Maternal mental health and childrearing context in the development of children at 6, 18 and 36 months: a Taiwan birth cohort pilot study

Background This study investigated a possible pathway of the childrearing context and maternal mental health at 6 months, and how these factors influence children's development at 6, 18 and 36 months. Methods Using random sampling, 2048 children and mothers were selected. The mother's health status was evaluated using the Taiwanese version of the 36‐Item Short Form Health Survey (SF‐36), and infant development was assessed using the high reliable Taiwan birth cohort study instrument. All data were collected using parental self‐report, and were analysed using multiple linear regression analysis and further pathway using structural equation modelling. Results This study showed that 12 factors effected children's development at 6 months, and some dissipated with growth. Of these, maternal education had an enduring effect on different domains of child development, and this effect intensified as the child grew older. Children who grew up in a family with more siblings would show a delay in language development at 6 months; they have a delay in motor and social development at 18 and 36 months. Additionally, maternal mental health effected the children's fine motor development at 6 months. However, this effect disappeared at 18 months, and influenced children's social development at 36 months. Conclusions This study demonstrated that the development of children at as young as 6 months is affected by various factors. These factors may dissipate, continue to influence child development up to 3 years of age, turn from being disadvantageous to beneficial, or affect different domains of child development. Also, parental self‐report instrument might be has its limitation and could be contributed by several confounding factors. Thus, continuous longitudinal follow‐up on changes in maternal conditions, family factors, and environmental factors is vital to understand how these early infantile factors affect each other and influence the developmental trajectories of children into early childhood.     

A pilot longitudinal follow-up study of the Brief Infant Toddler Social–Emotional Assessment (BITSEA) in Northern Finland: examining toddlers’ social–emotional,behavioural and communicative development

Developmental needs should be assessed in early infancy and followed longitudinally to improve identification, prevention and intervention efforts.The objective was to examine the relationship between competencies and areas of need in toddlers’ development, and to describe the properties and utility of the Brief Infant Toddler Social–Emotional Assessment (BITSEA) in a pilot study in Northern Finland. Parents (N?=?50) evaluated toddler development at 18 and 36 months. Assessments included the BITSEA, the Child Behavior Checklist and the MacArthur Communicative Development Inventories. Lower communicative skills were associated with an increase in toddler behavioural problems. Social–emotional competence (S-EC) was associated with better communication development. Parents reporting enhanced communication skills and S-EC in their toddlers also reported fewer behavioural problems in their young children; however, further research employing the BITSEA in a larger and heterogeneous sample of Finnish children is needed to determine appropriate cut-off scores and reliability especially for the unique subscales of BITSEA.     

Temperament,parental personality and parenting stress in relation to socio-emotional development at 51 months

ABSTRACT

This study examined the relevance of infant temperament, parent personality and parenting stress for children’s socio-emotional development, looking in addition for any differences between mothers and fathers. Participants, from a community sample, were 410 mothers and fathers reporting their personality (NEO Personality Inventory), child temperament in the first (Infant Characteristics Questionnaire) and second (Toddler Behavior Assessment Questionnaire) years, parenting stress to 36 months (Parenting Stress Index Short Form) and child behaviour at 51 months (Strengths and Difficulties Questionnaire). Difficult toddler temperament was associated with more externalizing and internalizing problems. Higher paternal extraversion was associated with more prosocial behaviour whereas lower maternal extraversion was associated with more internalizing problems. For both parents, describing a dysfunctional parent–child relationship was related to more externalizing problems and to less prosocial behaviour, for fathers also to more internalizing problems, which associated for mothers with more parental distress.     

Communication development and characteristics of influencing factors: a follow-up study from 8 to 36 months

In this follow-up study, we evaluated children's communication development at the ages of 8 (n?=?50), 18 (n?=?46), 24 (n?=?44) and 36 months (n?=?36) using the Finnish version of the MacArthur Communicative Developmental Inventories (MCDI). A sample of children (n?=?14) received family-based intervention 10 times in five months and mother–infant relationship was examined using the Parent-Child Early Relational Assessment (PC-ERA) before (at the age of 9–12 months) and after (at the age of 15–18 months) the intervention. The infants' communication skills developed from the use of few words and signs of understanding to that of longer sentences and better grammar during the study period. Specifically, girls scored higher than the boys on the 24-month MCDI. Eight-month-old infants with siblings in the family were more competent than those without siblings, measured using the PC-ERA infant variables. However, there were no significant differences in the MCDI or PC-ERA scores between children with and without intervention.     

Maternal parenting stress and its correlates in families with a young child with cerebral palsy

Objective   To investigate factors predicting parenting stress in mothers of pre-school children with cerebral palsy.
Method   Eighty mothers and children participated. Mothers completed the Parenting Stress Index (PSI) and the following measures of family functioning: family support, family cohesion and adaptability, coping strategies, family needs and locus of control. Children were assessed using the Griffiths Scales and the Gross Motor Function measure. The child's home environment was assessed using Home Observation for Measuring the Environment.
Results   Mothers had higher mean total PSI scores than the means for the typical sample; 43% had total PSI scores above the threshold for clinical assessment. Cluster analysis demonstrated five distinct clusters of families, more than half of whom were coping well. High stress items were role restriction, isolation and poor spouse support, and having a child who was perceived as less adaptable and more demanding. Lower stress items indicated that this sample of mothers found their children emotionally reinforcing and had close emotional bonds. Regression analysis showed that the factors most strongly related to parenting stress levels were high family needs, low family adaptability and cognitive impairment in the child.
Conclusions   The results confirmed the individuality of families, and that individual characteristics of coping and feeling in control, together with family support and cohesion, are associated with variation in amount of stress experienced in parenting a child with cerebral palsy.     

Effects of a short teacher training programme on the management of children's sexual behaviours: a pilot study

This small-scale quasi-experimental study set out to examine the effects of a brief training programme aiming to develop primary school teachers' knowledge, attitudes and confidence in recognising and responding to children who display sexual behaviours. Data on prevalence of sexual behaviours observed by teachers in the study, their level of concern and their response strategies were also examined. There were overall improvements in 16 of the 23 self-report questionnaire items after the training session, 6 of which, in comparison to a control group, were sustained at the three-week follow-up. These results suggest that short training courses can be a viable option in improving primary teachers' knowledge and confidence in dealing with children's sexual behaviours within the school setting. These significant findings are discussed in relation to implications for policy and practice as well as future research.     

Maternal stress: a comparative study of Australian and Singaporean mothers of young children

This study investigated the relationship between several indicators of psychological wellbeing and maternal stress measured by the Parental Stress Index in a volonteer sample of 109 Australian and 88 Singaporean mothers with children under five years of age. The findings indicated that, for both groups of mothers, psychological wellbeing was reasonably high. The level of maternal stress reported by both groups of mothers was extremely high with a higher percentage of Australian mothers reporting extreme levels of stress. The level of psychological wellbeing was not affected by nor did it impact upon levels of maternal stress in both groups. Levels of psychological wellbeing and stress were not related to objective characteristics but appear to be influenced by similar subjective perceptions regarding the parenting experience held by both Australian and Singaporean mothers. Stress in mothers of young children does not appear to be culture specific but an inherent aspect of the process of parenting young children accepted and tolerated by mothers from two different cultures. Cognitive-behavioural theory and practice is the recommended approach for professional intervention.     

Maternal stress: a comparative study of Australian and Singaporean mothers of young children

This study investigated the relationship between several indicators of psychological wellbeing and maternal stress measured by the Parental Stress Index in a volonteer sample of 109 Australian and 88 Singaporean mothers with children under five years of age. The findings indicated that, for both groups of mothers, psychological wellbeing was reasonably high. The level of maternal stress reported by both groups of mothers was extremely high with a higher percentage of Australian mothers reporting extreme levels of stress. The level of psychological wellbeing was not affected by nor did it impact upon levels of maternal stress in both groups. Levels of psychological wellbeing and stress were not related to objective characteristics but appear to be influenced by similar subjective perceptions regarding the parenting experience held by both Australian and Singaporean mothers. Stress in mothers of young children does not appear to be culture specific but an inherent aspect of the process of parenting young children accepted and tolerated by mothers from two different cultures. Cognitive‐behavioural theory and practice is the recommended approach for professional intervention.     

22q11.2 deletion syndrome: behaviour problems of children and adolescents and parental stress

Background 22q11.2 deletion syndrome can be associated with a variety of somatic symptoms, developmental delays and psychiatric disorders. At present, there is little information on behaviour problems, parental stress and possible relations between these factors. Therefore, this study investigates behaviour problems of children and adolescents with 22q11.2DS, and their primary caregivers’ stress. Methods Parents of 4–17 year old subjects known to the German 22q11.2 deletion syndrome foundation were anonymously asked to fill out several questionnaires, e.g. the Child Behavior Checklist 4–18 (CBCL/4–18). Results The primary caregivers of 77/126 children [43 males, 34 females, mean age: 8;0 (4;0–16;11) years] sent back filled‐out questionnaires. Forty‐six of 76 subjects were rated as clinical on at least one of the CBCL‐scales. Males had significantly higher scores on the total problems scale and the internalizing problems scale than females. The patients’ age correlated with several CBCL‐scales. Eleven of 49 subjects were suspicious of an autism spectrum disorder. Compared with the general population, but not with other parents of mentally and/or physically handicapped children, the primary caregivers experienced higher levels of stress, but showed normal life satisfaction. Conclusions In spite of high rates of clinical behaviour problems among children and adolescents with 22q11.2DS and despite increased parental stress, most primary caregivers seem to have effective coping strategies, e.g. partnership support, to sustain normal levels of life satisfaction.     

Maternal general health and children's cognitive development and behaviour in the early years: findings from the Millennium Cohort Study

Background Mothers often experience physical and psychological difficulties during the post‐natal period and these may continue through the early years of raising children and have negative effects on engagement and caregiving. Pathways between maternal depression, parental engagement and caregiving and children's subsequent development have been described in longitudinal studies; yet, less is known about how other aspects of maternal health may influence children's development. Methods A longitudinal analysis within the Millennium Cohort Study was conducted including 7906 families from England. Maternal general health and psychological well‐being were assessed when their children were 9 months and 3 years old, socio‐demographic characteristics were assessed at 9 months, and engagement and caregiving were assessed at 3 years. These were examined as predictors of children's learning and development and behaviour at age 5. Results There are clear associations between maternal general health and children's development with regard to both learning and development and behaviour. These effects are reduced if psychological distress is taken into account; yet, maternal general health maintains importance as a predictor for children's subsequent development. There is evidence of an association via engagement and caregiving which links maternal health to children's development and evidence of the influence of underlying socio‐demographic disadvantage. Conclusion General maternal health as well as psychological well‐being during the early years of raising children may be influential for children's development. This study suggests the need for a broader recognition of maternal health as well as psychological well‐being as a foundation for family well‐being, and speaks to support for mothers in maintaining engagement and caregiving for their children during periods of ill health.     

Associations between young children’s exposure to household violence and behavioural problems: Evidence from a rural Kenyan sample

ABSTRACT

Little is known about how young children in low- and middle-income countries (LMICs) experience violence in their homes, and how different types of household violence may affect child development. This study reports on levels of exposure to household violence and associations with child behavioural outcomes in preschool-aged children in western Kenya. A sample of 465 caregivers, whose children (n?=?497) attended early learning centres supported by an international NGO, were enrolled in the study. Caregivers reported on exposure to intimate partner violence (IPV), household discipline practices, attitudes about gender roles, and child behavioural outcomes. Multivariable analysis showed significant predictive effects of IPV (regression coefficient?=?1.35, SE?=?0.54, p?=?0.01) and harsh psychological child discipline (regression coefficient?=?0.74, SE?=?0.22, p?=?0.001), but not physical discipline (regression coefficient?=?0.42, SE?=?0.24, p?=?0.08), on worse child behavioural problems. These findings indicate that child exposure to violence in different forms is highly prevalent, and associated with poorer outcomes in young children. Community-based programmes focused on parenting and early child development are well-positioned to address household violence in LMIC settings, but must be supported to provide a broader understanding of violence and its immediate and long-term consequences.     

A longitudinal study of children's voices in regard to stress and coping during the transition to school

This study explores (1) how parental and teacher scaffolding and children's coping strategies contribute to children's adjustment during the transition from preschool to school; and (2) how children's perception of stress and coping are constructed over time. The sample included 216 six-year-old children, their parents and teachers. The parents, teachers and children reported that many children encountered social stress and being incompetent at school, and most of the children used either direct problem-solving or seeking social support to cope with stress, but had not used emotion-focused coping strategies learnt at preschool. Compared with the parents’ and teachers’ responses, the children reported more incidences of social stress. Compared with the children's responses, more parents and teachers reported children being incompetent in learning or self-help skills at school. Implications of the study were discussed at the end of the article.     

Work stress and reduced health in young physicians: prospective evidence from Swiss residents

OBJECTIVES: Job stress, investigated by the effort-reward model in various working environments in different countries, has been widely reported, yet studies addressing physicians are lacking. The present study investigated the perceived job stress, its association with the amount of working hours, and its impact on young physicians' self-reported health and their satisfaction with life during residency. METHODS: In a prospective study design, a cohort of Swiss medical school graduates was followed up, beginning in 2001. In their second and fourth years of residency, 433 physicians assessed their effort-reward imbalance, overcommitment, physical and mental well-being and satisfaction in life. Taking the longitudinal design into account, four categories of stressed residents were defined: (1) subjects not reporting high work stress at either measurement, (2) subjects reporting high work stress in the second but not in the fourth year of residency, (3) subjects with onset of high work stress in fourth year and (4) residents reporting high work stress at both measurements. RESULTS: All components of the perceived stress at work were significantly correlated with the amount of working hours, effort showing the highest correlation. While two-thirds of the participants do not report high work stress, assessed by the extrinsic part of the effort-reward imbalance model (the ratio between effort and reward) and 12% show a decrease of stress over time, there are 15% with an increase of stress over time, and 10% with persistently high stress experience. In terms of the intrinsic stress component (overcommitment), 71% show low values, 12% show a decrease, 9% an increase and 8% constantly high values. The groups with constant and increasing extrinsic and intrinsic stress experience exhibit significantly worse health and life satisfaction compared to the remaining groups, after controlling for gender and baseline health. CONCLUSIONS: Stress at work in young physicians, especially when being experienced over a longer period in postgraduate training, has to be a matter of concern because of its negative impact on health and life satisfaction and the risk of developing symptoms of burnout in the long run.     

Emotional and behavioural difficulties in children with diabetes: a controlled comparison with siblings and peers

This study describes a comparison of children with insulin dependent diabetes mellitus (IDDM) with two control groups: the sibling nearest to them in age, and peers matched for gender and age. A broad range of emotional and behavioural difficulties were assessed using the Conners' Teachers' and Parents' rating scales (CTRS 39 and CPRS 93). Individually completed children's questionnaires provided qualitative data about the children's problems. The results of the study showed markedly higher scores for the children with diabetes on the parent scales on factors such as hyperactivity, psychosomatic and restless/disorganized, in comparison to their siblings, but not their peers. These differences were not found on the Teachers' Scales. The findings are discussed in terms of parental perceptions of children with diabetes and the difficulties these children and their siblings experience in their lives. Suggestions are made for further research.     

The Tayside children's sleep questionnaire: a simple tool to evaluate sleep problems in young children

BACKGROUND: Behavioural sleep problems in young children are relatively common with between 20% and 40% of those aged 1 to 5 years being affected. This paper describes the development of a simple questionnaire to assess disorders of initiating and maintaining sleep (DIMS) in children aged between 1 and 5 years for use as a selection tool for research purposes or as a screening instrument in primary care. METHODS: A subsection of the Sleep Disturbance Scale for Children was adapted and piloted with a small sample of children in two inner city GP practices (n = 81). Face and content validity were initially established by expert review. Discriminant validity was assessed qualitatively using interviews with mothers of identified cases and non-cases. The validity of the cut-off score was assessed by blinded case note reviews off known cases; inter-rater reliability was also calculated. Following modifications, the final questionnaire was posted to a representative sample of parents across the region with children in the appropriate age band (n = 1023). Internal reliability was assessed using Cronbach's alpha and factor analysis was undertaken to identify significant factors within the questionnaire. RESULTS: The response rate to the population questionnaire was 61.5% (n = 628) with 218 of the children having sleep scores that were indicative of DIMS (35%), echoing other figures reported in the literature. There was good internal consistency for the items (Cronbach's alpha = 0.85) with two main factors accounting for 58% of the variance. CONCLUSION: The Tayside Children's Sleep Questionnaire (TCSQ) is an easy-to-read and reliable tool that could be used both as a clinical and research instrument to assess the severity and prevalence of DIMS in young children.     

Implications of a model of stress and coping for services to families of young disabled children

Summary Much recent research on families bringing up a disabled child has explored their coping strategies to deal with stress. The major findings are reviewed, and possible implications for the structure and content of service delivery suggested. The paper emphasizes the importance of social support networks, including the relationship between the mother and father, and of quality services in enhancing parental adaptation.     

Translating the tears: parents' use of behavioural cues to detect pain in normally developing young children with everyday minor illnesses or injuries

Objectives The objectives of this paper were to (i) identify the behavioural cues used by parents to detect young children's transient pain from minor illnesses or injuries (‘everyday pain’); and (ii) perform an initial psychometric evaluation of the Parents' Post‐operative Pain Measure (PPPM) in the context of children's everyday pain. Method Cross‐sectional Internet survey. Results One thousand seven hundred sixteen parents of children (1–6 years) completed the survey. The parents reported more behaviours when children had pain from minor illnesses than from minor injuries (9.6 ± 3.9 vs. 2.5 ± 2.3, P < 0.001). Principal component analysis of the PPPM revealed a two‐factor solution for illness‐related pain and a three‐factor solution for injury‐related pain. Behavioural cues varied with characteristics of children (age, gender and prior hospital experience) and parents (gender, age and parenting experience). Conclusions The PPPM is a promising tool for parental assessment of children's pain in everyday situations. Further research is needed to determine its utility in facilitating communication between parents and healthcare professionals, and in improving the management of young children's pain.     

Social and physical environmental factors and child overweight in a sample of American and Czech school-aged children: a pilot study

ObjectiveTo compare environmental factors that influence body mass index for age (BMI-for-age) between a sample of American and Czech school-aged children.DesignPilot study. A parent questionnaire and school visits were used to collect data from parents and children.SettingPublic schools in 1 American and 2 Czech cities.ParticipantsForty-five American and 97 Czech 4^th- through 6^th-graders and their parents.Variables MeasuredParenting style, food socialization and preparation practices, healthful food availability, and children's BMI-for-age were measured.AnalysisFactors from the parental scales were derived using factor analysis. Independent t tests compared environmental factors between American and Czech families. A regression model was used to identify environmental variables associated with BMI-for-age.ResultsAmerican parents used authoritative parenting style and positive food socialization practices more often than Czech parents (P <.001). Availability of healthful food and parental involvement in food preparation were higher (P <.001) in Czech households. Positive encouraging socialization practices, less frequent use of negative explanations, and a greater availability of vegetables were associated with lower BMI-for-age in the Czech sample of children.Conclusions and ImplicationsA future study should focus on identifying environmental factors that influence children's BMI-for-age with a large sample of Czech and American parents and their school-aged children.     

A community-based study of sleep and behaviour problems in 12- to 36-month-old children

Background While evidence suggests sleep problems are common in young children and linked to behavioural problems, studies of toddlers are rare. This community‐based cross‐sectional study examined associations between sleep problems and daytime behaviour among 58 children aged 1 to 3 years who attended daycare centres. Methods Mothers and daycare providers completed four and three questionnaires, respectively, about children's sleep patterns and behaviour. Two hypotheses were tested: (1) children with higher sleep problem scores would have more behavioural problems by parental and daycare provider report; (2) problematic napping behaviours would be associated with night sleep problems. Results Mothers' reports of sleep problems were positively associated with children's behavioural problems at home and daycare providers' reports of nap problems were positively correlated with children's behavioural problems at daycare. Daycare providers' reports of children's behavioural problems at daycare were associated with maternal reports of behavioural problems. Older children in the sleep problem group had maternal reports of more behavioural problems. Daycare providers reported that children with sleep problems were less happy at daycare. Children who were happier following naps had less reported night settling difficulties. Children with difficulty settling for naps at daycare had maternal reports of more behavioural problems. Conclusions Napping in daycare settings is an important component of toddlers' sleep. Crossover effects between children's sleep and behaviour at daycare and home indicate similarities in mothers' and daycare providers' perceptions. Findings suggest parent and daycare provider interactions include discussions about sleep problems and settling at home and in daycares. Parents and daycare providers would benefit from education about relationships between sleep and behavioural problems.