Tuning in to kids: an emotion‐focused parenting program—initial findings from a community trial

This study evaluated a new group parenting program, Tuning in to Kids, which taught emotion coaching skills to parents of preschool children. In a randomized control trial, 218 primary caregiver parents of children aged 4.0–5.11 years completed questionnaires assessing parent emotion socialization (emotion coaching vs. emotion dismissing), parent emotional competence, parent wellbeing and child behavior. Assessment occurred at preintervention and 10 weeks later. Parents randomized to the intervention condition (n=107) attended a 6‐session parenting program. Results showed parents in the intervention condition reported significant increases in emotion coaching and significant reductions in emotion dismissing with their children. Child behavior was also reported to improve. Of those with clinical levels of behavior difficulties, more than half were no longer at clinical level postprogram. These findings suggest that an emotion‐focused parenting intervention may assist parents to learn emotion‐coaching skills that have been linked to improved child behavior. © 2009 Wiley Periodicals, Inc.     

SUPPORTING POSITIVE PARENTING IN COMMUNITY HEALTH CENTERS: THE ACT RAISING SAFE KIDS PROGRAM

The present study involves an evaluation of the effect of the American Psychological Association's ACT Raising Safe Kids (RSK) program on parenting outcomes for families served by Community Health Centers. The ACT‐RSK program is a primary family violence and child physical abuse prevention program for parents of young children. Parents were trained in effective parenting including nonviolent discipline, child development, anger management, social problem‐solving skills, effects of violent media on children, and methods to protect children from exposure to violence. Results indicate improved nurturing and positive parenting behaviors and lower rates of psychologically and physically aggressive behavior toward children. These improvements occurred independent of children's age and prior levels of aggression. Use of this model within healthcare settings has the potential to more effectively address parents’ needs for parenting guidance while reducing the likelihood of child maltreatment.     

INVOLVING PARENTS IN A COMMUNITY‐BASED,CULTURALLY GROUNDED MENTAL HEALTH INTERVENTION FOR AMERICAN INDIAN YOUTH: PARENT PERSPECTIVES,CHALLENGES, AND RESULTS

An important predictor of youth well‐being and resilience is the presence of nurturing adults in a youth's life. Parents are ideally situated to fulfill this role but often face challenges and stressors that impede their ability to provide adequate support and guidance. American Indian parents may also be affected by intergenerational transmission of trauma and loss of traditional parenting practices, as a result of forced boarding school and/or relocation. Members of a community‐university partnership sought to interrupt cycles of violence and poor mental health of youth through a culturally‐grounded intervention for youth and their parents that focused on healing historical trauma, strengthening positive parenting practices and social skills, reconnecting to traditional cultural knowledge, and improving parent‐child relationships/communication. This article describes parental involvement and its challenges and provides mixed‐method results for 10 parents related to enculturation, parenting practices, parent‐child communication, family cohesion, historical loss and associated symptoms, and community involvement.     

Parent–child relationship qualities and child adjustment in highly stressed urban black and white families

Compared poor, highly stressed African-American and White, 2nd–6th grade urban parents and their children on: a) three parent–child relationship clusters (i.e., positive attitudes, involvement, and discipline practices); b) nine child adjustment variables; and c) patterns of relationships between these two sets of variables. There were no significant racial group differences on any parent–child relationship cluster. Although White children exceeded African-American children on social problem solving and realistic control variables, few group differences were found in the relationships between parenting- and child test-variables. In both groups, the parent attitude cluster, reflecting overall warmth and soundness of the parent–child relationship, was the strongest predictor of positive child outcomes on teacher and child self-ratings of adjustment. © 1999 John Wiley & Sons, Inc.     

CHILDHOOD TEMPERAMENT‐BASED ANTICIPATORY GUIDANCE IN AN HMO SETTING: A LONGITUDINAL STUDY

This study investigates whether individualized, anticipatory temperament guidance could benefit the parent‐child relationship and improve children's mental health over time. Parents of preschoolers in a health management organization completed a temperament questionnaire, received written parenting information tailored to their child's temperament, and were asked to complete a program evaluation questionnaire. The numbers of subsequent visits to the pediatric and psychiatry departments with anxiety, depression, attention deficit hyperactivity disorder, and other externalizing behavior diagnoses were compared over 15 years to a control sample that received only standard care. Parents positively reviewed the program and boys who received the intervention had fewer visits with psychiatric diagnoses. Analyses revealed an interaction effect, where boys with harder‐to‐manage temperaments saw a greater reduction in visits from the intervention. By sensitizing parents to their child's temperament and helping parents understand and manage temperament‐related behaviors, anticipatory guidance can encourage a positive parent‐child relationship and reduce future occurrences of psychiatric diagnoses.     

Teaching Parents to Teach Their Children: Applications in the Pediatric Setting

This study evaluated the effects of a training program designedto teach parents skills for facilitating the academic performanceof their children. Specifically, the parents were taught touse f(a) modeling (physical and verbal), (b) positive feedback;(c) corrective feedback, and (d) verbal reinforcement to teachtheir children letter-printing skills. A multiple base-linedesign across parents and children was employed. Training wasconducted and data were collected in the pediatric clinic andhome via direct observation of behavior and performance. Resultssuggested that child printing performance increased substantiallywhen the parents were trained in the four component skills.Generalization of parent skills occurred across settings andtarget skills, and was maintained on follow-up measures takenat 2- and 4-week intervals.     

Going for the Goal: Improving youths' problem‐solving skills through a school‐based intervention

This study evaluated Going for the Goal (GOAL), a school‐based intervention designed by Danish and colleagues to teach life skills to at‐risk urban adolescents. We extended previous evaluation of GOAL by including an assessment of means‐ends problem‐solving skills. The 10‐week program was administered to 479 middle school students by 46 trained high school student leaders in a predominantly Hispanic community. The program focused on setting positive, reachable goals; anticipating and responding to barriers to goal attainment; using social support; and building on one's strengths. Results demonstrated gains in knowledge of the skills being taught and improvement in problem‐solving skills. Leaders also showed an increase in their knowledge of life skills. The approach maximizes both community resources and ecological validity while giving high school leaders the chance to benefit in their role as helpers. © 2002 Wiley Periodicals, Inc.     

Interventions for women prisoners and their children in the post‐release period

Women offenders and their children represent a severely disadvantaged and marginalised population. For many children, the very risk factors that contributed to their own mother's incarceration are present in their current lives, creating an intergenerational vulnerability for poor outcomes. Providing an intensive individualised parenting intervention in the post‐release period may help improve family functioning. The aim of the present study was to ascertain the feasibility and short‐term effectiveness of delivering an intensive multifaceted parenting program, Parents Under Pressure (PUP), to women offenders after release or in low‐security confinement where they were living with their children. Twelve women commenced the program and eight completed treatment. Treatment completion was associated with significant positive change, in particular an improvement in maternal mental health and the quality of the parent‐child relationship, with reductions found in child abuse potential and problem child behaviours. The present results highlight the potential benefits of delivering intensive multifaceted parenting interventions, such as PUP, to women who have been involved in the criminal justice system.     

Impact of music therapy to promote positive parenting and child development

The effectiveness of a 10-week group music therapy program for marginalized parents and their children aged 0-5 years was examined. Musical activities were used to promote positive parent-child relationships and children's behavioral, communicative and social development. Participants were 358 parents and children from families facing social disadvantage, young parents or parents of a child with a disability. Significant improvements were found for therapist-observed parent and child behaviors, and parent-reported irritable parenting, educational activities in the home, parent mental health and child communication and social play skills. This study provides evidence of the potential effectiveness of music therapy for early intervention.     

Perspectives of parents and tutors on a self‐management program for parents/guardians of children with long‐term and life‐limiting conditions: “a life raft we can sail along with”

The lay‐led, community‐based Supporting Parents Programme (SPP) aims to assist parents caring for children with long‐term or life‐limiting conditions through support and cognitive behavioral techniques. The value of the SPP from the perspectives of parent participants and tutors was examined in focus groups and telephone interviews. Data were analyzed using framework analysis. Parents perceived a commonality of emotions and practical issues, valued meeting similar others, felt less isolated, more positive, motivated, and more calm; some had found the “real me again.” Changes were attributed to techniques learned. Parents were anxious of being cast adrift at the end of SPP. Tutors needed more support and additional training around child protection and confidentiality. © 2008 Wiley Periodicals, Inc.     

Parenting adolescents with ADHD: evaluation of a psychoeducation group

ADHD and disruptive behaviour disorders are the most common reasons for referrals of adolescents to children's mental health services. Psychosocial treatments for parents and adolescents, though routinely recommended, have not been well evaluated. This paper reports an evaluation of a clinic based, parent skills training and education group for parents of adolescents with ADHD. The parent education group is a manual based program which provides information about ADHD and training in problem solving and parenting skills. Using a pre-post design, we collected evaluation data from 163 parents of 103 adolescents before and after participation in the group. The outcome measures were two parent self-report measures, the conflict behaviour questionnaire, the issues checklist and an investigator-designed evaluation questionnaire. There was a statistically significant decrease in frequency and intensity of self-reported parent-adolescent conflict and in parent-reported problem behaviour. Parent reports of problem behaviour were not related to kin relationship or child age. There was a trend for parents of daughters to report more problem behaviours and more conflict in the parent-adolescent relationship. Participants reported positive effects on their parenting skills and confidence. They tended to evaluate the program as very helpful.     

Parents report better health‐related quality of life for their food‐allergic children than children themselves

Background Food allergy affects 5–6% of children and impairs health‐related quality of life (HRQL). Children and parents may differ in their views concerning the child's HRQL. In food allergy, child‐ and parent‐proxy‐reported HRQL have never been compared using valid disease‐specific instruments. Objective The aim of this study was to compare child‐ and parent‐proxy reports on HRQL in food‐allergic children (8–12 years). Methods The Food Allergy Quality of Life Questionnaire‐Child Form (FAQLQ‐CF), and ‐Parent Form (FAQLQ‐PF) and the Food Allergy Independent Measure‐Child Form and ‐Parent Form (FAIM‐CF and ‐PF) were completed by Dutch food‐allergic child–parent pairs. Child‐ and parent‐proxy reports were correlated and tested for significant differences. Construct validity (Spearman's correlation coefficient between the FAQLQs and FAIMs) and internal consistency (Cronbach's α) were assessed and compared. Results Seventy‐four child–parent pairs were included. The FAQLQ‐CF score was significantly higher than the FAQLQ‐PF score (3.74 vs. 2.68, P<0.001, where 1 indicates no impairment and 7 indicates extreme impairment). FAIM‐CF and ‐PF scores were almost identical (3.29 vs. 3.33, P=0.594). There was moderate agreement between the FAQLQ‐CF and ‐PF scores (ICC=0.57 [P<0.001]) and good agreement between the FAIM‐CF and ‐PF scores (ICC=0.80 [P<0.001]). Construct validity was confirmed for the FAQLQ‐CF (ρ=0.60, P<0.001) and ‐PF (ρ=0.58, P<0.001). Internal consistency was excellent for the FAQLQ‐CF (α=0.95) and ‐PF (α=0.95). Conclusions and Clinical Relevance Parents reported significantly less impact of food allergy on the child's HRQL than children themselves, while reported perceptions of disease severity were nearly identical. This may reflect real differences in perspectives between children and parents and may indicate that parents tend to underestimate their child's HRQL impairment. It is important for clinicians to include both the child's and their parent's perceptions in order to perform a complete assessment of the impact of food allergy on the child's HRQL and to identify areas of disagreement that need special attention in clinical practice. Cite this as: J. L. van der Velde, B. M. J. Flokstra‐de Blok, A. DunnGalvin, J. O'B. Hourihane, E. J. Duiverman and A. E. J. Dubois, Clinical & Experimental Allergy, 2011 (41) 1431–1439.     

Video feedback in widescreen: a meta-analysis of family programs

A meta-analysis of 29 studies (n=1844 families) shows statistically significant positive effects of video feedback interventions on the parenting behavior and attitude of parents and the development of the child. Parents become more skilled in interacting with their young child and experience fewer problems and gain more pleasure from their role as parent. Shorter programs appeared to be more effective in improving parenting skills. The intervention effects were smaller for the attitude domain at parent level. The experimental outcomes were smaller at child level if the parents belonged to a high-risk group.     

Behavior of injured and uninjured children and their parents in a simulated hazardous setting.

Compared the behavior of parents and their previously injured children with parents and their uninjured children in unstructured play and distracted parent conditions. Injured children were more disruptive, more active, and had more contacts with hazards, whereas uninjured children had more appropriate behavior. Parents of injured children had lower rates of play activities. Observable classes of parent and child behaviors amenable to change were associated with a history of child injury. Further study is needed to assess the use of safe and unsafe behavior as proxy measures for injuries and to identify functional classes of safe and unsafe behavior for which active strategies can be developed to prevent children's injuries.     

The prevention of depressive symptoms in rural school children: a randomized controlled trial

A controlled trial was conducted to evaluate a prevention program aimed at reducing depressive and anxious symptoms in rural school children. Seventh-grade children with elevated depression were selected. Nine primary schools (n = 90) were randomly assigned to receive the program, and 9 control schools (n = 99) received their usual health education classes. Children completed questionnaires on depression, anxiety, explanatory style, and social skills. Parents completed the Child Behavior Checklist (T. M. Achenbach, 1991). No intervention effects were found for depression. Intervention group children reported less anxiety than the control group after the program and at 6-month follow-up and more optimistic explanations at postintervention. Intervention group parents reported fewer child internalizing and externalizing symptoms at postintervention only.     

Cultural factors in help‐seeking for child behavior problems: Value orientation,affective responding,and severity appraisals among Chinese‐American parents

This study explored the relationships between cultural values, appraisal of child behavior problems, and associated help‐seeking intentions among Chinese‐American parents. Questionnaires were administered to 120 Chinese‐American parents of elementary‐school‐aged children. Parents were asked how they might respond if their child displayed the behavioral problems depicted in a hypothetical vignette. Influences of Chinese value orientation, severity appraisal, and affective reactions on help‐seeking intentions were examined using regression analyses and structural equation modeling. The study examined three hypotheses regarding the nature of the influence of cultural value orientation on help‐seeking intentions: (a) a direct effect model, (b) an indirect effect through cultural differences in severity appraisal, and (c) an indirect effect through cultural differences in affective responding. Results supported the hypothesis that cultural value orientation exerted an indirect effect on help‐seeking intentions through its influence on affective responding. Those parents who had more traditional Chinese values responded with more feelings of shame to child behavior problems and, in turn, reported lower intentions to seek help. Findings are discussed with reference to the literature on help‐seeking among Asian Americans. © 2001 John Wiley & Sons, Inc.     

Parent perceptions,beliefs, and fears around genetic treatments and cures for children with Angelman syndrome

Genetic therapies have shown recent promise in alleviating some of the cognitive issues associated with some genetic disorders; however, these therapies may come with significant health and socio‐ethical concerns, particularly when they involve child participants. Little is known about what parents of children with genetic disorders think about genetic therapies, or about their knowledge of how genetic‐based therapy might treat their child's symptoms. Forty‐two parents of children with Angelman syndrome (AS) and 27 parents of a mixed etiology comparison group completed an online survey reporting on their perceptions of, and priorities for, genetic therapy. Almost all parents of children with AS (95%) and the comparison group (89%) agreed that treatments aiming to reduce symptoms associated with their child's syndrome were positive. However, significantly more parents of children with AS (95%) than the comparison group (56%) felt that genetic treatment trials aiming to “cure” their child should be a research priority. AS parent priorities for the focus of clinical trials were neurology/seizures, communication skills, and motor skills/mobility. For the comparison group, the priorities were IQ, immune response, and expressive speech. Parents of both groups did not want treatments to change their child's personality or their happiness. Global assumptions cannot be made about targets for therapy between syndromes, about parental understanding of genetics, or about research evidence across syndromes. This study highlights the need for true family and patient engagement in all stages of the research design and treatment evaluation.     

Association of observed family relationship quality and problem-solving skills with treatment adherence in older children and adolescents with cystic fibrosis

OBJECTIVE: To examine associations between observations of the quality of family relationships and problem-solving skills and reported adherence to medical treatments for older children and adolescents with cystic fibrosis (CF). METHODS: Reports of adherence were obtained from 96 youth with CF and their parents recruited from six CF centers in the Midwest and southeastern United States. Videotaped observations of family discussions of high conflict issues were used to assess quality of relationships and problem-solving skills. RESULTS: Hierarchical regression analyses indicated that observed family relationship quality (RQ) was related to parent and child reports of adherence to airway clearance and aerosolized medications after controlling for demographic variables and illness severity. Observed family problem solving was not a significant predictor after controlling for RQ. CONCLUSIONS: Older children and adolescents who come from families experiencing unhappy and conflicted relationships may be at greater risk for poor adherence to treatments; thus, family relationships are appropriate targets for interventions aimed at improving adherence.     

Evaluation of dropout clients and of perceived usefulness of a parent education program

This study investigated parents' perceptions and demographic variables in relation to dropout rates and the perceived usefulness of parent education groups. Changes in parents' perceptions of themselves and their families following the groups were also assessed. Thirty-one parents volunteered to participate in the nine-session groups, which included both behavior modification and communication training components. Thirteen parents failed to complete the groups. Parents who dropped out of the groups initially reported they were happier within their family, happier with their child management skills, and more patient than the parents who completed the groups. Parents who finished treatment, but who felt the groups were relatively less useful, were found to have a lower income, older children, and children who had more difficulty understanding their parents.     

The conduct disordered child: An analysis of family problems

The purpose of this review was to examine the conduct disordered child and his/her family and determine how they differed from the “normal” or nonclinic family. Four areas were examined: child behavior, parent behavior, parent perceptions of child adjustment, and parental adjustment. Clinic-referred conduct disordered children were more deviant and less compliant than nonclinic children. Parents of the conducted disordered children issued more commands; emitted more negative, but not less positive, behavior toward their children; and perceived their children and themselves as less well adjusted than the parents in the nonclinic group. Why certain children are identified as conduct disordered and needing treatment is discussed as are the assessment and treatment implications of the findings.