Roles of caregiver-child interaction on the association of socioeconomic status with early childhood development: a population-based study in rural China.

OBJECTIVE: Socioeconomic status (SES) has been previously associated with children's early development, health, and nutrition; however, evidence about the potential role of caregiver-child interaction in such associations was limited. This study aimed to explore the effect of caregiver-child interaction on the associations of SES with child developmental outcomes, including early neurodevelopment and social-emotional behavior. METHODS: A cross-sectional survey was conducted among 2078 children aged 0-6 in a rural county that just lifted out of poverty in 2020 in Central China. The Ages & Stages Questionnaires-Chinese version (ASQ-C) and the Social-Emotional (ASQ: SE) questionnaire were used to assess children's early neurodevelopment and social-emotional behavior, respectively. Caregiver-child interaction was evaluated with the Brigance Parent-Child Interactions Scale. Regression-based statistical mediation and moderation effect were conducted with the PROCESS macro of SPSS. RESULTS: Children with low SES had an increased risk of suspected neurodevelopmental delay [OR = 1.92, 95% CI: 1.50, 2.44] and social-emotional developmental delay [OR = 1.31, 95% CI: 1.04, 1.66]. The caregiver-child interaction partially mediated the associations of SES with child developmental outcomes; the proportion of the indirect effect was 14.9% for ASQ-C total score and 32.1% for ASQ: SE score. Moreover, the caregiver-child interaction had a significant moderation effect on the association of SES with ASQ-C total score (P < 0.05). A weaker association was observed in children with high-level caregiver-child interaction than in medium and low ones. Similar moderating effects were found among boys but not girls. CONCLUSION: Caregiver-child interaction plays a vital role in the relationship between SES and child development. Children with low SES households will benefit more in terms of their early development from intervention programs strengthening caregiver-child interaction.

Evaluating caregiver-child interactions in low- and middle-income countries: a systematic review of tools and methods.

AIMS/BACKGROUND: The United Nations Sustainable Development Goals (SDGs) has placed emphasis on improving early child development globally. This is supported through the Nurturing Care Framework which includes responsive caregiving. To evaluate responsive caregiving, tools to assess quality of caregiver-child interactions are used, however there is little information on how they are currently employed and/or adapted particularly in low- and middle-income countries (LMICs) where children have a greater risk of adverse outcomes. The aim of this review is to provide a comprehensive guide on methodologies used to evaluate caregiver-child interaction - including their feasibility and cultural adaptation. DESIGN/METHODS: We conducted a systematic review of studies over 20years in LMICs which assessed caregiver-child interactions. Characteristics of each tool, their validity (assessed with COSMIN Risk of Bias checklist), and the quality of the study (Mixed Methods Appraisal Tool) are reported. RESULTS: We identified 59 studies using 34 tools across 20 different LMICs. Most tools (86.5%) employed video-recorded observations of caregiver-child interactions at home (e.g. Ainsworth's Sensitivity Scale, OMI) or in the laboratory (e.g. PICCOLO) with a few conducting direct observations in the field (e.g. OMCI, HOME); 13.5% were self-reported. Tools varied in methodology with limited or no mention of validity and reliability. Most tools are developed in Western countries and have not been culturally validated for use in LMIC settings. CONCLUSION: There are limited caregiver-child interaction measures used in LMIC settings, with only some locally validated locally. Future studies should aim to ensure better validity, applicability and feasibility of caregiver-child interaction tools for global settings.

Contingent conversations build more than language: How communicative interactions in toddlerhood relate to preschool executive function skills.

High-quality communicative interactions between caregivers and children provide a foundation for children's social and cognitive skills. Although most studies examining these types of interactions focus on child language outcomes, this paper takes another tack. It examines whether communicative, dyadic interactions might also relate to child executive function (EF) skills and whether child language might mediate this relation. Using a subset of data from the NICHD Study of Early Child Care and Youth Development, dyadic interactions between 2-year-olds and their mothers were coded for three behaviors: symbol-infused joint engagement, routines and rituals, and fluency and connectedness. Child language was assessed at age 3 and three facets of EF (self-regulation, sustained attention, and verbal working memory) were assessed at age 4.5. Structural equation modeling showed that dyadic interaction related to later child sustained attention and verbal working memory, indirectly through child language and directly related with child self-regulation. This suggests that communicative interactions with caregivers that include both verbal and non-verbal elements relate to child EF, in part through child language. Our findings have implications for the role of caregiver interactions in the development of language and cognitive skills more broadly. RESEARCH HIGHLIGHTS: Using structural equation modeling, we examined how communicative interactions between caregivers and toddlers relate to preschool executive function skills Communicative interactions relate to later language which in turn relates to sustained attention and verbal working memory in preschool Communicative interactions relate directly to self-regulation in preschool Associations between communicative interactions, language, and executive function vary across facets of executive function and may not be unidirectional.

Longitudinal examination of resilience among child welfare-involved adolescents: The roles of caregiver-child relationships and deviant peer affiliation.

Despite growing attention to resilience following childhood maltreatment, it remains unclear how the development of resilience unfolds over time among child welfare-involved adolescents. Further, little is known about the immediate and enduring effects of two important attachments in children's lives, namely caregiver-child relationship and deviant peer affiliation, on resilience development over time. This study sought to examine the ways in which caregiver-child relationships and deviant peer affiliation shape developmental trajectories of resilience among child welfare-involved youth. Data were drawn from the National Survey of Child and Adolescent Well-Being. Latent growth curve modeling was conducted on a sample of 711 adolescents. The results revealed that adolescents' resilience increased across a 36-month period since initial contact with Child Protective Services. Better caregiver-child relationships were associated with a higher initial level of resilience among adolescents, whereas higher deviant peer affiliation was associated with a lower initial level of resilience. Significant lagged effects were also found; caregiver-child relationship quality and deviant peer affiliation at baseline were associated with resilience at 18 months after. The findings suggest that interventions that aim to promote positive caregiver-child relationships and prevent deviant peer relationships may help foster resilience among adolescents who have experienced child maltreatment.

Promoting First Relationships® for Primary Caregivers and Toddlers in a Native Community: a Randomized Controlled Trial.

This study tested the effectiveness of Promoting First Relationships® (PFR), a preventive intervention program aimed at fostering positive caregiver-child relationships in Native families living on a rural reservation. Participants were 162 primary caregivers (96% Native; 93% female) and their Native toddlers (10-31 months old; 50% female). Families were randomized to a PFR group (n = 81) or Resource and Referral (RR) control group (n = 81), after baseline data collection (Time 1) to assess the quality of caregiver-child interaction, caregiver knowledge about children's social-emotional needs, caregiver depressive symptoms, and child externalizing behavior. After delivery of the PFR intervention or the RR service, follow-up assessments were repeated immediately post-intervention (Time 2) and 3 months later (Time 3). After controlling for baseline assessments, multivariate analyses of covariance revealed that caregivers in the PFR group had significantly higher scores on knowledge about children's social-emotional needs at Time 2 (p < .01, η2 = .06) and Time 3 (p < .05, η2 = .04) and less severe depressive symptoms at Times 2 and 3 (both p < .05, η2 = .04). At Time 3, the quality of caregiver-child interaction was better in the PFR group (p < .01, η2 = .06), an effect that was moderated by severity of depressive symptoms (p = .05, η2 = .06), with PFR having the greatest impact at low levels of initial symptoms (p = .02). Results support the positive impact of PFR in a Native community and suggest conditions under which the intervention may be most effective.

Exploring the role of "in the moment" and global caregiver and child factors in caregiver questioning during shared book viewing.

Questions of high (vs. low) cognitive demand (CD), which encourage children to engage in abstract or critical thinking (e.g., problem solve, reason about cause-and-effect relations, make inferences), may drive relations between children's language exposure and early skills. The present study adopted a micro-analytic approach to examine caregivers' high-CD questioning with their preschool-aged children while viewing a wordless picture book (n = 121) and "in the moment" (e.g., interaction time, child responses) and global factors (e.g., caregiver education). The probability of caregivers' high-CD questioning increased with interaction time and caregiver education. Post-hoc exploratory analyses revealed that the relation between children's responses and caregivers' high-CD questioning depended on caregivers' perceptions of children's vocabulary skills. Specifically, the probability of caregivers' subsequent high-CD questioning was greater if their child did not respond previously and if caregivers perceived them to have high vocabulary skills. In contrast, caregivers' questioning remained relatively constant for responsive children across different vocabulary skills. Thus, caregivers may employ certain types of input during brief, informal learning interactions with their children by considering their own and their child's propensities and micro-level changes that occur during their conversations.

Facilitating caregiver-child interactions in home visiting: A qualitative observational study.

Facilitating parent-child interactions is a key component of evidence-based early childhood home visiting programs. Several observational measures have been created to effectively capture home visiting activities from an operationalized perspective. While the field has a reasonable understanding of what home visitors can do to facilitate developmentally supportive interactions, and why, the how remains elusive for many home visitors. This qualitative study used a modified grounded theory approach to examine the facilitation of caregiver-child interactions during home visits. Home visit video recordings previously coded using the Home Visit Rating Scale (HOVRS) A+ were selected based on facilitation quality. Sixteen home visits (8 lower- and 8 higher-quality facilitation scores) were examined for differences in home visitor behaviors that support parent-child interactions during visits. We identified contextual and specific behaviors that home visitors used to actively engage caregivers and children together in developmentally supportive interactions. Results revealed 11 home visitor behaviors that discriminated higher quality facilitation. These behaviors were categorized into four domains: environmental conditions, executing the activity, strengths-based focus, and caregiver responses. This qualitative study highlights specific behaviors and professional development areas to support more effective home visiting services for a diverse population of families with young children.

Facilitar las interacciones progenitor-niño es un componente clave de los programas de visita a casa en la temprana niñez con base en la evidencia. Varias medidas de observación se han creado para captar eficazmente las actividades de visita a casa desde una perspectiva operacional. A pesar de que el campo tiene una comprensión razonable de lo que los visitantes a casa pueden hacer para facilitar las interacciones de apoyo al desarrollo, y el por qué, el cómo permanece aún esquivo para muchos visitantes a casa. Este estudio cualitativo usó un bien fundado acercamiento teórico modificado para examinar la manera de facilitar las interacciones cuidador-niño durante las visitas a casa. Con base en la calidad del proceso facilitador, se seleccionaron grabaciones en video de visitas a casa previamente codificadas usando la Escala de Puntuación de Visitas a Casa (HOVRS) A+. Dieciséis visitas a casa (8 con puntajes del proceso facilitador de más baja calidad y 8 de más alta calidad) se examinaron en cuanto a las diferencias en el comportamiento del visitador a casa que apoya las interacciones progenitor-niño durante las visitas. Identificamos comportamientos contextuales y específicos que los visitadores a casa usaron para hacer que los cuidadores y los niños participaran juntos activamente en las interacciones de apoyo al desarrollo. Los resultados revelaron 11 comportamientos del visitador a casa en que se comprometía la más alta calidad del proceso facilitador. Se categorizaron estos comportamientos en cuatro dominios: condiciones ambientales, ejecución de la actividad, enfoque con base en los puntos fuertes, así como las respuestas del cuidador. Este estudio cualitativo resalta comportamientos específicos y áreas de desarrollo profesional para apoyar servicios de visita a casa más eficaces para un diverso grupo de población de familias con niños pequeños.

La facilitation des interactions parent-enfant est une composante clé des programmes de visite à domicile de le petite enfance, fondés sur des données probantes. Plusieurs mesures d'observation ont été créées afin de capturer efficacement les activités de visite à domicile du point de vue de l'opération. Le domaine a une compréhension raisonnable de ce que les visiteurs à domicile peuvent faire pour facilité des interactions qui soutiennent le développement mais le pourquoi et le comment demeurent insaisissables pour bien des visiteurs à domicile. Cette étude qualitative a utilisé une approche théorique fondée modifiée pour faciliter les interactions personne prenant soin de l'enfant - enfant durant les visites à domicile. Des enregistrements vidéo de visite à domicile, préalablement codés en utilisant l'Echelle d'Evaluation de Visite à Domicile (HOVRS en anglais), A+ ont été sélectionnées basé sur la qualité de la facilitation. Seize visites à domicile (8 de scores de plus faible qualité et 8 de scores de la meilleure qualité de facilitation) ont été examinées pour leurs différences dans les comportements du visiteur à domicile qui soutiennent les interactions parent-enfant durant ces visites. Nous avons identifié des comportements contextuels et spécifiques que les visiteurs à domicile ont utilisés afin d'engager activement les personnes prenant soin des enfants et les enfants ensemble dans des interactions soutenant le développement. Les résultats ont révélé 11 comportements de visiteur à domicile qui dans la facilitation distinguant la facilitation de haute qualité. Ces comportements ont été catégorisés en quatre domaines: conditions environnementales, exécuter l'activité, attention mise sur les forces, et réponses de la personne prenant soin de l'enfant. Cette étude qualitative met en lumière des comportements spécifiques et des domaines de développement professionnel pour soutenir des services efficaces de visite à domicile pour une population diverse de familles avec de jeunes enfants.

Caregiver-child proximity as a dimension of early experience.

Human infancy and early childhood is both a time of heightened brain plasticity and responsivity to the environment as well as a developmental period of dependency on caregivers for survival, nurturance, and stimulation. Across primate species and human evolutionary history, close contact between infants and caregivers is species-expected. As children develop, caregiver-child proximity patterns change as children become more autonomous. In addition to developmental changes, there is variation in caregiver-child proximity across cultures and families, with potential implications for child functioning. We propose that caregiver-child proximity is an important dimension for understanding early environments, given that interactions between children and their caregivers are a primary source of experience-dependent learning. We review approaches for operationalizing this construct (e.g., touch, physical distance) and highlight studies that illustrate how caregiver-child proximity can be measured. Drawing on the concepts proposed in dimensional models of adversity, we consider how caregiver-child proximity may contribute to our understanding of children's early experiences. Finally, we discuss future directions in caregiver-child proximity research with the goal of understanding the link between early experiences and child adaptive and maladaptive functioning.

Child attachment in adjusting the species-general contingency between environmental adversities and fast life history strategies.

Extrinsic mortality risks calibrating fast life history (LH) represent a species-general principle that applies to almost all animals including humans. However, empirical research also finds exceptions to the LH principle. The present study proposes a maternal socialization hypothesis, whereby we argue that the more human-relevant attachment system adds to the LH principle by up- and down-regulating environmental harshness and unpredictability and their calibration of LH strategies. Based on a longitudinal sample of 259 rural Chinese adolescents and their primary caregivers, the results support the statistical moderating effect of caregiver-child attachment on the relation between childhood environmental adversities (harshness and unpredictability) and LH strategies. Our theorizing and findings point to an additional mechanism likely involved in the organization and possibly the slowdown of human LH.

Level and comfort of caregiver-young adolescent communication on sexual and reproductive health: a cross-sectional survey in south-western Uganda.

BACKGROUND: Communication on sexual and reproductive health (SRH) between caregivers and their young adolescent children plays a significant role in shaping attitudes and behaviours that are critical to laying the foundations for positive and safe SRH behaviours in later adolescence. Nevertheless, this communication is often limited, particularly in countries where adolescent sexuality is taboo. This study assessed the topics discussed ('level') and the comfort of caregivers with communicating with young adolescents on SRH, and their correlates.  METHODS: A cross-sectional survey was conducted among 218 caregivers of young adolescents (10-14 years) in Mbarara district of south-western Uganda in January and February 2020. Participants were selected through consecutive sampling. A structured, pre-tested questionnaire administered by interviewers was used for data collection. The surveys were computer-assisted using Kobo Collect software. Data was exported to STATA 14 for analysis. Level of SRH communication was measured based on 10 SRH communication topics, while comfort was based on 9 SRH discussion topics. Bivariate and multivariate linear regression analyses were conducted to determine correlates of level of, and comfort with, SRH communication P-value < 0.05 was considered for statistical significance. RESULTS: The mean number of topics that caregivers discussed was 3.9 (SD = 2.7) out of the 10 SRH topics explored. None of the respondents discussed all the topics; 2% reported ever discussing nine topics with their young adolescent, while 3.5% reported never discussing any of the topics. General health and bodily hygiene (89.9%) and HIV/AIDS and other sexually transmitted infections (STIs) (77.5%) were the most commonly discussed, while night emissions in boys (4.3%) and condoms (8.3%) were least discussed. The majority of caregivers (62%) reported a high level of comfort with discussing SRH. The mean comfort score was 21.9 (SD = 3.8). In general, the level of SRH communication increased with an increase in comfort with SRH communication ß = 0.22 (0.04); 95% CI = (0.15, 0.30). The level of comfort with SRH communication decreased with an increase in the number of YAs in a household ß = -0.92 (0.38); 95%CI = (-1.66,-0.18). CONCLUSION: Overall, the level of SRH communication is low and varies according to the number of SRH topics. Caregivers' comfort with SRH communication with YAs was a significant correlate of SRH communication. This justifies the need for interventions that aim to improve caregivers' comfort with communicating with young adolescents about SRH.

Experiences of Native Participants in the Promoting First Relationships® Intervention: Focus Group Findings.

OBJECTIVES: We tested Promoting First Relationships® (PFR), an evidence-based preventive intervention program for caregivers promoting attachment and social and emotional development of infants and toddlers, in a randomized controlled trial in a Native community. Quantitative results yielded evidence of efficacy; but in this report, our objective was to assess the participants' real-life experiences, challenges, and suggested enhancements to further adapt the program. METHODS: At the end of the study we conducted three focus groups (N = 17)-two groups for participants who completed the 10-week intervention and one group for those who did not. Focus groups were structured to generate discussion about (1) elements or activities of PFR they enjoyed and others that were challenging, (2) suggested solutions to participant challenges, (3) experiences with video recordings and handouts, and (4) aspects of the program that could be changed to make it more culturally-relevant. RESULTS: Qualitative analysis of the focus group transcripts revealed five themes: (1) appreciation for PFR providers and program, (2) personal growth, (3) improved caregiver-child relationships, (4) participant challenges, and (5) participant suggestions to improve the program. CONCLUSIONS: These qualitative results complement our quantitative assessment of the positive impact of the PFR program. Additionally, they provide importance guidance for future implementation of PFR in this, and other Native communities, as well as insight into broader issues to consider when adapting intervention programs for Native families.

"A Piece of Normal Life When Everything Else is Changed" Remote Early Childhood Music Classes and Toddler Socialization.

Parents of infants and toddlers have expressed concerns that their children's social-emotional development has been affected by the COVID-19 pandemic. The purpose of this intrinsic case study was to gather information about parents' and caregivers' perspectives of experiences in a remote early childhood music class that incorporated explicit social-emotional instruction based on state learning standards. This study is a follow up to a previous intrinsic case study concerning parents' experiences in a remote early childhood music class. Families who chose to participate in synchronous online caregiver-child classes at a local community music school were invited to participate in interviews. Eight adults, representing seven enrolled families, chose to participate. Four themes arose from the interviews: (a) Pandemic and the Upheaval of Family Life, (b) The Experience of the Child in Remote Music Class, (c) The Role of the Parent in Remote Music Class, and (d) The Unpredictable World of Remote Music Class. We share implications for teaching and suggestions for future research.

Enhancing the capacity for optimal social and personality function through the mediational intervention for sensitizing caregivers: A case illustration.

OBJECTIVE: Based on the well-known principle that the ability to meaningfully relate to others starts in the context of early attachment relationships, the current case illustration uses a recent extension of mentalization-based theory and practice to demonstrate how caregivers can enhance the capacity for optimal social and personality function through the mediational intervention for sensitizing caregivers (MISC). METHODS: Case material is presented to demonstrate the implementation of the MISC affective and cognitive components with a mother of an adopted 10-year-old girl who shows signs of affect avoidance, social isolation within and outside the family, and maladaptive personality development. RESULTS: The case illustration shows how video feedback sessions facilitate the gradual use of affective and cognitive components in the daily interactions between mother and daughter, thereby scaffolding optimal social and personality development. CONCLUSIONS: Affective and cognitive components of the Mediational Intervention for Sensitizing Caregiving can be effectively integrated to enhance mentalizing capacity in caregiver-child interactions.

Impact of the parent-child relationship on psychological and social resilience in pediatric cancer patients.

OBJECTIVES: The primary objective of this research was to examine patterns of parent-child relationship functioning among pediatric cancer survivors and their caregivers across a variety of relationship indicators (ie, Involvement, Attachment, Communication, Parenting Confidence, and Relational Frustration), and evaluate how these factors relate to psychosocial outcomes in survivors. METHODS: Young survivors aged 10 to 18 and their caregivers (N = 165) completed measures related to posttraumatic stress and general distress. Caregivers also completed assessments of parent-child relationship functioning, and survivors completed assessments of social functioning. Latent profile analysis was performed to identify patterns of relationship functioning. Medical, demographic, and parent functioning variables were examined as predictors, and youth's psychological and social functioning were examined as outcomes. RESULTS: A three-class solution was the best fit to the data. The struggling parent-child relationship profile (15%) evidenced below average levels of parent-child relationship functioning across several domains. The normative parent-child relationship (60%), was characterized by average levels of parent-child relationship functioning across all domains. Finally, the high-involved parent-child relationship profile (25%) demonstrated above average levels of parent-child relationship functioning in involved activities, communication, and attachment and normative levels of functioning across all other domains. Medical and parent functioning factors predicted profile membership. In turn, profile membership was associated with survivor psychological and social outcomes. CONCLUSION: Findings document the importance of extending existing research to examine patterns of parent-child relationship functioning, which may serve as a clinically relevant target to improve psychological and social outcomes in young survivors of childhood cancer.

Caregiver-child interaction influences causal learning and engagement during structured play.

The current study investigated the relation between the ways in which caregivers and children interact in a learning environment and children's learning outcomes and engagement with the learning task. We assessed caregiver-child interaction in a structured play environment in which 3- and 4-year-olds and a caregiver were tasked with learning a causal system. Children whose caregivers were more directive during their interaction learned the causal system the best and better than children whose caregivers were more hands off and allowed children to engage in unstructured exploration. These two groups of children explored for the same amount of time, indicating similar levels of engagement with the task. Children whose caregivers were more guiding, but not directive, played significantly longer than either of the other groups, suggesting deeper engagement. We discuss these findings in relation to how children engage in causal learning and how caregivers might contribute to children's learning and engagement with the learning process.

Social interaction in the emergence of toddler's mealtime spoon use.

The use of a spoon for eating is among the important daily skills in early development. The article provides an analysis of how caregiver-toddler interactions guides the attention of toddlers who were first learning how to use a spoon to spoon-related action opportunities that were relevant to the mealtime context. Our analysis revealed several related results. First, caregivers often manipulated objects on the table (i.e., food and dishes), and toddlers were more likely than chance to use their spoon to contact food immediately after watching these caregiver manipulations. Second, toddlers looked more often at the caregiver's hand than at their face. Third, toddlers tended to look at the caregiver's hand when the caregiver was manipulating objects on the table, and after these looks, toddlers were more likely than chance to contact food with their spoon. Finally, the toddlers' choices about when to look at the caregiver were influenced by their own behavior, as if they wanted to know how the caregiver would react to what they had done. We discuss these results in terms of the learning of socially promoted action opportunities for meal-related spoon use.

Randomized Controlled Trial of the Promoting First Relationships® Preventive Intervention for Primary Caregivers and Toddlers in an American Indian Community.

Preventive intervention programs that address parenting practices and children's developmental needs early in life have led to positive changes in caregiving behavior and children's developmental outcomes. However, little is known about the efficacy of such programs among American Indian families. This study tested the efficacy of the strengths-based Promoting First Relationships® (PFR) program in American Indian families living on a rural reservation. Participants were 34 toddlers (10-30 months old) and their primary caregivers. Families were randomized to an Immediate (n = 17) or Waitlist (n = 17) group after a home visit for baseline data collection, which included assessment of observed caregiver-child interactions, caregiver perceptions, and child behavior. After randomization, we delivered the PFR intervention in 10 visits to the Immediate group, with some adaptations based on focus groups with community members and staff input. We analyzed follow-up assessments by implementing multiple regression analyses, controlling for baseline scores and using multiple imputation to handle missing data. Results supported our primary hypotheses: the Immediate group, compared with Waitlist, had significantly higher scores on the quality (p = .011, d = 1.02) and contingent responsiveness (p = .013, d = 1.21) of caregiver-child interactions, as well as on caregiver knowledge of toddlers' social and emotional needs and level of developmentally appropriate expectations (p = .000, d = 0.58). Caregiver stress and caregivers' reports of child behavior did not differ significantly. Our results hold promise for additional PFR research in other Native communities.

Question-response-evaluation sequences in the home interactions of a bilingual child with autism spectrum disorder.

BACKGROUND: Prior research has described the prevalence and utility of questions in children's language learning environment. However, there has been little empirical investigation of the interaction sequences that ensue following caregiver questions. Understanding these interactions may be especially important for children with autism spectrum disorder (ASD), who may have difficulty engaging in reciprocal interactions. Question-response-evaluation sequences (QRE) are a particular type of interaction sequence launched by questions that have been examined primarily in classroom contexts. Less research has been devoted to understanding how caregivers and children with ASD leverage this interactional format in the context of home interactions. AIMS: We focus on QRE sequences within interactions between a 5-year-old bilingual child with ASD and his parents. In these sequences, the adult poses known-answer questions, the child responds and the adult evaluates the response. QRE sequences are primarily structured by the questioner (i.e., the parents in our context), and we examine the interactive work done by parents to initiate, maintain and close these sequences. We also examine the child's contributions to these sequences. METHODS & PROCEDURES: We applied conversation analysis (CA) to video recordings of home routines, such as play, book-reading and schoolwork. Videos were fully transcribed using CA conventions, and 55 QRE segments were isolated from the data corpus for further analysis. OUTCOMES & RESULTS: Q-word questions (i.e., where, what, why, when, how questions) were the most prevalent question format, and repetition of the child's response was the most prevalent form of evaluation. We found that QRE sequences were embedded within a variety of action trajectories that extend beyond pedagogical functions. These included repairing a prior utterance, extending collaborative play routines and engaging in topically connected labelling rituals. CONCLUSIONS & IMPLICATIONS: QRE sequences appeared to strike a balance in terms of the level of constraint they placed on the child's contributions to interactions, and the affordances they provide for participating in and progressing through interactions. This study can help clinicians understand the types of interactions that can be pursued with QRE sequences in their work with children with ASD. The findings may also aid intervention researchers' efforts to leverage caregivers' existing strengths for adapting their interactional overtures to maximize children's engagement. Finally, this study provides an illustration of caregiver-child interactions in a population that is currently under-represented in the literature.

A cross-sectional study of mother-child agreement on PTSD symptoms in a south Indian post-tsunami sample.

BACKGROUND: Few studies examine caregiver-child agreement on posttraumatic stress disorder (PTSD) symptoms in non-Western cultures. The present study investigated mother-child agreement for PTSD symptoms in a South Indian sample, which was affected by the Indian Ocean Tsunami in 2004. METHODS: Data was collected four years post-disaster. In total, 80 mothers rated PTSD symptoms for their 164 children and gave information about their own trauma symptoms. In addition, the children aged 8 to 17 reported about their own PTSD symptoms. RESULTS: Results showed that mother-child agreement on posttraumatic stress symptoms was poor, and a child's age, gender and living situation (fishing village vs. family-based out-of-home care) did not positively influence this concordance. Moreover, mothers' own posttraumatic symptoms were strongly related to maternal reports of the child's PTSD symptoms. Multivariate analyses showed that mothers' PTSD symptoms were the only significant predictor for discrepancies in the rating of the child's PTSD symptoms. That means, if mothers reported clinically relevant PTSD symptoms, the likelihood for disagreement on the child's PTSD ratings more than doubled. Neither age, nor gender nor the living situation had an influence on children's self-rated posttraumatic stress reactions. CONCLUSIONS: In general, long-term monitoring of posttraumatic stress symptoms of mothers and children should be planned by relief actions as recovery processes are decelerated through lacking resources in developing countries such as India. Specifically, the assessment of mothers' trauma symptoms is inevitable because the mothers' own responses to disaster highly influence their assessment of their children's symptoms. Mother-child agreement is discussed against the background of socio-cultural aspects.