Multi-parent families as "normal" families--segregation and parent-child-alienation after separation and divorce

Decisive for the question as to how children cope with their parents' divorce is whether or not the parents continue to perform their parental role together even after separation, or have at least made arrangements for the child to maintain a good relationship with each parent. These are the findings of a longitudinal study of 150 postdivorce families. The case of a multi-parent family after remarriage, which sees itself as a "normal" family and segregates the visiting parent, shows what consequences the breakdown of parent-child relationships has for the psychological health and the development of children. Alienation and long-term disruption of the contact between child and visiting parent is a phenomenon which the psychiatric and psychotherapeutic professions are increasingly confronted with. The American child psychiatrist R. A. Gardner has introduced the term "Parental Alienation Syndrome (PAS)" to encompass this childhood disorder that arises almost exclusively in the context of child-custody disputes.     

When a parent goes to war: effects of parental deployment on very young children and implications for intervention

Young children (birth through 5 years of age) are disproportionately represented in U.S. military families with a deployed parent. Because of their developmental capacity to deal with prolonged separation, young children can be especially vulnerable to stressors of parental deployment. Despite the resiliency of many military families, this type of separation can constitute a developmental crisis for a young child. Thus, the experience may compromise optimal child growth and development. This article reviews what is known about the effects of the military deployment cycle on young children, including attachment patterns, intense emotions, and behavioral changes and suggests an ecological approach for supporting military families with infants, toddlers, and preschoolers. Specifically, home-based family focused interventions seem to warrant the most serious consideration.     

Étayer les relations parents–enfants en groupe de jeux quand l’enfant souffre d’autisme ou de troubles envahissants du développement

The process of one's body mental integration depends notably on the quality of the first cares given to him/her in the beginning of his/her life in a reciprocal game of solicitations in his/her mothering surrounding. However, in autism and pervasive development disorders, the solicitations coming from the child are difficult to translate by parents. Then the sufferance of some parents settles in, from the fact that their child is different. This complicates the process of attachment, this threatens the homeostasis of the family system and then can threaten the required alliance with the family and the homeostasis of the therapeutic system. To prevent this we are looking to establish a partnership with these parents. Peter Pan is a playgroup bringing together children suffering of autism or pervasive development disorders with their parents. It is a part of the Mulhouse Psychotherapeutic Center for Children and Teenagers Daily Hospital, within the child–youthful psychiatrist sector 68I02 incorporated with the Rouffach Hospital (France). The project is a special adaptation to our public of the Calimusette and Pirouli^® Concept (parents–young children activities, around corporal and sensorial games). Peter Pan group's goal is to consolidate the relationship between child and parent notably by restoring a shared pleasure and the self-esteem in this bruised child–parent relationship. The designation “Peter Pan” refers to the child imaginary world and to the creativity potential that can immerged from interactions, where children and parents can learn together. The systemic inspired Structured Observation Model of the Children and Parents Interactions (MOSIPE^® in French) is one of our intervention resources. It's made of eight items: The existence of shared pleasure during the interactions, the possibility to benefit self-esteem from the interaction, child health, parent and child needs, how the interactions take place, the capacity to adapt when change occurs, which type of attachment, parents reactions from our restitution. We insist on the mimicry functions: To observe subtle signs, to get resonance with other with the goal to understand what he/her feels, to take contact with he/her and maintain it, to widen views, by introducing unobtrusively new element into the mimicry behavior, to develop subjectivity, to develop capacities to act. The meetings with our daily hospital colleagues are precious to maintain the homeostasis of the therapeutic system when developing its creativity and relevance. At Peter Pan playgroup, the bodily approach gives opportunities to get onto the relationship between a parent and his/her child in the most archaic dimension with their tonic, emotion, and affective components. All this work of observation, reading/decoding the psychomotor symptom, listening the sufferance of the parents, has enabled the parent to acquire what is required to decode, express ones needs and understanding to enable a better adjustment between each other. Supported in this way, parent recovers his/her parental function thanks the possibility to live shared pleasure and the self esteem in the interactions that restores their feeling of self efficacy and establishes identification ties with his/her child. He/her is recognized as an expert. This project is an answer to parents request to meet other parents that share common points: Having a disabled child who attends the daily hospital. Children come to the hospital with taxi, so parents do not have occasions to meet together, when other parents normally meet others waiting their children at the door of school. During the sessions we observed parents sharing advices to cope with problems, exchanging activities ideas, encouraging into ordeal. After some sessions parents have exchanged their addresses. In other words Peter Pan's Group has also functioned as a mutual aid group.     

A period prevalence study of being a parent in a secure psychiatric hospital and a description of the parents,the children and the impact of admission on parent–child contact

Background

Most secure psychiatric hospital patients are of childbearing age, but their parental status is minimally researched.

Aim

The aim of the study is to describe the parent patients in one regional secure hospital and explore post‐admission child–parent contact.

Methods

A 9‐year records survey of a complete secure hospital admissions cohort was conducted.

Results

Nearly half of the cohort of 165 patients (46%) were parents. Parent patients were less likely than childless patients to have diagnostic co‐morbidity or to have received childhood mental health care but were more likely to have committed a homicide/life‐threatening index offence with family or friend victims. Men, whether fathers or not, and childless women were unlikely ever to have harmed a child, but it was more likely than not that mother patients had. Records indicated minimal discussion about childlessness. Ninety‐four (60%) of the 157 children involved were under 18 years on parental admission. Adult children who had been living with the parent patient before the parent's admission invariably maintained contact with them afterwards, but nearly half (48%) of such under 18‐year‐olds lost all contact. The only characteristic related to such loss was the index offence victim having been a nuclear family member.

Conclusions

As the discrepancy in whether or not parent patients and their children continued contact with each other after the parent's admission seemed to depend mainly on the child's age and his or her resultant freedom to choose, acquisition of accurate data about affected children's perspective on visiting seems essential. Given that parent patients had experienced relative stability in interpersonal relationships and had rarely had childhood disorders, parenting support in conjunction with treatment seems appropriate. Copyright © 2017 John Wiley & Sons, Ltd.     

Factors Associated with Parent–Child Discrepancies in Reports of Mental Health Disorders in Young Children

The study compares parent and child reports of child mental health to determine the relationship between parent–child disagreement and parental psychological and attitudinal factors, and to determine how parent–child disagreement is associated with the use of specialized services. A cross-sectional study was conducted with 1268 children aged 6–11 years using the Dominic Interactive and the Strengths and Difficulties Questionnaire. Psychological distress and negative parental attitudes were associated with greater reporting of mental health problems, leading to greater parent-child agreement on symptom presence, and to parental over-reporting of symptoms. Parent/child agreement was associated with 43.83% of contact with a mental health provider for externalizing and 33.73% for internalizing problems. The contribution of key parental psychological and attitudinal factors in parent–child disagreement on child mental health status may prove helpful in improving the identification of children in need of specialized services.     

Impact of pediatric epilepsy on sleep patterns and behaviors in children and parents

Purpose: Disrupted sleep patterns in children with epilepsy and their parents are commonly described clinically. A number of studies have shown increased frequency of sleep disorders among pediatric epilepsy patients; however, few have characterized the association between epilepsy and parental sleep quality and household sleeping arrangements. The purpose of this study was to explore the effect of pediatric epilepsy on child sleep, parental sleep and fatigue, and parent‐child sleeping arrangements, including room sharing and cosleeping. Methods: Parents of children 2 to 10 years of age with and without epilepsy completed written questionnaires assessing seizure history, child and parent sleep, and household sleeping arrangements. Children’s Sleep Habits Questionnaire (CSHQ) scores were used to evaluate sleep disturbances for the child. The Pittsburgh Sleep Quality Index (PSQI) and the Iowa Fatigue Scale (IFS) were used to evaluate parental sleep and fatigue, respectively. The Early Childhood Epilepsy Severity Scale (E‐Chess) was used to assess epilepsy severity. Key Findings: One hundred five households with a child with epilepsy and 79 controls participated in this study. Households with a child with epilepsy reported increased rates of both parent–child room sharing (p < 0.001) and cosleeping (p = 0.005) compared to controls. Children with epilepsy were found to have greater sleep disturbance by total CSHQ score (p < 0.001) and the following subscores: parasomnias (p < 0.001), night wakings (p < 0.001), sleep duration (p < 0.001), daytime sleepiness (<0.001), sleep onset delay (p = 0.009), and bedtime resistance (p = 0.023). Parents of children with epilepsy had increased sleep dysfunction (p = 0.005) and were more fatigued (p < 0.001). Severity of epilepsy correlated positively with degree of child sleep dysfunction (0.192, p = 0.049), parental sleep dysfunction (0.273, p = 0.005), and parental fatigue (0.324, p = 0.001). Antiepileptic drug polytherapy was predictive of greater childhood sleep disturbances. Nocturnal seizures were associated with parental sleep problems, whereas room sharing and cosleeping behavior were associated with child sleep problems. Within the epilepsy cohort, 69% of parents felt concerned about night seizures and 44% reported feeling rested rarely or never. Finally, 62% of parents described decreased sleep quality and/or quantity with cosleeping. Significance: Pediatric epilepsy can significantly affect sleep patterns for both the affected child and his or her parents. Parents frequently room share or cosleep with their child, adaptations which may have detrimental effects for many households. Clinicians must not only be attentive to the sleep issues occurring in pediatric patients with epilepsy, but also for the household as a whole. These data provide evidence of a profound clinical need for improved epilepsy therapeutics and the development of nocturnal seizure monitoring technologies.     

Immediate antecedents of caretakers' methods of discipline

The interactions of children's behaviors and caretakers' disciplinary practices were studied. Mothers of one- to two-year-old children were trained to report parent-child interactions involving negative emotions. Mothers' observations thus provided data on sequences of child behaviors and parental discipline methods in affective encounters. Mothers' most frequent initial responses to children's misbehaviors were verbal prohibitions. Discipline methods less commonly used were explanations, restraint, instruction, physical punishment, and love withdrawal. Mothers made greater use of this range of control methods following children's noncompliance to discipline. Types of discipline were used differentially following noncompliance, depending upon the form of misbehavior. Children's harms against persons were associated with psychological discipline methods, such as reasoning and dramatization of distress. Destruction of property and lapses in self-control in children were associated with parental power assertive techniques, such as physical punishment and love withdrawal. These associations between child behaviors and parental discipline methods illustrate the interactive roles of child and parent in mediating parental attempts to control, teach, and punish their children.     

Source agreement in assessing youth stress and negative affectivity: New evidence for an old problem

The present study examined dichotomies potentially relevant to parentchild and interparent agreement in the assessment of internalizing problems in youngsters. Specifically, 98 children and their parents completed the Daily Life Stressors Scale or a variant to examine child ratings of daily stress, parent ratings of their children's daily stress, and parent predictions of how their children would self-rate their stress. In addition, a distinction was made between subscores of negative affectivity and stressful life events. Results indicated moderate parent-child and interparent agreement, with the latter somewhat more influenced by a negative affectivity-stressful events dichotomy. Parent-child agreement appeared more enhanced for items involving more parental contact. Implications of these data for future research are discussed.     

A small-scale randomized controlled trial of the self-help version of the New Forest Parent Training Programme for children with ADHD symptoms

The efficacy of a self-help parent training programme for children with attention deficit hyperactivity disorder (ADHD) was evaluated. The New Forest Parenting Programme Self-help (NFPP-SH) is a 6-week written self-help psychological intervention designed to treat childhood ADHD. Forty-three children were randomised to either NFPP-SH intervention or a waiting list control group. Outcomes were child ADHD symptoms measured using questionnaires and direct observation, self-reported parental mental health, parenting competence, and the quality of parent–child interaction. Measures of child symptoms and parental outcomes were assessed before and after the intervention. ADHD symptoms were reduced, and parental competence was increased by self-help intervention. Forty-five percent of intervention children showed clinically significant reductions in ADHD symptoms. Self-help intervention did not lead to improvements in parental mental health or parent–child interaction. Findings provide support for the efficacy of self-help intervention for a clinical sample of children with ADHD symptoms. Self-help may provide a potentially cost-effective method of increasing access to evidence-based interventions for clinical populations.     

The behavioural profile of children with attention-deficit/hyperactivity disorder and of their siblings

The behavioural profiles in N = 69 index children with attention-deficit/hyperactivity disorder (ADHD), N = 32 siblings with ADHD, N = 35 siblings without ADHD, and N = 36 normal controls were compared by the use of standardized parent and teacher rating scales. The four groups were matched by age and IQ. The behavioural profiles of the two ADHD groups were very similar not only in the behavioural domains of ADHD, but also in scales measuring emotional and conduct problems. Siblings without ADHD shared more similarities with normal controls except for more emotional problems. These general trends were stronger in the parent compared to the teacher ratings. These findings indicate that not only ADHD-related but also other behaviours show a strong family aggregation. The informant differences may reflect context dependent differences in child behaviour and contrast effects particularly in parental ratings.     

Families and intellectual disability

PURPOSE OF REVIEW: This review includes recent research pertaining to family functioning when there is a child or adult offspring with intellectual disability. The purpose was to broaden the examination of families research from an adjustment/coping perspective to consideration of more contextual factors (environment, culture, service delivery). RECENT FINDINGS: Studies continue to focus on parental well being, with parents of children with intellectual disability still showing evidence of stress and depression. Increasing evidence is accruing, however, that child behavior problems or specific syndrome more directly relate to poorer parental well being. On the other hand, parenting behaviors also contribute to child behaviors, with studies highlighting the importance of parenting context and dynamics. Interventions focus on child behaviors as well as on stress reduction for parents. Finally, the continued involvement of parents across the lifespan of their young adult with intellectual disability is apparent from studies of quality of life and living arrangements. SUMMARY: The well being of family members continues to be an area of interest, with special emphasis on siblings and cultural context. Methodological rigor in families research also continues to increase, with diverse methodologies represented. There is still a need, however, for the development of theoretical models within which to frame future research on topics such as siblings, as well as both negative and positive impact on families.     

Meta-analysis of quality of life in children and adolescents with ADHD: By both parent proxy-report and child self-report using PedsQL™

Attention deficit hyperactivity disorder (ADHD) is a prevalent developmental disorder that seriously and negatively impacts a child's health-related quality of life (HRQOL). However, no meta-analysis has been conducted to examine the magnitude of impact, domains affected and factors moderating the impact. This review included nine studies that compared HRQOL of children or adolescents with ADHD with those with typical development using both child self-reports and parent proxy-reports. Seven among nine studies were meta-analytically synthesized to examine the degree of impact of ADHD on children and adolescents, parent–child discrepancy, and the moderators. The results indicate that ADHD impact a child's or adolescent's HRQOL negatively with a moderate effect in physical and a severe effect in psychosocial (i.e., emotional, social, and school) domains. Parental ratings of overall HRQOL in children or adolescents with ADHD were not significantly different from child's ratings when compared with typically developing children and adolescents. Age was negatively associated with all domains of HRQOL in children and adolescents with ADHD both by parent- and child-ratings, and the strongest effect was found in parental ratings of child's emotional HRQOL, with a moderate correlation. This meta-analysis suggests that HRQOL may be assessed in children and adolescents with ADHD both by parent proxy- and child self-reports, and that interventions may be planned accordingly. Future meta-analysis may explore how measures of HRQOL and other factors including child, parental, familiar and school characteristics influence the impact of ADHD and the parent–child agreement in children and adolescents.     

Brief Report: Parental Child-Directed Speech as a Predictor of Receptive Language in Children with Autism Symptomatology

Facilitative linguistic input directly connected to children’s interest and focus of attention has become a recommended component of interventions for young children with autism spectrum disorder (ASD). This longitudinal correlational study used two assessment time points and examined the association between parental undemanding topic-continuing talk related to the child’s attentional focus (i.e., follow-in comments) and later receptive language for 37 parent–child dyads with their young (mean = 21 months, range 15–24 months) children with autism symptomology. The frequency of parental follow-in comments positively predicted later receptive language after considering children’s joint attention skills and previous receptive language abilities.     

Fostering a Social Child with Autism: A Moment-By-Moment Sequential Analysis of an Early Social Engagement Intervention

Young children with autism often experience limited social motivation and responsiveness that restricts establishment of crucial social momentum. These characteristics can lead to decreased opportunities for parental engagement and the social learning associated with these moments. Early social interventions that capitalize on pre-existing interests may be able to re-establish this developmentally critical feedback loop, in which both child and parent social behaviors simultaneously increase and influence one another. This investigation examined the moment-by-moment, micro-transactional relationship between parent and child social behavior gains observed in an early intervention study. Time-window sequential analyses revealed the presence of clinically and statistically significant sequential associations between parent and child social behaviors during an embedded social interaction intervention, but not in a comparable motivational intervention that utilized highly preferred toys and objects. Specifically, the onset of parent eye contact, directed positive affect, or offer of a reinforcing incentive predicted the immediate occurrence of child eye contact and positive affect in the experimental social intervention condition. Additionally, child verbal initiations, positive affect, and eye contact immediately predicted the onset of parent positive affect during this social intervention paradigm. Theoretical implications for the social developmental trajectory of autism are discussed.     

An Investigation of Control Among Parents of Selectively Mute,Anxious, and Non-Anxious Children

The authors examined parent–child interactions among three groups: selectively mute, anxious, and non-anxious children in different contexts. The relation between parental control (granting autonomy and high power remarks), child factors (i.e., age, anxiety, verbal participation), and parent anxiety was investigated. Parental control varied by context but parents of children with SM were more controlling than parents in the comparison groups in all contexts. Regression analyses indicated that child and parent anxiety predicted parental control, with increased anxiety associated with increased control. Older child age predicted less parent control. Group categorization moderated the relation between age and high power remarks, such that age was not a significant predictor for children with SM. Finally child-initiated speaking predicted high power remarks over and above other variables. These results support previous theories that parents take over for their children when they fail to meet performance demands, especially when the child or parent is anxious.     

Symptoms of Anxiety and Associated Risk and Protective Factors in Young Asian American Children

Anxiety is one of the most prevalent mental health problems in young children but there has been a dearth of studies focusing on Asian American children. This study examines the patterns and the predictors of childhood anxiety and related symptoms in young children in a diverse Asian American (ASA) sample (n = 101). Findings indicate that ASA children are at higher risk for anxiety, somatization, and depressive problems than their peers. Parents’ level of acculturation (i.e., American identity, English competence), parental negative emotion socialization, conflicted parent–child relationship, child emotional knowledge and adaptive skills, as well as teachers’ ethnic background and school class types were all associated with ASA children’s anxiety. A combination of cultural, family, and school factors explained from 17 to 39 % of the variance in anxiety symptoms. Findings inform prevention services for young ASA children.     

Preventive Intervention for Anxious Preschoolers and Their Parents: Strengthening Early Emotional Development

The high prevalence and early onset of anxiety disorders have inspired innovative prevention efforts targeting young at-risk children. With parent–child prevention models showing success for older children and adolescents, the goal of this study was to evaluate a parent–child indicated preventive intervention for preschoolers with mild to moderate anxiety symptoms. Sixteen children (ages 3–5) and at least one of their parents participated in Strengthening Early Emotional Development (SEED), a new 10-week intervention with concurrent groups for parents and children. Outcome measures included clinician-rated and parent-rated assessments of anxiety symptoms, as well as measures of emotion knowledge, parent anxiety, and parental attitudes about children’s anxiety. Participation in SEED was associated with reduced child anxiety symptoms and improved emotion understanding skills. Parents reported decreases in their own anxiety, along with attitudes reflecting enhanced confidence in their children’s ability to cope with anxiety. Reductions in child and parent anxiety were maintained at 3-month follow-up. Findings suggest that a parent–child cognitive-behavioral preventive intervention may hold promise for young children with mild to moderate anxiety. Improvements in parent anxiety and parental attitudes may support the utility of intervening with parents. Fostering increased willingness to encourage their children to engage in new and anxiety-provoking situations may help promote continued mastery of new skills and successful coping with anxiety.     

The impact of having a sibling with an intellectual disability: parental perspectives in two disorders

Background The potential effects on other children when there is a child with intellectual disability (ID) in the family are being increasingly recognized. This study describes the impact of having a sibling with Down syndrome or Rett syndrome using a questionnaire completed by parents. Methods The parents of 186 Western Australian children with Down syndrome and 141 Australian girls and women with Rett syndrome participated in the study. Patterns of reporting disadvantages and/or benefits were compared across a number of child and family variables (age, functional ability and birth order of the affected child, number of siblings and number of parents in the family home) and by socio‐economic status as measured by the index of relative socio‐economic disadvantage and by area of residence. Parents' responses to open‐ended questions about the benefits and/or disadvantages for siblings of their child were analysed for themes. Results The majority of parents in the Rett syndrome and Down syndrome groups reported both disadvantages and benefits for siblings. In the Rett syndrome group, families from outer regional areas were the least likely to mention disadvantages and those with a smaller family more likely to note disadvantages. In both groups, more socio‐economically advantaged families were more likely to report disadvantages. In the Down syndrome group, benefits were also more commonly reported by parents who were socio‐economically advantaged, and by larger and two‐parent families. Major disadvantages for siblings centred around parental and personal time constraints, relationships and socializing, restrictions, parental emotion and burden of helping. Major benefits were related to personality characteristics. Conclusion Parents identified both benefits and disadvantages to the siblings of their child with either Rett syndrome or Down syndrome. It is important that these findings are incorporated into any discussion around the impact on the family of a child diagnosed with an ID.     

A Parental Report on the Long-Term Consequences for Children of Abduction by the Other Parent

Little is known about the long-term impact on the child of abduction by a parent. Children who had been kidnapped by one of their parents and hidden for an average of 2.7 years have been followed for a decade through contact with the parent who recovered them. This study reports on the most recent series of interviews. It was hypothesized that children who were now late teens and young adults would, on the whole, be progressing satisfactorily into young adulthood and that relationships with their parents would be non-problematic. According to 32 parental reports gleaned both from a telephone interview with open-ended and closed-ended questions and from a brief mailed questionnaire with closed-ended questions, a significant minority of the children continue to suffer emotionally and may be having more physical ailments than their peers. Relations with recovering parents were non-problematic.