Promoting toddlers' self-regulation and healthy eating habits among families living in poverty: A randomized controlled trial of Recipe 4 Success.

The Recipe 4 Success preventive intervention targeted multiple factors critical to the health and well-being of toddlers living in poverty. This randomized controlled trial, which was embedded within Early Head Start home visits for 12 weeks, included 242 racially and ethnically diverse families (51% girls; toddler mean age = 2.58 years; data collected 2016-2019). Compared to parents in usual practice home visits, parents in Recipe 4 Success displayed greater sensitive scaffolding of toddlers' learning and more responsive food parenting practices (Cohen's d = .21-.30). Toddlers in Recipe 4 Success exhibited greater self-regulation and had healthier eating habits (Cohen's d = |.16-.35|). Results highlight the value of Recipe 4 Success in promoting parent and toddler behavior change that could have life-long benefits.

Estimation of nonlinear mixed-effects continuous-time models using the continuous-discrete extended Kalman filter.

Many intensive longitudinal measurements are collected at irregularly spaced time intervals, and involve complex, possibly nonlinear and heterogeneous patterns of change. Effective modelling of such change processes requires continuous-time differential equation models that may be nonlinear and include mixed effects in the parameters. One approach of fitting such models is to define random effect variables as additional latent variables in a stochastic differential equation (SDE) model of choice, and use estimation algorithms designed for fitting SDE models, such as the continuous-discrete extended Kalman filter (CDEKF) approach implemented in the dynr R package, to estimate the random effect variables as latent variables. However, this approach's efficacy and identification constraints in handling mixed-effects SDE models have not been investigated. In the current study, we analytically inspect the identification constraints of using the CDEKF approach to fit nonlinear mixed-effects SDE models; extend a published model of emotions to a nonlinear mixed-effects SDE model as an example, and fit it to a set of irregularly spaced ecological momentary assessment data; and evaluate the feasibility of the proposed approach to fit the model through a Monte Carlo simulation study. Results show that the proposed approach produces reasonable parameter and standard error estimates when some identification constraint is met. We address the effects of sample size, process noise variance, and data spacing conditions on estimation results.

Person-centered profiles of child temperament: A comparison of coder, mother, and experimenter ratings.

This study compared person-centered temperament group classifications derived from latent profile analyses on maternal reports, post-visit experimenter ratings, and task-based coder-rated behaviors at 18 months of age. Toddlers (N = 148) completed a laboratory visit with tasks intended to assess temperament and early regulatory abilities. Following the visit, experimenters rated child temperament using the Infant Behavior Record and coders rated toddlers' approach-withdrawal, affect, and regulatory behaviors across several laboratory tasks. Mothers completed the Early Childhood Behavior Questionnaire. Fisher's exact tests revealed that latent profiles characterized by temperamental inhibition and early regulatory abilities were quite consistent across assessments, whereas those characterized by surgent/exuberant qualities were less consistent. These results support a "components of variance" approach which suggests that different assessment methods produce both unique and overlapping information about child temperament.

Using machine learning to understand age and gender classification based on infant temperament.

Age and gender differences are prominent in the temperament literature, with the former particularly salient in infancy and the latter noted as early as the first year of life. This study represents a meta-analysis utilizing Infant Behavior Questionnaire-Revised (IBQ-R) data collected across multiple laboratories (N = 4438) to overcome limitations of smaller samples in elucidating links among temperament, age, and gender in early childhood. Algorithmic modeling techniques were leveraged to discern the extent to which the 14 IBQ-R subscale scores accurately classified participating children as boys (n = 2,298) and girls (n = 2,093), and into three age groups: youngest (< 24 weeks; n = 1,102), mid-range (24 to 48 weeks; n = 2,557), and oldest (> 48 weeks; n = 779). Additionally, simultaneous classification into age and gender categories was performed, providing an opportunity to consider the extent to which gender differences in temperament are informed by infant age. Results indicated that overall age group classification was more accurate than child gender models, suggesting that age-related changes are more salient than gender differences in early childhood with respect to temperament attributes. However, gender-based classification was superior in the oldest age group, suggesting temperament differences between boys and girls are accentuated with development. Fear emerged as the subscale contributing to accurate classifications most notably overall. This study leads infancy research and meta-analytic investigations more broadly in a new direction as a methodological demonstration, and also provides most optimal comparative data for the IBQ-R based on the largest and most representative dataset to date.

Improving Toddlers' Healthy Eating Habits and Self-regulation: A Randomized Controlled Trial.

OBJECTIVES: In this study, we tested whether Recipe 4 Success, a preventive intervention featuring structured food preparation lessons, was successful in improving the following 4 protective factors related to overweight and obesity among families living in poverty: toddlers' healthy eating habits, toddlers' self-regulation, parents' responsive feeding practices, and parents' sensitive scaffolding. METHODS: This randomized controlled trial was open to families enrolled in Early Head Start home visits and included 73 parents and their toddlers aged 18 to 36 months. Multimethod assessments were conducted at baseline and posttreatment. RESULTS: Compared with toddlers in usual practice Early Head Start, toddlers in Recipe 4 Success consumed healthier meals and snacks (d = 0.57; P < .03; 95% confidence interval [CI]: 0.08-1.06) and displayed better self-regulation (d = 0.95; P < .001; 95% CI: 0.43-1.45). Compared with parents in usual practice Early Head Start, parents in Recipe 4 Success engaged in more responsive feeding practices (d = 0.87; P < .002; 95% CI: 0.34-1.40) and were better able to sensitively scaffold their toddlers' learning and development (d = 0.58; P < .04; 95% CI: 0.07-1.09). CONCLUSIONS: This randomized controlled trial revealed medium to large intervention effects on 4 important protective factors that are related to overweight and obesity but are often compromised by living in poverty.

A laboratory-based assessment of mother-child snack food selections and child snack food consumption: Associations with observed and maternal self-report of child feeding practices.

This study explored how mothers' observed and self-reported child feeding practices (child control over food choices, encouragement of balance and variety, and teaching about nutrition) were associated with mother-child snack food selections and child snack food consumption in a laboratory setting. Mothers (N = 107) and their 4.5-year-old children (52% female) selected up to 5 snack foods (out of 9 snack foods: 6 higher-energy-density [ED] and 3 lower-ED) for optional child consumption throughout a one-hour laboratory visit. Mothers' in-the-moment child feeding practices during the snack food selection task were coded using observational coding schemes, and mothers' global child feeding practices (i.e., across meals and snacking occasions) were self-reported using the Comprehensive Feeding Practices Questionnaire (Musher-Eizenman & Holub, 2007). Results of multiple linear regression analyses with covariates showed that higher-ED snack food selections were positively associated with observed child control over food choices (B = 0.35, SE = 0.12, p = .006) and self-reported teaching about nutrition (B = 0.49, SE = 0.19, p = .010), and negatively associated with self-reported encouragement of balance and variety (B = -0.66, SE = 0.24, p = .007). Lower-ED snack food selections were positively associated with self-reported encouragement of balance and variety (B = 0.53, SE = 0.20, p = .008). Child consumption of higher-ED or lower-ED snack foods were not significantly associated with mothers' child feeding practices (observed or self-reported). We discuss the implications of these findings for future research on children's snack food selection and consumption.

It takes two: Infants' moderate negative reactivity and maternal sensitivity predict self-regulation in the preschool years.

The aim of this longitudinal study was to examine the association of infant fussing and crying with self-regulation in toddlerhood and the preschool years, as well as the moderating role of maternal sensitivity therein. When children (n = 149, 53.69% boys) were 6 months old, parents reported on their fussing and crying using a cry diary, and maternal sensitivity was coded during a novel toy procedure. Children participated in various tasks to assess self-regulation in toddlerhood (18 months) and the preschool years (4.5 years). Results indicated that the relation between infant fussing and preschool self-regulation took the shape of an inverted U, but only for children of highly sensitive mothers. For infants of less sensitive mothers, fussing was not related to later self-regulation. Crying was unrelated to preschool self-regulation. Neither fussing, crying, nor maternal sensitivity predicted self-regulation in toddlerhood. The findings support the optimal arousal theory, by demonstrating that for infants of highly sensitive mothers, moderate amounts of low intensity negative reactivity are associated with enhanced self-regulation in the preschool years. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Temperament in obesity-related research: Concepts, challenges, and considerations for future research.

Temperament, defined as individual differences in reactivity and regulation, has important implications for the development of childhood obesity. Indeed, numerous studies have demonstrated associations between temperament and children's eating behavior, parent feeding practices, and children's weight outcomes. Together, these findings have significantly improved our understanding of the developmental pathways to obesity-related outcomes. However, to better our understanding of the role of temperament in children's health, greater attention to how temperament is conceptualized and measured is needed. The purpose of this paper is to review the concept and principles of temperament, describe challenges in the measurement of temperament, and provide considerations for future research aimed at understanding the relationship between temperament, food intake, and childhood obesity. Moving forward, a fuller appreciation of the complexity of the temperament concept and thoughtful selection of temperament measures may help improve predictions and identify targets for interventions aimed at decreasing the risk for obesity in childhood.

Interactive effects of parenting behavior and regulatory skills in toddlerhood on child weight outcomes.

OBJECTIVES: There is limited research investigating whether maternal behaviors exhibited during non-feeding contexts play a role in the development of obesity, and whether this association varies based on children's emerging regulatory skills. The objective of this study was to investigate interactions between maternal behaviors and toddler regulation predicting child BMI z-scores (BMIZ) at 4.5 years. SUBJECTS/METHODS: Infant-mother dyads (n = 108) participated in laboratory visits when the child was 18 months and 4.5 years of age. Maternal interactive behaviors (i.e., positive responsiveness, gentle control) were coded from recordings of free play and clean-up tasks with their toddlers. Toddler regulation was assessed via an observational task, experimenter ratings, and parent ratings. Child and mother length/height and weight measurements were recorded and used to calculate child BMIZ and maternal BMI, respectively. RESULTS: After controlling for covariates, two significant interactions emerged between maternal behaviors and toddler regulation predicting BMIZ at 4.5 years. First, an interaction of positive responsiveness during free play and toddler regulation demonstrated that greater positive responsiveness significantly related to lower child BMIZ for toddlers with poor regulation. Second, an interaction of gentle control during clean-up and toddler regulation indicated that greater gentle control was associated with lower BMIZ for toddlers with lesser regulatory abilities, but higher BMIZ for well-regulated toddlers. No significant main effects emerged for maternal interactive behaviors or toddler regulation. CONCLUSIONS: These results suggest that associations between maternal behaviors and child BMIZ may depend on toddlers' emerging regulatory abilities. Maternal responsiveness during free play and gentle control during clean-up appear to protect against weight gain, especially for toddlers with lower regulatory abilities. However, greater levels of gentle control may have adverse effects on BMIZ for well-regulated toddlers. These results suggest that both parenting and toddler regulation, examined outside feeding contexts, may have important implications for child obesity.

Typologies of dyadic mother-infant emotion regulation following immunization.

Mother-infant dyadic emotion regulation - the joint modulation of affective rhythms as interactive partners dynamically respond to each other across time - has been shown to promote social-emotional wellbeing both during and beyond infancy. Although contributions of dyadic regulation to self-regulatory development may particularly apparent during infant distress, studies have traditionally examined dyadic regulation in low-stress contexts. The present study addresses this gap by identifying distinct patterns of mother-infant dyadic emotion regulation following a highly distressing immunization procedure and then examining how these groups differed in mother and infant personality and temperament characteristics. Mother-infant dyads (N = 131) were videotaped during a routine immunization procedure, and infant crying and maternal soothing behaviors were subsequently coded. Cluster analysis was applied to trajectories of latent states representing each dyad's post-immunization behaviors. Results indicated five typologies of dyadic regulation following infant immunization. These typologies reflected the effectiveness with which the dyad worked together to soothe infant distress, as well as the specific maternal soothing behaviors employed. Differences in maternal personality and infant temperament among clusters indicated that both mothers and infants contributed to the dynamic regulatory process.

Infant temperament and parent use of food to soothe predict change in weight-for-length across infancy: early risk factors for childhood obesity.

OBJECTIVES: Greater weight gain in infancy is a risk factor for childhood obesity. The present study examined the interaction between infant temperament and parent use of food to soothe infant distress (FTS) as predictors of weight gain across the first 2 years of life. SUBJECTS/METHODS: A total of 160 mother-infant dyads were recruited into a longitudinal study. Infant temperament was assessed by parents through a questionnaire (surgency, negativity) and by observer ratings (surgency, irritability) during a laboratory visit when infants were 6 months old. Parents also completed a 3-day infant cry diary when their children were 6 months of age to assess when they used food in response to infant cry/fuss bouts. Infant weight/length was measured in the lab at 6 and 18 months. Multiple regressions were run to test the moderating effect of FTS on weight gain. RESULTS: Significant interactions were revealed for both measures of surgency and parent FTS in predicting weight gain. Surgent infants whose parents had a greater tendency to use FTS had greater weight-for-length gain in 1 year than if their parents tended to use less FTS. The interaction between observer ratings of irritability and parent FTS was also significant but in an unexpected direction. CONCLUSIONS: The findings point to the role of temperament, specifically surgency, in weight gain during infancy, but only if their parents used FTS. Surgency may have evoked this feeding practice that increased their health risk.

Does Temperament Underlie Infant Novel Food Responses?: Continuity of Approach-Withdrawal From 6 to 18 Months.

This study investigated whether temperamental approach-withdrawal underlies infants' responses to novel foods. Data were drawn from a longitudinal study of mother-infant dyads (n = 136). Approach-withdrawal responses to novel foods and novel toys were coded when infants were 6 and 12 months of age. When infants were 18 months of age, approach-withdrawal behaviors, positive affect, and negative affect were used in a latent profile analysis to identify groups of toddlers who exhibited similar responses to novelty. As predicted, novel food and novel toy responses were concurrently associated at 12 months and followed a similar developmental pattern across the 1st year. Furthermore, novel food acceptance at 12 months of age, but not 6 months, predicted greater toddler approach.

Exuberant and inhibited children: Person-centered profiles and links to social adjustment.

The current study aimed to substantiate and extend our understanding regarding the existence and developmental pathways of 3 distinct temperament profiles-exuberant, inhibited, and average approach-in a sample of 3.5-year-old children (n = 121). The interactions between temperamental styles and specific types of effortful control, inhibitory control and attentional control, were also examined in predicting kindergarten peer acceptance. Latent profile analysis identified 3 temperamental styles: exuberant, inhibited, and average approach. Support was found for the adaptive role of inhibitory control for exuberant children and attentional control for inhibited children in promoting peer acceptance in kindergarten. These findings add to our current understanding of temperamental profiles by using sophisticated methodology in a slightly older, community sample, as well as the importance of examining specific types of self-regulation to identify which skills lower risk for children of different temperamental styles. (PsycINFO Database Record

Predicting toddler temperamental approach-withdrawal: Contributions of early approach tendencies, parenting behavior, and contextual novelty.

Research suggests that temperamental approach-withdrawal is subject to parenting influences, but few studies have explored how specific parenting behaviors and contextual novelty contribute to the observed pattern of effects. The present study examined associations between infant temperamental approach, mother behavior while introducing novel objects (12 months) and temperamental approach-withdrawal in toddlerhood (18 months) in a sample of 132 infants (68 males). Maternal positive affect predicted more toddler approach-withdrawal for high-approach infants and maternal stimulation predicted less toddler approach-withdrawal for low-approach infants; however, these patterns varied with intensity of novelty in both parenting and toddler outcome contexts. Thus, maternal behavior may lead to stronger associations between earlier and later measures of approach-withdrawal; however, these effects are tied to contexts of measurement.

Observed temperament from ages 6 to 36 months predicts parent- and teacher-reported attention-deficit/hyperactivity disorder symptoms in first grade.

This study tested the prospective association between observational indicators of temperament, which were obtained across multiple assessments when children were 6-36 months of age, and parent and teacher reports of children's attention-deficit/hyperactivity disorder (ADHD) behaviors, when children were in first grade. Data were drawn from the Family Life Project and included 1,074 children for whom temperament and either parent- or teacher-reported ADHD behavioral data were available. The results of variable-centered regression models indicated that individual differences in temperament regulation, but not temperamental reactivity, was uniquely predictive of parent- and teacher-reported ADHD behaviors. Latent profile analyses were used to characterize configurations of temperamental reactivity and regulation. Person-centered regression models were subsequently estimated in which temperamental profile membership replaced continuous indicators of temperamental reactivity and regulation as predictors. The results of person-centered regression models indicated that temperamental reactivity and regulation both contributed (both alone and in combination) to the prediction of subsequent ADHD behaviors. In general, the predictive associations from early temperament to later ADHD were of modest magnitude (R 2 = .10-.17). Results are discussed with respect to interest in the early identification of children who are at elevated risk for later ADHD.

Temperamental approach/withdrawal and food neophobia in early childhood: Concurrent and longitudinal associations.

The purpose of the present study was to investigate whether temperamental approach/withdrawal processes were concurrently and longitudinally associated with parent ratings and behavioral observations of food neophobia at 4.5 years of age. Additionally, maternal feeding practices were examined as potential moderators of the association between toddler temperament and food neophobia. Data were drawn from a longitudinal study following individuals (n = 82) from infancy through early childhood. At 18 months of age, toddlers were observed in an unfamiliar laboratory setting with an experimenter and their reactions were coded. At 4.5 years of age, the children were again observed in an unfamiliar setting and were also offered three novel foods (lychee, nori, and haw jelly). The number of foods they refused to taste was used as a measure of behavioral neophobia. Finally, mothers reported on their child's food neophobia and temperament, as well as their own feeding practices. As expected, temperament was associated with concurrent measures of food neophobia at 4.5 years of age. Also, low approach children who exhibited high negative affect and low positive affect in response to novelty at 18 months of age had higher levels of food neophobia at 4.5 years of age compared to their peers. Furthermore, evidence emerged to show that these neophobic tendencies in low approach children were strengthened by a maternal pressuring feeding style. Collectively, the results of this study emphasize that children who have low levels of temperamental approach are at a heightened risk for developing food neophobia during childhood.

Stability of food neophobia from infancy through early childhood.

The purpose of the present study was to examine whether rejection of novel foods during infancy predicted child behavioral and parent-reported neophobia at 4.5 years of age. Data for the present study were drawn from a longitudinal study following individuals (n = 82) from infancy through early childhood. At 6 and 12 months of age, the infants tasted a novel food (green beans, hummus, or cottage cheese) and their reactions were coded for rejection of the food (i.e. crying, force outs, or refusals). The children returned to the laboratory at 4.5 years of age and participated in a behavioral neophobia task where they were offered three novel foods (lychee, nori, and haw jelly) and the number of novel foods they tasted was recorded. Mothers also reported their own and their children's levels of food neophobia. Regression analyses revealed that rejection of novel foods at 6 months interacted with maternal neophobia to predict parent-rated child neophobia. Infants who exhibited low levels of rejection at 6 months showed higher levels of parent-rated neophobia when their mothers also showed high compared to low levels of neophobia. At 12 months of age, however, infants who exhibited high levels of rejection tended to have high levels of parent-rated neophobia regardless of their mothers' levels of neophobia. These results provide preliminary evidence that rejection of novel foods during infancy does predict neophobia during early childhood, but the results vary depending on when rejection of new foods is measured.

Understanding and measuring parent use of food to soothe infant and toddler distress: A longitudinal study from 6 to 18 months of age.

The present study examined the development of parent use of food to soothe infant distress by examining this feeding practice longitudinally when infants were 6, 12 and 18 months of age. Two measures of feeding to soothe were obtained: parent self-report and observations of food to soothe during each laboratory visit. Demographic and maternal predictors of food to soothe were examined as well as the outcome, infant weight gain. The findings showed that the two measures of food to soothe were unrelated but did reveal similar and unique relations with predictor variables such as parent feeding style and maternal self-efficacy. Only observations of the use of food to soothe were related to infant weight gain. The findings indicate that the two measures of food to soothe may be complementary and that observations of this feeding practice may capture certain relations that are not obtained through the use of self-report.

Infant and maternal predictors of early life feeding decisions. The timing of solid food introduction.

There is limited research on the maternal and infant characteristics associated with the timing of solid food introduction. The current study examined how maternal feeding style and infant temperament independently and interactively predicted the age at which infants were introduced to solid food. Data from 115 predominately white, middle-class mothers were collected when infants were 4 and 6 months of age. The timing of solid food introduction was positively correlated with mothers' age, education, breastfeeding at 4 months, self-reported responsiveness to infants' hunger and satiety cues, and negatively correlated with mothers' pre-pregnancy body mass index (BMI), beliefs about feeding infants solid food prior to 6 months of age, and infants' temperamental motor reactivity. When controlling for maternal age, education, pre-pregnancy BMI, and milk feeding method at 4 months, the timing of solid food introduction was negatively predicted by mothers' beliefs about feeding solid food prior to 6 months of age. Exploratory interaction analyses suggested that infant temperament marginally moderated maternal feeding style in predicting the timing of solid food introduction.

The epidemiology of observed temperament: Factor structure and demographic group differences.

This study investigated the factor structure of observational indicators of children's temperament that were collected across the first three years of life in the Family Life Project (N=1205) sample. A four-factor model (activity level, fear, anger, regulation), which corresponded broadly to Rothbart's distinction between reactivity and regulation, provided an acceptable fit the observed data. Tests of measurement invariance demonstrated that a majority of the observational indicators exhibited comparable measurement properties for male vs. female, black vs. white, and poor vs. not-poor children, which improved the generalizability of these results. Unadjusted demographic group comparisons revealed small to moderate sized differences (Cohen ds=|.23-.42|) in temperamental reactivity and moderate to large sized differences (Cohen ds=-.64--.97) in regulation. Collectively, demographic variables explained more of the variation in regulation (R(2)=.25) than in reactivity (R(2)=.02-.06). Follow-up analyses demonstrated that race differences were substantially diminished in magnitude and better accounted for by poverty. These results help to validate the distinction between temperamental reactivity and regulation using observational indicators.