Parents’ Preparedness for Their Infants’ Discharge Following First-stage Cardiac Surgery: Development of a Parental Early Warning Tool

Aim The aim of this study was to explore parental preparedness for discharge and their experiences of going home with their infant after the first-stage surgery for a functionally univentricular heart. Background Technological advances worldwide have improved outcomes for infants with a functionally univentricular heart over the last 3 decades; however, concern remains regarding mortality in the period between the first and second stages of surgery. The implementation of home monitoring programmes for this group of infants has improved this initial inter-stage survival; however, little is known about parents’ experiences of going home, their preparedness for discharge, and parents’ recognition of deterioration in their fragile infant. Method This study was conducted in 2011–2013; eight sets of parents were consulted in the research planning stage in September, 2011, and 22 parents with children aged 0–2 years responded to an online survey during November, 2012–March, 2013. Description of categorical data and deductive thematic analysis of the open-ended questions were undertaken. Results Not all parents were taught signs of deterioration or given written information specific to their baby. The following three themes emerged from the qualitative data: mixed emotions about going home, knowledge and preparedness, and support systems. Conclusions Parents are not adequately prepared for discharge and are not well equipped to recognise deterioration in their child. There is a role for greater parental education through development of an early warning tool to address the gap in parents’ understanding of signs of deterioration, enabling appropriate contact and earlier management by clinicians.

Parental reports of the oral health-related quality of life of children with cerebral palsy

BACKGROUND The severity of physical and mental impairments and oral problems, as well as socioeconomic factors, may have an impact on quality of life of children with cerebral palsy (CP). The aim of this research was to assess the impact of impairments and oral health conditions, adjusted by socioeconomic factors, on the Oral Health-Related Quality of Life (OHRQoL) of children with CP using their parents as proxies. METHODS Sixty children, between 6-14 years of age were selected. Their parents answered a children's OHRQoL instrument (5 domains) which combines the Parental-Caregivers Perception Questionnaire (P-CPQ) and Family Impact Scale (FIS). The severity of dental caries, type of CP, communication ability, gross motor function, seizures and socioeconomic conditions were assessed. RESULTS Considering the total score of the OHRQoL instrument, only the reduction of communication ability and dental caries severity had a negative impact on the OHRQoL (p < 0.05). Considering each domain of the instrument, the severity of the type of CP and its reduction of communication ability showed a negative impact on oral symptoms and functional limitations domains (p < 0.05). Seizures have a negative impact on oral symptoms domain (p = 0.006). The multivariate fitted model showed that the severity of dental caries, communication ability and low family income were negatively associated with the impact on OHRQoL (p = 0.001). CONCLUSIONS The severity of dental caries, communication ability, and family income are conditions strongly associated with a negative impact on OHRQoL of children with CP.

What Drives Parental Concerns about their 18-Month-Olds at Familial Risk for Autism Spectrum Disorder?

Thesis (Master's)--University of Washington, 2016-08

Child Safety Signal Learning in the Context of Parental Worry, Overprotection, PTSD, and Depression

Thesis (Ph.D.)--University of Washington, 2016-08

Indirect Effects of Parental Coping on Children’s Psychosocial Adjustment in the Context of Pediatric Cancer

Thesis (Ph.D.)--University of Washington, 2016-08

Parental influences and mothers’ experiences on infant and young child feeding practices

The objective of this thesis was to better understand how parental factors influence feeding practices, how mothers experience feeding and what factors mothers perceive influencing feeding in different contexts. This study is largely based on STEPS Study (Steps to Healthy Development of Children), which is a longitudinal cohort of 1797 families. In addition, qualitative data was collected among mothers in Finland and Solomon Islands. The results of this study show that different parental determinants associate with infant and young child feeding behavior and practices. Mothers with high cognitive restraint of eating introduced complementary foods earlier and neophobic mothers’ breastfed exclusively for a shorter time than mothers who ranked lower in these behaviors. Fathers’ poor diet quality associated with shorter total breastfeeding duration. Mothers’ postnatal depressive symptoms associated with shorter duration of exclusive breastfeeding, earlier introduction of complementary foods and lower compliance of feeding recommendations. The higher amount of marital distress associated with longer duration of exclusive breastfeeding and better compliance with feeding recommendations. Mothers, who participated in qualitative interviews, described how complex interplay of individual perceptions, significant others and socio-cultural environment influenced feeding practices and behavior. This study showed that several parental factors influence infant and young child feeding practices as well as compliance with the feeding recommendations. Maternal experiences and perceptions on child feeding relate to the context where mother-infant pair lives in. These results highlight the importance of targeting feeding support and, if needed, specific interventions to mothers and families who are in risk of poor feeding practices.

Effects of early childhood development interventions on parental behaviour: evidence from a home-visiting programme in Peru

Las visitas a domicilio tienen por objeto mejorar los resultados del niño, desplazando las habilidades de crianza de los cuidadores para que puedan ofrecer mejores oportunidades de estimulación a sus hijos. A pesar de este objetivo explícito, hay poca evidencia de países en desarrollo con respecto a los efectos del modelo de visitas a domicilio, en la provisión de la estimulación por los cuidadores. También hay una falta de pruebas de los programas de trabajo a gran escala y poca atención a los mecanismos mediante los cuales estas intervenciones afectan al comportamiento de los padres. Este análisis tiene por objeto contribuir a la literatura sobre las intervenciones de dos maneras. Primero, proporciona evidencia causal sobre los efectos de un programa de visitas a domicilio envergadura sobre el comportamiento del cuidador. En segundo lugar, se explora las restricciones que limitan este cambio de comportamiento y ofrece una forma de pensando en sus mecanismos que es consistente con la evidencia. Yo uso el aleatorio grupal diseño del componente de visitas al hogar del programa Cuna Más en Perú para recoger datos de 20 de control y de tratamiento de 20 distritos rurales sobre las prácticas de crianza y las creencias de los cuidadores en cuanto a la importancia de las interacciones entre padres e hijos para el desarrollo infantil.

An Examination of Parental Engagement During the Middle School Years

The purpose of this quantitative study was to explore the previously unexamined phenomenon of middle school parental engagement in a large urban/suburban/rural school district of 209 schools in the mid-Atlantic region of the United States. Across 22 middle schools serving grades six-eight, this study collected and examined perceptions of the three key adult stakeholder groups – administrators, teachers, and parents – most actively involved in middle school parental engagement as described within the theoretical framework of academic socialization. Their reports of observable parental engagement activities were used to document how district stakeholders operationalize behaviors that represent the five actionable constructs and three themes of academic socialization to determine how the district “fares” in employing academic socialization as a middle school parent engagement strategy. The study also applied quantitative descriptive analysis through a one-way ANOVA to determine the significance of observable variations in actionable constructs between the perspectives of the three stakeholder groups. Finally, the study illuminated, through regression modeling, when confounding factors/independent variables such as race, income, school size, administrator and teacher experience, parents’ educational background, etc., impacted operationalization of academic socialization behaviors for middle school parent and family engagement. Rejecting the null hypothesis, the study found that the three stakeholder groups had statistically significant differences in perceptions of their implementation of activities aligned to academic socialization. This study ultimately illuminated ways in which these adult stakeholder groups share similar and varied perceptions about their engagement actions that support the achievement and maturation of middle school students. Significantly, this study provided key findings that illuminated areas that can be systemically addressed to transform middle school parent engagement practices through applied academic socialization theory into consistent and effective collaborative efforts between the home and school. The process of operationalizing academic socialization was outlined in terms that any school or district can follow to improve programs and practices of middle school parental engagement to serve in the best interests of students during this period of great transition for both child/adolescent growth and development and adult navigation of systems to provide support for students in this unique stage of growth and maturation.

The effect of maternal employment on adolescents' transition to young adulthood

The purpose of this study was to examine relationships between multiple characteristics of maternal employment, parenting practices, and adolescents’ transition outcomes to young adulthood. The research addressed four main research questions. First, are the characteristics of maternal work (i.e., hours worked, multiple jobs held, work schedules, earnings, and occupation) related to adolescents’ enrollment in post-secondary education, employment, or involvement in neither of these types of activities as young adults? Second, are the work characteristics related to parental involvement and monitoring, and are the parenting practices related to adolescents’ transition outcomes? Third, do parental involvement and monitoring mediate any relationships between the characteristics of maternal employment and adolescents’ transition outcomes? Finally, do any associations between characteristics of maternal employment and parenting practices and adolescents’ transition outcomes vary by poverty status, race/ethnicity, or gender? To address these research questions, secondary data analysis was conducted, using data from the National Longitudinal Survey of Youth (NLSY) from 1998 through 2004. The study sample consisted of 849 youths who were 15 through 17 years of age in either 1998 or 2000, and were 19 through 21 years of age when their transition outcomes in young adulthood were measured four years later. Multinomial logistic and ordinary least squares regression models were estimated to answer the research questions. Study findings indicated that of the maternal work characteristics, mothers’ multiple jobs held, occupation, and work schedule were significantly related to the youths’ transition outcomes. When mothers held multiple jobs for 1 to 25 weeks per year, and when mothers held jobs involving lower levels of occupational complexity, their youths were more likely to experience employment rather than post-secondary education. Adolescents whose mothers worked a standard work schedule were less likely to experience other types of transitions than post-secondary education. With regard to the effects of maternal employment on parenting practices, none of the maternal work variables were related to parental involvement, and only one variable, mothers working less than 40 hours per week, was negatively related to parental monitoring. In addition, when parents were more involved with their youths’ education, the youths were less likely to transition into employment and other types of transitions rather than post-secondary education. The parenting practices did not mediate the relation between the significant work variables (holding multiple jobs, work schedule, and occupation) and youths’ transition outcomes. Finally, none of the interactions between maternal work characteristics and poverty status, race/ethnicity, and gender met the criteria for determining significance; but in a series of sub-group analyses, some differences according to poverty status and gender were found. Despite the lack of mediation and moderation, the findings of this study have important implications for social policy and social work intervention. Based on the findings, suggestions are made in these areas to improve working mothers’ lives and their adolescents’ development and successful transition to adulthood. Finally, directions for future research are discussed.

Parental contribution to progeny during experimental spawning of jungle perch, Kuhlia rupestris

When releasing captive-bred animals into wild populations, it is essential to maintain the capacity for adaptation and resilience by minimising the effect on population genetic diversity. Populations of the jungle perch (Kuhlia rupestris) have become reduced or locally extinct along the Queensland coast; thus, captive breeding of K. rupestris for restocking is presently underway. Currently, multiple individuals are placed in a tank to produce larvae, yet the number of adults contributing to larval production is unknown. We performed a power analysis on pre-existing microsatellite loci to determine the minimum number of loci and larvae required to achieve accurate assignment of parentage. These loci were then used to determine the number of contributing participants during a series of four spawning events through the summer breeding season in 2012-2013. Not all fish contributed to larval production and no relationship was found between male body size and parentage success. In most cases, there was a high skew of offspring to one mating pair (62% was the average contribution of the most successful pair per tank). This has significant implications for the aquaculture, restocking and conservation of K. rupestris.

The pre-reproductive period in a tropical bird: parental care, dispersal, survival, and avian life histories

The period between offspring birth and recruitment into the breeding population is considered one of the least understood components of animal life histories. Yet, examining this period is essential for studies of parental care, dispersal, demography, and life histories. Studies of the pre-reproductive period are particularly few in tropical regions, where the organization of life histories are predicted to differ compared to northern hemisphere species. For my dissertation I used radio-telemetry, mark-resighting, and field observations to study the pre-reproductive period in a Neotropical bird, the western slaty-antshrike (Thamnophilus atrinucha), in Panama. First, I found that parental care after offspring left the nest (the post-fledging period) was greater than care during the nestling period. Prolonged care resulted in a clear trade-off for parents as they did not nest again until fledglings from the first brood were independent. Parents fed offspring for a prolonged duration during the post-fledging period and higher post-fledging survival was observed compared to many northern hemisphere species. Second, I observed that offspring that remained with parents for longer periods on the natal territory had higher survival both while on the natal territory and after dispersal compared to those dispersing earlier. Parental aggression towards offspring increased with offspring age and offspring dispersed earlier when parents renested. Contrary to other family living species, only a small proportion of antshrike offspring remained on the natal territory until the following year and all dispersed to float. Floating is when juveniles wander within other breeding pairs’ territories. These results suggest that the benefits of delayed dispersal declined with offspring age and with renesting by parents. Third, I observed that survival during the dependent period and first year was greater in slaty antshrikes compared to that of northern hemisphere species. Pre-reproductive survival relative to adult survival was equal or greater than that observed in northern hemisphere species. The date offspring left the nest, mass, and age at dispersal influenced offspring survival, whereas offspring sex and year did not. Relatively high survival during the pre-reproductive period coupled with comparatively low annual productivity clarifies how many tropical species achieve replacement. High juvenile survival appears to obtain from extended post-fledging parental care, delayed dispersal, low costs of dispersal, and a less seasonal environment. Lastly, I experimentally manipulated begging at the nest to examine changes in parental behavior. Under elevated begging, parents increased provisioning rates and reduced the time between arrival to the nest and feeding of nestlings, potentially to reduce begging sounds. Furthermore, parents switched to preferentially feed the closest offspring during the begging treatment. This suggests parents either allowed sibling competition to influence feeding decisions, or feeding the closer nestling increased the efficiency of provisioning. In summary, I found that slaty antshrikes have delayed age at reproduction, higher post-fledging and first year survival, extended post-fledging parental care, equal or greater pre-reproductive survival relative to adult survival, and delayed dispersal compared to many northern hemisphere passerines. These results suggest that this tropical species has a strategy of high investment into few offspring. Furthermore, reproductive effort is equal or greater at least in slaty antshrikes compared to northern hemisphere species, suggesting that the latitudinal gradient in clutch size is not explained by a gradient in reproductive effort.

A importância do envolvimento parental nos projetos lúdicos

Relatório de Estágio apresentado à Escola Superior de Educação de Paula Frassinetti, para obtenção do grau de mestre em Educação Pré-Escolar

Exploring the Role of Parental Hearsay when Children Witness a Crime

In cases of potential child abuse, parents may provide hearsay testimony on behalf of a child, retelling events from the child’s perspective. However, according to the limited research that exists, parents may have a negative impact on their child’s memory of an event (Principe, DiPuppo, & Gammel, 2013). In order to gain a better understanding of parental hearsay, parents’ descriptions of information children provided in recorded parent-child discussions were compared to the actual information the children provided in the initial discussion and in a 1-week follow-up interview. Children interviewed by parents were also compared to children interviewed by a trained interviewer. To date, 11 children between the ages of 6-9 years have been assessed. While the current sample size was too small to yield many significant results, graphs and effect sizes suggest there are differences in memory accuracy and completeness between parents and children and across children’s interview condition. Whether hearsay testimony or children’s testimony is preferable may depend on how suggestive the initial parent-child discussion is.

The relationship of early social, mental, and behavioral experiences with adult obesity and Alcohol Use Disorder

Stressful life events early in life, including symptoms of mental disorders or childhood maltreatment, may increase risk for worse mental and physical health outcomes in adulthood. The purpose of this dissertation was to examine the effects of childhood Attention Deficit Hyperactivity Disorder (ADHD) symptoms and maltreatment experience on two adult outcomes: obesity and alcohol use disorder (AUD). Mediational effects of adolescent characteristics were explored. This dissertation used Waves I, III, and IV of the National Longitudinal Study of Adolescent to Adult Health. In Paper 1 (Chapter 3), we investigated the association between multiple types of child maltreatment and adult objective (body mass index; BMI) and subjective (self-rated) obesity, as well as mediating effects by adolescent characteristics including depressive symptoms and BMI. Results showed that after adjusting for sex, race/ethnicity, and maternal education, physical maltreatment was moderately associated with adulthood obesity as measured by BMI and self-reported obesity, while sexual maltreatment was more strongly associated with the objective measure but not the subjective measure. The indirect effects of mediation of adolescent BMI and depressive symptoms were statistically significant. In Paper 2 (Chapter 4), the objective was to examine mediation by adolescent depressive symptoms, alcohol consumption, peer alcohol consumption, and delinquency in the relationship between ADHD symptoms and adult AUD. The indirect effects of mediation of adolescent delinquency, alcohol consumption, and peer alcohol consumption were statistically significant in single and multiple mediator models. In Paper 3 (Chapter 5), the objective was to assess the joint effects of maltreatment/neglect on adult AUD. After adjusting for sex, race/ethnicity, child maltreatment, and parental AUD, ADHD symptoms were significantly associated with increased odds of AUD. There was no strong evidence of multiplicative interaction by maltreatment. This association was stronger for males than females, although the interaction term was not statistically significant. This dissertation adds to the literature by examining relationships between several major public health problems: ADHD symptoms, childhood maltreatment, AUD, depressive symptoms, and obesity. This project has implications for understanding how early life stress increases risk for later physical and mental health problems, and identifying potential intervention targets for adolescents.