Parents' Perceptions of Infant Crying: A Possible Path to Preventing Abusive Head Trauma.

OBJECTIVE: Infant crying can lead to parental frustration and is the most common trigger for abusive head trauma (AHT). We used qualitative methodology with an activating stimulus (an audiotape of an infant crying) to prime the participants to engage in open dialogue for the purpose of understanding their perceptions of infant crying and its association with AHT, with the aim that information from these interviews and the impact of hearing the activating stimulus could be used to inform interventions to prevent AHT that would resonate with parents. METHODS: We conducted 25 initial qualitative interviews and 16 subsequent interviews with mothers and fathers of newborns. Before the initial interview, parents listened to a 1-minute audio clip of a crying infant, followed by a preventive message regarding AHT. The transcribed data were analyzed, and themes were developed using the constant comparative method of grounded theory. Data collection and analysis continued past the point of thematic saturation. RESULTS: Four themes emerged from the initial interviews: 1) previous experience is helpful to manage infant crying, 2) babies cry for a reason, 3) shaking an infant is incomprehensible to parents, and 4) the role of safety planning to manage frustration with crying. Analysis of the subsequent interviews revealed 2 additional themes: 1) use of supports for infant crying (eg, technology and physician advice) and 2) effects of the audio clip on caregiving practices. CONCLUSION: Previous experiences and beliefs about crying affect parents' perceptions of infant crying and AHT. After discharge, parents reported using technology for information and support and thinking about the audio clip when caring for their infant. These experiences, beliefs, and practices may aid in shaping effective prevention strategies to prevent AHT.

Helping a Child with Autism Spectrum Disorder Cope with Divorce.

CASE: Aaron is an 11-year-old boy with autism spectrum disorder (ASD), with cognitive and language skills in the above-average range, whose parents have recently separated. Aaron's mother initiated the separation when she learned that Aaron's father had maintained a relationship with a woman with whom he has a 10-year-old daughter. When Aaron's mother discovered this relationship, she demanded that Aaron's father leave their home.Aaron's father has moved in with his long-term girlfriend and keeps in contact with Aaron by calling once a day. Neither Aaron's father nor mother has discussed the reason for their separation with Aaron. So far, they have explained their separation by telling Aaron that they are "taking a break."Aaron's mother has been deeply hurt by Aaron's father's infidelity and does not want to reconcile with him. Aaron's father recognizes this but would like to continue to have a close relationship with his son. He would also like Aaron to get to know his half-sister.Aaron's mother seeks guidance regarding how to talk to Aaron about the separation and his father's second family. Given Aaron's diagnosis of ASD, she is particularly concerned about his ability to cope with this unexpected change in circumstances. What is your advice?