Strengthening mother-child interactions among mothers and children with behavior problems at early development.

The present study examined the effectiveness of a personalized remote video feedback parenting program to improve mother-child interactions and child behavior outcomes among mothers of children with behavior problems in comparison to counterparts with no behavior problems. The sample comprised 60 mothers and their 2-to-6-year-old children, including children with behavior problems (BP = 19) and children without behavior problems (NoBP = 41). The Strengthening Bonds program included one in-person group session and remote personalized video feedback about their mother-child interactions in a play situation via smartphone for six weeks. Mother-child interactions were the primary outcome, and children's behaviors were the secondary outcome. Pre- and post-intervention assessments were performed. The mother-child interactions were recorded during free- and structured-play situations and were then analyzed by the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO) and the Dynamics of the dyad activity coding system. Additionally, the mothers answered the Strengths and Difficulties Questionnaire. The results showed that, in the post-intervention, the mother-child interaction pattern improved in the BP group, especially in the teaching dimension of the PICCOLO. Also, after the program, more children with normal classification were in the BP group.

Parental attendance in two early-childhood training programmes to improve nurturing care: A randomized controlled trial.

Parent training programmes have significant potential to improve the quality of children's early environments and thereby their development and life-course outcomes. The aim of this study was to identify and explain the extent to which parents engaged in two group-based training programmes, offered to high-risk families enrolled in a randomized controlled trial study called PIÁ in Southern Brazil. The programmes were: (1) ACT: Raising Safe Kids, a 9-week programme aiming to reduce harsh parenting and maltreatment and improve positive parenting practices; (2) Dialogic book-sharing (DBS), an 8-week programme aiming to promote parental sensitivity and improve child cognitive development and social understanding. Of the 123 mothers randomly allocated to the ACT programme, 64.2% (n = 79) completed the course, and of 124 mothers allocated to DBS, 76.6% (n = 95) completed the course. After the interventions, mothers were very positive about the experience of both programmes but highlighted practical difficulties in attending. In adjusted regression analyses, only two variables significantly predicted ACT course completion (maternal age and distance between the intervention site and household); no significant predictor was found for DBS attendance. We conclude that although high completion rates are possible, there are important challenges to engaging parents of young children in training programmes, and practical difficulties occurring during training courses may be more important for attendance than baseline participant characteristics.

Motor trajectories of preterm and full-term infants in the first year of life.

BACKGROUND: Motor development occurs throughout periods of motor skill acquisition, adjustment and variability. The objectives of this study were to analyze and compare biological and health characteristics and motor skill acquisition trajectories in preterm and full-term infants during the first year of life. METHODS: Two thousand, five hundred and seventy-nine infants (1,361 preterm) from 22 states were assessed using the Alberta Infant Motor Scale. Multivariate General Linear Model, t-tests, ANOVA, and Tukey tests were used. RESULTS: An age × group significant interaction was found for motor scores. On follow-up tests full-term infants had higher scores in prone, supine, sitting and standing postures that require trunk control from 9 to 10 months of age; although this advantage was observed for sitting from the second month of life. CONCLUSION: During the first trimester of life, preterm infants have higher scores in the supine and standing postures. Regarding motor trajectories, from newborn to 12 months, the period of higher motor acquisition was similar between full-term and preterm infants for prone (3-10 months), supine (1-6 months), and standing (6-12 months). For the sitting posture, however, full-term infants had a period of intensive motor learning of acquisition from the first to 7 months of life, whereas for preterm infants a shorter period was observed (3-7 months). CONCLUSION: Although the periods of higher motor acquisition were similar, full-term infants had higher scores in more control-demanding postures. Intervention for preterm infants needs to extend beyond the first months of life, and include guidance to parents to promote motor development strategies to achieve control in the higher postures.

Quality of life of individuals born preterm: a systematic review of assessment approaches.

PURPOSE: To review the existing literature regarding factors associated with quality of life (QoL) of individuals who were born preterm. The review focuses on assessment approaches and information sources. METHODS: A systematic review of empirical studies published in PubMed, PsycARTICLES, PsycINFO, LILACS, and SciELO databases between 2007 and 2015. Search terms were chosen that relate preterm birth to QoL. RESULTS: Twenty-two articles were included. Of these, ten investigated QoL in children, six investigated adolescents, and six investigated adults. All studies used generic instruments to assess QoL. There was a high rate of parental report to assess QoL in studies of children. Adolescent and adult studies most often assessed QoL through self-report. Parents of children who were born preterm reported worse QoL for their children compared with parents of children born full term. Teenagers and adults who were born preterm self-reported more positive outcomes in their QoL. The main risk factors associated with worse QoL in children who were born preterm were congenital malformations, mechanical ventilation during the neonatal phase, cognitive impairments, behavioral problems, physical disabilities, low family income, and black race. CONCLUSIONS: Agreement between parents and children about QoL in preterm individuals was lower in younger age groups compared with older age groups. The differences in QoL throughout the different age groups may have arisen because of developmental changes or differences in the source of information used (i.e., parent report or self-report). We recommend that QoL assessments in children born preterm should consider both parent report and self-report.

Maternal Emotional and Behavioral Regulation/Dysregulation and Parenting Practices: A Systematic Review.

Emotional and behavioral regulations are crucial for the development of perceptive, responsive, and flexible parenting. Moreover, maternal emotional dysregulation constitutes a risk for maltreatment behaviors. The present study aimed to conduct a systematic review of empirical studies on the associations between mothers' emotional and behavioral regulations and parenting practices with their children or adolescents. A systematic review was conducted, including papers that addressed these variables, analyzing the direct effects, and moderation or mediation effects of maternal emotional and behavioral regulation on parenting practices, targeting child and adolescent samples. We identified 35 studies for analysis. Most of the studies (86%) showed significant associations between maternal emotional and behavioral regulation and parenting practices. Mothers' emotional dysregulation was related to a high risk of maltreatment and negative parenting, such as unsupportive reactions and harsh discipline. High maternal emotional dysregulation and negative parenting, in turn, were associated with children's aggressive behaviors. Conversely, when mothers exhibited high emotional regulation, they engaged in more positive and supportive parenting. Additionally, maternal behavioral regulation with inhibitory control and effortful control led to supportive and warm parenting. Individual and contextual factors, such as maternal victimization history and symptoms of inattention and hyperactivity, had effects on maternal emotional dysregulation, which, in turn, impacted their parenting practices. Consequently, emotional and behavioral regulation played a crucial role in mothers' parenting practices with their children and adolescents. The findings of the current review could contribute to planning parenting interventions, including maternal emotional and behavioral regulation skills, aimed at preventing maltreatment of their children.

Stress and self-regulation behaviors in preterm neonates hospitalized at open-bay and single-family room Neonatal Intensive Care Unit.

The Neonatal Intensive Care Unit (NICU) could be a risk factor for the development of preterm neonates due to the stressful procedures they undergo. Stress-related behaviors must be managed through environmental strategies that support regulating the neonates' biobehavioural system to minimize the negative impact on their development. The study aimed to compare the NICU environment's stressful procedures and developmental care strategies and the stress and self-regulation behaviors of preterm neonates in groups differentiated by the NICU environmental design. The sample comprised 20 preterm neonates hospitalized in a NICU with an open-bay model (OB NICU) and 20 preterm neonates hospitalized in a single-family room model (SFR NICU). The stressful procedures were assessed by the Neonatal Infant Stressor Scale (NISS). The developmental care strategies and the preterm neonates' stress and self-regulation behaviors were assessed using a structured observational protocol. The between-group comparison was performed by the Mann-Whitney test, and the significance level was set at 5%. Both NICUs had similar stressful procedures and developmental care approaches. However, the preterm neonates hospitalized in the SFR NICU exhibited significantly fewer total stress behaviors, and specifically in the motor system, compared to those in the OB NICU. Additionally, the preterm neonates hospitalized in the SFR NICU exhibited significantly more total self-regulation behaviors, and specifically in the behavioral state system, compared to those in the OB NICU. The findings showed that the single-family room NICU model was consistent with the environmental protection of biobehavioural regulation in preterm neonates hospitalized in the NICU.

Maternal History of Childhood Adversities and Later Negative Parenting: A Systematic Review.

Adverse childhood experiences negatively impact future violence, victimization, perpetration, health, and lifelong development. The aim of the present study was to systematically review the scientific evidence of empirical studies on the association between maternal childhood adversity in a familial context, including maltreatment, household challenges, and later maternal negative parenting. A search was performed in the PubMed, PsycINFO, Web of Science, SciELO, and LILACS databases, using the combination of the following keywords: (neglect OR abuse OR maltreatment OR harsh parenting OR punishment OR discipline OR negative parenting practices) AND (adverse childhood experiences OR early adversity OR cycle of violence OR cycle of maltreatment OR history of maltreatment) AND (mother OR maternal). The results of 29 studies showed predominantly significant direct associations between maternal childhood adversities and negative parenting with their children (83%). Parental stress was also significantly associated with a maternal history of childhood adversities. Focusing on the type of maltreatment practices, there were similar intergenerational transmission types: homotypic and heterotypic. Few studies have examined the protective factors that could buffer the negative impact of a maternal childhood history of adversities on later negative parenting.

Maternal History of Adversity and Subsequent Mother-Child Interactions at Early Ages: A Systematic Review.

Adverse childhood experiences (ACEs) can negatively impact physical, emotional, cognitive, and social development, consequently affecting the next generation. The aim of the present study was to systematically review evidence from empirical studies on the association between maternal history of adversity in childhood (maltreatment and household dysfunction) and subsequent mother-child interactions at an early age. A search was performed in the PubMed, Web of Science, PsycINFO, EMBASE, Scopus, LILACS, and SciELO databases to identify studies, including measures of maternal childhood adversities and mother-child interaction, published between 2016 and 2022. Twenty-nine studies met the inclusion criteria. The results showed that in 90% of the studies, maternal childhood adversities negatively impacted subsequent mother-child interactions in early childhood, reducing maternal displays of affection, emotional availability, sensitivity, mother-child communication, and bonding. Biological factors (e.g., genetic and hormonal) and maternal emotional recognition moderated these associations. In addition, biological factors (i.e., neurobiological and hormonal) and psychosocial factors (e.g., depression, executive functioning, and violence) acted as mediators. Preventive interventions should be implemented to break out of the intergenerational cycle of violence that impacts mother-child interactions.

Prevention of Child Maltreatment: Integrative Review of Findings From an Evidence-Based Parenting Program.

This integrative review of the ACT Raising Safe Kids (ACT)-child maltreatment prevention program for parents-focuses on the program's theoretical framework, examines the ACT studies about the effects on caregivers, and discusses the ACT's implications for the practice and public policy. A systematic search of the PubMed, Web of Science, PsycINFO, and Lilacs databases was performed, along with a search on the ACT Program website and contacting program researchers. Twenty-five studies evaluating the ACT Program were reviewed. The evaluation studies were conducted in the United States, Brazil, Portugal, and Peru. The program improved parenting practices in general and targeted populations such as incarcerated parents, mothers with a history of childhood violence, and mothers of preterm children. Additionally, the program was effective in decreasing child behavioral problems. Overall, the ACT Program effectively decreased hostile, aggressive, and coercive parenting and child behavior problems, which are key predictors of family violence.

Spanking and Corporal Punishment Parenting Practices and Child Development: A Systematic Review.

Violence against children is a significant problem, particularly during early childhood development. Spanking and other forms of corporal punishment in child-rearing have been used by families worldwide to correct children's unwanted behaviors. Despite previous studies focusing on the negative consequences of these parental practices, open questions remain. The present study aimed to systematically review the empirical studies published in scientific literature that examined the associations between parenting practices of spanking and corporal punishment of mothers and their children's behaviors and development in early childhood. Search was performed in PubMed, APA PsycNet, Web of Science, SciELO, and LILACS databases using the combination of the following keywords: ((spank OR physical punishment OR physical abuse OR physical maltreatment OR corporal punishment) AND (parenting)) AND (child* development OR child* behavior). The inclusion and exclusion criteria were applied and 34 articles were selected for review. The inclusion criteria were the following: studies that evaluated associations between maternal spanking or corporal punishment practices and behaviors or development of 0-to-6-year-old children; quantitative studies; studies published in English, Spanish, or Portuguese language. The results showed that in 94% of the studies, there were significant associations between maternal spanking and corporal punishment with deteriorated child behavior and development, concurrently or later. In addition, maternal physical practices also acted as mediators or moderator variables in models that explained behavioral and developmental problems in early childhood.

The impact of preterm birth on the executive functioning of preschool children: A systematic review.

This paper presents a systematic review of the impact of preterm childbirth on the later executive functioning of preschool-aged children. A systematic search for studies published between 2014 and 2019 was performed using the following keywords: executive funct* AND preterm AND child. The methodological quality of the reports was examined using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Thirty-two studies were reviewed and scored at least 67% on the methodological quality assessment. In comparison to children born full-term, preschool children born preterm exhibit executive functioning deficits in the dimensions of the global index, inhibitory control, cognitive flexibility, working memory, and planning/executive functioning. These findings are independent of the degree of prematurity at birth. Since executive functioning has many complex components, future studies should assess the dimensions of executive functioning separately in preschool-aged children born preterm, rather than as a single measure.

Universal Intervention to Strengthen Parenting and Prevent Child Maltreatment: Updated Systematic Review.

Child maltreatment is a severe worldwide public health problem because of its negative consequences and should therefore be prevented through parenting programs to improve parental behavior and practices. The present review aimed to update a published review of 5 years of empirical studies on universal parenting programs to strengthen positive parenting and prevent child maltreatment. A systematic search of the PubMed, Web of Science, PsycINFO, Lilacs, and SciELO databases was performed to identify the studies of group-based structured parenting programs published from 2015 to 2019. Eighteen studies were found that fulfilled the inclusion and exclusion criteria. The results showed that 14 different parenting programs were conducted in high-, medium-, and low-income countries, showing an increase in the number of studies in low-income countries compared with the previous review. In 89% of the studies, the parenting outcomes improved in the post-intervention. Additionally, studies have demonstrated that these programs also improved other parental outcomes such as mental health, couple relationships, coparenting, and coping ability of parents. From 18 studies, nine child variables were evaluated, and eight of them showed a decrease in behavior problems. Regarding the methodological quality of the studies, 55%, 28%, and 17% were classified as moderate, weak, and strong, respectively. In conclusion, the positive changes in parenting and child behavior outcomes encourage the implementation of parenting programs as a universal prevention strategy. Further research should increase the methodological quality of the design study.

Development of neonatal high-risk preterm infants in comparison to full-term counterparts.

Studies on preterm infants usually exclude high-risk neonatal infants with neurological problems. However, it is important to study high-risk preterm infants to better understand later developmental problems. Therefore, this cross-sectional study aimed to compare the cognitive, motor, language, and social-emotional development of high-risk preterm (PT) infants with infants born full-term (FT) with no biological vulnerabilities during early development (up to the first 15 months of age). The sample comprised 133 infants (54 born PT and 79 born FT) assessed in independent subsamples at 6-8 and 12-15 months of age, considering the corrected age for prematurity in the PT infants. Infant development (cognitive, motor, language, and social-emotional) was evaluated using the Bayley-III Scales. Medical charts were reviewed to obtain the clinical history. A multivariate analysis of variance and analysis of variance tests were performed to examine the differences between groups related to infant developmental indicators, controlling for age and socioeconomic variables. Although the PT infants performed significantly more poorly than their FT counterparts, the scores of the PT group were still within the normal range on all Bayley-III domains (cognitive, language, motor, and social-emotional) than their FT counterparts. The findings of the present study provide a better understanding of the developmental prognosis of high-risk PT infants and extend support for preventive intervention programs to improve early childhood development.

Relations between bedtime parenting behaviors and temperament across 14 cultures.

Objectives: The present study examined parental sleep-supporting practices during toddlerhood in relation to temperament across 14 cultures. We hypothesized that passive sleep-supporting techniques (e.g., talking, cuddling), but not active techniques (e.g., walking, doing an activity together), would be associated with less challenging temperament profiles: higher Surgency (SUR) and Effortful Control (EC) and lower Negative Emotionality (NE), with fine-grained dimensions exhibiting relationships consistent with their overarching factors (e.g., parallel passive sleep-supporting approach effects for dimensions of NE). Methods: Caregivers (N = 841) across 14 cultures (M = 61 families per site) reported toddler (between 17 and 40 months of age; 52% male) temperament and sleep-supporting activities. Utilizing linear multilevel regression models and group-mean centering procedures, we assessed the role of between- and within-cultural variance in sleep-supporting practices in relation to temperament. Results: Both within-and between-culture differences in passive sleep-supporting techniques were associated with temperament attributes, (e.g., lower NE at the between-culture level; higher within-culture EC). For active techniques only within-culture effects were significant (e.g., demonstrating a positive association with NE). Adding sleep-supporting behaviors to the regression models accounted for significantly more between-culture temperament variance than child age and gender alone. Conclusion: Hypotheses were largely supported. Findings suggest parental sleep practices could be potential targets for interventions to mitigate risk posed by challenging temperament profiles (e.g., reducing active techniques that are associated with greater distress proneness and NE).

Motor development curve from 0 to 12 months in infants born preterm.

AIM: To trace a reference curve for motor development from birth up to 12 months of corrected chronological age in infants born preterm and low birth weight. METHODS: This is a cross-sectional study with a sample of 308 preterm infants (53% boys) weighing < 2500 g at birth. The Alberta Infant Motor Scale (AIMS) was used for motor development assessment. RESULTS: Comparing the motor performance of preterm infants with infants from a standardized sample on the AIMS, it was found that, except for the age group of the newborn, preterm infants showed lower motor development scores in comparison with the AIMS normative sample in all age groups between 1 and 12 months. The curve of motor development showed a continuous increase in the number of motor skills of preterm infants during their first 12 months of age. However, the average of motor acquisitions of preterm infants showed a nonlinear pattern with a standard indicator of stabilization between 8 and 10 months of age. CONCLUSION: Preterm infants, 1-12 months of age, showed motor development AIMS scores lower than the standards established in the normative sample. The findings may contribute as norm-reference for assessing the motor development of preterm infants in follow-up programmes in developing countries.

Perceptions of breastfeeding in mothers of babies born preterm in comparison to mothers of full-term babies.

The purpose of the present study was: a) to describe the theme of verbalizations about breastfeeding in mothers' pre-term (M-PT) and full-term (M-FT) infants; b) to examine the association between these themes and mother's anxiety and depression indicators and socio-demographic characteristics and, neonatal characteristics of the infants. The sample consisted of 50 M-PT and 25 M-FT. The mothers were assessed through State-Trait Anxiety Inventory and Beck Depression Inventory and were interviewed using a Guide focusing breastfeeding issues. The M-PT group had significantly more mothers with clinical symptom of anxiety than the M-FT group. The M-PT reported more uncertainties and worries about breastfeeding and figured out more obstacles for the successful breastfeeding than the M-FT. These reports were associated positively with the infants' risk neonatal status; lower birth-weight, higher neonatal clinical risk, and more length time stay in NICU were associated with more mothers' worries and seeing obstacles for breastfeeding. In conclusion, the strategies to enhance the breastfeeding rate in the preterm population have to take into account the mothers' psychological status and their ideas in addition to offering information about the advantages of breastfeeding for child development.

Negative affectivity moderated by preterm birth predicted toddlers' behavior problems.

OBJECTIVE: The present study aimed to examine the predictive effect of temperament moderated by preterm childbirth on behavioral problems in toddlerhood. METHOD: The sample comprised 100 toddlers of 18-36 months of chronological age and their mothers. They were divided into two groups: 50 toddlers born preterm and admitted to the Neonatal Intensive Care Unit (PT group), and 50 toddlers born full-term (FT group) and recruited from day-care centers. Mothers completed questionnaires about toddlers' temperament and behavior. The Early Childhood Behavior Questionnaire was used to assess temperament, and the Child Behavior Checklist (CBCL 1¹/²-5) to evaluate the total, internalizing, and externalizing behavior problems. Multiple regression analysis was performed to examine the moderation effects of preterm childbirth and temperament factors after controlling for toddlers' age and socioeconomic level. RESULTS: There was a moderation effect between preterm childbirth and temperament. Temperament with more Negative Affectivity, moderated by preterm birth, and less Effortful Control explained the total, internalizing, and externalizing behavior problems. CONCLUSION: The findings contribute to a better understanding of the impact of preterm childbirth and the dispositional traits of temperament on behavioral problems of toddlers born preterm.

Links between television exposure and toddler dysregulation: Does culture matter?

Television exposure in early childhood has increased, with concerns raised regarding adverse effects on social-emotional development, and emerging self-regulation in particular. The present study addressed television exposure (i.e., amount of time watching TV) and its associations with toddler behavioral/emotional dysregulation, examining potential differences across 14 cultures. The sample consisted of an average of 60 toddlers from each of the 14 countries from the Joint Effort Toddler Temperament Consortium (JETTC; Gartstein & Putnam, 2018). Analyses were conducted relying on the multi-level modeling framework (MLM), accounting for between- and within-culture variability, and examining the extent to which TV exposure contributions were universal vs. variable across sites. Effects of time watching TV were evaluated in relation to temperament reactivity and regulation, as well as measures of emotional reactivity, attention difficulties, and aggression. Results indicated that more time spent watching TV was associated with higher ratings on Negative Emotionality, emotional reactivity, aggression, and attention problems, as well as lower levels of soothability. However, links between TV exposure and both attention problems and soothability varied significantly between cultures. Taken together, results demonstrate that increased time spent watching television was generally associated with dysregulation, although effects were not consistently uniform, but rather varied as a function of culturally-dependent contextual factors.

Effortful control and attention as predictors of cognition in children born preterm.

BACKGROUND: Preterm childbirth increases the risk of developmental problems. The aim of the present study was to examine the effects of temperament and attention on the cognition of school-age children who were born preterm, controlling for socioeconomic variables. MATERIAL AND METHODS: The sample was composed of 50 six-year-old children who were born preterm with very low birth weight. The children were evaluated using the Wechsler Intelligence Scale for Children (WISC-III) and the Cancellation Attention Test. The mothers were interviewed using the Children's Behavior Questionnaire (CBQ). Statistical multiple linear regression analyses were performed. RESULTS: 70% of the children presented average or above-average full intellectual quotient (IQ). In the attention total score, 74% of the children were also within the average range or above. High verbal IQ associated with high maternal schooling explained 73% variability of the full IQ. High attention and maternal schooling, associated with children's temperament with more effortful control, explained 35% variability of the verbal IQ. High attention, associated with high maternal schooling and socioeconomic level, explained 37% variability of the performance IQ. The neonatal clinical variables (gestational age, birth weight, 5th-minute Apgar, and length of stay in neonatal intensive care unit (NICU) and hospital) were not predictors of cognitive outcomes. CONCLUSION: The majority of the children who were born preterm presented average or above-average cognitive and attentional performances at school age, demonstrating potential resources for learning. Taken together, attention and temperament, associated with maternal schooling and socioeconomic status, were predictors of cognitive outcomes of children born preterm at school age.

Does preterm birth affect child temperament? A meta-analytic study.

The present meta-analytic study was conducted to examine differences in temperament between preterm and full-term children, considering behavior style and psychobiological approaches. Moreover, we explored the potential moderators of the associations between prematurity and temperament. A systematic literature search was performed on PubMed, Scopus, Web of Science, and CINAHL. Twenty-two studies were analyzed. Preterm children showed a higher Activity level as well as lower Attentional Focusing and Attention Span/Persistence, in comparison with their full-term counterparts. Extremely preterm children showed a higher Activity level than other preterm levels. These findings support the conclusion that preterm children present with a less regulated temperament relative to those born full term.