Child Temperament as a Moderator of Promoting First Relationships Intervention Effects Among Families in Early Head Start.

As availability of parent-child interaction curricula increases, Early Head Start (EHS) provides a relevant context to test research-based parenting models as part of everyday practice. We trained EHS staff to incorporate the Promoting First Relationships (PFR) intervention into ongoing weekly home visits with mothers and their young children (n = 102) enrolled in EHS. Children had a mean age of 19.75 months and were 56% Hispanic, 23% Black, and 14% White. Families were randomly assigned to an intervention group where they participated in PFR as an EHS enhancement, or to a waitlist-control group where they received only typical EHS services. To explore the possibility that effectiveness of parent-child curricula may differ based on child characteristics, we used linear regression to examine children's temperament as a potential moderator of PFR efficacy on outcomes related to parenting stress, family functioning, and parent-child interaction. While we did not find a significant main effect of PFR for the full sample, there were several significant moderated effects. For families where children showed higher levels of surgency, mothers' parenting stress was significantly reduced after PFR participation. Also, when children showed higher levels of negative affect, mothers demonstrated higher sensitivity in parent-child interactions after participating in PFR. Given findings from our exploratory study, agencies should consider the characteristics of families served and the match with intervention priorities, when selecting intervention programs. When delivered as a home visitation enhancement, PFR may be a valuable support for certain enrolled families, based on child characteristics including high levels of surgency or negative affect.

EARLY HEAD START FAMILIES' EXPERIENCES WITH STRESS: UNDERSTANDING VARIATIONS WITHIN A HIGH-RISK, LOW-INCOME SAMPLE.

The federal Early Head Start program provides a relevant context to examine families' experiences with stress since participants qualify on the basis of poverty and risk. Building on previous research that has shown variations in demographic and economic risks even among qualifying families, we examined possible variations in families' perceptions of stress. Family, parent, and child data were collected to measure stressors and risk across a variety of domains in families' everyday lives, primarily from self-report measures, but also including assay results from child cortisol samples. A cluster analysis was employed to examine potential differences among groups of Early Head Start families. Results showed that there were three distinct subgroups of families, with some families perceiving that they experienced very high levels of stress while others perceived much lower levels of stress despite also experiencing poverty and heightened risk. These findings have important implications in that they provide an initial step toward distinguishing differences in low-income families' experiences with stress, thereby informing interventions focused on promoting responsive caregiving as a possible mechanism to buffer the effects of family and social stressors on young children.

Metabolic levels in the corpus callosum and their structural and behavioral correlates after moderate to severe pediatric TBI.

Diffuse axonal injury (DAI) secondary to traumatic brain injury (TBI) contributes to long-term functional morbidity. The corpus callosum (CC) is particularly vulnerable to this type of injury. Magnetic resonance spectroscopy (MRS) was used to characterize the metabolic status of two CC regions of interest (ROIs) (anterior and posterior), and their structural (diffusion tensor imaging; DTI) and neurobehavioral (neurocognitive functioning, bimanual coordination, and interhemispheric transfer time [IHTT]) correlates. Two groups of moderate/severe TBI patients (ages 12-18 years) were studied: post-acute (5 months post-injury; n = 10), and chronic (14.7 months post-injury; n = 8), in addition to 10 age-matched healthy controls. Creatine (energy metabolism) did not differ between groups across both ROIs and time points. In the TBI group, choline (membrane degeneration/inflammation) was elevated for both ROIs at the post-acute but not chronic period. N-acetyl aspartate (NAA) (neuronal/axonal integrity) was reduced initially for both ROIs, with partial normalization at the chronic time point. Posterior, not anterior, NAA was positively correlated with DTI fractional anisotropy (FA) (r = 0.88), and most domains of neurocognition (r range 0.22-0.65), and negatively correlated with IHTT (r = -0.89). Inverse corerlations were noted between creatine and posterior FA (r = -0.76), neurocognition (r range -0.22 to -0.71), and IHTT (r = 0.76). Multimodal studies at distinct time points in specific brain structures are necessary to delineate the course of the degenerative and reparative processes following TBI, which allows for preliminary hypotheses about the nature and course of the neural mechanisms of subsequent functional morbidity. This will help guide the future development of targeted therapeutic agents.