An invited commentary on mentoring in infant mental health: A symposium commemorating Robert N. Emde.

This paper is based on a symposium on mentoring in infant mental health that took place at the 18th World Association for Infant Mental Health (WAIMH) conference. The symposium commemorated Robert N. Emde who was one of the founders of the field of Infant Mental Health, and devoted much of his career to mentorship. From an IMH perspective, mentoring experiences are best thought of as relationships, significant for both mentor and mentee, with positive mentoring experiences crucial for the development of IMH clinicians and researchers. The symposium participants, two pairs of mentor-mentee dyads, first gave an opening statement about what mentoring meant for them generally and personally, and then addressed three issues: the goodness of fit between mentor and mentee, "light and shadow" in mentoring relationships, and balancing old wisdom with new trends in mentoring. The paper brings the participants' views and personal experiences regarding these issues in their own words, highlighting key personal and professional issues related to mentorship from the perspectives of both mentor and mentee.

Cet article est basé sur un symposium sur le Mentorat en Santé Mentale de la Petite Enfance qui s'est tenu lors de la 18ème conférence de l'Association Mondiale pour la Santé Mentale de la Petite Enfance (World Association Infant Mental Health ­ WAIMH). Ce symposium a commémoré Robert N. Emde qui fut l'un des fondateurs du domaine de la Santé Mentale de la Petite Enfance et a consacré une large partie de sa carrière au mentorat. Du point de vue de la Santé Mentale de la Petite Enfance les expériences de mentorat sont davantage considérées comme des relations, importantes pour à la fois le et le ou la mentoré(e), avec des expériences de mentorat positives et cruciales pour le développement des cliniciens et des chercheurs IMH. Les participants au symposium, deux paires de dyades mentor­mentoré, ont d'abord fait un discours d'ouverture sur ce que le mentorat signifiait pour eux généralement et personnellement, et ont ensuite parlé de trois défis: le bon ajustement entre mentor et mentoré, « la lumière et l'ombre ¼ dans la relation de mentorat et l'équilibre de la vieille sagesse avec les nouvelles tendances dans le mentorat. Cet article récapitule les vues et les expériences personnelles des participants pour ce qui concerne ces défis, avec leurs propres mots, mettant en valeur les défis personnels et professionnels clés liés au mentorat de la perspective d'à la fois le mentor et le mentoré.

Este artículo se basa en un simposio sobre Consejería en el campo de la Salud Mental Infantil que se llevó a cabo en el Decimoctavo Congreso de la Asociación Mundial para la Salud Mental Infantil (WAIMH). El simposio fue dedicado a Robert N. Emde, uno de los fundadores del campo de Salud Mental Infantil, quien dedicó gran parte de su carrera a la consejería y guía profesional. Desde una perspectiva de IMH, la mejor interpretación de las experiencias de consejería es verlas como una significativa relación tanto para el consejero como para el aconsejado, considerando que las positivas experiencias son cruciales para el desarrollo de los profesionales clínicos e investigadores de IMH. Los participantes en el simposio, dos pares de díadas consejero­aconsejado, dieron primero una presentación de apertura sobre lo que significaba para ellos la consejería general y personalmente, para entonces abordar tres asuntos: la bondad de ajuste entre consejero y aconsejado, "Luz y Sombra" en la relación de consejería, así como el equilibrio en la consejería entre la vieja sabiduría y los nuevos acercamientos. El ensayo presenta los puntos de vista y experiencias personales de los participantes sobre estos asuntos en sus propias palabras, subrayando asuntos personales y profesionales claves relacionados con la consejería desde la perspectiva tanto del consejero como del aconsejado.

Do dimensions of childhood adversity differ in their direct associations with youth psychopathology? A meta-analysis.

Growing evidence supports the unique pathways by which threat and deprivation, two core dimensions of adversity, confer risk for youth psychopathology. However, the extent to which these dimensions differ in their direct associations with youth psychopathology remains unclear. The primary aim of this preregistered meta-analysis was to synthesize the associations between threat, deprivation, internalizing, externalizing, and trauma-specific psychopathology. Because threat is proposed to be directly linked with socioemotional development, we hypothesized that the magnitude of associations between threat and psychopathology would be larger than those with deprivation. We conducted a search for peer-reviewed articles in English using PubMed and PsycINFO databases through August 2022. Studies that assessed both threat and deprivation and used previously validated measures of youth psychopathology were included. One hundred and twenty-seven articles were included in the synthesis (N = 163,767). Results of our three-level meta-analyses indicated that adversity dimension significantly moderated the associations between adversity and psychopathology, such that the magnitude of effects for threat (r's = .21-26) were consistently larger than those for deprivation (r's = .16-.19). These differences were more pronounced when accounting for the threat-deprivation correlation. Additional significant moderators included emotional abuse and youth self-report of adversity. Findings are consistent with the Dimensional Model of Adversity and Psychopathology, with clinical, research, and policy implications.

Attachment relationship quality with mothers and fathers and child temperament: An individual participant data meta-analysis.

A growing body of research suggests that, compared with single parent-child attachment relationships, child developmental outcomes may be better understood by examining the configurations of child-mother and child-father attachment relationships (i.e., attachment networks). Moreover, some studies have demonstrated an above-chance level chance of concordance between the quality of child-mother and child-father attachment relationships, and child temperament has been offered as a plausible explanation for such concordance. To assess whether temperament plays a role in the development of different attachment network configurations, in this preregistered individual participant data meta-analysis we tested the degree to which the temperament dimension of negative emotionality predicts the number of secure, insecure-avoidant, insecure-resistant, and disorganized attachment relationships a child has with mother and father. Data included in the linear mixed effects analyses were collected from seven studies sampling 872 children (49% female; 83% White). Negative emotionality significantly predicted the number of secure (d = -0.12) and insecure-resistant (d = 0.11), but not insecure-avoidant (d = 0.04) or disorganized (d = 0.08) attachment relationships. Nonpreregistered exploratory analyses indicated higher negative emotionality in children with insecure-resistant attachment relationships with both parents compared to those with one or none (d = 0.19), suggesting that temperament plays a small yet significant role in child-mother/child-father insecure-resistant attachment relationships concordance. Taken together, results from this study prompt a more in-depth examination of the mechanism underlying the small yet significantly higher chance that children with increased negative emotionality have for developing multiple insecure-resistant attachment relationships. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Configurations of mother-child and father-child attachment relationships as predictors of child language competence: An individual participant data meta-analysis.

An individual participant data meta-analysis was conducted to test pre-registered hypotheses about how the configuration of attachment relationships to mothers and fathers predicts children's language competence. Data from seven studies (published between 1985 and 2014) including 719 children (Mage : 19.84 months; 51% female; 87% White) were included in the linear mixed effects analyses. Mean language competence scores exceeded the population average across children with different attachment configurations. Children with two secure attachment relationships had higher language competence scores compared to those with one or no secure attachment relationships (d = .26). Children with two organized attachment relationships had higher language competence scores compared to those with one organized attachment relationship (d = .23), and this difference was observed in older versus younger children in exploratory analyses. Mother-child and father-child attachment quality did not differentially predict language competence, supporting the comparable importance of attachment to both parents in predicting developmental outcomes.

Epigenetic Age Acceleration and Chronological Age: Associations With Cognitive Performance in Daily Life.

DNA methylation-derived epigenetic clocks offer the opportunity to examine aspects of age acceleration (ie, the difference between an individual's biological age and chronological age), which vary among individuals and may better account for age-related changes in cognitive function than chronological age. Leveraging existing ambulatory cognitive assessments in daily life from a genetically diverse sample of 142 adults in midlife, we examined associations between 5 measures of epigenetic age acceleration and performance on tasks of processing speed and working memory. Covarying for chronological age, we used multilevel models to examine associations of epigenetic age acceleration (Horvath 1, Horvath 2, Hannum, PhenoAge, and GrimAge clocks) with both average level and variability of cognitive performance. Positive age acceleration (ie, epigenetic age greater than chronological age) was associated with poorer mean processing speed (Horvath 1 and 2) and working memory (GrimAge). Higher chronological age was also associated with poorer mean processing speed and working memory performance. Further, positive age acceleration was generally associated with greater intraindividual variability in working memory and processing speed tasks, whereas being chronologically older was associated with less intraindividual variability. Although further work is needed, our results indicate age acceleration effects have comparable or greater size as those for chronological age differences, suggesting that epigenetic age acceleration may account for additional risk and interindividual variation in cognitive performance above chronological age.

Meta-analysis of associations between childhood adversity and diurnal cortisol regulation.

Childhood adversity has been associated with hypothalamic-pituitary-adrenal axis dysregulation, which is associated with mental and physical health consequences. However, associations between childhood adversity and cortisol regulation in the current literature vary in magnitude and direction. This multilevel meta-analysis examines the association between childhood adversity and diurnal cortisol measures, as well as potential moderators of these effects (adversity timing and type, study or sample characteristics). A search was conducted in online databases PsycINFO and PubMed for papers written in English. After screening for exclusion criteria (papers examining animals, pregnant women, people receiving hormonal treatment, people with endocrine disorders, cortisol before age 2 months, or cortisol after an intervention), 303 papers were identified for inclusion. In total, 441 effect sizes were extracted from 156 manuscripts representing 104 studies. A significant overall effect was found between childhood adversity and bedtime cortisol, r = 0.047, 95% CI [0.005, 0.089], t = 2.231, p = 0.028. All other overall and moderation effects were not significant. The lack of overall effects may reflect the importance of the timing and nature of childhood adversity to adversity's impact on cortisol regulation. Thus, we offer concrete recommendations for testing theoretical models linking early adversity and stress physiology.

Prospective Associations Between Early Childhood Intimate Partner Violence Exposure and Middle Childhood Internalizing and Externalizing Psychopathology.

Co-occurring adversities are common for young children with child protective services (CPS) involvement, with high rates of intimate partner violence (IPV) exposure in this population. Despite extensive research linking childhood IPV exposure to later psychopathology, fewer studies have examined the prospective associations between IPV exposure and psychopathology using a dimensional approach. Here, we conducted secondary analyses of data from a randomized controlled trial of a parenting intervention for CPS-involved children, examining the associations between early childhood IPV exposure (i.e., threat), co-occurring deprivation, and middle childhood internalizing and externalizing symptoms. Adversity variables were coded from data collected when children were infants (N = 249, Mage = 7.97 months) through 48-month assessments; internalizing and externalizing psychopathology were modeled as latent variables reflecting the mean of data from yearly assessments between ages 8 to 10. Results of our structural equation model demonstrated that, accounting for the effects of co-occurring deprivation, IPV exposure was significantly associated with both internalizing, ß = .38, p = .001, and externalizing, ß = .26, p = .019, symptoms. Results suggest links between early childhood IPV exposure (i.e., threat) and later psychopathology. Findings support screening and intervention efforts to mitigate the developmental sequelae of IPV exposure among CPS-involved children.

Parent Coaching Fidelity Trajectories of In-Person and Telehealth Sessions during the COVID-19 Pandemic.

The COVID-19 pandemic has posed significant challenges to delivery of preventive and mental health services, and providers have rapidly transitioned to telehealth service provision. Factors such as sudden isolation, financial strain, and physical and mental health stress presented unique challenges for providers and families and highlight the need for accessible and effective services. Thus, providers' fidelity of implementation during the pandemic is an important area for research. The current observational study compared providers' fidelity across in-person and telehealth-delivered sessions before and during the COVID-19 pandemic in Attachment and Biobehavioral Catch-up (ABC), a preventive parent coaching intervention for infants and toddlers. Participants included 24 providers (95% female, 42% White, M age = 37) who participated in ABC training and consultation during the COVID-19 pandemic. Providers' fidelity data (N = 593 sessions) were modeled longitudinally using hierarchical linear modeling, and separate intercepts and slopes were estimated for in-person and telehealth-delivered sessions. When data were modeled across all available sessions, results indicated that providers demonstrated improving fidelity over the course of training. When in-person and telehealth-delivered sessions were compared, providers' fidelity in telehealth-delivered ABC sessions was not significantly different from their fidelity in in-person sessions. Providers demonstrated improving fidelity over time in telehealth-delivered sessions. Thus, providers were able to maintain and improve ABC fidelity during the COVID-19 pandemic when provided with implementation support. Rapid transition to telehealth delivery can be successful when ongoing support such as consultation is provided.

The physiology of maternal sensitivity to distress: An exploratory study of mothers' electrocortical and sympathetic nervous system reactivity.

Maternal sensitivity in response to infant distress is related to a number of physiological processes, including electrocortical activity and activation of the sympathetic nervous system. Several studies have examined these systems in isolation, but limited work to date has investigated how they may moderate one another in relation to maternal behavior. The current exploratory study aimed to investigate the interactive effect of the late positive potential (LPP) and skin conductance level (SCL) on observed maternal sensitivity to distress. Ninety-five mothers of 6- to 12-month-old infants participated in two reactivity tasks measuring their LPP and SCL responses to child crying stimuli. Maternal sensitivity to distress was coded from video-recorded mother-infant interactions. Results showed a significant interaction effect, such that LPP reactivity to infant crying was positively related to maternal sensitivity to distress among mothers with relatively low SCL reactivity. The findings highlight the importance of examining multiple systems when characterizing the physiological basis of maternal behavior.

Correction: Dagan et al. A Lifespan Development Theory of Insecure Attachment and Internalizing Symptoms: Integrating Meta-Analytic Evidence via a Testable Evolutionary Mis/Match Hypothesis. Brain Sci. 2021, 11, 1226.

In the original article [...].

Attachment goes to court: child protection and custody issues.

Attachment theory and research are drawn upon in many applied settings, including family courts, but misunderstandings are widespread and sometimes result in misapplications. The aim of this consensus statement is, therefore, to enhance understanding, counter misinformation, and steer family-court utilisation of attachment theory in a supportive, evidence-based direction, especially with regard to child protection and child custody decision-making. The article is divided into two parts. In the first, we address problems related to the use of attachment theory and research in family courts, and discuss reasons for these problems. To this end, we examine family court applications of attachment theory in the current context of the best-interest-of-the-child standard, discuss misunderstandings regarding attachment theory, and identify factors that have hindered accurate implementation. In the second part, we provide recommendations for the application of attachment theory and research. To this end, we set out three attachment principles: the child's need for familiar, non-abusive caregivers; the value of continuity of good-enough care; and the benefits of networks of attachment relationships. We also discuss the suitability of assessments of attachment quality and caregiving behaviour to inform family court decision-making. We conclude that assessments of caregiver behaviour should take center stage. Although there is dissensus among us regarding the use of assessments of attachment quality to inform child custody and child-protection decisions, such assessments are currently most suitable for targeting and directing supportive interventions. Finally, we provide directions to guide future interdisciplinary research collaboration.

Ecological Predictors of Parental Beliefs about Infant Crying in a Randomized Clinical Trial of ABC.

OBJECTIVE: Attachment theory suggests that parent responsiveness to infant distress predicts secure parent-child attachment and subsequent healthy child development. While much is known about microsystem factors that interfere with responsive caregiving, there is a paucity of research investigating how exosystem factors, such as neighborhood crime, affect parenting. METHOD: In a sample of 200 diverse caregivers and their 5- to 21-month-old infants (M = 11.82; 49% male), we leveraged data from a randomized clinical trial of Attachment and Biobehavioral Catch-up (ABC), an attachment-based intervention, to assess whether individual level burden (indicated by single-parent status, low income, residential instability, young parenthood, parental psychopathology, and own history of early adversity) and neighborhood crime density (geocoded within a 500 ft radius of parent's residence) were associated with their beliefs about infant crying, an indicator of responsive parenting. RESULTS: Consistent with Bronfenbrenner's ecological systems' theory of development, both greater exposure to individual burden indicators and greater neighborhood crime density predicted greater maladaptive beliefs about infant crying, suggesting that contextual factors outside the household are associated with parenting cognitions. Further, when accounting for the effect of crime and individual burden on parental beliefs about infant crying, participation in the ABC intervention was effective in reducing maladaptive parenting beliefs. CONCLUSIONS: We consider implications for multi-level intervention approaches that target family processes, neighborhood-level factors, and policy initiatives to promote community wellbeing and positive child development.

A biomarker of maternal vicarious reward processing and its association with parenting behavior.

Parenting styles play a critical role in child well-being, yet the neural bases of parenting behaviors remain nebulous. Understanding the neural processes associated with parenting styles can both clarify etiological mechanisms underlying parenting behaviors and point us toward new targets for intervention. A novel electrocortical biomarker called the observational reward positivity (oRewP) that occurs in response to observing another receive a reward has been linked to self-reported authoritarian parenting behavior. The current study sought to replicate associations between the oRewP and self-reported and observationally-coded parenting in a sample of mothers selected to be at elevated risk for problematic parenting. Self-reported authoritarian parenting was associated with observationally-coded problematic discipline, while no other self-reported parenting scales were associated with observationally-coded scores. We replicated the previously reported association between a blunted oRewP and increased self-reported authoritarian parenting. We additionally found that an attenuated oRewP was associated with greater permissive parenting, and that only the relationship with permissive parenting was conserved after adjusting for other parenting styles and other relevant covariates. We did not find significant associations between the oRewP and observationally-coded parenting. The current findings suggest that the neural process indexed by the oRewP are relevant to parenting behavior. Further research is needed to better understand the discrepancy between self-reported and observed parenting.

A Lifespan Development Theory of Insecure Attachment and Internalizing Symptoms: Integrating Meta-Analytic Evidence via a Testable Evolutionary Mis/Match Hypothesis.

Attachment scholars have long argued that insecure attachment patterns are associated with vulnerability to internalizing symptoms, such as depression and anxiety symptoms. However, accumulating evidence from the past four decades, summarized in four large meta-analyses evaluating the link between insecure attachment subtypes and internalizing symptoms, provide divergent evidence for this claim. This divergent evidence may be accounted for, at least in part, by the developmental period under examination. Specifically, children with histories of deactivating (i.e., insecure/avoidant) but not hyperactivating (i.e., insecure/resistant) attachment patterns in infancy and early childhood showed elevated internalizing symptoms. In contrast, adolescents and adults with hyperactivating (i.e., insecure/preoccupied) but not deactivating (i.e., insecure/dismissing) attachment classifications showed elevated internalizing symptoms. In this paper, we summarize findings from four large meta-analyses and highlight the divergent meta-analytic findings that emerge across different developmental periods. We first present several potential methodological issues that may have contributed to these divergent findings. Then, we leverage clinical, developmental, and evolutionary perspectives to propose a testable lifespan development theory of attachment and internalizing symptoms that integrates findings across meta-analyses. According to this theory, subtypes of insecure attachment patterns may be differentially linked to internalizing symptoms depending on their mis/match with the developmentally appropriate orientation tendency toward caregivers (in childhood) or away from them (i.e., toward greater independence in post-childhood). Lastly, we offer future research directions to test this theory.

Reliability of reward- and error-related brain activity in early childhood.

Event-related potential (ERP) measures of reward- and error-related brain activity have emerged as potential biomarkers of risk for the development of psychopathology. However, the psychometric properties of reward- and error-related brain activity have been primarily investigated in adolescents and adults. It is critical to also establish the reliability of ERPs in younger children, particularly if they are used as individual difference measures of risk during key developmental periods. The present study examined the reliability of the reward positivity (RewP) and error-related negativity (ERN) among 80 children (Mage  = 6.9 years old; 50% female). Participants completed the doors, flanker, and go/no-go tasks twice, separated by approximately 8 months, while electroencephalography (EEG) was recorded. Results indicated that the RewP demonstrated strong internal consistency and test-retest reliability. The ERN also demonstrated strong internal consistency, but test-retest reliability was only significant for the ERN measured during the flanker task and not the go/no-go task. These results are largely consistent with reported psychometric properties of reward- and error related ERPs in adolescents and adults, suggesting that the ERN and RewP may be appropriate biomarkers of individual differences in populations ranging from early childhood to adulthood.

Early Adverse Experiences and Repeated Wheezing From 6 to 30 Months of Age: Investigating the Roles of Hypothalamic-Pituitary-Adrenal Axis Functioning, Child Sex, and Caregiving Sensitivity.

This study examined associations among early adversity, diurnal cortisol, child sex, and caregiver sensitivity at age 6 months in relation to wheezing in children (47% male) followed to 30 months. Analyses included 676 mother-child dyads, 393 of whom completed an observational caregiver sensitivity measure. Participants were primarily ethnic minorities (42.7% Black, 25.4% Hispanic); 22.1% of children had ≥ 1 wheezing episode. Higher adversity was associated with increased wheeze frequency and blunted diurnal cortisol slope. The indirect effect of adversity on wheezing through cortisol slope was significant for females, but not males. Higher caregiver sensitivity was protective against wheezing for males, but not females, with high cortisol. Findings suggest complex associations among adversity, cortisol, child sex, and caregiver sensitivity in predicting wheezing.

It takes a village: a call for engaging attachment with adjunct disciplines to clarify "in-house" clinical conundrums.

Researchers have long discussed the rich clinical applications of attachment theory. Specifically, clinicians have been compelled by the idea that insecure attachment, broadly speaking, may bring about stressful (real or perceived) interpersonal experiences that increases risk for internalizing symptoms. However, recent meta-analyses examining the links between attachment representations and internalizing symptoms have challenged this assumption, highlighting the importance of considering insecure attachment subtypes in understanding one's vulnerability for internalizing symptoms. Here we expand on this special issue's target papers and propose that, despite an increase in citation impact of clinically relevant attachment research, there are still core theoretical and methodological questions left unanswered. We highlight three clinical conundrums: (1) hyperactivating, but not deactivating, attachment is linked to increased internalizing symptoms in adolescence and adulthood; (2) the magnitude of the associations between insecure attachment subtypes and internalizing symptoms varies depending on the developmental period; and (3) self-reported, but not narrative-based, deactivating attachment is associated with increased internalizing symptoms. We call for engagement with adjunct academic disciplines to elucidate these issues. These clinical conundrums have important ethical implications regarding how we understand insecure attachment and necessitate close theoretical and empirical attention before attachment findings can truly inform clinical practice.

Indicators of deprivation predict diurnal cortisol regulation during infancy.

Dysregulation of diurnal cortisol rhythms is often seen among children exposed to early adversity and has been associated with a variety of negative physical and mental health outcomes. The present study examined whether two indicators of deprivation, sociodemographic burden and observed parental insensitivity, were associated with child diurnal cortisol rhythms among a diverse community sample of 250 infants ages 5 to 22 months (M = 12.68 months, 47.2% male). The sample was diverse in terms of socioeconomic status as assessed by household income (M = $59,163, SD = $57,775, range = $0-230,000) and infant race/ethnicity (41.6% African American, 19.2% White, 17.2% multiracial, 14.0% Hispanic/Latin, 2.8% Caribbean, 2.8% other, 1.2% American Indian/Alaska Native, and 1.2% Asian). Sociodemographic burden indicators were assessed through questionnaires completed by the parent. Parental sensitivity was assessed through observations of parents' interactions with their infants during a play interaction task. Cortisol was assayed from infant saliva samples collected at waking and bedtime across 3 days. Structural equation modeling revealed that higher sociodemographic burden, but not parental insensitivity, was associated with blunted diurnal cortisol slopes. Neither sociodemographic burden nor parental insensitivity were associated with the cortisol awakening response. These findings suggest that sociodemographic burden may be an important early predictor of diurnal cortisol slope dysregulation, highlighting the importance of interventions providing support to individuals who experience sociodemographic burden and promoting reduction of these early stressors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Externalizing behavior and stress system functioning in infants exposed to early adversity: A multi-system exploration.

Children who experience early adversity often show alterations across multiple stress response systems, including the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS). Changes in the diurnal rhythm of salivary cortisol (a marker of HPA axis functioning) and alpha-amylase (a marker of ANS functioning) may increase their probability of developing behavior problems. The goal of this study is to examine how these analytes may interact to predict externalizing behavior in infants exposed to early stress. Participants included 179 parents and their 6- to 20-month old infants recruited from a low-income neighborhood. Parents reported on their infants' externalizing behaviors and collected saliva samples from their children at wake-up and bedtime over three days. Diurnal cortisol and alpha-amylase were modeled using latent difference scores. Four models were tested examining the effects of cortisol and alpha-amylase morning values and slopes, as well as their interactions, on externalizing behavior. Results showed a significant interaction effect of cortisol and alpha-amylase morning values, such that low morning cortisol was associated with decreased externalizing behavior when morning alpha-amylase was high but not low. These findings highlight the importance of examining multiple systems when characterizing the physiological correlates of externalizing behavior among infants experiencing adversity.

Foster parent responsiveness and young children's diurnal cortisol production.

Foster children are at risk for dysregulated hypothalamic pituitary adrenal (HPA) axis functioning, conferring risk for negative health outcomes. Responsive parenting may support young children's HPA axis regulation; however, few studies have examined the association between responsive parenting and cortisol production among children in foster care. In a sample of 97 foster parent-child dyads, we examined whether variation in foster parent responsiveness was linked to children's waking and bedtime levels of cortisol. Children's saliva samples were collected at wake-up and bedtime for three consecutive days. Foster parent responsiveness, as indicated by parent sensitivity, intrusiveness, and positive regard, was assessed during video-recorded semistructured play interactions between foster parents and children. Foster parent responsiveness significantly predicted children's waking cortisol levels (ß = 0.26, p = .023). Follow-up analyses revealed that foster parent sensitivity uniquely predicted waking cortisol (ß = 0.46, p = .006), over and above other dimensions of parenting, such that children with more sensitive foster parents had higher waking cortisol than children with less sensitive foster parents. The association between foster parent sensitivity and the waking-to-bedtime slope of cortisol across the day was nonsignificant. Findings suggest that sensitive caregiving may support foster children's healthy HPA axis functioning.