The transactional relationship between parenting and emotion regulation in children with or without developmental delays

Unidirectional or Bidirectional? Relation between Parental Responsiveness and Emotion Regulation in Children with and without Oppositional Defiant Disorder

Parenting is crucial for emotion regulation in children. Much less is known, however, concerning the association between parenting and emotion regulation in children with oppositional defiant disorder (ODD), who are known to have poor emotion regulation. The current study aimed to examine how parental responsiveness and child emotion regulation related either unidirectionally or bidirectionally to one another over time and to investigate whether the associations were different in ODD and non-ODD groups. Data were collected each year for three consecutive years from a sample of 256 parents of children with ODD and 265 parents of children without ODD in China. The results from the random intercepts cross-lagged panel model (RI-CLPM) suggested that the directionality of the link between parental responsiveness and child emotion regulation differs according to ODD status. The non-ODD group demonstrated a unidirectional link between early emotion regulation and subsequent parental responsiveness, consistent with the "child effect". However, in the ODD group, the link between parental responsiveness and emotion regulation was transactional, in line with social coercion theory. Multiple-group comparisons found that increased parental responsiveness was more strongly associated with improved child emotion regulation in the ODD group only. The research established a dynamic and longitudinal relationship between parental responsiveness and emotion regulation and suggested that intensive interventions should aim to improve parental responsiveness to children with ODD.

Telehealth Treatment of Behavior Problems in Young Children With Developmental Delay: A Randomized Clinical Trial

Importance

Early behavior problems in children with developmental delay (DD) are prevalent and impairing, but service barriers persist. Controlled studies examining telehealth approaches are limited, particularly for children with DD.

Objective

To evaluate the efficacy of a telehealth parenting intervention for behavior problems in young children with DD.

Design, Setting, and Participants

A randomized clinical trial was conducted from March 17, 2016, to December 15, 2020, in which children with DD and externalizing behavior problems were recruited from early intervention and randomly assigned to a telehealth parenting intervention or control group and evaluated through a 12-month follow-up. Most children were from ethnic or racial minoritized backgrounds. Over one-half of children were in extreme poverty or low income-need ratio categories.

Interventions

Internet-delivered parent-child interaction therapy (iPCIT), which leverages videoconferencing to provide live coaching of home-based caregiver-child interactions. Families received 20 weeks of iPCIT (provided in English or in Spanish) or referrals as usual (RAU).

Main Outcomes and Measures

Observational and caregiver-report measures of child and caregiver behaviors and caregiving stress were examined at preintervention, midtreatment, and postintervention and at 6- and 12-month follow-ups.

Results

The sample included a total of 150 children (mean [SD] age, 36.2 [1.0] months; 111 male children [74%]) and their caregivers with 75 each randomly assigned to iPCIT or RAU groups. Children receiving iPCIT relative to RAU displayed significantly lower levels of externalizing problems (postintervention Cohen d = 0.48; 6-month Cohen d = 0.49; 12-month Cohen d = 0.50) and significantly higher levels of compliance to caregiver direction after treatment. Of those children with data at postintervention, greater clinically significant change was observed at postintervention for children in the iPCIT group (50 [74%]) than for those in the RAU group (30 [42%]), which was maintained at the 6-month but not the 12-month follow-up. iPCIT did not outperform RAU in reducing caregiving stress, but caregivers receiving iPCIT, relative to RAU, showed steeper increases in proportion of observed positive parenting skills (postintervention odds ratio [OR], 1.10; 95% CI, 0.53-2.21; 6-month OR, 1.31; 95% CI, 0.61-2.55; 12-month OR, 1.64; 95% CI, 0.70-3.07) and sharper decreases in proportion of observed controlling/critical behaviors (postintervention OR, 1.40; 95% CI, 0.61-1.52; 6-month OR, 1.72; 95% CI, 0.58-1.46; 12-month OR, 2.23; 95% CI, 0.53-1.37). After treatment, iPCIT caregivers also self-reported steeper decreases in harsh and inconsistent discipline than did than RAU caregivers (postintervention Cohen d = 0.24; 6-month Cohen d = 0.26; 12-month Cohen d = 0.27).

Conclusions and Relevance

Results of this randomized clinical trial provide evidence that a telehealth-delivered parenting intervention with real-time therapist coaching led to significant and maintained improvements for young children with DD and their caregivers. Findings underscore the promise of telehealth formats for expanding scope and reach of care for underserved families.

Trial Registration

ClinicalTrials.gov Identifier: NCT03260816.

Envisioning translational hyperscanning: how applied neuroscience might improve family-centered care

From the very beginning of their life, human beings are immersed in a social and interactive environment that contributes to shaping their social and cognitive development under typical and at-risk conditions. In order to understand human development in its bidirectional relationship with the social environment, we need to develop a 'complexity-sensitive' approach in neuroscience. Recent advances have started to do so with the application of hyperscanning techniques which involve recording adult and child neural activity simultaneously and highlighting the presence of similar patterns of brain activity in the dyad. Numerous studies focused on typically developing children have been published in recent years with the application of this technique to different fields of developmental research. However, hyperscanning techniques could also be extremely beneficial and effective in studying development in atypical and clinical populations. Such application, namely translational hyperscanning, should foster the transition toward a two-brain translational neuroscience. In this paper, we envision how the application of hyperscanning to atypical and clinical child populations can inform family-centered care for children and their parents.

Maternal verbal scaffolding: association with higher language skills for 20-month-old children with prenatal polysubstance exposure

BACKGROUND

The number of children with prenatal polysubstance exposure is increasing. Supportive mother-child interaction is a protective factor, which can ameliorate adverse effects of prenatal polysubstance exposure on developmental outcomes.

AIM

To examine the role of maternal verbal scaffolding on cognitive and language development in children with prenatal polysubstance exposure.

STUDY DESIGN

Pregnant women were recruited, and we prospectively followed mother-child dyads to 20 months of age. This analysis included 66 dyads (33 healthy controls and 33 with prenatal polysubstance exposure). Multivariable linear regression modelling was used to examine the cross-sectional association between maternal scaffolding and Bayley Scales of Infant and Toddler Development (BSID-III) score, as well as an interaction between the study group and scaffolding score.

OUTCOME MEASURES

The BSID-III cognitive and language score was used. Videotaped mother-child play was coded to obtain a maternal verbal scaffolding score. Effect sizes were measured using average differences in scores between groups.

RESULTS

There was no evidence of an association between study group and maternal scaffolding scores. Children in the polysubstance exposure group had lower cognitive and language scores compared to controls, but this association was not statistically significant after controlling for maternal education. Maternal scaffolding was predictive of language scores, with scores increasing by 1.24 points on average (95% CI: 0.42, 2.06) for every 1-point increase in scaffolding score after adjustment for covariates. There was no evidence of a study group-by-scaffolding interaction with respect to the language or cognitive scores.

CONCLUSIONS

Maternal scaffolding during play was associated with language development in children with and without prenatal polysubstance exposure.

Parental Structuring in Response to Toddler Negative Emotion Predicts Children's Later Use of Distraction as a Self-Regulation Strategy for Waiting

Structuring is a parental response to young children's behavior that may foster children's attempts to use cognitive skills to engage in self-regulation. Using a rural, economically strained sample, parental structuring in response to 127 eighteen-month-olds' negative emotion was observed during a home visit. Children's distraction, a useful cognitive strategy when waiting for a reward, was assessed during a laboratory wait task at 18, 24, 36, and 48 months. More frequent parental structuring at child age 18 months predicted more developmental growth in children's use of distraction between 18 and 48 months, in contrast with parental directives. Consistent with Kopp's (1989) framework, parental structuring may capitalize on children's cognitive development to play a unique role in fostering children's self-regulation of negative emotion.

The Characteristics and Age Effects of Emotional Lability in ADHD Children With and Without Oppositional Defiant Disorder

Objective: This study evaluated the concurrent validity of emotional lability (EL) in children with ADHD. Method: A total of 2,015 children with ADHD and 745 typically developed controls (TDCs) were assessed and compared on EL. Results: ADHD participants expressed higher EL scores than TDCs, not influenced by gender or IQ. Higher levels of EL symptoms were found in children with comorbid oppositional defiant disorder (ODD) and with ADHD-combined subtype. Receiver operating characteristic (ROC) analyses showed a strong screening efficacy of EL symptoms on ADHD. The effect of developmental age on EL showed a desisting pattern in TDCs, as opposed to a persisting pattern in ADHD (not influenced by ODD comorbid status). ODD symptoms in ADHD showed an ascending pattern. Conclusion: EL can potentially serve as a sentinel index for the presence of ADHD, especially when the ADHD presentation is atypical. ODD may embody a developmental entity distinct from EL.

Emotionale Kompetenzen bei drei- bis sechsjährigen Kindern mit und ohne Entwicklungsbeeinträchtigungen

Zusammenfassung. Das Ziel dieser Studie war es, den Zusammenhang zwischen emotionalen Kompetenzen und kognitiven oder sprachlichen Entwicklungsbeeinträchtigungen bei drei- bis sechsjährigen Kindern zu untersuchen. An der Studie nahmen 111 Kinder mit Entwicklungsbeeinträchtigungen teil, die einen Schulkindergarten besuchten, der an ein Förderzentrum mit Förderschwerpunkt geistige oder sprachliche Entwicklung angeschlossen ist, sowie 107 Kinder ohne Entwicklungsbeeinträchtigung, die einen allgemeinen Kindergärten besuchten. Die Kinder wurden mit dem „Inventar zur Erfassung emotionaler Kompetenzen bei Drei- bis Sechsjährigen“ (EMK 3 – 6) untersucht. Die pädagogischen Fachkräfte bewerteten die sozial-emotionalen Kompetenzen im Alltag mittels der „Verhaltensskalen für das Kindergartenalter“ (VSK). Interne Konsistenz und Inter-Korrelationen der EMK 3 – 6 – Untertests waren in beiden Teilgruppen hoch. Kinder mit kognitiven und/oder sprachlichen Entwicklungsbeeinträchtigungen wiesen signifikant niedrigere Werte in drei der vier emotionalen Kompetenzskalen des EMK 3 – 6 auf (Emotionen erkennen und benennen, Wissen um prosoziales Verhalten, Wissen um empathische Reaktionen). Bei Kindern mit Entwicklungsbeeinträchtigung, die einen Schulkindergarten besuchen, erwiesen sich das Wissen um prosoziale Kompetenzen und empathische Reaktionen als signifikante Prädiktoren für die Einschätzung der sozial-emotionalen Kompetenzen durch die pädagogischen Fachkräfte. Bei Kindern mit kognitiven und/oder sprachlichen Beeinträchtigungen sollte eine gezielte Förderung emotionaler Kompetenzen zur Schulvorbereitung gehören.

Development of an Observational Parental Scaffolding Measure for Youth with Spina Bifida

OBJECTIVE

To examine the reliability and validity of a new observational measure of parental scaffolding, as well as the impact of parental scaffolding on academic and social outcomes among youth with spina bifida (SB).

METHODS

As part of a larger study, 137 families of youth with SB participated in family interaction tasks and self-report questionnaires at the baseline assessment. Teachers also reported on youth's academic independence and competence, as well as social skills. Guided by previous research and theoretical formulations, a rational approach to measure development was employed whereby maternal and paternal scaffolding composites were created using the Family Interaction Macro-coding System (Holmbeck, Zebracki, Johnson, Belvedere, & Hommeyer (2007). Parent-child interaction macro-coding manual. Unpublished coding system. Chicago: Loyola University Chicago).

RESULTS

The scaffolding measure demonstrated acceptable interrater and scale reliabilities. Additionally, both the maternal and paternal scaffolding composites were significantly associated with scores from self-report questionnaires of parenting behaviors in the expected directions. Maternal scaffolding was positively associated with IQ, academic competence, academic independence, and social self-control in youth with SB, whereas paternal scaffolding was positively associated with social cooperation and social self-control. Differences in scaffolding emerged between mothers and fathers, as well as across demographic variables.

CONCLUSION

Initial findings support the use of the scaffolding measure. Future research should continue to examine the utility of this scaffolding measure in families of youth with SB.

Polymorbidity of developmental disabilities: Additive effects on child psychosocial functioning and parental distress

BACKGROUND

While parents of children with developmental disabilities show greater parenting burden and distress compared with their counterparts, little is known about to what extent developmental polymorbidity in children escalates and magnifies the risk of parental distress.

AIMS

This study investigated the co-occurrence of developmental disabilities among a sample of elementary school children and examined its additive effects on child psychosocial functioning and parental distress.

METHODS AND PROCEDURES

A cross-sectional survey among 710 parents of elementary school children in Hong Kong included measures of child psychosocial functioning and parental stress. Structural equation modeling was used to test a hypothesized model in which child psychosocial functioning mediates the effect of developmental polymorbidity on parental distress.

OUTCOMES AND RESULTS

About one-fourth of the participants reported their children having two or more developmental disabilities. The number of developmental disabilities was positively related to the severity of emotional and behavioral problems in children, which in turn explained general and parenting distress in parents.

CONCLUSIONS AND IMPLICATIONS

Given the heightened vulnerability to distress among parents of children with multiple developmental disabilities, psychological care should particularly target this population. Early identification and intervention strategies are also needed to detect children with multiple co-occurring developmental disabilities, which could potentially alleviate their emotional and behavioral problems and lessen the parenting burden.

A Cross-Sectional Examination of the Internalization of Emotion Co-regulatory Support in Children with ASD

Cross-sectional data from Fenning et al. (J Autism Dev Disord, 48:3858-3870, 2018) were used to examine age differences in processes related to the development of emotion regulation in children with autism spectrum disorder (ASD). Forty-six children with ASD between the ages of 4 and 11 years and their primary caregivers participated in structured laboratory tasks from which parental scaffolding and child dysregulation were coded. Moderation analyses suggested increased internalization of parental co-regulatory support with age, as evidenced by more coherence in dysregulation across dyadic and independent contexts and a stronger inverse relation between parental scaffolding and independent dysregulation. Children's estimated mental age did not account for these effects. Implications for understanding and promoting the development of emotion regulation in children with ASD are discussed.

Longitudinal Associations among Depression, substance Abuse, and Crime: A Test of competing Hypotheses for Driving Mechanisms

PURPOSE

Crime, depression, and substance abuse, often co-occur. This study examined competing models considering each problem domain individually as a driving mechanism for the other problems to better understand etiology and inform prevention efforts. Gender differences were also examined.

METHODS

Data were drawn from the Seattle Social Development Project, a multiethnic and gender-balanced urban panel of 808 participants constituted in 1985. Cross- lagged models examined prospective assessments of early (grades 7 & 8) and late (grades 9-12) adolescent internalizing problems, substance use, and delinquency, as well as measures of depression, substance dependence, and crime at early adulthood (ages 21-24) and later adulthood (ages 27-30).

RESULTS

Comparisons of nested models by gender showed (a) continuity in internalizing behaviors/depression, substance use/dependence, and delinquency/crime for both women and men; (b) accounting for continuity, depression did not consistently drive other problems for either women or men; (c) among women, both substance abuse and crime appeared to be important driving mechanisms; and (d) among men, crime emerged as the most pertinent driving mechanism.

CONCLUSION

Findings suggest that externalizing problems may be more important driving mechanisms for depression than vice versa. Preventing crime and substance abuse may have the important added benefit of reducing early adult depression.

Socioeconomic Status, Family Functioning and Delayed Care Among Children With Special Needs

Parents of children with special healthcare needs (CSHCN) face tremendous stress in caring for their children. Families of CSHCN face increased barriers to health services as evidence also reflects the influence of socioeconomic factors on access. This study investigates the impact of socioeconomic factors and family functioning on delayed care. Descriptive, bivariate, and adjusted multivariate logistic regression were performed using sampling weights. findings suggest that family dynamics are more impactful on delayed care than socioeconomic predictors. Promoting family-centered care that incorporates social support for families to reduce barriers is essential for improved quality of life and health outcomes.

Intrinsic and Extrinsic Predictors of Emotion Regulation in Children with Autism Spectrum Disorder

Difficulties regulating emotion have been linked to comorbid psychopathology in children with autism spectrum disorder (ASD), but little empirical work has examined predictors of dysregulation in this population. Forty-six families of children with ASD participated in a laboratory visit that included direct measurement of children's IQ, ASD symptoms, and psychophysiological reactivity. Child emotion regulation was observed during independent and co-regulatory tasks, and parental scaffolding was rated in the dyadic context. ASD symptom severity emerged as the strongest predictor of child emotion dysregulation across contexts. Child age and parental scaffolding also uniquely predicted child dysregulation in the dyadic task. Implications for conceptualizing intrinsic and extrinsic influences on emergent emotion regulation in children with ASD are discussed, as are applications to intervention.

Developmental delay and emotion dysregulation: Predicting parent-child conflict across early to middle childhood

Cumulative risk research has increased understanding of how multiple risk factors impact various socioemotional and interpersonal outcomes across the life span. However, little is known about risk factors for parent-child conflict early in development, where identifying predictors of change could be highly salient for intervention. Given their established association with parent-child conflict, child developmental delay (DD) and emotion dysregulation were examined as predictors of change in conflict across early to middle childhood (ages 3 to 7 years). Participants (n = 211) were part of a longitudinal study examining the development of psychopathology in children with or without DD. Level of parent-child conflict was derived from naturalistic home observations, whereas child dysregulation was measured using an adapted CBCL-Emotion Dysregulation Index. PROCESS was used to examine the conditional interactive effects of delay status (typically developing, DD) and dysregulation on change in conflict from child ages 3 to 5 and 5 to 7 years. Across both of these timeframes, parent-child conflict increased only for families of children with both DD and high dysregulation, providing support for an interactive risk model of parent-child conflict. Findings are considered in the context of developmental transitions, and implications for intervention are discussed. (PsycINFO Database Record

The effects of early positive parenting and developmental delay status on child emotion dysregulation

BACKGROUND

Emotion regulation has been identified as a robust predictor of adaptive functioning across a variety of domains (Aldao et al. ). Furthermore, research examining early predictors of competence and deficits in ER suggests that factors internal to the individual (e.g. neuroregulatory reactivity, behavioural traits and cognitive ability) and external to the individual (e.g. caregiving styles and explicit ER training) contribute to the development of ER (Calkins ). Many studies have focused on internal sources or external sources; however, few have studied them simultaneously within one model, especially in studies examining children with developmental delays (DD). Here, we addressed this specific research gap and examined the contributions of one internal factor and one external factor on emotion dysregulation outcomes in middle childhood. Specifically, our current study used structural equation modelling (SEM) to examine prospective, predictive relationships between DD status, positive parenting at age 4 years and child emotion dysregulation at age 7 years.

METHOD

Participants were 151 families in the Collaborative Family Study, a longitudinal study of young children with and without DD. A positive parenting factor was composed of sensitivity and scaffolding scores from mother-child interactions at home and in the research centre at child age 4 years. A child dysregulation factor was composed of a dysregulation code from mother-child interactions and a parent-report measure of ER and lability/negativity at age 7 years. Finally, we tested the hypothesis that positive parenting would mediate the relationship between DD and child dysregulation.

RESULTS

Mothers of children with DD exhibited fewer sensitive and scaffolding behaviours compared with mothers of typically developing children, and children with DD were more dysregulated on all measures of ER. SEM revealed that both DD status and early positive parenting predicted emotion dysregulation in middle childhood. Furthermore, findings provided support for our hypothesis that early positive parenting mediated the relationship between DD and dysregulation.

CONCLUSIONS

This work enhances our understanding of the development of ER across childhood and how endogenous child factors (DD status) and exogenous family factors (positive parenting) affect this process. Our findings provide clear implications for early intervention programmes for children with DD. Because of the predictive relationships between (a) developmental status and ER and (b) parenting and ER, the results imply that sensitive parenting behaviours should be specifically targeted in parent interventions for children with DD.

Maternal control and early child dysregulation: Moderating roles of ethnicity and child delay status

BACKGROUND

Maternal controlling behaviour has been found to influence child development, particularly in behavioural and emotional regulation. Given the higher rates of interfering parent control found in mothers of children with developmental delays (DD) and Latina mothers, their children could be at increased risk for behavioural and emotional dysregulation. While studies generally support this increased risk for children with DD, findings for Latino children are mixed and often attributed to cultural models of child rearing. The present study sought to determine the moderating roles of child DD and mother ethnicity in determining the relationships between two types of parent control (supportive directiveness and interference) and child dysregulation over time.

METHODS

The present study, involving 178 3-year old children with DD (n = 80) or typical development (n = 98), examined observed parent control (directive versus interfering) of Latina and Anglo mothers as it relates to change in preschool child dysregulation over 2 years.

RESULTS

Interfering parent control was greater for children with DD and also for Latino mothers. Supportive directive parenting generally related to relatively greater decline in child behaviour and emotion dysregulation over time, while interfering parenting generally related to less decline in child behaviour dysregulation over time. In Anglo but not Latino families, these relationships tended to vary as a function of child disability.

CONCLUSIONS

Parent directives that support, rather than deter, ongoing child activity may promote positive regulatory development. These results particularly hold for children with DD and Latino families, and have implications for parenting practices and intervention.