Association Between Mothers' Alcohol Use Histories and Deficient Parenting in an Economically Disadvantaged Sample.

OBJECTIVE: Problematic maternal alcohol use confers risk for child maltreatment, though the effect on specific aspects of parenting is unclear. This study examined concurrent and prospective links among maternal alcohol use history, care neglect, supervisory neglect, and harsh or inconsistent discipline. METHOD: Multimethod multisource data were utilized to assess deficient parenting in 311 economically disadvantaged mothers at high risk of child maltreatment. Structural equation modeling was used to test hypothesized relations. RESULTS: Maternal history of alcohol use was associated with more inconsistent discipline and higher levels of subsequent supervisory neglect. Secondary analyses among two-parent families found that paternal substance misuse was associated with maternal care neglect and poor supervision. CONCLUSIONS: Among low socioeconomic status families, maternal alcohol use increases the risk of inconsistent discipline and inadequate supervision. Inconsistent discipline may also lead to punitive parenting practices. Given the potential effect of paternal substance use on maternal parenting, findings highlight the importance of screening all caregivers for substance use in child welfare and research contexts to clarify when and how to intervene most effectively.

The effects of musical and linguistic components in recognition of real-world musical excerpts by cochlear implant recipients and normal-hearing adults.

BACKGROUND: Cochlear implants (CI) are effective in transmitting salient features of speech, especially in quiet, but current CI technology is not well suited in transmission of key musical structures (e.g., melody, timbre). It is possible, however, that sung lyrics, which are commonly heard in real-world music may provide acoustical cues that support better music perception. OBJECTIVE: The purpose of this study was to examine how accurately adults who use CIs (n = 87) and those with normal hearing (NH) (n = 17) are able to recognize real-world music excerpts based upon musical and linguistic (lyrics) cues. RESULTS: CI recipients were significantly less accurate than NH listeners on recognition of real-world music with or, in particular, without lyrics; however, CI recipients whose devices transmitted acoustic plus electric stimulation were more accurate than CI recipients reliant upon electric stimulation alone (particularly items without linguistic cues). Recognition by CI recipients improved as a function of linguistic cues. METHODS: Participants were tested on melody recognition of complex melodies (pop, country, & classical styles). Results were analyzed as a function of: hearing status and history, device type (electric only or acoustic plus electric stimulation), musical style, linguistic and musical cues, speech perception scores, cognitive processing, music background, age, and in relation to self-report on listening acuity and enjoyment. Age at time of testing was negatively correlated with recognition performance. CONCLUSIONS: These results have practical implications regarding successful participation of CI users in music-based activities that include recognition and accurate perception of real-world songs (e.g., reminiscence, lyric analysis, & listening for enjoyment).

Temporal stability of music perception and appraisal scores of adult cochlear implant recipients.

BACKGROUND: An extensive body of literature indicates that cochlear implants (CIs) are effective in supporting speech perception of persons with severe to profound hearing losses who do not benefit to any great extent from conventional hearing aids. Adult CI recipients tend to show significant improvement in speech perception within 3 mo following implantation as a result of mere experience. Furthermore, CI recipients continue to show modest improvement as long as 5yr postimplantation. In contrast, data taken from single testing protocols of music perception and appraisal indicate that CIs are less than ideal in transmitting important structural features of music, such as pitch, melody, and timbre. However, there is presently little information documenting changes in music perception or appraisal over extended time as a result of mere experience. PURPOSE: This study examined two basic questions: (1) Do adult CI recipients show significant improvement in perceptual acuity or appraisal of specific music listening tasks when tested in two consecutive years? (2) If there are tasks for which CI recipients show significant improvement with time, are there particular demographic variables that predict those CI recipients most likely to show improvement with extended CI use? RESEARCH DESIGN: A longitudinal cohort study. Implant recipients return annually for visits to the clinic. STUDY SAMPLE: The study included 209 adult cochlear implant recipients with at least 9 mo implant experience before their first year measurement. DATA COLLECTION AND ANALYSIS: Outcomes were measured on the patient's annual visit in two consecutive years. Paired t-tests were used to test for significant improvement from one year to the next. Those variables demonstrating significant improvement were subjected to regression analyses performed to detect the demographic variables useful in predicting said improvement. RESULTS: There were no significant differences in music perception outcomes as a function of type of device or processing strategy used. Only familiar melody recognition (FMR) and recognition of melody excerpts with lyrics (MERT-L) showed significant improvement from one year to the next. After controlling for the baseline value, hearing aid use, months of use, music listening habits after implantation, and formal musical training in elementary school were significant predictors of FMR improvement. Bilateral CI use, formal musical training in high school and beyond, and a measure of sequential cognitive processing were significant predictors of MERT-L improvement. CONCLUSION: These adult CI recipients as a result of mere experience demonstrated fairly consistent music perception and appraisal on measures gathered in two consecutive years. Gains made tend to be modest, and can be associated with characteristics such as use of hearing aids, listening experiences, or bilateral use (in the case of lyrics). These results have implications for counseling of CI recipients with regard to realistic expectations and strategies for enhancing music perception and enjoyment.

The role of care neglect and supervisory neglect in childhood obesity in a disadvantaged sample.

OBJECTIVE: Assess the roles of care neglect and supervisory neglect, and the moderating influence of child age on childhood obesity. Study Design Child BMI, parental care neglect, and supervisory neglect were assessed in an ethnically diverse sample of 571 young children from two Midwestern States. Hierarchical linear regression was used to assess the influence of both forms of neglect and the moderating role of age. RESULTS: Fifteen percent of the children were overweight and 16.3% were obese. Care neglect significantly correlated with child BMI for younger but not older children, while supervisory neglect significantly correlated with child BMI for older but not younger children. CONCLUSIONS: The impact of two types of neglect on obesity varied across age, highlighting the importance of differentiating between types of neglectful parenting when addressing the high rate of childhood obesity in disadvantaged children.

Patterns and predictors of growth in divorced fathers' health status and substance use.

Health status and substance use trajectories are described over 18 months for a county sample of 230 divorced fathers of young children aged 4 to 11. One third of the sample was clinically depressed. Health problems, drinking, and hard drug use were stable over time for the sample, whereas depression, smoking, and marijuana use exhibited overall mean reductions. Variance components revealed significant individual differences in average levels and trajectories for health and substance use outcomes. Controlling for fathers' antisociality, negative life events, and social support, fathering identity predicted reductions in health-related problems and marijuana use. Father involvement reduced drinking and marijuana use. Antisociality was the strongest risk factor for health and substance use outcomes. Implications for application of a generative fathering perspective in practice and preventive interventions are discussed.

Assessing children's exposure to intimate partner violence.

Child exposure to intimate partner violence (IPV) is widely acknowledged as a threat to the psycho-social and academic well-being of children. Unfortunately, as reflected in the literature, the specific link between such exposure and childhood outcomes is ambiguous. Based on a review of the literature, this article suggests that this state of affairs is due, in part, to the manner with which exposure to IPV is operationally defined. After reviewing the dominant strategies for operationally defining exposure to IPV and the problems associated with those strategies, this article reports original data contrasting three measures derived from maternal reports, three measures derived from child reports, and the limited concordance among those different indices of exposure to IPV. The implications of these findings for research on child outcomes and the clinical assessment of children who might have been exposed to IPV are discussed.

Multivariate predictors of music perception and appraisal by adult cochlear implant users.

The research examined whether performance by adult cochlear implant recipients on a variety of recognition and appraisal tests derived from real-world music could be predicted from technological, demographic, and life experience variables, as well as speech recognition scores. A representative sample of 209 adults implanted between 1985 and 2006 participated. Using multiple linear regression models and generalized linear mixed models, sets of optimal predictor variables were selected that effectively predicted performance on a test battery that assessed different aspects of music listening. These analyses established the importance of distinguishing between the accuracy of music perception and the appraisal of musical stimuli when using music listening as an index of implant success. Importantly, neither device type nor processing strategy predicted music perception or music appraisal. Speech recognition performance was not a strong predictor of music perception, and primarily predicted music perception when the test stimuli included lyrics. Additionally, limitations in the utility of speech perception in predicting musical perception and appraisal underscore the utility of music perception as an alternative outcome measure for evaluating implant outcomes. Music listening background, residual hearing (i.e., hearing aid use), cognitive factors, and some demographic factors predicted several indices of perceptual accuracy or appraisal of music.

Contingent responses of mothers and peers to indirect and direct aggression in preschool and school-aged children.

The primary goal of the study was to determine whether mother and peer's responses to direct and indirect aggression would contribute to children's use of direct and indirect aggression. Using adaptations of the Direct and Indirect Aggression Scale, a multi-informant strategy, and a sample of disadvantaged families, data were collected from 296 mothers of children ages 4-11, 237 children ages 6-11, and 151 teachers of those children. Mothers and peers were reported to react more harshly in response to direct aggression compared with indirect aggression, and higher rates of direct aggression were associated with reduced popularity. These findings were seen as being consistent with the hypothesis that different forms of aggression result in differential responding by mothers and peers, as well as the notion that direct aggression is a higher cost option than indirect aggression. Results also replicated previous findings that boys tend to use physical aggression more than girls, but girls use indirect aggression more than boys. Finally, low IQ was correlated with higher direct aggression in girls but had no relation with aggression in boys.

Maternal depression and trait anger as risk factors for escalated physical discipline.

To test the hypothesized anger-mediated relation between maternal depression and escalation of physical discipline, 122 economically disadvantaged mothers were assessed for current and lifetime diagnoses of depression using the Current Depressive Episode, Past Depression, and Dysthymia sections of the Structured Clinical Interview for DSM-IV (SCID) and a measure of current depressive symptoms, the Beck Depression Inventory-Second Edition (BDI-II). Escalation of physical discipline was assessed using a video analog parenting task; maternal anger not specific to discipline was assessed using the Spielberger Trait Anger Expression Inventory. Reports of anger were associated with the diagnosis of depression and depressive symptoms. Bootstrap analyses of indirect effects indicated that the link between depression and escalated discipline was mediated by anger. Parallel analyses based on BDI-II scores identified a marginally significant indirect effect of depression on discipline. Findings suggest that anger and irritability are central to the putative link between depression and harsh discipline.

Schedule-induced electrodermal responding in children.

The current studies were designed to determine whether different intermittent schedules of reinforcement would have a differential effect on the skin conductance responses (SCRs) of children in the 8-12-year-old age range. Results of two experiments indicated that the amplitude of children's SCRs immediately following the occurrence of reinforcement were a function of the schedule of reinforcement, with larger SCRs associated with longer inter-reinforcement intervals. The findings are consistent with the research literature suggesting that long inter-reinforcement intervals can be evocative of aversively motivated emotions, as well as with research on the effects of interstimulus intervals on SCRs. Possible implications for these findings are discussed.

Social and emotional characteristics of adults seeking a cochlear implant and their spouses.

OBJECTIVES: Because past research has shown that benefits of cochlear implantation may include a significant decrease in psychological and emotional difficulties, this study examined whether persons seeking cochlear implants in recent years differed psychologically from those referred in the early 1980s. A second objective was to explore mechanisms by which profound deafness could contribute to psychological and emotional difficulties for implant candidates and their spouses. METHODS: 178 cochlear implant candidates referred from 1981 to 1998 at the University of Iowa Hospitals completed a standard battery of psychological tests and questionnaires. The sample was divided into six 3-year cohorts and compared on standardized measures of psychological and emotional adjustment, and in participation in social and non-social activities. Spouses of implant candidates completed a similar assessment. RESULTS: The sample was characterized by elevations in depression, social introversion, suspiciousness, and social anxiety and loneliness. There were no significant differences among cohorts across time except for an increase in expectations for implant success. Spouses also evidenced elevated levels of psychological distress. Hearing status was associated with significant differences in social activity participation. A paradoxical interaction was found between marital status and deafness. CONCLUSIONS: There was no evidence that the psychological status of implant candidates is changing across time, suggesting continued psychological benefit for persons receiving cochlear implants. Both candidates and their spouses participated in fewer social activities than normal controls. Findings underscore the complex relation between marital status, deafness, and engagement and participation in positive activities.

Recognition of "real-world" musical excerpts by cochlear implant recipients and normal-hearing adults.

OBJECTIVE: The purposes of this study were (a) to compare recognition of "real-world" music excerpts by postlingually deafened adults using cochlear implants and normal-hearing adults; (b) to compare the performance of cochlear implant recipients using different devices and processing strategies; and (c) to examine the variability among implant recipients in recognition of musical selections in relation to performance on speech perception tests, performance on cognitive tests, and demographic variables. DESIGN: Seventy-nine cochlear implant users and 30 normal-hearing adults were tested on open-set recognition of systematically selected excerpts from musical recordings heard in real life. The recognition accuracy of the two groups was compared for three musical genre: classical, country, and pop. Recognition accuracy was correlated with speech recognition scores, cognitive measures, and demographic measures, including musical background. RESULTS: Cochlear implant recipients were significantly less accurate in recognition of previously familiar (known before hearing loss) musical excerpts than normal-hearing adults (p < 0.001) for all three genre. Implant recipients were most accurate in the recognition of country items and least accurate in the recognition of classical items. There were no significant differences among implant recipients due to implant type (Nucleus, Clarion, or Ineraid), or programming strategy (SPEAK, CIS, or ACE). For cochlear implant recipients, correlations between melody recognition and other measures were moderate to weak in strength; those with statistically significant correlations included age at time of testing (negatively correlated), performance on selected speech perception tests, and the amount of focused music listening following implantation. CONCLUSIONS: Current-day cochlear implants are not effective in transmitting several key structural features (i.e., pitch, harmony, timbral blends) of music essential to open-set recognition of well-known musical selections. Consequently, implant recipients must rely on extracting those musical features most accessible through the implant, such as song lyrics or a characteristic rhythm pattern, to identify the sorts of musical selections heard in everyday life.

Care neglect, supervisory neglect, and harsh parenting in the development of children's aggression: a replication and extension.

To understand the effects of neglectful parenting, poor supervision, and punitive parenting in the development of children's aggression, 218 children ages 4 to 8 years who were disadvantaged and their mothers were recruited from two states to develop a sample that was diverse with respect to degree of urbanization and ethnicity. Multimethod and multisource indices of the predictive constructs (Social Disadvantage, Denial of Care Neglect, Supervisory Neglect, and Punitive Discipline) and the criterion construct (Aggression) were used in a test of a theoretical model using structural equation modeling. The results established the role of care neglect, supervisory neglect, and punitive parenting as mediators of the role of social disadvantage in the development of children's aggression, the importance of distinguishing between two subtypes of neglect, and the need to consider the role of discipline in concert with neglect when attempting to understand the parenting in the development of aggression.

Outcomes and achievement of students who grew up with access to cochlear implants.

OBJECTIVES/HYPOTHESIS: To provide long-term speech perception and production, educational, vocational, and achievement outcome data for pediatric cochlear implant recipients. STUDY DESIGN: This is a retrospective study using consecutive referrals of prelingually, profoundly deaf children at the University of Iowa Hospitals and Clinics. METHODS: Twenty-seven prelingually deaf young adults who received a cochlear implant between the ages of 2 and 12 years participated. Outcome measures included device-use information, perceptual information, reading results for all participants and educational achievement results for 17 of 27 participants, educational placement information/vocational information for all students, as well as a comparison of the child's educational/vocational outcome with that of the parent's educational/vocational outcome. RESULTS: Speech perception and production scores were highly correlated. Achievement test results indicated that scores were within 1 SD from normative data based on hearing individuals. Over 50% of the college-age eligible students enrolled in college. This initial group of implant users had a nonuse rate of 11% in the first 3 years. Eighty-nine percent of the users maintained full-time use for 7 years, and 71% of this group have maintained full-time use to date. CONCLUSIONS: This cohort of cochlear implant users compared favorably with their hearing peers on academic achievement measures. Although there was a wide distribution of educational and vocational outcomes, the children tended to follow the educational/vocational patterns of their parents. As age of implantation decreases, it will be important to compare achievement outcomes of this first generation with those of subsequent generations of cochlear implant users.

Disciplinary choices of mothers of deaf children and mothers of normally hearing children.

OBJECTIVE: To assess the disciplinary preferences of mothers of profoundly deaf children and normally hearing children in a test of the hypothesized link between child disabilities and punitive parenting. METHOD: Disciplinary preferences of mothers seeking a cochlear implant for their profoundly deaf child (n=57), mothers not seeking an implant for their deaf child (n=22), and mothers of normally hearing children (n=27) were assessed using an analog task in which subjects select discipline in response to slide images of children engaging in normative or frankly deviant behaviors that are potentially irritating. RESULTS: Results indicated that mothers of children with profound hearing impairments were more likely to select physical discipline in response to depicted child transgressions and more likely to escalate to physical discipline when the depicted child was described as persisting in the transgression. Additionally, escalation was more probable in response to scenes depicting children engaged in dangerous and destructive acts than in rule-violating acts. CONCLUSIONS: Findings were consistent with the hypothesized link between childhood disabilities and child maltreatment as well as the hypothesis that children with disabilities associated with communication problems could be at risk of physical abuse.

The child maltreatment log: a computer-based program for describing research samples.

The Child Maltreatment Log (CML) is a computer-based program designed to record information about children's maltreatment experiences and associated life events. Addressing concerns posed by scientific panels and grant review panels, the CML was designed to improve upon existing instruments to facilitate collaboration among researchers interested in maltreatment. The CML encourages researchers to collect information from multiple sources and informants concerning children's maltreatment experiences. Rather than classifying types of maltreatment a priori, the CML allows researchers to describe children's experiences using objective descriptors pertaining to potential acts of abuse, potential perpetrators, frequency, onset, consequential injuries, and treatment. The CML can be downloaded by interested agencies and groups without charge.

Biology-environment interaction and evocative biology-environment correlation: contributions of harsh discipline and parental psychopathology to problem adolescent behaviors.

Using an adoption paradigm, the Bioecological Model of development proposed by Bronfenbrenner and Ceci in 1994 was tested by concurrently modeling for biology-environment interaction and evocative biology-environment correlation. A sample of 150 adult adoptees (ages, 18-45 years) provided retrospective reports of harsh adoptive parent discipline, which served as the environmental independent variables. Birth parent psychopathology served as the biological predictor. The dependent variables were retrospective adoptee and adoptive parent reports on adolescent aggressive and conduct-disordered behaviors. Finally, adoptees were classified as experiencing contextual environmental risk using the presence of two or more adverse factors in the adoptive home (e.g., adoptive parent psychopathology) as the cutoff. The contextual environment was found to moderate the biological process of evocative biology-environment correlation, providing empirical support for the Bronfenbrenner and Ceci (1994) Bioecological Model.

Performance of cochlear implant recipients with GJB2-related deafness.

Congenital profound hearing loss affects 0.05-0.1% of children and has many causes, some of which are associated with cognitive delay. For prelingually-deafened cochlear implant recipients, the etiology of deafness is usually unknown. Mutations in GJB2 have been established as the most common cause of heritable deafness in the United States. In this report, we identify cochlear implant recipients with GJB2-related deafness and examine the performance of these individuals. Cochlear implant recipients received a battery of perceptive, cognitive, and reading tests. Neither subjects nor examiners knew the etiology of deafness in these individuals. The implant recipients were then examined for mutations in GJB2 using an allele-specific polymerase chain reaction assay, single-strand conformation polymorphism analysis, and direct sequencing. GJB2 mutations were the leading cause of congenital deafness among the cochlear implant recipients screened. Cochlear implant recipients with GJB2-related deafness read within one standard deviation of hearing controls better than other congenitally deaf cochlear implant recipients and non-cochlear implant recipients. Individuals with congenital deafness should be offered GJB2 screening. Positive results establish an etiologic diagnosis and provide prognostic, genetic, and therapeutic information. Effective rehabilitation for profoundly deaf individuals with GJB2-related deafness is possible through cochlear implantation.

Recognition of familiar melodies by adult cochlear implant recipients and normal-hearing adults.

The purpose of this study was to compare melody recognition and pitch perception of adult cochlear implant recipients and normal-hearing adults and to identify factors that influence the ability of implant users to recognize familiar melodies. Forty-nine experienced cochlear implant recipients and 18 normal-hearing adults were tested on familiar melody recognition. The normal-hearing adults were significantly (p < 0.0001) more accurate than implant recipients. Implant recipients showed considerable variability in perception of complex tones and pure tones. There were significant negative correlations between melody recognition, age at the time of testing, length of profound deafness and complex-tone perception, and significant positive relations between melody recognition and speech recognition scores.