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

The use of video feedback to promote developmentally supportive parent-child interactions with young children with ASD or at risk: study protocol for a randomized controlled trial (VIFEPOPA-RCT)

BACKGROUND

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by difficulties in social communication and interaction, and repetitive and restrictive behaviors and interests from an early age. ASD often negatively affects caregiver-child interactions, caregiver emotional well-being and self-efficacy, and quality of family life. Positive caregiver-child interactions are crucial for good developmental outcomes, leading to the development of Parent-Mediated Interventions (PMIs). PMIs tend to follow an expert model where professionals provide direct instruction on treatment techniques and parental behaviors. However, research supports a shift towards a more collaborative and reflective approach, using coaching strategies that highlight caregiver strengths and encourage self-reflection. This study tests a video-feedback intervention (VFI) with parents of young children at risk of ASD.

METHODS

A randomized controlled trial (RCT) with 60 families, recruited from Early Intervention Centers in Spain, meeting inclusion criteria: adequate use of internet, child aged 24-36 months with a high risk of ASD (M-CHAT-R score ≥ 8), and participant primary caregiver (mother or father) with high anxiety, depression, or parental stress (score ≥ 1 SD above M), and low or medium-low developmentally supportive parental behaviors (PICCOLO score ≤ 40). Families will be randomly assigned to an intervention group (receiving usual services plus VFI) or a control group (usual services). The intervention includes twelve bi-weekly 90-min sessions over six months, with the caregiver. Outcome measures include parenting behaviors, emotional state, self-efficacy, family quality of life, and child development collected at pre-intervention, post- intervention and six-month follow-up.

DISCUSSION

The study will assess whether the intervention enhances developmentally supportive parental behaviors, emotional well-being, self-efficacy, and family quality of life, with a secondary positive impact on child development. If proven effective, it could be a cost-effective intervention with both short and long-term benefits.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier NCT06604988. Registered on September 17, 2024. Retrospectively registered.

Effects of a video-feedback intervention on parenting behavior and state anxiety in mothers of children with neurodevelopmental disabilities

Neurodevelopmental disability (ND) poses a significant challenge to infants' socio-emotional and cognitive development, as well as to caregiving dynamics, such as parental sensitivity and mother-infant interaction. Prior research highlights the crucial role of early parenting support interventions in enhancing parental behaviors, serving as a protective developmental factor for children at risk for or diagnosed with ND. This single-cohort, multicentric study aims to evaluate the efficacy of early video-feedback intervention (VFI) in improving maternal parenting behaviors. Thirty-four mothers with their children diagnosed with ND participated in the study. Different dimensions of parenting behavior (i.e., affection, responsiveness, encouragement, teaching) were assessed during 10-minute mother-infant interactions, both before (T0) and after (T1) completing six weekly VFI sessions. Additionally, mothers completed standardized questionnaires assessing parenting stress, anxiety, and depressive symptoms. The results indicated significant improvements in maternal responsiveness, encouragement, and teaching following the intervention. Furthermore, mothers reported a state anxiety reduction at T1. Additionally, higher scores in affection and responsiveness were correlated with reduced maternal stress. These findings support the utility of VFI as a valuable tool for enhancing positive parenting skills in the context of ND, and provide insights into the dyadic processes through which parenting behaviors may promote socio-emotional and cognitive development in children with ND.

Participation of fathers and siblings in home rehabilitation programmes for children with neuro-developmental delay: a scoping review

BACKGROUND

The role of, and impact on, mothers caring for children with neuro-developmental delay (NDD) is well documented. However, the role of fathers and siblings in families of children with NDD remains significantly understudied, particularly in low- and middle-income countries (LMICs). There has been an increased call for holistic rehabilitation of children with NDD at the family level. This study aimed to explore the involvement of fathers and siblings in the home rehabilitation programmes of children with NDD.

METHODS

A scoping review was conducted using the Joanna Briggs Institute (JBI) Peters et al.'s methodology and reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Articles were retrieved from PUBMED, ScienceDirect, PsycINFO, SCOPUS, PEDro, and Google Scholar. Reference lists of relevant studies were also manually searched.

RESULTS

Thirty research articles were identified. Father and sibling participation in home-based rehabilitation and caregiving is low in LMICs compared to high-income countries due to economic factors and cultural beliefs. Reduced participation stresses mothers and reduces developmental outcomes in children with NDD.

CONCLUSIONS

This review highlights the need for rehabilitation professionals to encourage father and sibling participation in caregiving for children with NDD in home rehabilitation programmes.

Fatherhood in disability rehabilitation in the United Arab Emirates: Exploring fathers' involvement in raising children with disabilities

BACKGROUND

The first agent of socialisation is the family, who are expected to facilitate the inclusion of children in societal activities. While mothers' voices have been widely captured in the literature regarding their experiences raising children with disabilities, fathers' perceptions of their knowledge of and involvement in the development of children with disabilities have been understudied, particularly in non-Western contexts.

AIM

The main aim of this study was to examine fathers' perceptions of their involvement in raising children with disabilities in the United Arab Emirates.

METHODS AND PROCEDURES

In total, 469 fathers were recruited to understand their involvement in raising their children with disabilities. The Fathers' Involvement in Development and Rehabilitation Scale was used to collect data, which were analysed using SPSS and AMOS.

OUTCOMES AND RESULTS

The results showed that fathers rated themselves highly for their attitudes, support, and participation in training to support their children with disabilities. Demographic variables, such as nationality and educational qualifications, provided additional insight into their involvement in raising their children with disabilities.

CONCLUSIONS AND IMPLICATIONS

The study concludes with suggestions for training programmes to change fathers' attitudes towards children with disabilities, as such programmes can enable them to better support their children's development.

Nationwide study of fathers' involvement in the rehabilitation of children with disabilities in the United Arab Emirates

Purpose

Parental involvement is fundamental to the successful inclusion of children with disabilities in social, academic and communities' services. However, very little is known about UAE fathers' involvement in the support, care, and treatment. and facilitation of engagement in the social, academic, and recreational activities of children with disabilities. Importantly, the role of fathers in facilitating children's participations in social services within the community is unknown. The aim of the current study was to learn father's involvement in the life of children with disabilities in the United Arab Emirates (UAE).

Materials and methods

A total of 1027 parents (fathers = 469, and mothers = 558) completed the revised Fathers' Involvement in Development and Rehabilitation Scale, with three sub-scales (support, attitudes, and participation in training). The Statistical Package for Social Science (SPSS) version 29 was used to calculate means, t-tests, and moderation analyses.

Results

The mean scores showed high involvement of fathers; fathers rated themselves highly on attitudes and support towards their children with disabilities compared to mothers. Also, parental type (fathers vs mothers) significantly moderated the relationship between the support needs of children and paternal support to children with disabilities.

Conclusion

The study concludes with suggestions for targeted training programmes to enable fathers to better support the development of their children with disabilities.

The role of women in the field of early intervention

This study examines the intersection of early intervention and the role of women as primary caregivers for children with disabilities. Studies for this analysis were collected through a meticulous search in the Web of Science (WoS) and Scopus databases. This process ensured the inclusion of a wide range of relevant literature from the field of study. A rigorous procedure of identification, selection, eligibility assessment, and inclusion of potentially relevant studies in this research area was conducted. We analyzed 130 articles, identifying 8 key research areas. Significant factors include the impact on parental interactions, communication skills, the role of women in developmental disabilities, mothers' understanding of their children's disabilities, emotional overload, parental stress, and psychological aspects. These factors significantly affect the well-being and development of mothers and children with disabilities. The study also considers the impact on women's careers. While research on psychological aspects and maternal overload is well-developed, establishing early intervention systems to optimize resources for proper child development is a challenge. The findings have high social value, paving the way for improving the quality of early childhood services.

Fathers' involvement in raising children with intellectual disabilities: Mothers' ratings of the contribution of their spouses

BACKGROUND

Intellectual disability (ID) is a lifelong condition characterized by individuals' inability to perform cognitive tasks and participate in daily living activities. While parenting children with ID has been reported to be demanding, studies draw mainly on mothers. In contexts such as the United Arab Emirates (UAE), there is little literature on fathers' involvement in raising children with IDs.

OBJECTIVES

The purpose of this study was to explore, from the perspectives of mothers, the extent of fathers' involvement in raising children with ID in the UAE.

METHODS

One hundred and fifty-eight (N = 158) mothers with children with ID completed the fathers' involvement in disability and rehabilitation scale. Mothers who had enrolled their children with ID in special schools or receiving services at rehabilitation centres were invited to participate in this study. The data were subjected to the following analyses: mean computation, multivariate analysis of variance, hierarchical regression, and moderation analysis.

RESULTS

The results showed high fatherly support, participation in training, and contribution to the development of their children with ID. However, the mothers' ratings showed the fathers' ambivalence toward parenting children with ID. A relationship was found between attitude and support, as well as marital status and the educational level of mothers, providing insight into the involvement of fathers.

CONCLUSION

The study recommends training programs aimed at improving the attitudes of fathers toward raising children with ID and other study implications.

Severity of developmental delay and parenting behavior in toddlers with neurodevelopmental disabilities

Introduction

The presence of a neurodevelopmental disability (ND) represents an adverse condition for child's development and parent-child relationship, and it is reasonable to assume that the severity of delay may influence parenting behavior. Previous research, however, did not specifically address this issue.

Methods

This cross-sectional study compared parental behaviors of mothers of toddlers with moderate/severe or mild/borderline developmental delay and mothers of toddlers with typical development, while considering maternal emotional states. A total of 88 dyads with children aged between 12 and 47 months participated in a 10-min video-recorded interaction then coded with the PICCOLO, a validated observation checklist that assesses four dimensions of parenting: affection, responsiveness, encouragement, and teaching. The mothers also fulfilled two standardized questionnaires assessing parental stress and presence of depressive symptoms. MANOVA and MANCOVA models were used to explore between-group differences in specific parenting dimensions, also considering parental stress.

Results

Mothers of toddlers with ND were less responsive than the comparison group, while the presence of a moderate/severe developmental delay specifically affected teaching behaviors. No differences emerged for affection and encouragement behaviors. Importantly, although mothers of toddlers with moderate/severe ND reported higher child-related dysfunctional interaction stress, this did not directly affect parenting behaviors.

Discussion

These findings highlight how the presence of a disability and the severity of developmental delay can affect specific dimensions of parenting (i.e., responsiveness, teaching) and might inform clinical practice and research on early parental interventions.

Triple-P: Interaction of mother-adolescent with intellectual and developmental disability

This study aimed to investigate the effect of a Positive Parenting Program (Triple-P) on the interaction of the mother-adolescent with intellectual disability. The pre-test and post-test randomized experimental design was used for this research. Thirty-four mothers of adolescents with intellectual disability took part in the present research and were assigned to experimental and control groups, each comprised of 17 people. The experimental group took part in an 8-session Triple-P and each session lasted 75 minutes, but the control group did not participate in this intervention. The data were analyzed using MANCOVA. The findings revealed that Triple-P intervention significantly influenced dependency, closeness, conflict, and positive interaction between the mother and the child with intellectual disability. The present study emphasized that Triple-P will improve the interaction of mother-adolescent with intellectual disability; therefore, Triple-P is a useful intervention.

Supporting Depressed Mothers of Young Children with Intellectual Disability: Feasibility of an Integrated Parenting Intervention in a Low-Income Setting

As a lifelong condition, intellectual disability (ID) remains a public health priority. Parents caring for children with ID experience serious challenges to their wellbeing, including depression, anxiety, stress and health-related quality of life. Integrated parenting interventions, which have been well evidenced for depressed mothers, may also effectively support depressed parents with a child with ID in low-resource settings such as Pakistan, and in turn optimise child outcomes. We conducted a mixed-method rater-blind feasibility randomised controlled trial, which assessed the feasibility and acceptability of the Learning Through Play in My Own Way Plus (LTP-IMOW Plus) intervention. Mothers who screened positive for depression (n = 26) with a young child (age 3-6 years) with ID were recruited from two low-resource community settings. Participants in the intervention arm (n = 13) received 12 group sessions of LTP-IMOW Plus and others (n = 13) received routine care. The intervention was feasible and acceptable with 100% retention and 100% session attendance. The intervention improved depression, anxiety, parenting stress and child socialisation score outcomes relative to the routine care arm. The framework utilised to analyse the qualitative interviews with seven participants at pre-intervention identified a range of struggles experienced by the mothers, and at post-intervention, found improved knowledge of child development and practices, improved mother-child relationships, recommendations for the intervention and perceived practical barriers and facilitators. The findings highlight the prospects for a clinical and cost-effective trial of an integrated parenting intervention to manage long-term parental mental health needs and improve child outcomes.

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.

The Effect of Parenting and the Parent-Child Relationship on a Child's Cognitive Development: A Literature Review

Various studies have been done on subjects such as parenting, parent-child relationships, parenting style, effortful parenting, the concept of parenting, the cognitive development of children, and the cognition of parents. This research is mainly based on parenting practice, child development, and maturation. Children's cognitive development starts in the first year of life and then progresses gradually. Children require positive parenting in painful and different situations. Parenting gives a child the confidence to face crucial, challenging problems. Sensitive parenting and caregiving are required for the child's maturity and cognitive development. Media has been observed to be essential in improving parenting practices. Children exhibit internalizing and externalizing symptoms as a result of harsh, aggressive, and intrusive parenting. According to the data, it is seen that the risk of depression increases in adolescence. The main reason for the rise in depression in children is the non-cooperation and support of mothers and fathers. The risk of depression decreases in children whose mothers and fathers are cooperative and supportive. While family and social stress increase the chances of depression in children, a negative parenting style means children face family and social anxiety. Due to the high level of hostile parenting and low level of positive parenting, they experience stress, peer pressure, and social and family relationship problems. Another excellent term for effortful control parenting is required for children's cognitive development. Parenting is necessary for the regulation of emotions and behavior. There are many problems seen in infancy, early childhood, and late childhood. There are four types of parenting styles seen: authoritative parenting, authoritarian parenting/controlling parenting, permissive parenting/indulgent parenting, and uninvolved parenting/neglecting to parent. Good parenting requires one to know the concept of good parenting, the idea of parenting, the importance of parenting and children's needs, the components of parenting, and the consequences of parenting.

Parental interaction style, child engagement, and emerging executive function in fetal alcohol spectrum disorders (FASD)

Children with fetal alcohol spectrum disorders (FASD) are known to experience cognitive and neurobehavioral difficulties, including in areas of executive function and social skills development. Interventions for these challenges have focused on a number of areas, including parent-based training. Despite the general consensus that specific parenting styles consistent with an "authoritative" - warm but firm - parenting approach may influence behavioral self-regulation, it is not known what specific parental interaction styles are associated with child engagement and emerging executive function in this population. The current study used an observation-based behavioral coding scheme during parent-child play interactions and associated parent report-based executive function measures in children with FASD. Here, we demonstrate that parental interaction styles with increased responsive/child-oriented behavior and parental affect are associated with higher levels of child play engagement, while parental interaction that has increased achievement-orientation is associated with higher levels of emerging executive function in children with FASD. These findings help inform future studies on behavioral targets in parent-based training programs and highlight the importance of considering certain parental interaction styles during parent-child play.

Parenting of Spanish mothers and fathers playing with their children at home

The aims of this study were to compare the parenting behaviors of mothers and fathers when evaluated in a free play situation at home and to study how these behaviors were related to the sociodemographic variables of the family. The study included 155 mothers and 155 fathers from the same families in Spain. The children (90 boys and 65 girls) were typically developing and were aged between 10 and 47 months old. The parents completed a sociodemographic questionnaire, and parenting behaviors in four domains (Affection, Responsiveness, Encouragement, and Teaching) were assessed from self-recorded videotapes, in accordance with the Spanish version of the PICCOLO. Our results showed both commonalities and differences between the mothers and fathers. The mean scores for the four parenting domains followed a similar pattern in both mothers and fathers: the highest mean score was in the Responsiveness domain, followed by the Affection, Encouragement, and the Teaching domains. Regarding the second aim, no differences were observed in parenting according to the child’s gender and the only domain related to the child’s age was mother’s Teaching. Mothers with a higher educational level scored higher on all parenting domains, except for Responsiveness. Family income was positively related to maternal Affection, Encouragement, and the total PICCOLO score, and to the father’s score in the Teaching domain. This study provides evidence that Spanish mothers and fathers show very similar strengths for promoting children’s development during interactions. These results are relevant to inform social public policies and family programs.

Early Intervention Services During the COVID-19 Pandemic in Spain: Toward a Model of Family-Centered Practices

Early intervention services (EIS) worked hard to continue serving children and their families during the COVID-19 lockdown, using online applications. This study aimed to determine families’ and professionals’ perceptions of the functioning of the early intervention (EI) model in Spain during the pandemic. The study sample comprised two subsamples: 81 families of children attended at an EIS (72 mothers and 9 fathers) and 213 professionals recruited from EIS. The survey was conducted online several weeks after the end of the strict lockdown in Spain. Descriptive statistics of the questionnaire answered by families and professionals were compiled, comparisons were made between the families’ and the professionals’ responses, and the relationships with several sociodemographic variables were analyzed. The results indicated that parents who cared for their children and were fully responsible for housework, parents who had used telematic tools before the lockdown, and younger professionals had a more positive perception of the EI model and the incorporation of family-centered practices (FCP) during the pandemic. The results also showed statistically significant differences in some items between parents and professionals: for example, professionals perceived more advantages than families during the lockdown, quoting the greater participation of families in the intervention and a greater focus on families’ needs. The data obtained from professionals suggested a more positive attitude toward FCP: however, the results show that they continued to adopt a directive role in the intervention, a position that is at odds with the tenets of FCP. There is a clear need for more training if a paradigm shift to FCP is to be achieved. Families’ and caregivers’ perceptions of telerehabilitation, and their adherence to telerehabilitation programs, are discussed. The implications of this study with regard to guiding future telematic interventions and family support are also considered.

Assessing Parenting Interactions With Children: Spanish Validation of PICCOLO With Fathers

Background/Objective: To gain knowledge about mothers' and fathers' interactions with their sons and daughters, we need reliable and valid tools to assess parental behaviors that can be used for different caregivers and in a variety of cultural contexts. The aim of this study was to analyze the psychometric properties of Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO) to assess fathers' interaction with their children at early ages. PICCOLO is an observational tool originally developed in the United States for mothers and fathers and previously validated in Spain with a sample of mothers. Methods: One hundred and ninety-one father-child dyads were observed during free-play situations at home when the children were between 10 and 47 months of age (55.0% male). The fathers auto recorded 8-10 minutes of interaction and trained evaluators assessed the recordings with PICCOLO. Results: Confirmatory factor analysis (CFA) confirmed the dimensional structure of the original version of the scale: four first-order factors (Affection, Responsiveness, Encouragement and Teaching) and one second-order factor (Parenting). The tool was found to have high inter-rater reliability at domain and total score level. Ordinal alpha and omega coefficients for each domain ranged between 0.79 and 0.85, and 0.64 and 0.79, respectively. No statistically significant differences were found in any PICCOLO domain or in the total score according to the child's gender. In assessments of the child's development with the Bayley-III scales, moderate positive correlations were found between Encouragement and receptive language (r = 0.32), and between Teaching and expressive (r = 0.34) and composite language (r = 0.31). Conclusion: The Spanish version of PICCOLO can be used to assess fathers' parenting. As PICCOLO is clearly linked to intervention goals, it is of particular interest for practitioners in early intervention and family programs.