1
|
Ilchena C, Slayen C, Rennie S, Cheung K, Gaulke T, Theule J. Parenting stress and FASD: A scoping review. Res Dev Disabil 2023; 137:104498. [PMID: 36990050 DOI: 10.1016/j.ridd.2023.104498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) is a complex neurodevelopmental disorder that may arise following prenatal exposure to alcohol. Children with FASD tend to experience a diverse set of physical, social, cognitive, and behavioral symptoms. Caregivers of these children likely experience elevated levels of parenting stress; however, research in this area is still in its infancy. AIM The present study sought to more fully understand the current state of the literature on parenting stress experienced by caregivers of children with FASD. METHOD Databases including PsycInfo, Scopus, PsycArticles, and Google Scholar were searched for records meeting our inclusion criteria. RESULTS AND CONCLUSION 15 studies were deemed eligible for this review. This literature suggests that caregivers of children with FASD experience heightened levels of parenting stress. Child factors, especially child behavior and executive functioning difficulties are associated with Child Domain stress, while parent factors are associated with Parent Domain stress. Gaps were identified in child and caregiver mental health issues, as well as placement information.
Collapse
Affiliation(s)
- Cassidy Ilchena
- University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba, R3T 2N2 Canada
| | - Cari Slayen
- University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba, R3T 2N2 Canada
| | - Samantha Rennie
- University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba, R3T 2N2 Canada
| | - Kristene Cheung
- Department of Clinical Health Psychology, University of Manitoba, 1155 Notre Dame Avenue Winnipeg, Manitoba R3E 3G1
| | - Taryn Gaulke
- University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba, R3T 2N2 Canada
| | - Jennifer Theule
- University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba, R3T 2N2 Canada.
| |
Collapse
|
2
|
Wright B, Fearon P, Garside M, Tsappis E, Amoah E, Glaser D, Allgar V, Minnis H, Woolgar M, Churchill R, McMillan D, Fonagy P, O’Sullivan A, McHale M. Routinely used interventions to improve attachment in infants and young children: a national survey and two systematic reviews. Health Technol Assess 2023; 27:1-226. [PMID: 36722615 PMCID: PMC9900465 DOI: 10.3310/ivcn8847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Attachment refers to an infant's innate tendency to seek comfort from their caregiver. Research shows that attachment is important in promoting healthy social and emotional development. Many parenting interventions have been developed to improve attachment outcomes for children. However, numerous interventions used in routine practice have a limited evidence base, meaning that we cannot be sure if they are helpful or harmful. OBJECTIVES This research aimed to conduct a large-scale survey to identify what interventions are being used in UK services to improve child attachment; conduct a systematic review to evaluate the evidence for parenting attachment interventions; and develop recommendations for future research and practice. DESIGN AND METHODS We worked closely with our Expert Reference Group to plan a large-scale survey focused on relevant UK services. We then conducted two systematic reviews. One searched for all randomised controlled trial evidence for any attachment parenting intervention. The second searched for all research for the top 10 routinely used interventions identified from the survey. RESULTS The survey collected 625 responses covering 734 UK services. The results identified the 10 most commonly used interventions. The responses showed a limited use of validated measures and a wide variety of definitions of attachment. For the first review, seven studies were included from 2516 identified records. These were combined with results from previous reviews conducted by the team. Meta-analyses showed that, overall, parenting interventions are effective in reducing disorganised attachment (pooled odds ratio 0.54, 95% confidence interval 0.39 to 0.77) and increasing secure attachment (pooled odds ratio 1.85, 95% confidence interval 1.36 to 2.52). The second review searched the literature for the top 10 routinely used interventions identified by the survey; 61 studies were included from 1198 identified records. The results showed that many of the most commonly used interventions in UK services have a weak evidence base and those with the strongest evidence base are not as widely used. CONCLUSIONS There is a need for better links between research and practice to ensure that interventions offered to families are safe and effective. Possible reasons for the disparity include the cost and accessibility of training. There is also a need for improved understanding by professionals regarding the meaning of attachment. LIMITATIONS Although the survey had good geographical spread, most respondents were based in England. For review 2 we were unable to access a large number of papers; however, we conducted extensive reference checking to account for this. FUTURE WORK There is a need for robust research to test the efficacy of routinely used attachment interventions. Research could also explore why routinely used interventions are not consistently subject to thorough evaluation; how to embed dissemination, cost-effectiveness, fidelity and sustainability into research; and how to keep clinical practice up to date with research developments. STUDY REGISTRATION This study is registered as PROSPERO CRD42019137362. FUNDING This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 27, No. 2. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Barry Wright
- Hull York Medical School, University of York, York, UK
| | - Pasco Fearon
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Megan Garside
- Leeds and York Partnership NHS Foundation Trust, Leeds, UK
| | - Eleni Tsappis
- Leeds and York Partnership NHS Foundation Trust, Leeds, UK
| | - Elaine Amoah
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Danya Glaser
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Victoria Allgar
- Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Helen Minnis
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Rachel Churchill
- Centre for Reviews and Dissemination, University of York, York, UK
| | | | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | | | | |
Collapse
|
3
|
Peacock-Chambers E, Buckley D, Lowell A, Clark MC, Friedmann PD, Byatt N, Feinberg E. Relationship-Based Home Visiting Services for Families Affected by Substance Use Disorders: A Qualitative Study. J Child Fam Stud 2022; 31:2121-2133. [PMID: 36909674 PMCID: PMC9997720 DOI: 10.1007/s10826-022-02313-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 06/18/2023]
Abstract
Home visiting programs face many challenges when providing evidence-based services to families affected by substance use disorders (SUDs). We conducted interviews and focus groups with community stakeholders and parents to elucidate important considerations when intentionally attempting to meet the needs of families affected by SUDs through home visiting programs. We identified one primary theme "Who is the client?" that describes how to ensure caregivers perceive themselves as an important focus of the program. Collectively, participants revealed that understanding caregivers' emotional experiences was critical for effectively transforming their subjective experiences of the program. These emotional experiences were related to the quality of their relationships with their children, other family members, and service providers. Three sub-themes illustrate specific examples: 1) responding to the unique emotional needs of mothers in recovery, 2) considering emotional states to inform inclusion in programs, and 3) addressing complex family dynamics related to SUDs in the home. Implications of these findings are discussed.
Collapse
Affiliation(s)
- Elizabeth Peacock-Chambers
- Department of Pediatrics, UMass Chan Medical School-Baystate, Springfield, MA, USA
- Department for Healthcare Delivery and Population Science, 3601 Main Street, Third Floor, Springfield, MA 01199, USA
| | - Deirdre Buckley
- UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Amanda Lowell
- Department of Psychiatry, Yale School of Medicine, 300 George Street #901, New Haven, CT 06511, USA
- Yale Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT 06519, USA
| | - Maria Carolina Clark
- Department of Pediatrics, UMass Chan Medical School-Baystate, Springfield, MA, USA
- Department for Healthcare Delivery and Population Science, 3601 Main Street, Third Floor, Springfield, MA 01199, USA
| | - Peter D. Friedmann
- Department of Medicine, UMass Chan Medical School-Baystate, 3601 Main Street, Third Floor, Springfield, MA 01199, USA
| | - Nancy Byatt
- Department of Psychiatry, UMass Chan Medical School, 222 Maple Ave – Chang Building, Shrewsbury, MA 01655, USA
| | - Emily Feinberg
- Department of Pediatrics, Boston University School of Medicine, 72 East Concord Street, Boston, MA 02118, USA
| |
Collapse
|
4
|
Flannigan K, Coons-Harding KD, Anderson T, Wolfson L, Campbell A, Mela M, Pei J. A Systematic Review of Interventions to Improve Mental Health and Substance Use Outcomes for Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder. Alcohol Clin Exp Res 2020; 44:2401-2430. [PMID: 33119894 PMCID: PMC7839542 DOI: 10.1111/acer.14490] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/18/2020] [Indexed: 12/25/2022]
Abstract
Individuals with fetal alcohol spectrum disorder (FASD) experience remarkably high rates of mental health and substance use challenges, beginning early in life and extending throughout adulthood. Proactive intervention can help to mitigate some of these negative experiences. Although the literature on FASD intervention is growing, there is currently a lack of consolidated evidence on interventions that may improve mental health and substance use outcomes in this population. Informed by a life course perspective, we undertook a systematic review of the literature to identify interventions that improve mental wellness through all developmental stages for people with prenatal alcohol exposure (PAE) and FASD. A total of 33 articles were identified, most of which were focused on building skills or strategies that underlie the well‐being of children with PAE and FASD and their families. Other interventions were geared toward supporting child and family wellness and responding to risk or reducing harm. There was a notable lack of interventions that directly targeted mental health and substance use challenges, and a major gap was also noted in terms of interventions for adolescents and adults. Combined, these studies provide preliminary and emerging evidence for a range of intervention approaches that may support positive outcomes for individuals with FASD across the life course.
Collapse
Affiliation(s)
- Katherine Flannigan
- (KF, KDC-H, LW, MM, JP), Canada FASD Research Network, Vancouver, British Columbia, Canada
| | - Kelly D Coons-Harding
- (KF, KDC-H, LW, MM, JP), Canada FASD Research Network, Vancouver, British Columbia, Canada.,Psychology Department, (KDC-H), Laurentian University, Sudbury, Ontario, Canada
| | - Tara Anderson
- (TA), Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada
| | - Lindsay Wolfson
- (KF, KDC-H, LW, MM, JP), Canada FASD Research Network, Vancouver, British Columbia, Canada.,(LW), Centre of Excellence for Women's Health, Vancouver, British Columbia, Canada
| | - Alanna Campbell
- (AC), Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| | - Mansfield Mela
- (KF, KDC-H, LW, MM, JP), Canada FASD Research Network, Vancouver, British Columbia, Canada.,Department of Psychiatry, College of Medicine, (MM), University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jacqueline Pei
- (KF, KDC-H, LW, MM, JP), Canada FASD Research Network, Vancouver, British Columbia, Canada.,Department of Educational Psychology, (JP), University of Alberta, Edmonton, Alberta, Canada.,Department of Pediatrics, (JP), University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
5
|
Huber A, Hicks AM, Ball M, McMahon C. Postintervention and follow-up changes in caregiving behavior and representations after individually or group delivered hybrid Circle of Security-intensive intervention with New Zealand caregiver-child dyads. Attach Hum Dev 2020; 23:931-952. [PMID: 32799752 DOI: 10.1080/14616734.2020.1809057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The Circle of Security Intensive intervention (COS-I) aims to improve child attachment security and reduce disorganisation by improving caregiver capacities, including caregiving behavior and representations. Research on COS-I effectiveness with these goals is limited and none examines if positive changes are sustained. A recently revised hybrid COS-I protocol (COS-I-RH) incorporates Circle of Security-Parenting (COS-P) material and individual or group delivery options. We examined (1) post intervention and follow-up changes in caregiving behavior and representations after COS-I-RH and (2) if individual or group delivery moderated changes. New Zealand parent-child dyads with relationship concerns (n=36; child age M =35 months) referred to a community-based program completed COS-I-RH. Four caregiver capacities (supportive and unsupportive parenting (CTNES), parenting self-efficacy and satisfaction (PSOC)) were measured pre- and post-treatment, and one year later. Regardless of delivery mode, after COS-I-RH, parents showed large improvements on all 4 indices of caregiving behavior and representations, maintained at one-year follow-up.
Collapse
Affiliation(s)
- Anna Huber
- Centre for Emotional Health, Macquarie University, Sydney, Australia
| | | | - Michelle Ball
- Waitemata District Health Board, Child, Youth & Family Mental Health Services, Auckland, New Zealand
| | - Catherine McMahon
- Centre for Emotional Health, Macquarie University, Sydney, Australia
| |
Collapse
|
6
|
Adebiyi BO, Mukumbang FC, Erasmus C. The Distribution of Available Prevention and Management Interventions for Fetal Alcohol Spectrum Disorder (2007 to 2017): Implications for Collaborative Actions. Int J Environ Res Public Health 2019; 16:ijerph16122244. [PMID: 31242673 PMCID: PMC6617245 DOI: 10.3390/ijerph16122244] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 06/05/2019] [Accepted: 06/18/2019] [Indexed: 11/16/2022]
Abstract
The global prevalence of Fetal Alcohol Spectrum Disorder (FASD) remains high despite the various preventive and management interventions that have been designed and implemented to tackle the issue in various settings. The aim of the scoping review is to identify and classify prevention and management interventions of FASD reported globally across the life span and to map the concentration of these interventions across the globe. We searched some selected databases with predefined terms. Framework and narrative approaches were used to synthesize and report on the findings. Thirty-two prevention intervention studies and 41 management interventions studies were identified. All the interventions were reported to be effective or showed promising outcomes for the prevention and management of FASD, except four. Although Europe and Africa have a relatively higher prevalence of FASD, the lowest number of interventions to address FASD were identified in these regions. Most of the interventions for FASD were reported in North America with comparatively lower FASD prevalence. The uneven distribution of interventions designed for FASD vis-à-vis the burden of FASD in the different regions calls for a concerted effort for knowledge and intervention sharing to enhance the design of contextually sensitive preventive and management policy in the different regions.
Collapse
Affiliation(s)
- Babatope O Adebiyi
- School of Public Health, University of the Western Cape, Cape Town 8001, South Africa.
| | - Ferdinand C Mukumbang
- School of Public Health, University of the Western Cape, Cape Town 8001, South Africa.
| | - Charlene Erasmus
- Child and Family Studies, University of the Western Cape, Cape Town 8001, South Africa.
| |
Collapse
|