Mothers’ positive parenting increased during early and middle childhood in children with and without developmental delays. Mothers who reported more education had significantly higher levels of positive parenting when their children were 3 years old. Mothers who reported more family income grew at a significantly faster rate in positive parenting. There was preliminary support that mothers with more income were more likely to be members of a class that started off and remained at a higher level of positive parenting over time. Implications are discussed.

Autism spectrum disorders in the era of mobile technologies: impact on caregivers

OBJECTIVE

This paper explores possible connections among existing literature on parental stress, augmentative and alternative communication (AAC), and use of mobile technology for persons with autism spectrum disorder (ASD).

METHODS

A narrative review of the literature.

RESULTS

Parental support contributes to positive outcomes for children who use AAC. Parents identify communication as a high priority, but describe the process as challenging. AAC is often used with children with ASD, a population in which parental stress is especially high. Though there is research evidence that mobile technology is a promising tool for individuals with ASD, potentially misleading media anecdotes exist, and the effects on parental expectations and stress remain unstudied questions.

CONCLUSION

Increased understanding of the connections in these research areas should help clarify the potential impact of mobile technologies on parental stress level, help to define appropriate future research directions, and contribute to development of appropriate caregiver training.

Parenting styles and parents' perspectives on how their own emotions affect the functioning of children with autism spectrum disorders

The grounded theory method was used to analyze the parenting styles used by caregivers to rear children with autism spectrum disorders (ASD) and to investigate parents' experiences regarding how to help their child overcome the symptoms. Thirty-two parents from 28 families of children with ASD in mainland China were interviewed. Analysis of interview transcripts revealed four patterns of parenting styles which varied in affiliation to the roles of caretaker and coach. Based on their experience, a sizable group of parents perceived that their own emotions influence the child's emotions and his/her symptoms. The results suggest the value of developing intervention programs on emotion regulation and positive parenting for the parents of children with ASD.

Associations between child disabilities and caregiver discipline and violence in low- and middle-income countries

Using nationally representative samples of 45,964 two- to nine-year-old children and their primary caregivers in 17 developing countries, this study examined the relations between children's cognitive, language, sensory, and motor disabilities and caregivers' use of discipline and violence. Primary caregivers reported on their child's disabilities and whether they or anyone in their household had used nonviolent discipline, psychological aggression, and physical violence toward the target child and believed that using corporal punishment is necessary. Logistic regression analyses supported the hypothesis that children with disabilities are treated more harshly than children without disabilities. The findings suggest that policies and interventions are needed to work toward the United Nations' goals of ensuring that children with disabilities are protected from abuse and violence.

The Roles and Needs of Families of Adolescents with ASD

The transition of a student out of high school and into the adult world can be a stressful time for many families of high school students. This major life transition can be particularly challenging for students with ASD and their families. In this paper we first discuss the roles of families in the transition process for their son or daughter with ASD. Next, we present literature on the unique needs of families of adolescents with ASD during the transition to adulthood. Finally, we highlight current research on best practices for supporting transition-aged students and their families as well as discuss future directions for research and practice.