A parent-report measure of children's anxiety: psychometric properties and comparison with child-report in a clinic and normal sample

This study examined the psychometric properties of the parent version of the Spence Children's Anxiety Scale (SCAS-P); 484 parents of anxiety disordered children and 261 parents in a normal control group participated in the study. Results of confirmatory factor analysis provided support for six intercorrelated factors, that corresponded with the child self-report as well as with the classification of anxiety disorders by DSM-IV (namely separation anxiety, generalized anxiety, social phobia, panic/agoraphobia, obsessive-compulsive disorder, and fear of physical injuries). A post-hoc model in which generalized anxiety functioned as the higher order factor for the other five factors described the data equally well. The reliability of the subscales was satisfactory to excellent. Evidence was found for both convergent and divergent validity: the measure correlated well with the parent report for internalizing symptoms, and lower with externalizing symptoms. Parent-child agreement ranged from 0.41 to 0.66 in the anxiety-disordered group, and from 0.23 to 0.60 in the control group. The measure differentiated significantly between anxiety-disordered children versus controls, and also between the different anxiety disorders except GAD. The SCAS-P is recommended as a screening instrument for normal children and as a diagnostic instrument in clinical settings. (C) 2003 Elsevier Ltd. All rights reserved.

Measuring parent satisfaction with a neonatal hearing screening program

The primary aim of the present study was to investigate parent satisfaction with a neonatal hearing screening program through use of a valid and reliable questionnaire developed for this purpose (Parent Satisfaction Questionnaire with Neonatal Hearing Screening Program; PSQ-NHSP). Eighty parents whose children had received hearing screening participated in this study. High levels of satisfaction were reported with more than 90% of parents satisfied with all aspects of the program. The PSQ-NHSP was analyzed for validity and reliability and demonstrated excellent internal consistency reliability (sigma = 0.94) and excellent test-retest reliability (rho = 0.97). Content validity of the PSQ-NHSP was partially established by reviewing available literature on parent satisfaction studies in other pediatric health-care service programs. Construct validity of the PSQ-NHSP was indicated by a significant positive relationship between overall satisfaction and the three specific dimensions in the questionnaire. The satisfaction questionnaire was found to be a useful instrument for identifying service shortfalls, and routine use of the PSQ-NHSP in other neonatal hearing screening programs is recommended.

Disabling a family? Emotional dilemmas experienced in becoming a parent of a child with learning disabilities

Becoming the parent of a child diagnosed with learning disabilities can have a dramatic impact. Chrissie Rogers, the author of this article, is both a lecturer in education studies at Keele University and the mother of a daughter who has learning disabilities. She argues here that the pressures on mothers to produce ‘perfect’ babies and to meet all their needs are immense. These pressures arise from both internalised norms and societal expectations and, in the face of these pressures, parents may feel shock, loss and disappointment. These feelings may lead, in turn, to denial, anxiety and conflict affecting both the parents and the professionals involved with the family. Drawing on a series of in-depth interviews and personal narratives, Chrissie Rogers makes a powerful case for the importance of support, whether that support is formal or informal. She suggests that, without the right levels of support and understanding, having a child with a diagnosis of learning disability can disable the whole family.

Investigating the role of parent and child characteristics in healthy eating intervention outcomes

While numerous studies have investigated the efficacy of interventions at increasing children's vegetable consumption, little research has examined the effect of individual characteristics on intervention outcomes. In previous research, interventions consisting of modelling and rewards have been shown to increase children's vegetable intake, but differences were identified in terms of how much children respond to such interventions. With this in mind, the current study investigated the role of parental feeding practices, child temperament, and child eating behaviours as predictors of intervention success. Parents (N = 90) of children aged 2-4 years were recruited from toddler groups across Leicestershire, UK. Parents completed measures of feeding practices, child eating behaviours and child temperament, before participating in one of four conditions of a home-based, parent led 14 day intervention aimed at increasing their child's consumption of a disliked vegetable. Correlations and logistic regressions were performed to investigate the role of these factors in predicting intervention success. Parental feeding practices were not significantly associated with intervention success. However, child sociability and food fussiness significantly predicted intervention success, producing a regression model which could predict intervention success in 61% of cases. These findings suggest that future interventions could benefit from being tailored according to child temperament. Furthermore, interventions for children high in food fussiness may be better targeted at reducing fussiness in addition to increasing vegetable consumption.

Parent emotional functioning, parent responsiveness, and child adjustment

Over the past two decades, interest in the psychological development of children has steadily increased (Beg, Casey, & Saunders, 2007), presumably because statistics describing childhood psychological illness are alarming. Certain parent interaction styles or behaviors are known to influence child adjustment. According to attachment theory, the reason for these findings is that interaction with a caregiver informs an individual’s construction of an internal working model (IWM) of the self in relation to others in the environment. The purpose of this study was to gain a greater understanding of the factors contributing to child adjustment by examining the influence of parents’ emotional functioning and parent responsiveness to children’s bids for interaction. This dissertation tested a multivariate model of attachment-related processes and outcomes with an ethnically diverse sample. Results partially supported the model, in that parent emotional intelligence predicted some aspects of child adjustment. Overall, the study adds to knowledge about how parent characteristics influence child adjustment and provides support for conceptualizing emotional intelligence as a concrete and observable manifestation of the nonconscious attachment IWM.

The Impact of Workshops on the Quality and Quantity of Parent-Child Booksharing Skills

A pilot study posits that conducting a number of literacy workshops with teenage mothers translated into a greater number of appropriate booksharing skills implemented while reading to the child. The results of one- and two-way ANOVAs and of a contingency table with crosstabs are included.

Children's perceptions of marital conflict, parent -child relations and anxiety in children: A proposed systemic model

This study tested a systemic model in which internalizing behaviors in a clinically-referred sample of children are predicted by children's perceptions of marital conflict in the context of three additional, well-researched, familial variables: parent-child relations, mother's emotional functioning, and children's perception of social support. After finding preliminary support for the model, its generalizability was tested in a combined sample of the clinically-referred group and a community-based group of elementary school children. ^ The clinical group consisted of 31 participants from a specialty clinic for children's anxiety disorders: 15 boys and 16 girls, aged 6 to 16, from both intact and divorced homes. Children's reports and mothers' reports of children's internalizing behaviors were submitted to separate analyses. Mothers' reports of children's internalizing behaviors were predicted only by mothers' emotional functioning. As hypothesized by the model, children's own reports of their internalizing behaviors were predicted significantly by children's perceptions of marital conflict. Parent-child relations, children's perception of social support, and one interaction term, children's perception of marital conflict x children's perception of parental rejection, contributed to the regression solution, while mother's emotional functioning failed to meet entry criterion. ^ The combined sample added 37 community-based children, 18 boys and 19 girls, aged 6 to 11, creating a total of 68 subjects. The model was replicated on the combined sample. ^ Findings of the study suggest child perceptions of marital conflict have a strong direct effect on child internalizing behaviors, accounting for 28% of the variance between marital conflict and child outcome in the clinical sample and 42% in the combined sample. In the past only about 10% of the variance in children's internalizing behaviors was explained by marital conflict. Importance implications are made for optimal assessment and specific treatment strategies for children and families experiencing marital conflict, especially for those at risk for anxiety disorders. ^

Obstetric mode of delivery and child psychological development

Background/aims: Objective of the current thesis is to investigate the potential impact of birth by Caesarean section (CS) on child psychological development, including autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), behavioural difficulties and school performance. Structure/methods: Published literature to date on birth by CS, ASD and ADHD was reviewed (Chapter 2). Data from the UK Millennium Cohort Study (MCS) were analysed to determine the association between CS and ASD, ADHD and parent-reported behavioural difficulties (Chapter 3). The Swedish National Registers were used to further assess the association with ASD, ADHD and school performance (Chapters 4-6). Results: In the review, children born by CS were 23% more likely to be diagnosed with ASD after controlling for potential confounders. Only two studies reported adjusted estimates on the association between birth by CS and ADHD, results were conflicting and limited. CS was not associated with ASD, ADHD or behavioural difficulties in the UK MCS. In the Swedish National Registers, children born by CS were more likely to be diagnosed with ASD or ADHD. The association with elective CS did not persist when compared amongst siblings. There was little evidence of an association between birth by elective CS and poor school performance. Children born by elective CS had slight reduction in school performance. Conclusions: The lack of association with the elective CS in the sibling design studies indicates that the association in the population is most probably due to confounding. A small but significant association was found between birth by CS and school performance. However, the effect may have been due to residual confounding or confounding by indication and should be interpreted with caution. The overall conclusion is that birth by CS does not appear to have a causal relationship with the aspects of child psychological development investigated.

Adolescent substance use in the context of the family: a qualitative study of young people’s views on parent-child attachments, parenting style and parental substance use

Background: Adolescent substance use can place youth at risk of a range of poor outcomes. Few studies have attempted to explore in-depth young people’s perceptions of how familial processes and dynamics influence adolescent substance use.
Objectives: This paper aimed to explore risk and protective factors for youth substance use within the context of the family with a view to informing family based interventions.
Methods: Nine focus groups supplemented with participatory techniques were facilitated with a purposive sample of sixty-two young people (age 13-17 years) from post-primary schools across Northern Ireland. The data were transcribed verbatim and analysed using thematic analysis.
Results: Three themes emerged from the data: 1) parent-child attachments, 2) parenting style and 3) parental and sibling substance misuse. Parent-child attachment was identified as an important factor in protecting adolescents from substance use in addition to effective parenting particularly an authoritative style supplemented with parental monitoring and strong parent-child communication to encourage child disclosure. Family substance use was considered to impact on children’s substance use if exposed at an early age and the harms associated with parental substance misuse were discussed in detail. Both parent and child gender differences were cross-cutting themes.
Conclusion: Parenting programmes (tailored to mothers and fathers) may benefit young people via components on authoritative styles, parental monitoring, communication, nurturing attachments and parent-child conflict. Youth living with more complex issues, e.g. parental substance misuse, may benefit from programmes delivered beyond the family environment e.g. school based settings.

Disorder and disconnection: parent experiences of liminality when caring for a dying child

Parents caring for a child with a life threatening or life limiting illness experience a protracted and largely unknown journey, as they and their child oscillate somewhere between life and death. Using an interpretive qualitative approach, interviews were conducted with parents (n = 25) of children who had died. Findings reveal parents’ experiences to be characterised by personal disorder and transformation as well as social marginalisation and disconnection. As such they confirm the validity of understanding these experiences as, fundamentally, one of liminality, in terms of both individual and collective response. In dissecting two inter-related dimensions of liminality, an underlying tension between how transition is subjectively experienced and how it is socially regulated is exposed. In particular, a structural failure to recognise the chronic nature of felt liminality can impede parents’ effective transition.

Reducing child conduct disordered behaviour and improving parent mental health in disadvantaged families: a 12 month follow-up and cost analysis of a parenting intervention

The effectiveness of the Incredible Years Basic parent programme (IYBP) in reducing child conduct problems and improving parent competencies and mental health was examined in a 12-month follow-up. Pre- to post-intervention service use and related costs were also analysed. A total of 103 families and their children (aged 32–88 months), who previously participated in a randomised controlled trial of the IYBP, took part in a 12-month follow-up assessment. Child and parent behaviour and well-being were measured using psychometric and observational measures. An intention-to-treat analysis was carried out using a one-way repeated measures ANOVA. Pairwise comparisons were subsequently conducted to determine whether treatment outcomes were sustained 1 year post-baseline assessment. Results indicate that post-intervention improvements in child conduct problems, parenting behaviour and parental mental health were maintained. Service use and associated costs continued to decline. The results indicate that parent-focused interventions, implemented in the early years, can result in improvements in child and parent behaviour and well-being 12 months later. A reduced reliance on formal services is also indicated.

Childhood Attention Problems and the Development of Comorbid Symptoms at the Transition to High School: The Mediating Role of Parent and Peer Relationships

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk for the development of depression and delinquent behavior. Children and adolescents with ADHD also experience difficulty creating/maintaining high quality friendships and parent-child relationships, and these difficulties may contribute to the development of co-morbid internalizing and externalizing symptoms in adolescence. However, there is limited research examining whether high quality friendships and parent-child relationships mediate the relation between ADHD and the emergence of these co-morbid symptoms at the transition to high school. This study examines the mediating role of relationship quality in the association between ADHD and depressive symptoms/delinquent behaviors at this developmentally significant transition point. Results revealed significant indirect effects of grade 6 attention problems on grade 9 depressive symptoms through friendship quality and quality of the mother-child relationship in grade 8. Interventions targeting parent and peer relationships may be valuable for youth with ADHD to promote successful transitions to high school.