Optimizing health services for young children in poverty: enhanced collaboration between Early Head Start and pediatric health care.

Given the importance of health to educational outcomes, and education to concurrent and future health, cross-systems approaches, such as the Whole School, Whole Community, Whole Child (WSCC) framework, seek to enhance services typically in K-12 settings. A major gap exists in cross-systems links with early care and education serving children birth to age 5. Both pediatric health systems and early family and child support programs, such as Early Head Start (EHS) and Head Start (HS), seek to promote and optimize the health and wellbeing of infants, toddlers, preschoolers, and their families. Despite shared goals, both EHS/HS and pediatric health providers often experience challenges in reaching and serving the children most in need, and in addressing existing disparities and inequities in services. This paper focuses on infant/toddler services because high-quality services in the earliest years yield large and lasting developmental impacts. Stronger partnerships among pedicatric health systems and EHS programs serving infants and toddlers could better facilitate the health and wellbeing of young children and enhance family strengths and resilience through increased, more intentional collaboration. Specific strategies recommended include strengthening training and professional development across service platforms to increase shared knowledge and terminology, increasing access to screening and services, strengthening infrastructure and shared information, enhancing integration of services, acknowledging and disrupting racism, and accessing available funding and resources. Recommendations, including research-based examples, are offered to prompt innovations best fitting community needs and resources.

Stress Intensity and Exhaustion Among Infant and Toddler Teachers: Descriptive Analysis and Associations with Sources of Stress and Coping Strategy Use.

This study described infant/toddler teachers' (N = 106) perceptions of stress intensity and exhaustion (emotional, physical, mental) intensity. We examined the associations between stress and exhaustion and teachers' reports of stress sources and coping strategy use. Using ecological momentary assessment (EMA), teachers from Early Head Start (EHS), EHS childcare-partnerships, or independent childcare programs (midwestern U.S.) completed twice-weekly reports of: stress and exhaustion intensity; stress sources (workload, children's behaviors, personal life); and, coping strategies (support from colleagues, distraction, mindfulness techniques, reframing). Research Findings: Stress and exhaustion reports were similar to studies of preschool teachers. Workload and personal life stressors were associated with stress and all exhaustion types. Teachers used fewer than two different coping strategies/per reporting day. Only reframing was negatively associated with stress and emotional exhaustion. Teachers reported greater stress at end-of-week than beginning-of-week. Older teachers reported greater stress and emotional exhaustion. Although one-third of teachers reported ≥4 ACEs, early adversity was not associated with stress or exhaustion. Practice or Policy: We discuss the results relative to the sparse literature on infant/toddler teachers' well-being and suggest areas for professional development supports while underscoring the need for EHS federal policy makers and program administrators to consider how to reduce/streamline workload.

Longitudinal associations between parental reflective functioning and maternal mind-mindedness.

Little work has examined longitudinal associations between parental reflective functioning (PRF) and mind-mindedness (MM), limiting the understanding of separate or bidirectional trajectories of these related but distinct forms of mentalization. We examined cross-lagged associations between PRF, assessed via interview, and MM, coded from play interactions, over 12 months among 90 parents (86% female; 57% White, 43% Black) of infants (Mage = 10.56 months, SD = 8.20) who were participating in The Michigan Model of Infant Mental Health Home Visiting. Data were collected at study enrollment Time 1 (T1) and at 6-month Time 2 (T2) and 12-month Time 3 (T3) postenrollment. Mind-minded comments were coded as appropriate, reflecting accurate interpretation of mental states or nonattuned, characterizing inaccurate interpretations. PRF and appropriate MM each remained stable over time. PRF at the T1 positively predicted appropriate MM at T2. No other cross-lagged associations between PRF and appropriate MM were significant. Concurrent correlations between appropriate MM and PRF were significant only at T3. Nonattuned MM showed stability from T1 to T2 but nonattuned MM at the T2 did not predict nonattuned MM at T3. Greater PRF at T1 predicted less nonattuned MM at T2. No other cross-lagged associations between PRF and nonattuned MM were significant. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Relationships reduce risks for child maltreatment: Results of an experimental trial of Infant Mental Health Home Visiting.

Background: Research examining the effectiveness of home visiting programs that reduce child maltreatment or associated risks yield mixed findings; some find positive significant impacts on maltreatment, whereas others find small to no effects. The Michigan Model of Infant Mental Health Home Visiting (IMH-HV) is a manualized, needs-driven, relationship-focused, home-based intervention service that significantly impacts maternal and child outcomes; the effect of this intervention on child maltreatment has not been sufficiently evaluated. Objective: The current study examined associations between treatment and dosage of IMH-HV and child abuse potential in a longitudinal, randomized controlled trial (RCT). Participants and setting: Participants included 66 mother-infant dyads (Mother M age = 31.93 years at baseline; child M age = 11.22 months at baseline) who received up to 1 year of IMH-HV treatment (Mdn = 32 visits) or no IMH-HV treatment during the study period. Methods: Mothers completed a battery of assessments including the Brief Child Abuse Potential Inventory (BCAP) at baseline and at the 12-month follow-up assessment. Results: Regression analyses indicated that after controlling for baseline BCAP scores, those who received any IMH-HV treatment had lower 12-month BCAP scores compared to those who received no treatment. Additionally, participation in more visits was associated with lower child abuse potential at 12 months, and a reduced likelihood of scoring in the risk range. Conclusion: Findings suggest that greater participation in IMH-HV is associated with decreased risk for child maltreatment 1 year after initiating treatment. IMH-HV promotes parent-clinician therapeutic alliance and provides infant-parent psychotherapy which differentiate it from traditional home visiting programs.

University-Community Partnerships to Support Responsive Caregiving: The Hearts and Minds on Babies Implementation Story.

Consistent, sensitive caregiving across home and childcare contexts supports optimal development. In this paper, we share the story of the development of Hearts and Minds on Babies (HMB) for Early Head Start (EHS) administrators, teachers, and parents. HMB was designed to support caregiver reflective functioning and sensitivity and reduce caregiver stress. This paper describes a series of Plan-Do-Study-Act cycles used to adapt an existing parenting intervention into the HMB programming for EHS. Throughout the paper, we present HMB concepts and learning objectives and share teachers' and parents' feedback and adaptations to content and delivery options that support implementation by EHS programs. Feedback from the final cycle suggests that HMB supports EHS administrators, teachers, and parents in their roles and improves relationships. The paper highlights the importance of research-practice partnerships in developing programming that meets the needs of EHS.

Simply Dinner: A Randomized Controlled Trial of Home Meal Delivery.

OBJECTIVE: To determine the effect of a bundled intervention (home meal delivery and provision of cooking/serving resources) on preschoolers' body mass index z-score (BMIz), dietary quality, and family meal frequency. METHODS: Participants (299 families; mean child age 4.4 years, 47% male, 55% White, 18% Black, 27% Hispanic or other race and ethnicity, and 25% were overweight or obese) were randomized to a control group or to provision of cooking/serving resources plus home meal delivery for 12 weeks (meals provided by Meals on Wheels [MOW cohort, n = 83] or a commercial service [COM cohort, n = 216]). Outcomes were child dietary quality, family meal frequency, and child BMIz. RESULTS: The intervention increased dinnertime intake of red and orange vegetables in the full sample (MOW cohort+COM cohort) (0.10 pre- to 0.15 cup equivalents (CE) post-in the intervention group vs 0.10 pre- to 0.09 post- in the control group; P = .01) and the COM cohort (0.11 pre- to 0.17 CE post- vs 0.11 pre- to 0.09 post-; P = .002), and typical daily dietary intake of fruit and fruit juice in the MOW cohort (1.50 CE pre- to 1.66 post- vs 1.48 pre- to 1.19 post-; P = .05). The intervention did not change meal frequency or BMIz. CONCLUSIONS: Short-term home meal delivery with provision of cooking/serving resources improved dietary quality among preschool-aged children but did not change meal frequency or BMIz. Expansion of Meals on Wheels programs to preschool-aged children may be a promising intervention to improve dietary quality. Family meals, when already frequent, are not further increased by reducing the burden of meal preparation.

Risks and resources for college students' mental health: ACEs, attachment, and mindfulness.

Objective: To examine associations between risks and resources in predicting college students' depressive symptoms at the beginning of one semester and change over the semester. Participants: Participants were undergraduate students taking human development courses at one of 11 universities in the U.S. (N = 854). Methods: Survey data were collected at the beginning and end of the semester. Results: Experiencing more direct abusive or neglectful adverse childhood experiences (ACEs), and attachment preoccupation were associated with higher depressive symptoms at the beginning of the semester. Conversely, greater mindful awareness and attachment security were associated with lower initial depressive symptoms. Experiences of ACEs were associated with increases in depressive symptoms, as were higher levels of attachment dismissiveness. Greater mindful acceptance was associated with decreases in depressive symptoms. In most analyses, resources did not moderate the associations between ACEs and depressive symptoms. Conclusions: Results may inform instructors and counselors in supporting students' well-being.

Characteristics of eating behavior profiles among preschoolers with low-income backgrounds: a person-centered analysis.

BACKGROUND: Individual differences in eating behaviors among young children are well-established, but the extent to which behaviors aggregate within individuals to form distinct eating behavior profiles remains unknown. Our objectives were to identify eating behavior profiles among preschool-aged children and evaluate associations with temperament and weight. METHODS: A secondary, cross-sectional analysis of baseline data from 2 cohort studies was conducted involving 1004 children aged 3-4 years and their parents with low-income backgrounds. Children's eating behaviors and temperament were assessed by parental report. Body mass index z-scores and weight status were calculated using measured heights and weights. Latent profile analysis (LPA) was used to generate profiles and bivariate analyses were used to evaluate associations with temperament and weight status. RESULTS: LPA revealed the presence of 3 eating behavior profiles among children. Children with High Food Approach profiles (21.2%) had lower temperamental inhibitory control and the highest percent of children with obesity relative to the other profiles. Children with High Food Avoidant profiles (35.6%) had lower temperamental impulsivity and lower BMI z-scores relative to the other profiles, whereas children with Moderate Eating profiles (intermediary levels of all behaviors; 43.2%) had higher temperamental inhibitory control and lower anger/frustration, than other profiles. CONCLUSIONS: Young children's eating behaviors appear to aggregate within individuals to form empirically distinct profiles reflecting food approach, food avoidance, and moderate approaches to eating that are differentiated by aspects of temperament and weight. Future work should seek to understand the extent to which health promotion and obesity prevention approaches should be tailored to take into account children's fundamental dispositions towards eating.

Stressed Mothers Receiving Infant Mental Health-Based Early Head Start Increase in Mind-Mindedness.

Maternal mind-mindedness is a characteristic of supportive parenting and contributes to many positive social-emotional outcomes in early childhood. However, there is limited knowledge of mind-mindedness among parents experiencing parenting stress from low-income settings. This is a critical gap in evidence given the robust role of supportive parenting in children's development and the capacity of home-based interventions to improve children's outcomes through enhancing supportive parenting. This study examined: (1) maternal mind-mindedness, operationalized as mothers' appropriate mind-related comments (MRC), across toddlerhood in mothers of toddlers who participated in infant mental health (IMH) based Early Head Start (EHS) services; and (2) whether parenting stress moderated EHS program effects on appropriate MRC over time. Data from a primarily White midwestern site in the United States were collected at study enrollment and when toddlers were 14-, 24-, and 36-months of age (N = 152; mothers M age = 22.4 years, SD = 5.1; toddlers M age = 14.4 months, SD = 1.3; 51% females). Data included parent-completed questionnaires and observed parent-child interactions, which were coded for MRC. Although there were no main effects of EHS programming on mothers' appropriate MRC over time, multilevel growth curve modeling indicated that parenting stress moderated EHS effects on mothers' appropriate MRC over time. Among mothers with greater parenting stress, those who received IMH-based EHS services demonstrated greater proportions of MRC over time as compared to mothers with greater stress in the control group. IMH-based parenting interventions that target parenting stress may promote appropriate MRC in low-income populations during toddlerhood.

Supporting family meal frequency: Screening Phase results from the Simply Dinner Study.

We aimed to test main, additive, interactive effects, and feasibility of all possible combinations of six intervention components implemented for 8 weeks (Cooking/Serving Resources; Meal Delivery; Ingredient Delivery; Community Kitchen; Nutrition Education; Cooking Demonstrations). Primary outcomes were family meal frequency and preschoolers' dietary quality; secondary outcomes included family meal preparation type, meal preparation barriers, family functioning, and kitchen inventory adequacy. All possible intervention combinations were tested using a randomized factorial trial design in the first phase of a Multiphase Optimization Strategy (MOST). Feasibility was assessed via attendance, delivery logs, and satisfaction. Parent-reported data collection included: socio-demographics, frequency and type of family meals; preschooler dietary intake; perceived barriers to meal planning and preparation; assessment of family functioning; and a kitchen inventory of materials generally needed for meal preparation. Participants (n = 499) were recruited at two Head Start agencies in mid-Michigan with data collection and delivery of some intervention components in participants' homes. Promising intervention bundles were identified by evaluating pre-to post-intervention effect sizes. The combination of Cooking/Serving Resources and Meal Delivery increased family meal frequency (Cohen's d = 0.17), cooking dinner from scratch (d = 0.21), prioritization of family meals (d = 0.23), and kitchen inventory (d = 0.46) and decreased use/consumption of ready-made (d = -0.18) and fast foods (d = -0.23). Effects on diet quality were in the expected direction but effect sizes were negligible. Community Kitchen, Nutrition Education, and Cooking Demonstration showed poor feasibility due to low attendance while Ingredient Delivery was infeasible due to staffing challenges related to its labor intensity. Additionally, although not one of our pre-specified outcomes, Cooking/Serving Resources (RR = 0.74) and Meal Delivery (RR = 0.73) each decreased food insecurity. Cooking/Serving Resources combined with Meal Delivery showed promise as a strategy for increasing family meal frequency.

Call to action: Centering blackness and disrupting systemic racism in infant mental health research and academic publishing.

The Infant Mental Health Journal is committed to ending systemic racism and promoting diversity, equity, and inclusion in academic publishing. IMHJ unequivocally denounces all forms of racism and white supremacy, including systemic racism in academic publishing. We commit to investigating and working to terminate the ways in which systemic racism has become normalized in academic publishing, including examining our practices and processes at IMHJ. We invite you to join us in intentional, anti-racist work through your scholarship. As part of this effort, IMHJ has updated the author guidelines to include new information regarding how authors can express the ways in which they are engaging with intention in diverse, anti-racist research. These guidelines are available under the author guidelines section on the IMHJ website (https://onlinelibrary.wiley.com/journal/10970355). As a second immediate response relative to promoting diverse, equitable, and inclusive research, IMHJ is releasing the following Call to Action, focusing on centering Blackness in infant and early childhood mental health research. This call is designed as a first step in our efforts, and IMHJ looks forward to coming initiatives aimed at disrupting systemic racism in infant and early childhood mental health research for the many scholars studying and working with diverse populations marginalized by racism and systemic inequities.

La Revista de Salud Mental Infantil está comprometida a terminar el racismo sistémico y promover la diversidad, la equidad y la inclusividad en las publicaciones académicas. La Revista IMHJ censura categóricamente toda forma de racismo y supremacía de la raza blanca, incluyendo el racismo sistémico en publicaciones académicas. Estamos comprometidos a investigar y trabajar para erradicar los medios por los cuales el racismo sistémico se ha convertido en la norma en las publicaciones académicas, incluyendo el examinar nuestras prácticas y procesos dentro de la Revista IMHJ. Les invitamos a que se nos unan en nuestro esfuerzo intencional, antirracista, por medio de sus investigaciones profesionales. Como parte de este esfuerzo, la Revista IMHJ ha actualizado los parámetros para los autores para incluir nueva información acerca de cómo los autores pueden expresar de qué maneras están trabajando con intención en investigaciones diversas, antirracistas. Estos parámetros se encuentran disponibles bajo la sección de parámetros de autor en la página electrónica de la Revista IMHJ (https://onlinelibrary.wiley.com/journal/10970355). Como una segunda respuesta inmediata en relación con el fomento de la investigación diversa, igualitaria e incluyente, la Revista IMHJ presenta esta Llamada a la Acción, la cual se enfoca en centralizar la Negritud en la investigación de salud mental en infantes y la temprana niñez. Esta llamada está diseñada como un primer paso en nuestros esfuerzos y la Revista IMHJ anticipa próximas iniciativas dedicadas a poner fin al racismo sistémico en la investigación sobre salud mental en infantes y la temprana niñez para los muchos investigadores profesionales que estudian y trabajan con grupos diversos de población marginalizados por el racismo y las desigualdades sistémicas.

Le Infant Mental Health Journal s'engage à mettre fin au racisme endémique et à promouvoir la diversité, l'équité, et l'inclusion dans les publications académiques. L'IMHJ dénonce sans équivoque toutes les formes de racisme et de suprématie de la race blanche, y compris le racisme systémique dans les publications académiques. Nous nous engageons à déterminer comment le racisme systémique s'est normalisé dans les publications académiques et nous nous engageons à travailler à éradiquer cette normalisation ainsi qu'à examiner et à disséquer les pratiques et les processus de l'IMHJ. Nous vous invitons à nous rejoindre dans ce travail intentionnel, délibéré et anti-raciste à travers vos recherches. Dans cette optique l'IMHJ a mis à jour les directives pour les auteurs afin d'inclure plus d'informations sur la manière dont les auteurs peuvent exprimer les façons dont ils s'engagent délibérément dans des recherches diverses et anti-racistes. Ces directives sont disponibles dans la section « directives pour auteurs ¼ dans le site de IMHJ (https://onlinelibrary.wiley.com/journal/10970355). De plus, en tant que deuxième réaction immédiate liée à la promotion de recherches diverses, équitables et inclusives, l'IMHJ rend publique l'Appel à l'Action suivant, mettant l'accent sur la nécessité de centrer la condition noire dans les recherches sur la santé mentale du nourrisson et de la petite enfance. Cet appel est le premier pas de nos efforts et l'IMHJ attend avec intérêt les initiatives à venir se donnant pour but de contrecarrer le racisme systémique dans les recherches sur la santé mentale du nourrisson et de la petite enfance pour les nombreux chercheurs étudiant et travaillant avec des populations diverses marginalisées par le racisme et les inéquités systémiques.

A pilot evaluation of the Building Early Emotional Skills (BEES) curriculum in face-to-face and online formats.

The Building Early Emotional Skills (BEES) parenting program is designed to promote parent-child relationships and more optimal social-emotional development by addressing four sequentially built skills in parenting infants/toddlers: (1) building parental awareness of emotions in self and child; (2) listening and interacting sensitively; (3) identifying and labeling emotions; and (4) intentionally supporting early self-regulation skills. BEES used an 8-session format delivered in online or face-to-face platforms (N = 264 female caregivers; n = 214 online, n = 50 face-to-face). Linear mixed modeling for pre-to-post changes showed significant increases in knowledge, emotion coaching beliefs, acceptance of negative emotions, and self-reported emotionally supportive responses to emotions; and, significant decreases in rejection of emotions, emotionally unsupportive responses, and parenting distress. Results suggested no differences in rate of change by program delivery type. Caregivers with more depressive symptoms showed greater improvement in their parenting distress. The BEES program may be a tool to support early positive parenting.

Maternal Mindfulness Is Associated With Lower Child Body Mass Index Z Score.

BACKGROUND: Parental mindfulness may be a novel intervention target for child obesity prevention. OBJECTIVE: To examine associations between maternal mindfulness and child body mass index z-score (BMIz). METHODS: In a secondary data analysis of preintervention data from a randomized controlled trial, we assessed survey and anthropometric data from English-speaking mother/child dyads enrolled in Head Start in south central Michigan (n = 105). Surveys included demographic information, child dietary intake, family meal frequency, and the Philadelphia Mindfulness Questionnaire. Multivariable linear regression examined associations between maternal mindfulness and child BMIz, child intake of fruits and vegetables, and frequency of family meals. RESULTS: Children were M = 53.7 (standard deviation [SD] 7.5) months old, and mothers were M = 31.6 (SD 8.3) years old. The sample of children was 39% white, 26% black, 14% Hispanic, and 35% of children were overweight or obese. Mean maternal BMI was 32.0 (SD 8.3). Greater mindfulness was associated with child BMIz (ß = -.02 (SE 0.01), P = .027) adjusting for child race/ethnicity, household food security, maternal education, maternal age, and maternal BMI. Mindfulness was not associated with child fruit intake, child vegetable intake or frequency of family meals. The results were consistent with alternative outcomes of BMI percentile (P = .016) and BMI at the trend level (P = .0595) at the trend level. CONCLUSIONS: Greater maternal mindfulness was associated with lower child BMIz. Future work should consider mechanisms of association. Pediatric providers might consider supporting maternal mindfulness as one element of multicomponent strategies for child obesity prevention.

Rural-urban differences in body mass index and obesity-related behaviors among low-income preschoolers.

BACKGROUND: With one in eight preschoolers classified as obese in the USA, childhood obesity remains a significant public health issue. This study examined rural-urban differences in low-income preschoolers' body mass index z-scores (BMIz), eating behaviors, dietary quality, physical activity (PA) and screen time. METHODS: Pre-intervention data from 572 preschooler-parent dyads participating in a randomized, controlled obesity prevention trial in the Midwest USA were analyzed. We examined the associations among living in rural versus urban areas, child BMIz and child obesity-related behaviors, including eating behaviors, dietary quality, PA and screen time. RESULTS: Rural children had higher BMIz, more emotional overeating behaviors and more time spent playing outdoors compared with urban children. We found no associations between children living in rural versus urban areas and dietary quality and screen time. CONCLUSIONS: The study found that rural-urban differences in BMIz may start as early as 3-4 years of age, if not earlier. To reverse the weight-related health disparities between rural and urban low-income preschoolers, structural changes in rural locations and family supports around coping skills may be needed.

Temperament, socioeconomic adversity, and perinatal risk as related to preschoolers' BMI.

OBJECTIVE: Disparities in childhood obesity necessitate identification of risk-protective and risk- augmenting factors for young children experiencing socioeconomic adversity born with perinatal risk. Temperamental reactivity is a biological marker of susceptibility to environmental characteristics. This study tested whether temperamental reactivity moderated the relation between socioeconomic risk and children's body mass index (BMI). METHOD: This study examined 100 Head Start preschoolers (Mage = 4.07 years, SD = 0.56) with perinatal risk, defined as preterm birth (PT, <37 weeks gestation) or low birth weight (LBW, <2500g). Anthropometric measurements were collected from children and parents. Parents completed questionnaires on family level demographics and household food insecurity to create a cumulative socioeconomic risk variable. Parents also completed the Children's Behavior Questionnaire to assess preschoolers' temperamental reactivity. RESULTS: Results supported a differential susceptibility hypothesis such that preschoolers' temperamental reactivity significantly moderated the relation between socioeconomic risk and child BMI z-score (BMIz). Higher BMIz was observed in highly reactive children exposed to higher socioeconomic risk. Alternatively, lower exposure to socioeconomic risk was related to lower BMIz for highly reactive children. CONCLUSIONS: Findings suggest that highly reactive PT/LBW preschoolers are differentially susceptible to early socioeconomic adversity in a for better or for worse manner regarding BMIz. Thus, consideration of temperament as a marker of biological sensitivity to context may be necessary to inform obesity prevention for PT/LBW preschoolers from low-income families. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Role of maternal affect and regulatory strategies in toddlers' emotion and behavior regulation.

Using a moment-to-moment multilevel approach, we examined the relative effectiveness of (a) toddlers' lagged (i.e., previous-interval) regulatory strategies and toddlers' lagged expression of negative emotion, as moderated by maternal affect, and (b) maternal lagged regulatory strategies, on toddlers' current-interval (1) expression of negative emotion, and, (2) ability to delay gratification during a wait task. Two-level random coefficient models, with twelve repeated-measurement occasions (10 s-intervals) of observed behaviors (N = 1571) nested within 134 mother-toddler dyads from low-income families (67 girls; Mage = 25.77 months, SDage = 1.60) were examined. Cross-level interactions revealed that maternal positive affect buffered severity of toddlers' expression of negative emotion between lagged and current-intervals, while maternal negative affect disrupted toddlers' effective utilization of lagged regulatory strategies on current-interval expression of negative emotion. However, regardless of maternal affect, toddlers who displayed higher expression of negative emotion and utilized more regulatory strategies in lagged-intervals displayed greater delay of gratification in current-intervals. Also, as mothers displayed greater minimization of toddlers' emotional distress, higher physical restraint, and used fewer distractions, toddlers displayed more intense expression of negative emotion in subsequent intervals. Similarly, as mothers used higher physical restraint and fewer distractions, toddlers were less able to wait in subsequent intervals. Results illustrate the disruptive roles of maternal negative affect and unsupportive regulatory strategies on toddlers' emotion and behavior regulation. Together, these findings point to targeting maternal positive affect in combination with supportive regulatory strategies to promote toddlers' transition from external- to internal-regulation.

Cross-lagged associations between behaviour problems and obesity in head start preschoolers.

BACKGROUND: Behaviour problems and obesity are related but research findings have been inconclusive regarding the direction of effects. OBJECTIVES: This study examined the cross-lagged associations between behaviour problems, body mass index (BMI) and obesity in preschoolers, and whether sex modified these associations. METHODS: Repeated measures of teacher-reported externalizing (EXT) and internalizing behaviour problems (clinically significant T scores were >90th percentile), BMI z-scores (BMI-Z) and obesity status (BMI ≥95th for age and sex) were assessed in the fall (T1) and spring (T2) of the school year in Head Start preschoolers (N = 423). Associations were examined with cross-lagged modelling. RESULTS: Prospective paths from T1 clinically significant EXT to both T2 BMI-Z (ß = .05) and obesity (ß = .18) were significant. There was no evidence that T1 BMI-Z or obesity preceded T2 behaviour problems. However, sex-specific models indicated that T1 BMI-Z was prospectively associated with higher T2 EXT for boys (ß = .13), but not girls. T1 EXT was predictive of subsequent BMI-Z (ß = .09) and obesity (ß = .33) at T2 for girls only. CONCLUSION: Findings suggest that behaviour problems, particularly externalizing behaviours, are prospectively related to childhood obesity, and early prevention methods should reflect sex-specific modifications.

A Person-Centered Approach to Child Temperament and Parenting.

The aim of this study was to examine how variations in children's temperamental reactivity and mothers' parenting stress relate to parenting behavior. A sample of 3,001 mother-child dyads was assessed when children were 14, 24, 36, and 54 months. Latent profile analysis identified a group of temperamentally "easy" children whose mothers experienced little parenting stress, along with two groups of highly reactive children differentiated by mothers' stress levels. Maternal negative regard over time was highest in the group of reactive children with highly stressed mothers. Mothers in this group also perceived more child behavior problems and had less knowledge of child development. Results are discussed relative to Person × Environment interactions and the complex interplay between parent and child characteristics.