Within-dyad bidirectional relations among maternal depressive symptoms and child behavior problems from infancy through preschool

Although dyadic theory focuses on the impact of a mother’s mental health on her own child and the impact of a child’s mental health on their own mother, commonly used statistical approaches are incapable of distinguishing the desired within-dyad processes from between-dyad effects. Using autoregressive latent trajectory modeling with structured residuals, the current study evaluated within-dyad, bidirectional associations between maternal depressive symptoms and child behavior problems from child age 1–4.5 years among a sample of low-income, Mexican American women (N = 322, Mage = 27.8) and their children. Women reported on maternal depressive symptoms and child behavior problems during laboratory visits at child age 1, 1.5, 2, 3, and 4.5 years. Results provide novel evidence of child-driven bidirectional association between maternal depressive symptoms and child behavior problems at the within-dyad level as early as child age 1 year and within-person stability in child behavior problems emerging early in life.

Is staff consistency important to parents’ satisfaction in a longitudinal study of children at risk for type 1 diabetes: the TEDDY study

Background Participants’ study satisfaction is important for both compliance with study protocols and retention, but research on parent study satisfaction is rare. This study sought to identify factors associated with parent study satisfaction in The Environmental Determinants of Diabetes in the Young (TEDDY) study, a longitudinal, multinational (US, Finland, Germany, Sweden) study of children at risk for type 1 diabetes. The role of staff consistency to parent study satisfaction was a particular focus. Methods Parent study satisfaction was measured by questionnaire at child-age 15 months (5579 mothers, 4942 fathers) and child-age four years (4010 mothers, 3411 fathers). Multiple linear regression analyses were used to identify sociodemographic factors, parental characteristics, and study variables associated with parent study satisfaction at both time points. Results Parent study satisfaction was highest in Sweden and the US, compared to Finland. Parents who had an accurate perception of their child’s type 1 diabetes risk and those who believed they can do something to prevent type 1 diabetes were more satisfied. More educated parents and those with higher depression scores had lower study satisfaction scores. After adjusting for these factors, greater study staff change frequency was associated with lower study satisfaction in European parents (mothers at child-age 15 months: − 0.30,95% Cl − 0.36, − 0.24, p < 0.001; mothers at child-age four years: -0.41, 95% Cl − 0.53, − 0.29, p < 0.001; fathers at child-age 15 months: -0.28, 95% Cl − 0.34, − 0.21, p < 0.001; fathers at child-age four years: -0.35, 95% Cl − 0.48, − 0.21, p < 0.001). Staff consistency was not associated with parent study satisfaction in the US. However, the number of staff changes was markedly higher in the US compared to Europe. Conclusions Sociodemographic factors, parental characteristics, and study-related variables were all related to parent study satisfaction. Those that are potentially modifiable are of particular interest as possible targets of future efforts to improve parent study satisfaction. Three such factors were identified: parent accuracy about the child’s type 1 diabetes risk, parent beliefs that something can be done to reduce the child’s risk, and study staff consistency. However, staff consistency was important only for European parents. Trial registration NCT00279318.

Do the Child Welfare and Protection Services Involve Children in Cases With Parental Mental Health Problems? A Norwegian Case-File Study

Background: Parental mental health problems is a common source of concern reported to child welfare and protection services (CWPS). In this study we explored to what extent the child was invited to participate in the investigation process. We aimed to study: (a) what was the current practice in the child protection service in Norway when the CWPS received a report of concern about children whose parents were affected by mental health problems or substance abuse, (b) to what extent were children involved and consulted, (c) which factors predicted the decision to involve the children, and (d) in cases in which conversations with children were conducted: what was the main content of the conversations.Method: The study was a cross-sectional case file study (N = 1,123). Data were collected retrospectively from case records in 16 different child protection agencies. The cases were randomly drawn from all referrals registered in the participating agencies. Differences in how investigations were conducted in cases with and without concerns about parental mental health were analyzed using t-tests and chi-square testes. Predictors of child involvement in cases with parental mental health problems (N = 324) were estimated by logistic regression analyses.Results: When the referral to the CWPS contained concerns about parental mental health, there were more consultations with parents, more frequent home visits and the investigation took longer to conclude. The children, however, were less likely to be involved. Children in such cases were consulted in 47.5% of cases. Predictors for involving the children in those cases were child age, concern about the child's emotional problems and if the child was known from previous referrals.Conclusion: In Norwegian child protection investigations, in which there were concerns about the parent's mental health, conversations with children were conducted to a significantly lower degree compared to cases where the child's problem was the main concern. In such cases, the CWPS workers have to overcome a threshold before they consult with the child. The threshold decreases with child age and when case worker already knows the child.

Associations between infant and maternal characteristics measured at child age 5 months and maternal feeding styles and practices up to child age two years

Facilitating positive feeding practices from infancy may be an important strategy to prevent childhood overweight and obesity. Since the feeding situation early in life constitutes a bidirectional relationship, it is important to understand the impact of both maternal and infant characteristics on maternal feeding practices to intervene in a customized and tailored way. Few studies have concurrently examined associations between maternal and infant characteristics in relation to early maternal feeding practices. The aim of the present study was to explore potential associations between infant and maternal characteristics measured at child age five months, and maternal feeding styles and practices during the child’s first two years. Cross-sectional data from a Norwegian randomized controlled trial in which participants responded to questionnaires at child age 5 months (n = 474), 12 months (n = 293) and 24 months (n = 185) were used to explore potential associations. All maternal and child predictor variables were collected at child age five months. Maternal feeding styles and practices were mapped using subscales from the Infant Feeding Questionnaire at child age 5 and 12 months and the Child Feeding Questionnaire and the Parental Feeding Style Questionnaire at child age 24 months. The subscale-scores were split into roughly equal tertiles, and the upper or lower tertile for the outcome of interest were used to create binary outcome variables. Multivariable binary logistic regression models were conducted for each outcome. We found that maternal education and mental health symptoms as well as infant weight, temperament and feeding mode were associated with maternal feeding styles and practices over time. Our findings indicate that risk factors which may have long-term implications for child weight and health outcomes can be identified early. Larger, population-based studies with a longitudinal design are needed to further explore these pathways.

Distance Learning Effects Among Italian Children and Parents During COVID-19 Related School Lockdown

Background: During the COVID-19 pandemic, both children and their parents experienced consequences related to distance learning (DL). However, positive and negative effects have varied greatly among families, and the specific factors explaining these differences in experiences are still underexplored. In this study, we examined children's executive functions (EF) and parents' psychological well-being in relation to negative and positive effects of DL on both children and their parents.Method: Participants were 637 Italian parents (92% mothers) with a child (48% male) aged between 6 and 19 years involved in DL due to school closures during the first wave of the COVID-19 pandemic. Data were collected using an online survey. We performed three fixed-order hierarchical multiple regression analyses with child age and sex, children's EF deficits, and parents' psychological well-being as independent variables, and DL-related negative effects (on the child and on the parent) and DL-related positive effects as dependent variables.Results: The results of the regression analyses showed that for negative effects of DL, younger age and greater EF deficits explained most part of the variance. Specifically, regarding negative effects on children, the most important factor was EF deficits, whereas regarding negative effects on parents, child age was the most important factor. For positive effects of DL, all variables explained only a small part of the variance. Child age was the most important factor, but EF deficits and parents' psychological well-being also had a significant impact.Conclusions: The effects of DL during school closures vary widely across families. Our findings indicate that intervention efforts need to consider background variables, child factors, as well as parent factors when supporting families with homeschooling in times of pandemic.

Perception versus reality: Investigating the impact of talkativeness on children’s credibility and reliability

<p>Does how much children say predict how credible they are as a witness? Children’s talkativeness can be easily observed by jurors, but we know very little about how it affects judgements of children’s credibility. The present research investigates the effect of talkativeness on juror perceptions and children’s actual testimony. In Study 1 participants rated six transcripts from low/high talkative 5-, 8-, or 12-year old children. Results showed that mock jurors rated high-talkative children more favourably than low-talkative children and older children were rated more favourably than younger children. In Study 2 we analysed transcripts of memory interviews from 5-, 8-, and 12-year-old children. Talkativeness was not associated with accuracy, but child age was. Talkativeness and child age were both associated with the amount of information recalled. This research shows that talkativeness of child witnesses not only influences juror perceptions but also is an indication of the amount of information that children recall in a memory interview. It is not just what a child says, but also how they say it that matters.</p>

Perception versus reality: Investigating the impact of talkativeness on children’s credibility and reliability

<p>Does how much children say predict how credible they are as a witness? Children’s talkativeness can be easily observed by jurors, but we know very little about how it affects judgements of children’s credibility. The present research investigates the effect of talkativeness on juror perceptions and children’s actual testimony. In Study 1 participants rated six transcripts from low/high talkative 5-, 8-, or 12-year old children. Results showed that mock jurors rated high-talkative children more favourably than low-talkative children and older children were rated more favourably than younger children. In Study 2 we analysed transcripts of memory interviews from 5-, 8-, and 12-year-old children. Talkativeness was not associated with accuracy, but child age was. Talkativeness and child age were both associated with the amount of information recalled. This research shows that talkativeness of child witnesses not only influences juror perceptions but also is an indication of the amount of information that children recall in a memory interview. It is not just what a child says, but also how they say it that matters.</p>

Economic evaluation of an Australian nurse home visiting programme: a randomised trial at 3 years

ObjectivesTo investigate the additional programme cost and cost-effectiveness of ‘right@home’ Nurse Home Visiting (NHV) programme in relation to improving maternal and child outcomes at child age 3 years compared with usual care.DesignA cost–utility analysis from a government-as-payer perspective alongside a randomised trial of NHV over 3-year period. Costs and quality-adjusted life-years (QALYs) were discounted at 5%. Analysis used an intention-to-treat approach with multiple imputation.SettingThe right@home was implemented from 2013 in Victoria and Tasmania states of Australia, as a primary care service for pregnant women, delivered until child age 2 years.Participants722 pregnant Australian women experiencing adversity received NHV (n=363) or usual care (clinic visits) (n=359).Primary and secondary outcome measuresFirst, a cost–consequences analysis to compare the additional costs of NHV over usual care, accounting for any reduced costs of service use, and impacts on all maternal and child outcomes assessed at 3 years. Second, cost–utility analysis from a government-as-payer perspective compared additional costs to maternal QALYs to express cost-effectiveness in terms of additional cost per additional QALY gained.ResultsWhen compared with usual care at child age 3 years, the right@home intervention cost $A7685 extra per woman (95% CI $A7006 to $A8364) and generated 0.01 more QALYs (95% CI −0.01 to 0.02). The probability of right@home being cost-effective by child age 3 years is less than 20%, at a willingness-to-pay threshold of $A50 000 per QALY.ConclusionsBenefits of NHV to parenting at 2 years and maternal health and well-being at 3 years translate into marginal maternal QALY gains. Like previous cost-effectiveness results for NHV programmes, right@home is not cost-effective at 3 years. Given the relatively high up-front costs of NHV, long-term follow-up is needed to assess the accrual of health and economic benefits over time.Trial registration numberISRCTN89962120.

The Effect of Maternal Traumatic Life Events and Social Support on Maternal-Child Interaction at Child Age 3 Years

Introduction: Becoming a parent is a very important role and responsibility in people’s lives and knowing the role traumatic life events (TLEs) may play on a mother-child relationship is a very important area to explore. TLEs are known to have adverse effect on individuals; however, little is known regarding the effect of maternal TLEs on maternal-child interaction. Social support has been known to positively affect the overall wellbeing of individuals, but little is known about the effect of social support on mothers who experienced TLEs and interaction with their children thus the need for this study. This study examines the effect of maternal TLEs and social support on maternal-child interaction. The Child Health Assessment Model and the Barnard Model will be used in this study. This study will examine the occurrence and severity of maternal TLEs and levels of social support and their relationship with sociodemographic factors of mothers and their 3-year-olds. It will examine the relationship between maternal TLEs, and maternal-child interaction measured by the NCAST Parent-Child Interaction (PCI) Teaching scale at child age 3 years; maternal social support and maternal-child interaction at child age 3 years; maternal TLEs and social support with maternal-child interaction at child age 3 years. Method: This study was a secondary analysis of data from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study, a longitudinal cohort study designed to improve the health, development, and well-being of children in Shelby County, Tennessee. Researchers recruited 1503 women in their second trimester of pregnancy. Data were collected at the 2nd and 3rd trimesters, at the child's birth, and from mother-child dyads at different points through child age three years. Nine hundred and eighty-six mother-child dyads were included in this analysis. Data analysis was performed using R version 4.0.3 (2020-10-10). The CANDLE Study Publications and Presentations Committee approved a Manuscript Analysis Plan Proposal prior to conducting this study. Results: Children and mothers were largely Black/African American (65.2%), and 34.8% were White. TLEs were associated with sociodemographic variables such as age, education, race, marital status, and child sex—with increased TLEs among Black/African American mothers, divorced/separated/widowed mothers, and mothers without college/professional degree, older mothers reported a lower number of ACEs than younger mothers. Mothers of male children reported fewer events associated with fear and helplessness than mothers of female children. Mother Total score and Contingency score were associated with several sociodemographic variables. Mothers with private health insurance for children ages 2- and 3-years had higher PCI Teaching scale scores. Mothers with at least a college degree at enrollment, child age 2, and child age 3 had higher PCI Teaching scale scores than mothers with no college degree. In the univariate analysis, we did not observe a significant association between maternal TLEs in the third trimester and maternal-child interaction at child age 3 years. When both maternal traumatic life events at the third trimester and social support are included, both were significantly associated with maternal-child interaction at child age 3 years. Although the associations between TLEs and PCI Teaching scale scores were non-significant the number of individuals providing social support was associated with PCI Teaching scale scores. More individuals providing social support was associated with increased PCI Teaching scale Mother-child Total (p < 0.0001) and Mother-child Contingency scores (p < 0.0001). Health insurance was associated with PCI Teaching scale scores — having private insurance was associated with increased Child Total scores at ages 2 (p = 0.037 and 3 (p = 0.004) years. Conclusion: The association between the number of individuals providing social support and mother-child interaction reinforces the need to provide resources such as home visitation programs to mothers and their young children. Each additional person providing social support in the third trimester was associated with increased PCI Teaching scale scores on both the Mother Total scores and Mother-child Total scores. This points to the relationship between support during the third trimester and the long-term outcome related to maternal-child interaction. The lack of association between TLEs and PCI Teaching scale scores before and after controlling for sociodemographic variables may reflect mothers' resilience. The interaction effect between TLEs and social support on maternal child interaction is notable and shows the need for an upstream approach to prevent TLEs since its interaction with social support diminishes the effect of support on maternal-child interaction.

Characterizing the quality-of-life impact of Duchenne muscular dystrophy on caregivers: a case-control investigation

Background This study examined the impact of Duchenne muscular dystrophy (DMD) on family-member caregivers in terms of quality of life, life stress, and indirect costs, as compared to a stratified comparison group of parents of similar-age children without DMD. Methods A web-based survey included DMD caregivers and a nationally representative comparison group of parents of children without DMD stratified by Child Age Group. Outcomes included quality of life, resilience, caregiver impact, stressful life events, financial strain, out-of-pocket expenditures, work productivity and unrealized ambitions. General linear models assessed the main effect of Caregiver Group and the interaction of Caregiver Group with Child-Age-Group, after adjusting for demographic covariates. Results Compared to parents without a DMD child, DMD Caregivers reported better physical health but worse mental health, positive affect/well-being, environmental mastery, difficulty paying bills, and more hours missed from work. Providing caregiving support for DMD teenagers was the most challenging. DMD caregivers curtailed their educational and professional ambitions, and modified their homes to accommodate the disability associated with DMD. Their non-DMD children had to make sacrifices as well. Nonetheless, in resilience and life stress, DMD caregivers were comparable to the comparison group, and showed consistent levels of positive emotions across the age of their DMD child. Conclusion DMD caregivers fared worse on most outcomes and faced more hurdles in work life. They face constraints and hidden costs that impact their health and financial well-being. Caregivers of teenagers with DMD reported higher impact. Nonetheless, parents of DMD children of all ages maintained notable resilience and positivity.