Use of a serious game simulation to build early childhood staff capacity for reducing unintentional childhood injuries.

INTRODUCTION: Unintentional home injuries are common and costly, with over 1.6 million occurring among U.S. children ages 0-4 in 2018. Home visitors and other early childhood professionals can provide valuable prevention education and intervention to reduce unintentional injury risk for children. This proof-of-concept study aimed to test the feasibility of the first phase of Home Safety Hero, a software-based serious game simulation that trains users in identification of home safety risks, as a capacity building tool for early childhood professionals. METHODS: The game simulation's potential for knowledge promotion and engagement in a sample of home visitors was explored based on play of the first phase. Repeated measures ANOVAs were used to assess learning via reaction time, and engagement was measured via the User Engagement Scale (UES). RESULTS: Reaction time (i.e., average time to identify hazards) improved from the first to last levels in both single and mixed category levels in this trial. Participant indicated agreement with four subscales of engagement measured by the UES, and neutral to agree on a fifth subscale, focused attention. CONCLUSIONS: We propose that this game simulation can meet the unique training needs of early childhood professionals while promoting home safety knowledge that can improve prevention work with families. Participant feedback was largely positive, and results suggest that the game simulation is engaging and contributes to knowledge. PRACTICAL APPLICATIONS: The Home Safety Hero serious game simulation is a flexible training option that appeared to be feasible for reducing time to hazard identification among home visitors in this proof-of-concept study. The design of the game simulation has utility in meeting the specialized training needs of early childhood professionals and potential to build their capacity to provide direct intervention around home safety, reducing risk for unintentional injury among children.

Additive Contributions of Social Information Processing and Economic Stress to Maltreatment Risk in Disadvantaged Rural Fathers.

Child maltreatment is a critical concern in rural communities. Fathers perpetrate a substantial proportion of maltreatment cases and are overrepresented as perpetrators of severe physical abuse and fatalities. Despite this heightened risk, little research has examined risk of abuse and neglect among fathers in rural areas. The current study examined the contributions of social information processing (SIP) factors and economic stress to multiple indicators of maltreatment risk in a sample of 61 disadvantaged rural fathers of 2- to 6-year-old children. Results for the SIP model of maltreatment risk provide some support for its extension to fathers. Considered all together, SIP factors were associated with more inconsistent parenting and maladaptive injury prevention beliefs. Specific SIP factors of unrealistic expectations for children and poorer executive functioning were associated with more maladaptive injury prevention beliefs. With regard to economic stress, fewer economic resources were associated with greater child abuse potential, more inconsistent parenting, and poorer quality home environments, while less economic security was associated with greater child abuse potential. Analyses found evidence for independent additive effects of SIP and economic stress. Findings highlight the importance of fathers' cognition and economic stress in children's risk of physical abuse, neglect, and unintentional injuries.

How Does the Neighborhood "Come through the Door?" Concentrated Disadvantage, Residential Instability, and the Home Environment for Preschoolers.

Living in a disadvantaged neighborhood is associated with heightened risk for poor school readiness and health outcomes in early childhood, and the home environment is thought to be a primary mechanism by which neighborhood context impacts preschoolers. This study examined the effects of neighborhood concentrated disadvantage and neighborhood residential instability on the home physical environment and home learning environment for preschoolers in economically disadvantaged families (N = 187). Using structural equation modeling, mothers' perceived neighborhood disorder and depressive symptoms were examined as mechanisms by which neighborhood context "comes through the door." Mothers' neighborhood social embeddedness was also explored as a protective factor. Results showed that concentrated disadvantage was negatively associated with the quality of the home physical environment, and residential instability was negatively associated with the quality of the home learning environment. Concentrated disadvantage had an indirect effect on the home learning environment through mothers' perceived neighborhood disorder and depressive symptoms. The effects of concentrated disadvantage on the home environment were buffered by mothers' neighborhood social embeddedness. Study findings advance understanding of socioeconomic- and place-based disparities in developmental outcomes and identify potential targets for interventions aimed at lessening effects of neighborhood disadvantage on families with young children.

Latent classes of older foster youth: Prospective associations with outcomes and exits from the foster care system during the transition to adulthood.

Youth in the foster care system face considerable challenges during the transition to adulthood. However, there is significant variability within this population. This study uses person-oriented methods and a longitudinal dataset of youth aging out of foster care to examine differences in how subgroups of foster youth fare during the transition to adulthood. We identified four distinct latent classes, consistent with prior person-oriented studies of this population, and validated these classes by examining differences on additional relevant factors at age 17. After establishing these classes, we tested their predictive validity by examining differences in outcomes at age 19 in domains relevant to the transition to adulthood, including education and employment, problem behaviors, and mental health problems. Finally, given the importance of extended foster care in promoting better outcomes, we used survival analysis to prospectively examine whether class membership was associated with differences in the rates at which youth left foster care between ages 17 and 19. One large group of youth exhibited moderate behavior problems and left care quickly, while another large group of resilient youth had favorable outcomes and left care relatively slowly. A small group exhibited considerable behavior and mental health problems, but left care more slowly, and a very small group was characterized by a history of pregnancy. Findings suggest considerable variability in service need among older foster youth. Implications for service provision during the transition to adulthood are discussed.

Child neglect and maternal cross-relational social cognitive and neurocognitive disturbances.

A social information processing (SIP) theory of parenting risk posits that social-cognitive and neurocognitive incapacities characterize at-risk parents, and that these cognitive difficulties operate across relational domains. This study focused on highly disadvantaged mothers of preschoolers and compared mothers with histories of perpetrating child neglect (n = 69) to demographically similar mothers without such histories (n = 76). Participants completed measures of unrealistic expectations for children and other adults, social problem-solving in parenting and nonparenting situations, executive functioning (EF), and attributions for children and other adults. As predicted, associations among these measures were found within and across relational domains. Exploratory factor analysis revealed two distinct clusters that distinguished the two groups. The first included measures of expectations and attributions (for both children and other adults) and the second included problem-solving difficulties and EF. When group differences were examined on individual variables, mothers with histories of perpetrating neglect exhibited more unrealistic expectations of children and other adults, more hostile attributions toward children and other adults, and poorer performance on tests of EF than comparisons. Only interpersonal problem-solving (in both parenting and nonparenting situations) failed to differentiate the neglect group from comparisons. In regression analyses, both parenting and nonparenting social cognition and EF contributed significantly to child neglect. These findings provide some support for this cognitive model of parenting risk and suggest widespread disturbances in parenting and nonparenting social cognition and neurocognition, may play a role in child neglect. (PsycINFO Database Record

Social Cognition, Child Neglect, and Child Injury Risk: The Contribution of Maternal Social Information Processing to Maladaptive Injury Prevention Beliefs Within a High-Risk Sample.

Objective: Inadequate supervision has been linked to children's injuries. Parental injury prevention beliefs may play a role in supervision, yet little theory has examined the origins of such beliefs. This study examined whether mothers who perpetrated child neglect, who as a group provide inadequate supervision, have more maladaptive beliefs. Then, it tested a social information processing (SIP) model for explaining these beliefs. Methods: SIP and injury prevention beliefs were assessed in disadvantaged mothers of preschoolers (N = 145), half with child neglect histories. Results: The neglect group exhibited significantly more maladaptive injury prevention beliefs than comparisons. As predicted, SIP was linked to beliefs that may increase injury risk, even after accounting for relevant sociodemographic variables. Conclusions: Findings support the link of beliefs to injury risk and suggest that specific cognitive problems may underlie these beliefs. Future work should further validate this model, which may inform enhancements to prevention efforts.

Maternal Social Information Processing and the Frequency and Severity of Mother-Perpetrated Physical Abuse.

The frequency and severity of physical abuse influences children's outcomes, yet little theory-based research has explored what predicts its course. This study examined the potential role of social information processing (SIP) factors in the course of abuse. Mothers with histories of perpetrating physical abuse ( N = 62) completed measures of SIP, and the frequency and severity of mother-perpetrated physical abuse were collected from Child Protection Services records. Poorer problem-solving capacities were significantly related to greater frequency of physical abuse. Hostile attributions toward children were positively associated with abuse severity. Controlling for demographics and co-occurrence of neglect, SIP factors together accounted for a significant proportion of variance in the frequency of physical abuse, but not severity. With the exception of unrealistic expectations, preliminary evidence supported a link between maternal SIP and the course of abuse perpetration. Future research directions and implications for intervention are discussed.

Active war in Sri Lanka: Children's war exposure, coping, and posttraumatic stress disorder symptom severity.

Posttraumatic stress disorder (PTSD) in response to active war is understudied among Sinhalese children in Sri Lanka. We investigated PTSD symptom severity in children using child (n = 60) and mother (n = 60) reports; child-reported war exposure and coping; as well as self-reported maternal PTSD symptom severity. The study addressed active war in 2 rural locations (acute and chronic community war exposure). Child-reports were significantly greater than mother-reports of child PTSD symptom severity. Furthermore, children's war exposure, child-reported and mother-reported child PTSD symptom severity, and maternal PTSD symptom severity were significantly greater in the acute versus chronic community war exposure location, but children's approach and avoidance coping did not significantly differ, indicating a potential ceiling effect. Children's war exposure significantly, positively predicted child-reported child PTSD symptom severity, controlling for age, gender, and maternal PTSD symptom severity, but only maternal PTSD symptom severity significantly, positively predicted mother-reported child PTSD symptom severity. Avoidance coping (in both acute and chronic war) significantly positively mediated the children's war exposure-child-reported child PTSD symptom severity relation, but not mother-reports of the same. Approach coping (in chronic but not acute war) significantly, positively mediated the children's war exposure-child-reported and mother-reported child PTSD symptom severity relations. We advanced the literature on long-term active war by confirming the value of children's self-reports, establishing that both approach and avoidance coping positively mediated the war-exposure-PTSD symptom severity relation, and that the mediation effect of approach coping was situationally moderated by acute verses chronic community war exposure among Sri Lankan children. (PsycINFO Database Record

Practices Changes in the Child Protection System to Address the Needs of Parents With Cognitive Disabilities.

Parents with cognitive disabilities (PCD) are over-represented in the child protection system. However, the current state of the child protection system is not well prepared for working with them. Biases that exist against their parenting, the need for accommodations in assessment and intervention practices, and specific training in staff and cross systems barriers need to be addressed. This paper argues for changes that will ensure such parents are more effectively served and that child protection staff and contract providers are better equipped to work with them. Specific changes are discussed in assessment and intervention practices. These changes will require human capacity building and organizational restructuring. Although empirically based behavioral approaches with PCD will be emphasized, recent empirical work suggests that social information processing and neurocognitive problems occur in PCD. Approaches to working with such problems are emerging and must also be considered and integrated into a blueprint for change.

Intellectual Disabilities and Neglectful Parenting: Preliminary Findings on the Role of Cognition in Parenting Risk.

Parents with intellectual disabilities (PID) are over-represented in the child protective services (CPS) system. This study examined a more nuanced view of the role of cognition in parenting risk. Its goal was to validate a social information processing (SIP) model of child neglect that draws on social cognition research and advances in neuroscience. Mothers who had CPS child neglect cases were compared with mothers with no CPS involvement on a set of SIP factors. Mothers with low IQs were oversampled. As predicted, the Neglect group had significantly greater SIP problems than the Comparison mothers. SIP problems were associated with direct measures of neglect (e.g., cognitive stimulation provided children, home hygiene, belief regarding causes of child injuries). Further, for the direct measures that were most closely linked to CPS Neglect Status, IQ did not add significant predictive capacity beyond SIP factors in preliminary model testing. Implications for intervention with PID discussed.

Cognitive and emotional contributors to intimate partner violence perpetration following trauma.

Exposure to potentially traumatic events often leads to a wide range of interpersonal difficulties, including the perpetration of intimate partner violence. Maladaptive, threat-relevant thoughts and beliefs regarding the trauma or its sequelae can play an important role in a person's emotional and behavioral responses. Among 185 trauma-exposed study participants who were currently in an intimate relationship, levels of maladaptive posttraumatic cognitions were associated with the perpetration of psychological aggression and physical violence in their current relationships. These links were mediated by misappraisal of anger in auditory emotion stimuli and emotion-regulation deficits. Results support a cognitive model of posttraumatic pathology, with implications for clinical intervention and a broad conceptualization of the effects of trauma.

Beliefs and attributions of partner violence perpetrators: the physical and psychological violence of adolescent males.

Partner violence is a crime of national concern. Understanding the cognitions of adolescent males who perpetrate partner violence is critical to develop appropriate interventions. One hundred and thirty-two partnered undergraduate males were assessed on gender beliefs, relationship beliefs, and partner attributions. More than 80% of males endorsed psychological or physical violence perpetration in the past year. Adolescent males who perpetrated psychological or physical partner violence were more likely to endorse hostile beliefs about women, negative partner attributions, and unrealistic relationship beliefs, as compared with nonviolent adolescents. Further, the relationship belief that partners cannot change and hostile partner attributions significantly predicted the frequency of psychological partner violence. The relationship belief disagreement is destructive predicted the frequency of physical partner violence, controlling for the influence of psychological violence. Clinical implications and future directions are discussed.

Child maltreatment and childhood injury research: a cognitive behavioral approach.

OBJECTIVE: Both child maltreatment and childhood injuries affect large numbers of children each year. In a seminal paper, Peterson and Brown (1994) drew parallels in the antecedents of both forms of harm and suggested a more unified approach in research efforts and intervention development. This article provides a unified cognitive model that would both guide research and inform interventions directed at parents. METHODS: This article overviews information-processing elements that may explain parental oversights that would increase risk to children, including maladaptive parental schema, executive functioning problems, and maladaptive appraisals. Contextual variables that may negatively impact on information processing are also included. RESULTS: Studies supporting the validity of the model are presented, and implications for interventions are drawn. Data supporting the effectiveness of cognitive enhancements to current interventions are given. CONCLUSIONS: The promise of such a unified model is discussed, and obstacles to its dissemination are presented.

Parenting schemas and the process of change.

Parents' childrearing behaviors are guided by schemas of the caregiving role, their functioning in that role, what children need in general, and what their own children are like in particular. Sometimes, however, parenting schemas can be maladaptive because they are too rigid or simple, involve inappropriate content, or are dominated by negative affect. In this article, we describe parenting schemas and provide an overview of empirical work documenting the characteristics of maladaptive parenting schemas. We review how intervention practices common to multiple therapeutic approaches (cognitive-behavior therapy, family therapy, parent training, attachment-based interventions, and psychoanalytic parent-infant psychotherapy) attempt to modify schemas to promote more optimal functioning among parents. We highlight how research in cognitive science may explain, in part, treatment effectiveness.

Evaluating the parental fitness of psychiatrically diagnosed individuals: advocating a functional-contextual analysis of parenting.

The parental fitness of psychiatrically diagnosed individuals is often questioned in termination of parental rights cases. The goal of this article is to shift the focus from a predisposing bias of unfitness to a functional-contextual analysis of parenting behavior and competency. Three underlying biased assumptions are relevant for the courts' decision making: (a) that a diagnosis (past or present) predicts inadequate parenting and child risk, (b) that a diagnosis predicts unamenability to parenting interventions, and (c) that a diagnosis means the parent is forever unfit. Each assumption will be considered in light of empirical evidence, with major depression, schizophrenia, substance abuse, and mental retardation provided as examples of diagnostic labels often assumed to render a parent unfit. A research agenda to improve clinicians' ability to assess parental fitness and understanding of how parental mental illness, mental retardation, or substance abuse might compromise parenting capacities is discussed for forensic purposes.