Early Parental Knowledge and Parent-Child Conversations Promote Preschool Language Skills: A Randomized Controlled Trial.

OBJECTIVE: This randomized controlled trial examined the long-term impact of the 3Ts-HV intervention on preschool-aged children's language skills through promoting parental knowledge and parent-child conversational turns during toddlerhood among families from low-SES backgrounds, controlling for parental education level, parental language skills, and child's age. METHODS: 92 parent-toddler dyads of low SES were randomized to receive either the 3Ts-HV intervention (n = 46) or Healthy Lifestyle control (n = 46) curriculum from 14 to 20 months. Parental language skills were assessed at 14 months; parental knowledge was assessed at 14 and 26 months; parent-child conversational turn count was assessed at 14 and 38 months; children's language skills were assessed at 50 months. RESULTS: A significant serial mediation effect (ß = 0.05, 95% CI [0.002; 0.13]) revealed that the 3Ts-HV intervention increased parental knowledge at 26 months, contributed to more frequent parent-child conversational turns at 38 months, and in turn promoted children's language skills at 50 months. CONCLUSIONS: The present study provides empirical evidence illustrating the underlying longitudinal processes from increasing parental knowledge and enriching parent-child linguistic interactions during toddlerhood, to promoting children's language development at preschool age. These findings point to a significant path to supporting families who face socioeconomic challenges early in life to promote equity in children's early language experiences and narrow disparities in children's developmental outcomes. WHAT'S NEW: The empirical finding of this randomized controlled trial illustrates the longitudinal processes from increasing parental knowledge and enriching parent-child linguistic interactions during toddlerhood to promoting children's language development at preschool age among families from low-SES backgrounds.

Video-Based Anticipatory Guidance on Early Cognitive and Language Development in the First 6 Months: A Randomized Controlled Trial.

This randomized controlled trial showed that video-based anticipatory guidance implemented at well-child visits in the first 6 months increased knowledge of early cognitive and language development (P < .001), which in turn promoted cognitive growth fostering behaviors among parents of low socioeconomic status (95% CI 0.09-0.57). TRIAL REGISTRATION: ClinicalTrials.gov: NCT02812017.

What Parents Know Matters: Parental Knowledge at Birth Predicts Caregiving Behaviors at 9 Months.

OBJECTIVE: To examine the mediating role of socioeconomically disadvantaged parents' knowledge of early cognitive and language development at the first postpartum visit in the relation between education and caregiving behaviors at 9 months. STUDY DESIGN: Parental knowledge was assessed at the 1-week newborn visit (n = 468); anticipatory guidance received and desired at 1-month (n = 212) and 6-month (n = 191) visits were reported; and caregiving behaviors toward infants during a teaching task were observed at 9-month visit (n = 173). RESULTS: We found substantial variation in knowledge and caregiving behaviors. Parents who had more knowledge of infant development at 1 week were more likely to respond to cues (r = 0.18; P < .05) and foster social-emotional (r = 0.17; P < .05) and cognitive growth (r = 0.20; P < .05) at 9 months. Importantly, the indirect effect of education on cognitive growth fostering at 9 months through knowledge at 1 week was significant, controlling for primary language and number of other children in the home (infancy: ß = 0.06; B = 0.07; SE = 0.04; 95% CI, 0.007-0.165; early childhood: ß = 0.04; B = 0.06; SE = 0.03; 95% CI, 0.008-0.152). Open-ended responses indicated that anticipatory guidance in the first 6 months focused on infant physical growth; however, parents did not request additional anticipatory guidance from their pediatricians. CONCLUSIONS: This study sheds light on the importance of promoting parental knowledge about cognitive and language development to foster parental cognitive stimulations and language inputs during the first year of life. This study highlights the important role of anticipatory guidance on cognitive and language development during the earliest well-child visits and the need to better understand parental baseline knowledge to tailor anticipatory guidance to the family strengths and needs.

The Long-Term Socialization Goals of Chinese and Korean Immigrant Mothers in the United States.

OBJECTIVES: The socialization goals of immigrant parents in the United States for their children reflect the childrearing priorities of both their culture of origin and the mainstream culture. These goals, which guide parenting, likely have shared and unique characteristics with other immigrant groups from the same geographical region of origin. The current study aimed to explore and compare the socialization goals of Chinese and Korean immigrant mothers in the United States; the role of child gender in mothers' socialization goals was also investigated. METHODS: Ninety-six Chinese (M age = 37.60) and 97 Korean immigrant mothers (M age = 35.87) with preschool-age children living in the United States were interviewed regarding their socialization goals. The qualitative interview transcripts were coded by trained research assistants. RESULTS: The interviews revealed seven socialization goals (Self-maximization, Lovingness,Personal Integrity, Proper Demeanor, Religious Values, Self-control, and No High Expectations) across both groups. Findings demonstrated that Chinese and Korean immigrant mothers were similar on their endorsement of five socialization goals. However, group differences were found for goals of Religious Values and No High Expectations, which further differed across child gender. CONCLUSIONS: These findings highlighted the common socialization priorities of Chinese and Korean immigrant mothers of young children in urban contexts, but also the need to examine sub -ethnic groups separately to understand their shared and unique parenting experiences. These findings have meaningful implications for clinicians and other professionals towards providing more effective services to Asian immigrant families in the U.S.

Parenting and toddler self-regulation in low-income families: What does sleep have to do with it?

Toddlerhood is a sensitive period in the development of self-regulation, a set of adaptive skills that are fundamental to mental health and partly shaped by parenting. Healthy sleep is known to be critical for self-regulation; yet, the degree to which child sleep alters interactive child-parent processes remains understudied. This study examines associations between observed parenting and toddler self-regulation, with toddler sleep as a moderator of this association. Toddlers in low-income families (N = 171) and their mothers were videotaped during free play and a self-regulation challenge task; videos were coded for mothers' behavior and affect (free play) and toddlers' self-regulation (challenge task). Mothers reported their child's nighttime sleep duration via questionnaire. Results revealed significant Sleep × Maternal Negative Affect and Sleep × Maternal Negative Control interactions. Children who did not experience negative parenting had good self-regulation regardless of their nighttime sleep duration. For children who did experience negative parenting, self-regulation was intact among those who obtained more nighttime sleep, but significantly poorer among children who were getting less nighttime sleep. Thus, among children who were reported to obtain less nighttime sleep, there were more robust associations between negative parenting and poorer self-regulation than among toddlers who were reported to obtain more sleep.

Los primeros años de la niñez son un período sensible en el desarrollo de la auto-regulación, un grupo de habilidades adaptables que son fundamentales para la salud mental y a las que en parte les da forma la crianza. Es sabido que el dormir bien es esencial para la auto-regulación y, aun así, el nivel al que el sueño del niño altera los procesos interactivos entre progenitor y niño permanece poco estudiado. Este estudio examina las asociaciones entre la crianza observada y la auto-regulación del niño pequeño, tomando como moderador de tal asociación el proceso de dormir del niño pequeño. Se grabó en video a niños pequeños de familias de bajos ingresos (N=171) y sus madres durante una sesión de juego libre y una tarea de auto-regulación que suponía un reto; los videos fueron codificados en cuanto al comportamiento y afecto de las madres (juego libre) y la auto-regulación de los niños pequeños (tarea que suponía reto). Las madres reportaron acerca del sueño nocturno de sus niños por medio de un cuestionario. Los resultados revelaron interacciones significativas en cuanto al dormir y el negativo afecto materno, así como el dormir y el negativo control materno. Los niños que no experimentaron una crianza negativa tenían una buena auto-regulación independientemente de la duración de su sueño nocturno. En el caso de los niños que experimentaron una crianza negativa, la auto-regulación quedó intacta en aquellos que lograban más tiempo nocturno de dormir, pero fue significativamente más pobre en los niños que tenían menos tiempo de sueño nocturno. Por tanto, en el caso de los niños indicados en el reporte con menos tiempo de dormir nocturno, se dieron asociaciones más robustas entre la crianza negativa y una más pobre auto-regulación que entre los niños pequeños indicados en el reporte con más tiempo de dormir.

La petite enfance est une période sensible dans le développement de l'auto-régulation, un ensemble de compétences qui sont fondamentales pour la santé mentale et en partie formées par le parentage. L'on sait qu'un sommeil sain est critique pour l'auto-régulation et pourtant la mesure dans laquelle le sommeil de l'enfant altère les processus interactifs enfant-parent demeure peu étudiée. Cette étude examine les liens entre le parentage observé et l'auto-régulation du petit enfant, le sommeil de l'enfant ayant un effet modérateur dans ce lien. Des jeunes enfants de familles issues de milieux défavorisés (N=171) et leurs mères ont été filmés durant un jeu libre et un exercice de défi d'auto-régulation. Les vidéos ont été codées pour le comportement des mères et l'affect (jeu libre) et l'auto-régulation des jeunes enfants (exercice de défi). Les mères ont fait état de la durée de sommeil nocturne de leur enfant au moyen d'un questionnaire. Les résultats ont révélé que : sommeil significatif x l'affect négatif maternel et le sommeil x négatif maternel contrôle les interactions. Les enfants qui n'avaient pas fait l'expérience d'un parentage négatif avaient une bonne auto-régulation quelle qu'ait été la durée du sommeil nocturne. Pour les enfants ayant fait l'expérience d'une parentage négatif, l'auto-régulation était intacte chez ceux ayant plus dormi, mais bien moindre chez les enfants qui avaient moins dormi. Donc, chez les enfants ayant moins de sommeil nocturne les liens bien plus robustes ont été découverts entre le parentage négatif et une moindre auto-régulation que chez les petits enfants dormant plus durant la nuit.

Parent-directed intervention in promoting knowledge of pediatric nutrition and healthy lifestyle among low-SES families with toddlers: A randomized controlled trial.

OBJECTIVE: The objective of this study is to determine the efficacy of an interactive, home visiting curriculum tailored to low socio-economic status families in improving parental knowledge of paediatric nutrition and healthy lifestyle. METHODS: Parents of toddlers aged 13-16 months living with a household income below 200% of the federal poverty line were randomized into healthy lifestyle intervention and control home visiting curriculum groups. Each curriculum consisted of 12 one-on-one educational sessions with parents facilitated by a trained home-visitor that were administered over a 6-month intervention period. Knowledge assessments were administered before and after the intervention period. RESULTS: Results of a one-way analysis of covariance (ANCOVA) analysis showed that parents in the intervention group (M = 26.05, SD = 4.24) scored significantly higher than control parents (M = 23.84, SD = 4.26) post-intervention, controlling for parent education level, F(1, 102) = 7.494 (95% confidence interval [-3.68, -0.59]). One-way ANCOVA analysis showed no significant mean difference between the parents in the intervention group (M = 24.13, SD = 4.37) and the control group (M = 23.93, SD = 4.16) at baseline, controlling for parent education level, F(1, 163) = 0.002 (95% confidence interval [-1.28, 1.22]). CONCLUSIONS: An interactive healthy lifestyle intervention focused on low-SES families significantly improved parental knowledge of paediatric healthy lifestyle. Changes in parental knowledge is a key preliminary step in behaviour change to ultimately affect behaviour. Informing and encouraging parents of toddlers to guide healthy lifestyle development early remains a promising point of intervention for prevention, rather than remediation, of childhood obesity.

Positive Parenting Moderates the Association between Temperament and Self-Regulation in Low-Income Toddlers.

Self-regulation develops rapidly during the toddler years and underlies many important developmental outcomes, including social-emotional competence and academic achievement. It is important to understand factors that contribute to early self-regulation skills among children at risk for adjustment difficulties in these domains, such as children growing up in poverty. The current study examined mother-reported child temperament (negative affect, effortful control) and observed maternal parenting (during a mother-child free play) as contributing factors to toddlers' observed self-regulation during delay of gratification tasks at 27 months (snack delay) and 33 months (gift delay). Participants were 198 toddlers (M age = 27 months; 53% boys; 48% non-Hispanic white) and their mothers from low-income families. Mothers' negative parenting characterized by negative affect, hostility, and negative control was associated with poorer self-regulation contemporaneously. Toddlers' lower negative affect and higher effortful control predicted better self-regulation at 33 months, but positive parenting characterized by positive affect and sensitivity moderated these associations at both time points. Specifically, we found a buffering effect of high positive parenting among toddlers with a temperamental risk and a deleterious effect of low positive parenting despite toddlers' temperamental strength. Results highlight the importance of positive parenting for fostering the development of self-regulation among toddlers growing up with poverty-related and child-level risks.

Chinese Malaysian Adolescents' Social-Cognitive Reasoning Regarding Filial Piety Dilemmas.

This study examined the social-cognitive reasoning of 52 Chinese Malaysian preadolescents (9-12 years old; M = 11.02, SD = 0.94) and 68 adolescents (13-18 years old; M = 14.76, SD = 1.39) in resolving filial dilemmas within the personal and moral domain. Preadolescents deferred to parental authority, whereas adolescents endorsed filial obligation reasoning to justify compliance in the personal domain. Both appealed to filial obligation, pragmatic, or welfare and safety reasoning to justify compliance but fairness or rights reasoning to justify their noncompliance, for the moral issue. Distinctions between authoritarian and reciprocal filial piety reasoning were revealed. Findings demonstrated complex decision-making and cognitive reasoning processes among Chinese Malaysian adolescents as they negotiate their filial obligations and autonomy development.

Oxytocin and parenting behavior among impoverished mothers with low vs. high early life stress.

Recent work suggests that key aspects of sensitive parenting (e.g., warmth, emotional attunement) may be shaped in part by biology, specifically the neuropeptide oxytocin. However, some studies have found that oxytocin may not act in expected ways in higher-risk populations (e.g., those with postnatal depression or borderline personality disorder). This study examined the relation between oxytocin and parenting among mothers with varying levels of early life stress. Forty low-income mothers and their 34- to 48-month-old child participated in this study. Mother-child dyads were observed in an interaction task in their home, and videos of these interactions were later coded for parenting behaviors. Mothers' oxytocin production before and after the interaction task was assessed through saliva. Mothers' early stress was assessed via the Adverse Childhood Experiences Scale (ACES; Felitti et al. Am J Prev Med 14:245-258, 1998). For mothers with low ACEs, higher oxytocin secretion was associated with more positive parenting. For mothers with high ACEs, higher oxytocin secretion was associated with lower levels of positive parenting. Oxytocin may be operating differently for mothers who experienced harsh early social environments, supporting more defensive behaviors and harsh parenting than anxiolytic and prosocial behaviors.

Educating Parents About Infant Language Development: A Randomized Controlled Trial.

A total of 427 women (aged 18-45 years) who delivered a singleton neonate without serious medical complications were randomized to watch either an educational intervention (n = 225) or the sudden infant death syndrome (n = 202) video. Linear mixed models showed that the intervention women significantly gained knowledge over time. Knowledge gain was largest among high-socioeconomic status (high-SES) and middle-SES English-speaking, smaller among low-SES Spanish-speaking, and nonsignificant among low-SES English-speaking women. Analysis of deviance revealed that the intervention women of all SES learned strategies fostering secure attachment and language acquisition. Participants considered watching an educational video alongside the universal newborn hearing screening (UNHS) conveniently timed. The intervention women were more likely than the control women to recognize the importance of timely UNHS follow-up.

Understanding Chinese immigrant and European American mothers' expressions of warmth.

Maternal warmth, the quality of the affectional bond between mothers and their children, has been found to be consistently associated with children's positive developmental outcomes in Western cultures. However, researchers debate the potential differences in the cultural meanings of maternal warmth, particularly between Chinese and European American families. To address the lack of empirical research on this issue, the present study examined culturally derived perceptions and practices of maternal warmth through open-ended interviews with 70 Chinese immigrant and 70 European American mothers of preschoolers. Specifically, we compared mothers' perceived importance and degree of expression of warmth toward their children, and why and how they express warmth toward their children in the 2 cultural groups. Results showed that, although mothers perceived expressing warmth to be similarly important, European American mothers perceived expressing more warmth toward their children. Moreover, both cultural similarities and differences were found in why these 2 groups of mothers believed it was important to express warmth and the specific practices they used. Chinese immigrant mothers' responses were interpreted as reflecting a cultural emphasis on nurturance and instrumental support, whereas European American mothers' responses reflected the Western cultural focus on more direct and outward demonstrations of warmth.

Maternal representations of their children in relation to feeding beliefs and practices among low-income mothers of young children.

Identifying maternal characteristics in relation to child feeding is important for addressing the current childhood obesity epidemic. The present study examines whether maternal representations of their children are associated with feeding beliefs and practices. Maternal representations refer to mothers' affective and cognitive perspectives regarding their children and their subjective experiences of their relationships with their children. This key maternal characteristic has not been examined in association with maternal feeding. Thus the purpose of the current study was to examine whether maternal representations of their children, reflected by Working Model of the Child Interview typologies (Balanced, Disengaged, or Distorted), were associated with maternal feeding beliefs (Authority, Confidence, and Investment) and practices (Pressure to Eat, Restriction, and Monitoring) among low-income mothers of young children, with maternal education examined as a covariate. Results showed that Balanced mothers were most likely to demonstrate high authority, Distorted mothers were least likely to demonstrate confidence, and Disengaged mothers were least likely to demonstrate investment in child feeding. Moreover, Balanced mothers were least likely to pressure their children to eat. Findings are discussed with regard to implications for the study of childhood obesity and for applied preventions.

Surgency and negative affectivity, but not effortful control, are uniquely associated with obesogenic eating behaviors among low-income preschoolers.

Despite increased attention to the role of temperament in children's obesogenic eating behaviors, there is a paucity of research examining whether different dimensions of temperament may be differentially associated with specific eating behaviors among preschool-age children. The purpose of the current study was to examine whether three temperament dimensions (surgency, negative affectivity, and effortful control) were uniquely associated with six obesogenic eating behaviors (caregiver-reported food responsiveness, enjoyment of food, emotional overeating, satiety responsiveness, and tantrums over food; and observed eating in the absence of hunger) among low-income preschool-age children, covarying home environment quality. Results showed that temperament dimensions were differentially associated with different eating behaviors. Specifically, preschoolers with higher surgency were more likely to overeat in response to external cues, have frequent desire to eat, derive pleasure from food, and eat in the absence of hunger. In contrast, preschoolers with higher negative affectivity were more likely to have tantrums over being denied food and less likely to eat in the absence of hunger. Effortful control was not uniquely associated with obesogenic eating behavior. Findings remained significant even when home chaos was accounted for, suggesting that child surgency and negative affectivity are important to consider, independent of home environment. Results are discussed with regard to theoretical implications for the study of childhood obesity and for applied prevention implications.

Understanding "Tiger Parenting" Through the Perceptions of Chinese Immigrant Mothers: Can Chinese and U.S. Parenting Coexist?

How Chinese immigrant mothers perceive "Chinese" and "U.S." parenting and changes in their parenting postmigration remains unclear, despite recent interest in Chinese parenting particularly in response to A. Chua's (2011) controversial book on "Tiger Mothers". The present study addressed this issue by examining the parenting beliefs and practices of Chinese immigrant mothers through qualitative interviews. Participants included 50 first-generation Chinese immigrant mothers (mean age = 38.39 years; SD = 5.19) with a 3- to 6-year-old child. Mothers had been in the U.S. for an average of 10.20 years and were interviewed regarding their perceptions of the contrasts between typical Chinese and U.S. parenting, the strengths of Chinese and U.S. parenting, and what changes (if any) occurred in their own parenting after they migrated to the U.S. Mothers identified key differences between the parenting in the 2 cultures across 4 themes. Importantly, mothers endorsed different aspects of parenting from both cultures and attempted to achieve a balance between supporting their child's development of autonomy and individuality versus maintaining a sense of relatedness and familism in their parenting, contrary to Chua's (2011) portrayal of rigid "Chinese parenting." With regard to their parenting acculturation, mothers discussed having to be flexible across different areas of their parenting in order to accommodate the cultural values of the larger societal context and promote their child's development in the U.S. These complex dynamics highlighted the challenges that Chinese immigrant mothers face as they adapt and adjust to the new cultural context, and how their parenting beliefs and practices acculturate.

Predicting the filial behaviors of Chinese-Malaysian adolescents from perceived parental investments, filial emotions, and parental warmth and support.

The present study examined the mediating role of perceived parental warmth and support in predicting Chinese Malaysian adolescents' filial behaviors from their age, perceived parental investments, and positive filial emotions toward their parents. The effects of these predictors were examined separately for mothers and fathers. Participants included 122 Chinese adolescents (M = 13.14 years; SD = 2.22) in Malaysia. Adolescents' perceived parental investments, filial emotions, and warmth and support from each parent were positively, and age was negatively associated with their filial behaviors. No gender differences were found. Perceived maternal warmth and support significantly mediated the effect of age, perceived investments from, and filial emotions toward mothers on adolescents' filial behaviors, but perceived paternal warmth and support did not have a mediating role. The present study sheds light on the unique maternal versus paternal filial role, and important familial processes in Chinese-Malaysian children and adolescents from a cultural perspective.

Authoritative parenting among immigrant Chinese mothers of preschoolers.

The goals of this study were: (a) to examine authoritative parenting style among Chinese immigrant mothers of young children, (b) to test the mediational mechanism between authoritative parenting style and children's outcomes; and (c) to evaluate 3 predictors of authoritative parenting style (psychological well-being, perceived support in the parenting role, parenting stress). Participants included 85 Chinese immigrant mothers and their preschool children. Mothers reported on their parenting style, psychological well-being, perceived parenting support and stress, and children's hyperactivity/attention. Teacher ratings of child adjustment were also obtained. Results revealed that Chinese immigrant mothers of preschoolers strongly endorsed the authoritative parenting style. Moreover, authoritative parenting predicted increased children's behavioral/attention regulation abilities (lower hyperactivity/inattention), which then predicted decreased teacher rated child difficulties. Finally, mothers with greater psychological well-being or parenting support engaged in more authoritative parenting, but only under conditions of low parenting stress. Neither well-being nor parenting support predicted authoritative parenting when parenting hassles were high. Findings were discussed in light of cultural- and immigration-related issues facing immigrant Chinese mothers of young children.