The role of social buffering on chronic disruptions in quality of care: evidence from caregiver-based interventions in foster children

How does sensitivity influence early executive function? A critical review on hot and cool processes

There is compelling evidence that the quality of caregiver-child interactions during toddlerhood and the preschool years supports the development of executive function (EF) (Bernier et al., 2010; 2015; 2016; Fay-Stammbach et al., 2014; Geeraerts et al., 2021). Based on such findings, we make the case herein that sensitivity may be one of the most important dimensions of parenting contributing to early EF. In the present article, we will review empirical evidence, integrating findings from a wide range of scientific disciplines - cognitive psychology, neuroscience, and developmental psychopathology - and present theoretical ideas about how two contexts of sensitive caregiving - i.e. sensitivity to distress and non-distress cues - may be contributing differently to hot and cool EF development. Implications for future investigations on the environmental contributors of early EF, and its mechanisms, are discussed.

A systematic review and meta-analysis of the association between parenting and child autonomic nervous system activity

Parental socialization may influence the development of children's autonomic nervous system (ANS), a key stress-response system. However, to date no quantitative synthesis of the literature linking parenting and child ANS physiology has been conducted. To address this gap, we conducted a pre-registered meta-analysis. A systematic review of the literature identified 103 studies (n = 13,044 participants) with available effect sizes describing the association between parenting and either parasympathetic nervous system (PNS) or sympathetic nervous system (SNS) activity in children. The overall analysis revealed non-significant associations between parenting and child ANS physiology on average. However, moderation analyses revealed a positive association between more positive parenting and higher resting PNS activity that was stronger when a study was experimental rather than correlational, and when the sample included children with a clinical condition. In conclusion, well-controlled experimental studies show that positive parenting is associated with the development of higher resting PNS activity, an effect that may be stronger among children who are at elevated developmental risk.

Caregiving quality modulates neuroendocrine and immunological markers in young children in foster care who have experienced early adversity

BACKGROUND

Early adversity is believed to alter the body's stress-response systems, putting children at increased risk for somatic and mental health problems. However, it remains unclear whether such alterations normalize under improved caregiving experiences. Thus, the goal of the present study was to investigate (a) whether children in foster care show endocrine and immunological alterations relative to children living with their biological families, (b) whether these alterations change over time spent with the foster family, and (c) whether the alterations are modulated by current caregiving experiences.

METHODS

A total of 94 children in foster care and 157 biological children, aged two to seven years, took part in a longitudinal study with three assessments conducted over a 12-month study period. At the initial assessment, children lived for an average of 18 months with their current foster families. Children's cortisol, dehydroepiandrosterone (DHEA) and progesterone concentrations and cortisol/DHEA ratios were measured in scalp hair and children's secretory immunoglobulin A (sIgA) levels in saliva. Caregiving quality was assessed based on caregiver-reports and observational measures of caregiver-child interactions.

RESULTS

Children in foster care had lower cortisol/DHEA ratios and higher progesterone concentrations than biological children, while no group differences were found for cortisol, DHEA or sIgA. Time spent with the current foster family did not significantly influence the child's endocrine or immunological markers. Importantly, caregiving quality modulated cortisol/DHEA ratios and sIgA concentrations: children in foster care of lower caregiving quality had lower cortisol/DHEA ratios than children in foster care of higher caregiving quality and showed decreasing, rather than increasing, sIgA concentrations across the study period.

CONCLUSIONS

Our results indicate that caregiving quality in the foster family may have an important modulating effect on selected indicators of the child's stress response and could thereby mitigate the possible consequences of early childhood adversity.

Parenting matters: Parents can reduce or amplify children's anxiety and cortisol responses to acute stress

Parents serve important functions in regulating children's responses to stress and challenge. However, the parental characteristics that modulate the effectiveness of parents as stress buffers remain to be fully characterized. To address this gap, this study examined parental characteristics and behaviors that may explain variation in parents’ ability to buffer cortisol responses to acute stress of 180 children (ages 9–11 years old, M = 9.9 years, SD = .58). Children were randomly assigned to either participate in a public speaking task, the Trier Social Stress Test – modified for children (TSST-M) or a control condition. Children in the TSST-M condition were randomly assigned to prepare for the public speaking task either with their parent (N = 59) or alone (N = 60), whereas 61 children were assigned to the control condition (no TSST-M). We found that parental education moderated the effect of condition on children's responses to acute stress. Children whose parents had lower levels of education exhibited reduced cortisol responses in the parent condition compared to the alone condition, showing a buffered pattern of reactivity. In contrast, children of parents with high levels of education displayed higher cortisol reactivity in the parent condition compared to the alone and control conditions. Parental education was also positively associated with higher levels of state anxiety within the parent condition. These results suggest that highly educated parents may emphasize performance over comfort, amplifying their children's state anxiety and cortisol responses to a public performance.

Alpha electroencephalogram (EEG) asymmetry among toddlers in foster care

The majority of children living in foster care in the United States have a history of maltreatment and/or disrupted caregiving. Maltreatment in early childhood adversely affects development at many levels, including neurobiology and behavior. One neurobiological measure associated with maltreatment is alpha electroencephalogram (EEG) asymmetry. Prior research has found greater right frontal asymmetry among children with a history of maltreatment. However, little research has been extended developmentally downward to examine alpha asymmetry and its behavioral correlates among toddlers in foster care; this was the purpose of the present study. Differences in EEG asymmetry were examined between a sample of foster toddlers (mean age = 3.21 years, n = 38) and a community comparison, low-income sample without a history of foster care (mean age = 3.04 years, n = 16). The toddlers in the foster care group exhibited greater right alpha asymmetry, primarily driven by differences in parietal asymmetry. Neither frontal nor parietal asymmetry were clearly related to internalizing or externalizing behaviors, measured concurrently or at previous time points. These findings reveal differences in alpha EEG asymmetry among toddlers in foster care, and highlight the need to better understand associations between neurobiological and behavioral functioning following early adversity.

Childhood Parental Warmth and Heart Rate Variability in Midlife: Implications for Health

The current study investigated high-frequency heart rate variability (HF-HRV) as a potential mediator between childhood parental warmth and later health and mortality outcomes. Participants were 1,255 adults (56.9% female). Childhood parental warmth was reported retrospectively at mean age 46; resting HF-HRV was measured at mean age 57; cardiovascular health and self-evaluated health were assessed at mean age 57 and 63, and mortality records extracted at mean age 63. Results revealed a positive association between childhood parental warmth and resting HF-HRV, as well as associations between higher HF-HRV and reduced risk of having a later cardiovascular health problem and of mortality by age 63. Mediation analyses revealed a small significant indirect effect of parental warmth, through HF-HRV, on cardiovascular health.

Association between prolonged separation from parents and allostatic load among children in China

OBJECTIVE

To capture the association of exposure to prolonged separation from both parents early in life and allostatic load (AL), a measure of biological multi-system dysregulation.

METHODS

We used data from 557 7-12-year-old children enrolled in rural area of Chizhou city, Anhui Province, China. We computed an AL score based on eleven biomarkers representing four regulatory systems: immune/inflammatory system (high sensitivity C-reactive protein); metabolic system (body mass index; high density lipoprotein; low density lipoprotein, total cholesterol; triglycerides; fasting glucose; glycated hemoglobin; insulin) and cardiovascular system (systolic and diastolic blood pressure). Child's experiences of parent-child separation were collected a brief online questionnaire by parents of children.

RESULTS

More than 1 in 3 of our participants separated with both parents at age 6 or younger and nearly 1 in 10 persistently separated from both parents after birth. The AL score was significantly higher among children separated from both parents during early childhood (3.25 ± 1.98) or persistently since birth (3.48 ± 1.92), compared with those who did not separated from both parents (2.34 ± 1.53, F = 12.992, P<0.001). After adjustment of demographic covariates, body mass index as well as parent frequency of communication and parental warmth, children who separated from both parents in early childhood (β = 0.84, 95%CI:0.40, 1.28, P < 0.001) or persistently into adolescence (β = 1.27, 95%CI:0.43, 2.12, P = 0.003) evinced the highest levels of AL.

CONCLUSION

This study is the first to show an association between prolonged parent-child separation and physiological wear-and-tear as measured by AL, which provides potential insights into the biological mechanisms underpinning long-term health outcomes in contexts of parent-child separation.

Early adversity, child neglect, and stress neurobiology: From observations of impact to empirical evaluations of mechanisms

Research on the effects of early life adversity, and in particular on the absence of responsive caregiving, has shown long-term impacts on well-being and development. These investigations have been conducted both in human populations and in animal models. The work has demonstrated that neglect experienced in the early years can affect not only behavior but also neurobiological functioning. In particular, studies of children in the foster care system show convergence with research on children adopted following institutional rearing in terms of dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, which produces the neuroendocrine hormone cortisol. The characteristic pattern that has been most commonly observed involves diminished diurnal cortisol production, particularly in terms of low levels of cortisol upon awakening. Notably, however, a number of evidence-based interventions for infant, toddler, and preschool-aged foster children have been shown to produce more typical patterns of cortisol production, in combination with improved behavioral, socioemotional, and foster care placement outcomes. In this paper, we review the literature on the effects of early disruptions in care on biobehavioral development, and summarize the results of the interventions for young foster children.

A Preliminary Study Investigating Maternal Neurocognitive Mechanisms Underlying a Child-Supportive Parenting Intervention

Although interventions that promote child-supportive parenting for children have been shown to positively impact caregiving behaviors as well as child behavioral and neurobiological functioning, less is known about which aspects of maternal brain functioning are affected by such interventions. In the present study, we conducted a preliminary evaluation of the impact of the Filming Interactions to Nurture Development (FIND) video coaching program on mothers with at least one child age four or younger. We employed a waitlist control design with pre-post data. Compared to mothers in the control condition (n = 16), mothers who received FIND (n = 16) showed changes in neural measures of inhibitory control and behavioral measures of parenting self-evaluation during a series of functional neuroimaging tasks. Specifically, we found a group by time interaction in clusters in the left inferior frontal gyrus (IFG) and insula for the Correct Stop > Correct Go contrast of the stop signal task (SST), where FIND increased brain activity associated with inhibitory control compared to mothers in the control condition; and FIND increased mothers’ endorsement of child-supportive parenting traits in the parenting self-evaluation task (PSET). Exploratory moderators, study limitations, and the implications of these findings for strength-based parenting programs are discussed.

Foster care, syndemic health disparities and associations with HIV/STI diagnoses among young adult substance users

OBJECTIVES

Foster care history is associated with many health and social problems, including sexual risk behaviours, HIV and other sexually transmitted infections (STIs). This cross-sectional study compares sexual risk behaviours among a sample of young adult substance users in Miami (N=602) with and without foster care histories.

METHODS

Participants completed a comprehensive assessment which included sections on foster care, sexual risk behaviours and related health and social problems. Logistic regression was used to examine the relationship between foster care history, associated syndemic vulnerabilities and increased likelihood of having a prior HIV/STI diagnosis.

RESULTS

Bivariate analyses indicated that foster care alumni were more likely to report a prior HIV/STI diagnosis, higher condomless sex frequencies, being high on alcohol or drugs during sex, sexual victimisation and a history of homelessness compared with other participants in the sample (p<0.05). Multivariate analyses revealed that foster care history, sexual victimisation and group sex participation are associated with a prior HIV/STI diagnosis (p<0.05). Group sex participation doubled the odds of a prior HIV/STI diagnosis for foster care alumni, compared with other participants (p<0.5).

CONCLUSIONS

This exploratory study identifies characteristics that distinguish foster care alumni from non-alumni and signals the need to better serve the sexual and related health needs of individuals with foster care histories. Clinicians and healthcare providers should provide foster care alumni with detailed HIV/STI risk reduction information and resources and services to address related syndemic vulnerabilities (eg, victimisation and homelessness).

[Child maltreatment and new morbidity in pediatrics : Consequences for early child support and child protective interventions]

The effects of child maltreatment on children's chronic health conditions have become more visible during recent years. This is true for mental health problems as well as some chronic physical conditions, both summarized as new morbidity within pediatrics. As several Bradford Hill criteria (criteria from epidemiology for the determination of the causal nature of a statistical association) are met, the likely causal nature of underlying associations is discussed. Early family support may have the potential to modify such associations, although empirical evidence is lacking. At least for attachment-based interventions with foster carerers after child maltreatment, positive effects on child HPA axis dysregulation have been demonstrated.