Prospective evaluation of parent and child outcomes following admission to a 'virtual' early parenting residential programme.

OBJECTIVES: Australian early parenting residential services provide interventions for families experiencing complex early parenting issues. Many services have recently shifted to virtual care models but the clinical effectiveness of such programmes is currently unknown. This study sought to test outcomes of a 'virtual' early parenting residential programme and to compare these with those of an in-person programme. DESIGN: Prospective cohort study; self-report questionnaires on admission, at discharge and 6-week follow-up. SETTING: An early parenting residential unit in Sydney, Australia. PARTICIPANTS: Consecutive series of parent-child dyads admitted to the unit virtually (n=56) or in person (n=44) between August 2021 and January 2022. INTERVENTIONS: Participants in both groups received a 4-night/5-day intervention programme involving access to 24-hour support from a multidisciplinary team of health professionals. The in-person programme was delivered at a residential unit; the virtual programme involved provision of support via video calls, phone calls, SMS and emails. PRIMARY AND SECONDARY OUTCOME MEASURES: Infant sleep, parenting self-efficacy (primary outcomes); parenting empathy, emotion, hostility, helplessness, mentalisation and stress (secondary outcomes). RESULTS: Parents who received the virtual programme reported improvements from admission to discharge, and from admission to 6-week follow-up, in a range of areas including parenting self-efficacy, empathy, mentalisation, hostility, helplessness, stress and infant sleep resistance (ps<0.05). At 6 weeks, they also reported improvements in emotion and understanding related to their child (p<0.05). In contrast to expectation, outcomes at discharge and 6 weeks were not superior in the in-person group. In fact, at 6 weeks, parents who attended the virtual residential group reported significantly lower levels of parenting hostility and parenting stress, and greater levels of parenting confidence compared with those in the in-person group (ps<0.05). CONCLUSIONS: Virtual early parenting residential interventions may be effective in bringing positive changes for families, and there is no evidence to suggest that outcomes are inferior to those of in-person programmes.

Supporting families with complex early parenting needs through a virtual residential parenting service: An investigation of outcomes, facilitators and barriers.

AIM: To investigate clients' perspectives about outcomes of a telehealth residential unit (RU) program for families experiencing complex early parenting issues, and to explore facilitators and barriers to positive client outcomes. DESIGN: Qualitative study using semi-structured interviews. METHODS: Semi-structured interviews were conducted with mothers (n = 18) admitted to a telehealth RU program. Interview transcripts were analysed using thematic analysis. RESULTS: Mothers reported short-term improvements in their child's presenting issues (e.g. feeding to sleep, night-time waking, co-sleeping), increased confidence and increased partner involvement. According to participants, program outcomes were facilitated by a positive parent-clinician relationship, the accessibility of clinicians and being able to take part in the program from their own home. Barriers included difficulties with technical equipment and connecting with the clinician overnight, and challenges with implementing strategies in the longer term. CONCLUSION: This nurse-led telehealth program was viewed positively by parents and the study identified a number of areas for improvement. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Telehealth early parenting programs provide an important way for parents to receive support with early child sleep, settling and feeding issues. Clinicians working in this area should focus on the development of positive parent-nurse relationships, enhancing communication and availability for parents during overnight periods and supporting parents to develop early parenting skills that will be applicable across the early childhood period. IMPACT: The study is the first to address client experiences of a telehealth RU program. Facilitators and barriers identified will inform service improvements to the program going forward, and similar telehealth programs for families; to ensure benefits and service outcomes are maximised for parents for such a crucial service. REPORTING METHOD: The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines for qualitative research were followed.

"Mummy, keep it steady": phonetic variation shapes word learning at 15 and 17 months.

Fifteen-month-olds have difficulty detecting differences between novel words differing in a single vowel. Previous work showed that Australian English (AusE) infants habituated to the word-object pair DEET detected an auditory switch to DIT and DOOT in Canadian English (CanE) but not in their native AusE (Escudero et al., ). The authors speculated that this may be because the vowel inherent spectral change variation (VISC) in AusE DEET is larger than in CanE DEET. We investigated whether VISC leads to difficulty in encoding phonetic detail during early word learning, and whether this difficulty dissipates with age. In Experiment 1, we familiarized AusE-learning 15-month-olds to AusE DIT, which contains smaller VISC than AusE DEET. Unlike infants familiarized with AusE DEET (Escudero et al., ), infants detected a switch to DEET and DOOT. In Experiment 2, we familiarized AusE-learning 17-month-olds to AusE DEET. This time, infants detected a switch to DOOT, and marginally detected a switch to DIT. Our acoustic analysis showed that AusE DEET and DOOT are differentiated by the second vowel formant, while DEET and DIT can only be distinguished by their changing dynamic properties throughout the vowel trajectory. Thus, by 17 months, AusE infants can encode highly dynamic acoustic properties, enabling them to learn the novel vowel minimal pairs that are difficult at 15 months. These findings suggest that the development of word learning is shaped by the phonetic properties of the specific word minimal pair.