Multisite randomized efficacy trial of educational materials for young children with incarcerated parents.

Although children with incarcerated parents exhibit more behavior problems, health concerns, and academic difficulties than their peers, few interventions or resources are available to support affected children. This randomized, controlled, multisite efficacy trial evaluated Sesame Street's "Little Children, Big Challenges: Incarceration" initiative with children aged 3 to 8 years with a jailed father. Seventy-one diverse children and their caregivers were randomized to an educational outreach group (n = 32) or wait list control group (n = 39). Researchers observed children during jail visits and interviewed caregivers by phone 2 and 4 weeks later. The effects of the intervention on children's behavior and emotions occurring during a jail visit depended on what children had been told about the father's incarceration. Children who were told honest, developmentally appropriate explanations showed less negative affect at entry, an increase in negative affect when the intervention was administered, and a decrease in negative affect during the visit. Intervention group children who were told distortions, nothing, or explanations that were not developmentally appropriate showed more negative affect initially, and their negative affect remained relatively stable during their time in the jail. In addition, children who were told the simple, honest truth about the parent's incarceration (a recommendation in the educational materials) exhibited more positive affect during the visit, with a medium effect size. Caregivers in the educational outreach group reported more positive change in how they talked to children about the incarceration over time compared to the control group.

Fathers in Jail and their Minor Children: Paternal Characteristics and Associations with Father-Child Contact.

OBJECTIVES: More than five million children have experienced a co-resident parent leaving to spend time behind bars. Most incarceration occurs in jails, yet little is known about contact between parents in jail and their minor children. Such information is essential to inform programming and policy to support families in the context of incarceration. METHODS: In the present study, 315 fathers in jail with minor children (3-17 years old) were recruited from four jails in the Midwest region of the United States. Fathers in jail reported their demographic information, incarceration-related characteristics (e.g., number of prior arrests), children's exposure to incarceration-related events, and frequency of contact with their children. RESULTS: Four main findings emerged: 1) telephone contact was the most common modality for engaging with children during a paternal jail stay, with 22% of fathers reporting daily phone contact with children, 2) types of contact were correlated, so that more phone contact and letter writing were associated with more frequent visits, 3) White, non-Hispanic fathers and those who did not plan to live with their children upon release were less likely to report telephone contact with their children, and 4) children who witnessed their fathers' arrest were less likely to write and children who witnessed their fathers' criminal activity were less likely to visit. CONCLUSIONS: Contact between fathers in jail and children has implications for the parent-child relationship. Future research should explore quality of and barriers to contact, including incarceration-related events.

Cognitively-Based Compassion Training for parents reduces cortisol in infants and young children.

This study tests a group-based secular contemplative practice intervention, Cognitively-Based Compassion Training (CBCT), with parents of young children. We report on a randomized controlled preliminary efficacy study. Certified teachers administered CBCT for 20 hr across 8 to 10 weeks in two cohorts of parents with infants and young children. The intervention group was compared to a waitlist control group. Thirty-nine parents and their children, who ranged in age from 4 months to 5 years, were evaluated at pre- and postintervention (n = 25 intervention, n = 14 waitlist control) on hair cortisol concentration. Parents also completed self-administered questionnaires at both time points regarding demographics, physical symptoms of stress, parenting stress, self-compassion, and mindfulness. Children of parents in the CBCT group experienced significant decreases in cortisol at the postintervention assessment, as compared with the control group. However, parent cortisol and self-report measures did not significantly change other than a small effect on clinical levels of parenting stress. CBCT may be a positive new way to intervene with parents to lower infants' and young children's cumulative physiological stress.

Este estudio puso a prueba una práctica de intervención contemplativa secular con base en un grupo, el Entrenamiento Compasivo con Base Cognitiva (CBCT), con padres de niños pequeños. Nosotros reportamos sobre un estudio de efectividad preliminar controlado al azar. Maestros titulados administraron el CBCT por 20 horas a lo largo de 8-10 semanas en dos grupos de padres con infantes y niños pequeños. El grupo de intervención fue comparado con un grupo de control en lista de espera. Treinta y nueve padres y sus niños, que oscilaban en edad de 4 meses a 5 años, fueron evaluados antes y después de la intervención (n=25 grupo de intervención, n=14 grupo de control en lista de espera) en cuanto a la concentración de cortisol en el cabello. Los padres también completaron cuestionarios auto-administrados en ambos momentos temporales con respecto a información demográfica, síntomas físicos de estrés, estrés de crianza, auto-compasión, así como plena conciencia. Los niños de padres en el grupo CBCT experimentaron una significativa disminución de cortisol al momento de la evaluación posterior a la intervención, tal como se les comparó con el grupo de control. Sin embargo, el cortisol de los padres y las medidas de auto-reporte no cambiaron significativamente. El CBCT pudiera ser una nueva manera positiva de intervenir con padres para reducir el estrés fisiológico cumulativo de infantes y niños pequeños.

Cette étude a testé une intervention de pratique contemplative séculaire et basée sur un groupe, la Formation de Compassion Cognitive (abrégé ici selon l'anglais CBCT), avec des parents de jeunes enfants. Cet article porte sur une étude d'efficacité préliminaire randomisée et contrôlée. Des formateurs certifiés ont procédé à une CBCT de 20 heures réparties sur 8-10 semaines chez deux cohortes de parents avec des nourrissons et des jeunes enfants. Le groupe d'intervention a été comparé à un groupe de contrôle en liste d'attente. Trente-neuf parents et leurs enfants, allant de 4 mois à 5 ans d'âge, ont été évalués avant et après l'intervention (n=25 intervention, n=14 contrôle de liste d'attente) sur la concentration de cortisol capillaire. Les parents ont également rempli des questionnaires auto-administrés aux deux temps d'évaluation, concernant des données démographiques, les symptômes physiques de stress, le stress de parentage, l'auto-compassion et la pleine conscience. Les enfants de parents du groupe CBCT ont fait preuve de baisses de niveau de cortisol importantes à l'évaluation post-intervention en comparaison au groupe de contrôle. Cependant le cortisol parental et les mesures auto-rapportées n'ont pas changé de manière importante. La CBCT peut être une nouvelle manière positive d'intervenir avec les parents afin de faire baisser le stress physiologique cumulatif des nourrissons et des jeunes enfants.

Jailed Parents and Their Young Children: Residential Instability, Homelessness, and Behavior Problems.

This study examined family disruption in the form of jailed parents' housing instability in the year leading up to their most recent incarceration, including periods of homelessness with and without their children, and links between parental housing instability and children's behavior problems. Using the Family Stress Proximal Process Model to understand the links between stressors related to family disruption and child outcomes, the study analyzed data from interviews and surveys with 165 jailed fathers and mothers with young children (age 2-6 years) regarding jailed parents' reports of housing instability during the 12 months prior to their incarceration and child behavior problems. Analyses showed that housing instability, homelessness, and recidivism in jailed parents were relatively common, with a significant proportion of the disruptions occurring with young children, although many disruptions involved parental absence from children. Results indicated that the more months that parents lived with their children prior to incarceration in jail during the past year, the less housing instability the parents experienced. Additionally, multiple regression analyses revealed that more housing instability experienced by parents in the year leading up to their incarceration in jail were associated with elevations in children's internalizing and externalizing behavior problems. These results have implications for future research that explores family disruption as a mechanism in understanding recidivism and homelessness among adults and risk for child behavior problems in families affected by parental incarceration.

Trajectories of Externalizing and Internalizing Behaviors in Preterm Children Admitted to a Neonatal Intensive Care Unit.

OBJECTIVE: To examine the trajectories of internalizing and externalizing behavior problems of preterm children between 16 months and 6 years of age and predictors of trajectories, including gestational age, child dysregulation, maternal depression, socioeconomic status, and parenting. STUDY DESIGN: This longitudinal study followed 148 children and their mothers from neonatal intensive care unit discharge until 6 years of age. Gestational ages ranged from 23 to 36 weeks. The study included assessment of maternal-reported behavior problems, maternal depression, neonatal and socioeconomic characteristics, and observations of dysregulated behavior and parenting. Trajectories were identified with a semiparametric group-based analytic method, and multinomial logistic regression was used to identify significant risk factors. RESULTS: Three distinct trajectories for preterm children were found for both internalizing and externalizing behavior problems. For the 2 groups with greater behavior problems (groups 1 and 2), trajectories reached their peak between 24 and 36 months of age, then leveled off or decreased. Group 3 showed a stable low level of externalizing behaviors, and a low, but slightly increasing level of internalizing behaviors. Maternal depression, child dysregulation, gestational age, and socioeconomic challenges were identified as risk factors that predicted less optimal behavior problem trajectories. CONCLUSIONS: Children born prematurely followed 1 of 3 distinct developmental trajectories for both internalizing and externalizing behavior problems. The most severe behavior problems started early in development and were associated with increased child dysregulation, maternal depression, and lower socioeconomic status. These findings have implications for screening and monitoring preterm children.

Attachment in young children with incarcerated fathers.

The present study examined young children's attachment behaviors during paternal incarceration and reported on initial validity of a new measure used to rate children's attachment-related behaviors and emotions during visits in a corrections setting. Seventy-seven children, age 2 to 6 years, and their jailed fathers and current caregivers participated in the home visit portion of the study, whereas 28 of these children participated in the jail visit. The results indicated that 27% of children witnessed the father's crime and 22% of children witnessed the father's arrest, with most children who witnessed these events exhibiting extreme distress; children who witnessed these events were more likely to have insecure attachments to their caregivers. Consistent with attachment theory and research, caregivers who exhibited more sensitivity and responsivity during interactions with children and those who provided more stimulating, responsive, learning-oriented home environments had children who were more likely to have secure attachments (measured with the Attachment Q-Sort). We also found preliminary evidence for the validity of our new measure, the Jail Prison Observation Checklist, in that children's attachment-related behaviors and emotions during the jail visit correlated with their attachment security observed in the home. Our observations indicate that, in certain contexts, noncontact visits with incarcerated parents can be stressful for children and that children's caregivers may play a significant role during these visits.

Risk and resilience in preterm children at age 6.

Children born preterm are at risk for experiencing significant deleterious developmental outcomes throughout their childhood and adolescence. However, individual variation and resilience are hallmarks of the preterm population. The present study examined pathways to resilience across multiple domains (e.g., social activities, peer relations, attention-deficit/hyperactivity disorder symptomology, externalizing and internalizing behavior, and sleep quality) as children born preterm reached school age. The study also examined early child and family predictors of resilience. Using a prospective longitudinal design, 173 infants born preterm and without significant neurological complications were assessed at five time points: neonatal intensive care unit discharge, 9 months, 16 months, 24 months, and 6 years. Three pathways of adaptation emerged at 6 years: children who were resilient, those who remained at-risk, and children who exhibited significant difficulties. Resilient children were less likely to have experienced negative parenting at 9 and 16 months, more likely to delay gratification at 24 months, and more likely to experience neonatal health complications than nonresilient children.

Early parenting, represented family relationships, and externalizing behavior problems in children born preterm.

Through assessment of 173 preterm infants and their mothers at hospital discharge and at 9, 16, 24, 36, and 72 months, the study examined early parenting, attachment security, effortful control, and children's representations of family relationships in relation to subsequent externalizing behavior problems. Less intrusive early parenting predicted more secure attachment, better effortful control skills, and fewer early behavior problems, although it did not directly relate to the structural or content characteristics of children's represented family relationships. Children with higher effortful control scores at 24 months had more coherent family representations at 36 months. Moreover, children who exhibited less avoidance in their family representations at 36 months had fewer mother-reported externalizing behavior problems at 72 months. The study suggests that early parenting quality and avoidance in children's represented relationships are important for the development of externalizing behavior problems in children born preterm.

Parental attributions for the behavior problems of children and adolescents with autism spectrum disorders.

OBJECTIVE: The authors examined parental attributions for child behavior problems in 63 married couples of children and adolescents (aged 3-20 years) with autism spectrum disorders (ASDs). Both child-referent attributions (i.e., beliefs about causes related to the child or adolescent) and parent-referent attributions (i.e., beliefs about causes related to the parent) were examined along the dimensions of locus, stability, and controllability. Parent and child/adolescent factors related to parental attributions were identified, and the associations between parental attributions and parenting burden were explored. METHOD: Mothers and fathers independently completed self-reported measures of parental attributions, parenting burden, and child behavior problems. Couples jointly reported on their son or daughter's severity of autism symptoms, intellectual disability status, age, and gender. RESULTS: Parents tended to attribute the behavior problems of their child/adolescent with an ASD to characteristics that were not only internal to and stable in the child/adolescent but also controllable by the child/adolescent. Mothers were more likely to attribute their son or daughter's behavior problems to characteristics that were less internal to and less stable in the child/adolescent with an ASD than were fathers. In addition, parents with a higher level of symptoms of the broader autism phenotype, parents of younger children, and parents of children/adolescents with intellectual disability, a higher severity of autism symptoms, and a higher severity of overall behavior problems were more likely to attribute their son or daughter's behavior problems to characteristics that were more internal to and stable in the child/adolescent and factors that were less controllable by the child/adolescent. Parental attributions were related to parents' level of parenting burden. IMPLICATIONS: Findings have implications for designing appropriate interventions and services for families of children and adolescents with ASDs.

Effortful control, positive emotional expression, and behavior problems in children born preterm.

The present study focused on the role of high effortful control in the expression of positive emotion and development of behavior problems in children born preterm (mean gestational age = 31.4 weeks). Using data from a prospective longitudinal study, the present study assessed effortful control and behavior problems at 24 and 36 months and positive emotional expression at 24 months in a sample of 173 children born preterm. Less positive emotional expression was associated with higher effortful control for boys but not girls. Higher effortful control was associated with fewer total behavior problems, but this relation was attenuated when socioeconomic assets were included in the model. More socioeconomic assets were associated with fewer behavior problems for both boys and girls and higher effortful control for girls. Socioeconomic assets appear to be an important factor in the development of effortful control and behavior problems in children born preterm regardless of gender, whereas positive emotional expression was important for boys. Future intervention research should examine fostering adaptive levels of effortful control in high-risk populations as a means to facilitate resilience processes.

Parenting Stress, Social Support, and Mother-Child Interactions in Families of Multiple and Singleton Preterm Toddlers.

The study investigated family support as a buffer of stress in 153 mothers and preterm toddlers. Data were collected regarding maternal depressive symptoms, parenting stress, and family support; infant health; and videotaped mother-child interactions. Although more parenting stress related to less optimal child play, only information support functioned as a protective factor. Information support predicted positive play under high, but not low, maternal stress. Mothers of multiples reported more parenting stress than mothers of singletons.

Preterm infants who are prone to distress: differential effects of parenting on 36-month behavioral and cognitive outcomes.

BACKGROUND: The differential susceptibility (DS) model suggests that temperamentally prone-to-distress infants may exhibit adverse outcomes in negative environments but optimal outcomes in positive environments. This study explored temperament, parenting, and 36-month cognition and behavior in preterm infants using the DS model. We hypothesized that temperamentally prone to distress preterm infants would exhibit more optimal cognition and fewer behavior problems when early parenting was positive; and less optimal cognition and more behavior problems when early parenting was less positive. METHODS: Participants included 109 preterm infants (gestation <37 weeks) and their mothers. We assessed neonatal risk and basal vagal tone in the neonatal intensive care unit; infant temperament and parenting interactions at 9 months post-term; and child behavior and cognitive skills at 36 months post-term. Hierarchical regression analyses tested study hypotheses. RESULTS: Temperamentally prone-to-distress infants exhibited more externalizing problems if they experienced more critical parenting at 9 months (ß = -.20, p < 0.05) but fewer externalizing problems with more positive parenting. Similarly, variations in maternal positive affect (ß = .25, p < .01) and intrusive behaviors (ß = .23, p < .05) at 9 months predicted 36-month cognition at high but not at low levels of infant temperamental distress. Higher basal vagal tone predicted fewer externalizing problems (ß = -.19, p < .05). CONCLUSIONS: Early parenting behaviors relate to later behavior and development in preterm infants who are temperamentally prone to distress, and neonatal basal vagal tone predicts subsequent externalizing behaviors. These findings suggest that both biological reactivity and quality of caregiving are important predictors for later outcomes in preterm infants and may be considered as foci for developmental surveillance and interventions.

Infant physiological regulation and maternal risks as predictors of dyadic interaction trajectories in families with a preterm infant.

This longitudinal study examined predictors of rates of growth in dyadic interaction quality in children born preterm who did not experience significant neurological findings during neonatal intensive care unit (NICU) hospitalization. Multiple methods were used to collect data from 120 preterm infants (48% girls, 52% boys) and their mothers. Infant heart rate variability (HRV), gestational age, neonatal health, feeding route, and maternal socioeconomic (SES) risks were assessed at NICU discharge (mean of 36 weeks postconception). Mother-child interactions were observed at 4, 9, 16, and 24 months postterm and analyzed with hierarchical linear modeling. On average, children's quality of play, interest, and attention increased over time while their dysregulation and irritability decreased, whereas average maternal positive affect and involvement declined in quality (ps < .05), although there was individual variation in rates of change. Mothers of infants with higher postfeeding HRV (i.e., vagal regulation) exhibited less decrease in positive affect and involvement between 4 months and 24 months, compared with mothers of infants with lower HRV (p < .05). Although infants with higher postfeeding HRV showed less positive affect and communication at 4 months, they exhibited significantly greater increases in positive affect and social competence and decreases in dysregulation and irritability between 4 months and 24 months, compared with infants with lower HRV (ps < .05). Dyads experiencing more SES risks showed less optimal interactions at 4 months; this difference remained as children grew older (ps < .05). Results have implications for our understanding of social development in preterm infants.