Unique Profiles of Postpartum Family Needs and Evidence of Racial and Ethnic Disparities: Insights from Community Implementation of Family Connects.

OBJECTIVES: To delineate specific family needs during the postpartum period using data from Family Connects (FC), a universal home-visiting initiative, and to scrutinize potential racial and ethnic disparities in these needs. METHOD: FC implementation data spanned from July 1, 2009, to August 31, 2021, in seven counties across the USA. Data encompassed nurse-led in-home assessments for 34,119 families. Nurses evaluated needs across four domains (healthcare, parenting/childcare, safe home, and parent support) comprising 12 risk factors. FINDINGS: Overall, families reported high levels of need, and community connections were facilitated for 57% of visited families. Significant differences in need profiles between whites and minority groups were revealed, reflecting both disparity and uniqueness. Employing the Oaxaca decomposition approach, we found that racial/ethnic disparities in socioeconomic attributes were associated with racial/ethnic gaps in the need profiles. CONCLUSIONS: The event of giving birth is both high risk and high opportunity for preventive intervention. Home-visiting programs, as an evidence-based approach, must address the diverse spectrum of familial needs comprehensively.

Building an ecological momentary assessment smartphone app for 4- to 10-year-old children: A pilot study.

OBJECTIVE: Ecological momentary assessment (EMA) minimizes recall burden and maximizes ecological validity and has emerged as a valuable tool to characterize individual differences, assess contextual associations, and document temporal associations. However, EMA has yet to be reliably utilized in young children, in part due to concerns about responder reliability and limited compliance. The present study addressed these concerns by building a developmentally appropriate EMA smartphone app and testing the app for feasibility and usability with young children ages 4-10 (N = 20; m age = 7.7, SD = 2.0). METHODS: To pilot test the app, children completed an 11-item survey about their mood and behavior twice a day for 14 days. Parents also completed brief surveys twice a day to allow for parent-child comparisons of responses. Finally, at the end of the two weeks, parents provided user feedback on the smartphone app. RESULTS: Results indicated a high response rate (nearly 90%) across child surveys and high agreement between parents and children ranging from 0.89-0.97. CONCLUSIONS: Overall, findings suggest that this developmentally appropriate EMA smartphone app is a reliable and valid tool for collecting in-the-moment data from young children outside of a laboratory setting.

Risk and Protective Factors Associated with Adverse Childhood Experiences in Vulnerable Families: Results of a Randomized Clinical Trial of SafeCare®.

Early adversity predicts increased risk for mental and physical health problems. As such, intervention efforts, such as home-based parenting programs, have been initiated with vulnerable families to reduce adversity exposure and promote child well-being. The present randomized clinical trial had a parallel design and 1:1 allocation ratio of SafeCare augmented for an urban high-risk population (SC+) compared to standard home-based mental health services (SAU) to examine risk and protective factors proximal to child maltreatment. Parents (N=562) of young children (5 years or less) at risk of depression, intimate partner violence, or substance abuse were randomized to SC+ or SAU. A significant program effect was found in favor of SC+ for parental depression and social support, as well as within-group improvements for both groups in depression, intimate partner victimization, family resources, and social support. Promising next steps include future trials examining how improvements in parental depression and social support impact child well-being over time and further augmentation of SafeCare to enhance healthy relationships and address cultural congruency of services.

Perceived Social Status and Suicidal Ideation in Maltreated Children and Adolescents.

Recent decades have seen an alarming increase in rates of suicide among young people, including children and adolescents ("youth"). Although child maltreatment constitutes a well-established risk factor for suicidal ideation in youth, few efforts have focused on identifying factors associated with maltreated youths' increased risk for suicidal ideation, especially across development. The present study examined the relations between maltreated youths' (N = 279, M = 12.06 years, 52% female, 53% Latinx) perceptions of their social status and suicidal ideation and compared those relations between pre-adolescents and adolescents. Findings revealed unique developmental patterns: Perceived social status was associated with suicidal ideation, but only in adolescents, who showed greater risk for suicidal ideation if they viewed themselves as lower ranked in society and lower risk for suicidal ideation if they viewed themselves as higher ranked in society. Findings have implications for scientific and practical efforts aimed at better understanding and preventing suicide in a high-risk developmental population.

Predictors of family violence in North Carolina following initial COVID-19 stay-at-home orders.

BACKGROUND: Although there is evidence that family violence increased in the United States during the COVID-19 pandemic, few studies have characterized longitudinal trends in family violence across the course of initial stay-at-home orders. OBJECTIVE: The purpose of the present study is to investigate patterns and predictors of family violence, such as child maltreatment and harsh punishment, during the first eight weeks of the pandemic after initial stay-at-home orders in North Carolina. PARTICIPANTS AND SETTING: Participants included 120 families with children ages 4-11 (53% non-White, 49% female) and a primary caregiver (98% female) living in rural and suburban areas in North Carolina. Participants were recruited based on high risk of pre-pandemic family violence exposure. METHODS: Caregivers completed weekly surveys during the pandemic assessing family violence, caregiver employment status, and caregiver emotion reactivity. In addition, all caregivers completed pre-pandemic surveys on family violence. RESULTS: Mixed-effects models revealed that family violence was highest following initial stay-at-home orders and decreased linearly over time. Higher pre-pandemic child violence exposure and caregiver unemployment were associated with higher initial family violence. Higher caregiver emotion reactivity was associated with changes in family violence across time. CONCLUSIONS: We observed high levels of family violence following stay-at-home orders, especially in families with higher baseline violence, higher caregiver emotion reactivity, and caregiver unemployment or underemployment. These associations suggest that vulnerable families may respond to the additional stressor of stay-at-home orders with increased violence and thus need additional support in moments of crisis.

Heterogeneity of Social Marginalization in Early Adolescence: Longitudinal Associations with Behavioral and Social Adjustment.

Integration into formal and informal peer groups is a key developmental task during early adolescence. As youth begin to place greater value on attaining acceptance and popularity among peers, social status among one's peer group becomes an important marker of social functioning during this developmental period. Whereas much empirical research has been devoted to understanding heterogeneity among youth holding high status positions, similar distinctions have largely not been examined among socially marginalized youth. The present study sought to address this gap in the research by examining the extent to which two aspects of social marginalization, peer rejection and social network isolation, were differentially associated with trajectories of social and behavioral adjustment across two school years in early adolescence. Peer nominations were used to assess rejection, isolation, and the behavioral outcomes of interest (i.e., aggression, internalizing behaviors, and victimization), and participants self-reported the extent to which peers would come to their aid in bullying situations (i.e., peer protection from bullying). Using a longitudinal sample of early adolescents (n = 1075; 53.0% female; 47.2% White; 27.1% African American; 12.7% Hispanic) in grades 5 through 7, preliminary analyses revealed little overlap between rejection and isolation at each time point. Moreover, a series of multilevel models revealed that rejection and isolation were associated with somewhat distinct behavioral and social adjustment trajectories. Peer rejection was positively associated with peer-nominated aggression, both within and across time points, and negatively associated with prosocial behaviors. Conversely, isolation was positively associated with peer-nominated internalizing behaviors, both within and across time points. Rejection and isolation were each positively associated with peer nominations of victimization; however, only isolation was related to lower perceptions of peer protection from bullying. In general, support was found for assessing rejection and isolation as two distinct forms of social marginalization in early adolescence.

Adversity and Emotional Functioning.

Exposure to early adversity has been linked to variations in emotional functioning. To date, however, the precise nature of these variations has been difficult to pinpoint given widespread differences in the ways in which aspects of emotional functioning are defined and measured. Here, more consistent with models of emotional functioning in typically developing populations (e.g., Halberstadt et al., 2001), we propose defining emotional functioning as consisting of distinct domains of emotion expression, perception, knowledge, reactivity, and regulation. We argue that this framework is useful for guiding hypothesis generation about the specific impact of early adversity on children's emotional functioning. We operationalize the construct of emotional functioning, highlight what is currently known about the association between adversity exposure and each domain of emotional functioning, propose potential mechanisms for these associations, and set the stage for future research examining the development of emotional functioning in the context of early adversity.

Quality of Sibling Relationships in Maltreated Youth Residing in Out-of-Home-Care.

When children are removed from their parents's custody because of substantiated maltreatment and placed in out-of-home placements, they may be placed separately from siblings, potentially leading to even higher levels of stress in children. This possibility emerges insofar as siblings serve as a source of support during the uncertain times that accompany maltreatment and subsequent removal. We explored these issues in the present study, focusing on whether sibling relationship quality was related to post-removal behavioral functioning in maltreated children and adolescents. A total of 102 six- to seventeen-year-olds residing in a residential facility completed questionnaires about their sibling relationship quality and behavioral functioning. With age, sibling relationships became more hostile; although in girls, sibling affection also increased with age, at least when their sibling was a girl. Sibling hostility was related to increases in aggression and behavioral problems. Surprisingly, greater sibling affection was associated with increased problems, particularly when children had little contact with their sibling. Results provide insight into perceptions of sibling relationships in maltreated children and have implications for placement decisions.

Primary and Secondary Variants of Psychopathic Traits in at-Risk Youth: Links with Maltreatment, Aggression, and Empathy.

The current study examined whether two variants of psychopathic traits (PT) were identifiable in high-risk youth who had not yet been identified as antisocial, some of whom had documented histories of maltreatment (N = 167, Mage = 14.84), and then whether the variants differed in levels of aggression and empathy. High-PT youth with low anxiety and trauma (i.e., primary variant PT) and high anxiety and trauma (i.e., secondary variant PT) were differentiated. The secondary variant group was comprised largely of youth with documented histories of maltreatment. This group of youth also reported higher levels of proactive and reactive aggression than did the primary variant youth and low-PT youth. All youth reported similar levels of affective empathy and only small differences in cognitive empathy emerged: Primary variant youth reported lower cognitive empathy than low-PT youth. Findings support generalization of two variant groups of youth with psychopathic traits to diverse, high-risk samples not already identified as antisocial and have important implications for policy and practice.

Early adversity and children's emotion regulation: Differential roles of parent emotion regulation and adversity exposure.

Exposure to early life adversity (ELA) is associated with increased rates of psychopathology and poor physical health. The present study builds on foundational work by Megan Gunnar identifying how ELA results in poor long-term outcomes through alterations in the stress response system, leading to major disruptions in emotional and behavioral regulation. Specifically, the present study tested the direct effects of ELA against the role of parent socialization to shed light on the mechanisms by which ELA leads to emotion regulation deficits. Children ages 4-7 years (N = 64) completed interviews about their experiences of deprivation and threat, a fear conditioning and extinction paradigm, and an IQ test. Parents of the children completed questionnaires regarding their own emotion regulation difficulties and psychopathology, their children's emotion regulation, and child exposure to adversity. At the bivariate level, greater exposure to threat and parental difficulties with emotion regulation were associated with poorer emotion regulation in children, assessed both via parental report and physiologically. In models where parental difficulties with emotion regulation, threat, and deprivation were introduced simultaneously, regression results indicated that parental difficulties with emotion regulation, but not deprivation or threat, continued to predict children's emotion regulation abilities. These results suggest that parental socialization of emotion is a robust predictor of emotion regulation tendencies in children exposed to early adversity.

Participation in Social Skills Therapy is Associated With Enhanced Recall Memory by Children With Down Syndrome: An Exploratory Study.

Participation in social skills therapy (SST) facilitates cognitive functioning in children with developmental disabilities. The present pilot study examined whether participation in SST was associated with enhanced encoding and 1-month delayed recall in children with Down syndrome (DS). Children were presented with novel three-step event sequences in an elicited imitation procedure. Immediate imitation was permitted as an index of encoding; long-term memory was assessed 1 month later. Parents completed questionnaires inquiring about children's participation in SST. Participation in SST was associated with enhanced encoding of temporal order information and 1-month delayed recall of individual target actions. In addition, encoding mediated the relation between group and 1-month delayed recall. The conducted research indicates that involvement in SST may be beneficial for children with DS despite their noted strengths in imitation and social learning. As such, additional experimental work is warranted to determine causality.

Sleep problems and recall memory in children with Down syndrome and typically developing controls.

BACKGROUND: Research conducted with typically developing (TD) infants and children generally indicates that better habitual sleep and sleep after learning are related to enhanced memory. Less is known, however, about associations between sleep and recall memory in children with Down syndrome (DS). AIMS: The present study was conducted to determine whether parent-reported sleep problems were differentially associated with encoding, 1-month delayed recall memory, and forgetting over time in children with DS and those who were TD. METHODS AND PROCEDURES: Ten children with DS (mean age = 33 months, 5 days) and 10 TD children (mean age = 21 months, 6 days) participated in a two-session study. At each session, recall memory was assessed using an elicited imitation paradigm. Immediate imitation was permitted at the first session as an index of encoding, and delayed recall was assessed 1 month later. In addition, parents provided demographic information and reported on child sleep problems. OUTCOMES AND RESULTS: Although parents did not report more frequent sleep problems for children with DS relative to TD children, regression-based moderation analyses revealed that more frequent sleep problems were associated with increased forgetting of individual target actions and their order by children with DS. Evidence of moderation was not found when examining encoding or delayed recall. CONCLUSIONS AND IMPLICATIONS: Although group differences were not found when considering parent-reported sleep problems, more frequent sleep problems were positively associated with increased forgetting by children with DS relative to those who were TD. Although future experimental work is needed to determine causality, these results suggest that improved sleep in children with DS might reduce forgetting, ultimately improving long-term recall memory.

Early Environmental Unpredictability: Implications for Youth's Perceptions and Social Functioning.

According to an evolutionary perspective, early environmental unpredictability induces expectations in youth that their future is uncertain and increases their likelihood of engaging in opportunistic, impulsive, and aggressive behaviors. Although considerable evidence supports the links between environmental unpredictability and such behaviors, less is known about how youth growing up in volatile environments actually perceive their lives and how these perceptions relate to their behavior. In this study, two samples of 10-17 year-olds, one with a history of maltreatment and removal from home (n = 90; 52% female; 67% Hispanic-American) and one without (n = 80; 54% female; 69% Hispanic-American), reported on their perceptions of unpredictability and social functioning. Maltreated youth endorsed greater perceptions of unpredictability than non-maltreated youth. For both groups, greater perceptions of unpredictability were associated with increased aggression and conduct problems and decreased prosociality. Findings advance understanding of a developmental pathway contributing to opportunistic and risky social behavior in youth.

Deprivation and threat, emotion dysregulation, and psychopathology: Concurrent and longitudinal associations.

Maltreatment increases risk for psychopathology in childhood and adulthood, thus identifying mechanisms that influence these associations is necessary for future prevention and intervention. Emotion dysregulation resulting from maltreatment is one potentially powerful mechanism explaining risk for psychopathology. This study tests a conceptual model that distinguishes deprivation and threat as distinct forms of exposure with different pathways to psychopathology. Here we operationalize threat as exposure to physical and/or sexual abuse and deprivation as exposure to neglect. We test the hypothesis that threat and deprivation differentially predict use of avoidant strategies and total regulation. Data were drawn from the Longitudinal Studies on Child Abuse and Neglect (LONGSCAN study; N = 866), which followed high-risk children from age 4 to 18. At age 6, children and their parents reported on adversity exposure. Case records documented exposure to abuse and neglect. At 18, adolescents reported on regulation strategies and psychopathology. Regression analyses indicated that greater exposure to threat, but not deprivation, predicted greater use of avoidant strategies in adolescence. Moreover, avoidance partially mediated the longitudinal association between exposure to threat in early childhood and symptoms of internalizing psychopathology in adolescence. Results suggest that abuse and neglect differentially predict regulation strategy use and that regulation strategy use predicts psychopathology.

Cognitive Functioning in Children with Down Syndrome: Current Knowledge and Future Directions.

Infants and children with Down syndrome (DS) can look forward toward bright futures, as individuals with DS are living healthier, more productive lives than ever due to medical advances, opportunities for early and continued intervention, and inclusive education. Despite these advances, infants and children with DS experience challenges in specific domains of cognitive functioning relative to their typically developing (TD) peers. Over the long term, individuals with DS are also more likely to develop Alzheimer's disease relative to the general population. Understanding cognitive functioning early in life may be important in charting cognitive decline over time. This chapter synthesizes the literature on cognitive functioning in infants and children with DS specific to general intelligence or IQ, language development, recall memory, and executive functioning, with additional focus on critical issues and future directions. These research findings provide important information for understanding cognitive competencies and intervention opportunities for children with DS and also serves to provide a foundation from which to plan longitudinal studies examining stability and change in cognitive functioning over time.

Unpacking the Associations Among Maltreatment, Disengagement Coping, and Behavioral Functioning in High-Risk Youth.

Given the association between child maltreatment and a host of negative behavioral consequences, there remains a need to continue to identify mechanisms underlying this association as a means of improving intervention efforts. The present study examined one potential mechanism, namely, disengagement coping. We asked 6- to 17-year-old maltreated ( n = 249) and comparison ( n = 133) youth questions about emotional experiences that induced sadness and anger, strategies they used to cope with those emotions, and behavioral functioning (i.e., behavioral problems and aggression). Maltreated adolescents reported higher levels of behavioral problems and aggression relative to comparison adolescents, and adolescents who disengaged from emotional situations reported more behavioral problems relative to those who did not disengage. Tests of mediation suggested that, for adolescent-age youth, part of the association between maltreatment status and behavioral problems was explained by disengagement. In children, maltreatment was not associated with disengagement or behavioral problems. Results have implications for understanding age-related differences in the emotional and behavioral consequences of maltreatment.

Three-year Trajectories of Emotional Expressiveness among Maltreating Mothers: The Role of Life Changes.

Parents are perhaps the most direct and profound influences on children's development of emotional competence. For example, how and what emotions parents express in the family has implications for children's ability to understand and regulate their emotions. What is less well understood is what potential environmental or contextual factors impact parents' emotional expressiveness, particularly in high-risk samples prone to atypical emotional expressiveness (e.g., deficits in the production and recognition of emotional expressions). The present longitudinal study examined the association between life changes and parents' expression of positive and negative emotions, as well as, how these associations changed over time in a sample of maltreating mothers. Eighty-eight mothers with a substantiated history of physical abuse completed measures of emotional expressiveness and life changes experienced over the past 6 months when their children were in preschool, kindergarten, and first grade. Results indicated that life changes decreased over time, while parental emotional expressiveness remained stable. Moreover, life changes were associated across time with the expression of negative emotions, but were unrelated to expressions of positive emotions. Findings have important implications for understanding emotional expressiveness in high-risk samples.

Longitudinal associations between physically abusive parents' emotional expressiveness and children's self-regulation.

The present study took a developmental psychopathology approach to examine the longitudinal association between parents' emotional expressiveness and children's self-regulation. Data collection spanned from 2004 to 2008. Ninety-two physically abusive parents completed yearly assessments of their emotional expressiveness, as well as their children's self-regulation abilities. Observational and behavioral measures were also obtained yearly to capture both parents' emotional expressiveness and children's self-regulation. Specifically, parents participated in a parent-child interaction task, which provided insight into their levels of flat affect. A puzzle box task was completed by each child to assess self-regulation. Results indicated, first, that greater parental expression of negative emotions predicted poorer self-regulation in children, both concurrently and across time. Second, parental expressions of positive emotions and parents' flat affect were unrelated to children's self-regulation. Findings inform our understanding of parental socialization of self-regulation and provide insight into the roles of distinct components of emotional expressiveness. Moreover, findings have crucial implications for understanding emotional expressiveness in high-risk samples and increase our understanding of within-group functioning among maltreating families that may serve as a means to direct intervention efforts.

The role of maltreatment in the development of coping strategies.

Child maltreatment leads to deleterious effects in virtually every developmental domain, including cognitive, psychological, and behavioral functioning. Although difficulties with coping have been identified as contributing to these effects, less attention has been paid to the precise nature of maltreated children's coping difficulties, particularly in terms of the strategies they use to cope with negative emotions and how these strategies vary with age. We asked maltreated (n = 195) and comparison (n = 103) 10 to 17 year olds to describe emotional experiences and what strategies they used to cope with those emotions. Maltreated adolescents reported using more disengagement and antisocial strategies than did comparison adolescents. Differences between maltreated and comparison adolescents were consistent across age. Results have important implications for treatment and intervention efforts designed to improve coping strategies among vulnerable maltreated populations.

Parental Attachment and Children's Memory for Attachment-Relevant Stories.

Despite evidence that parents' attachment is associated with children's memory, less is known about the mechanisms underlying this association or the contexts in which the association is most meaningful. The present study examined whether parents' attachment predicted children's memory for stories about attachment-related topics, whether the cohesiveness of children's stories mediated the association between attachment and memory, and whether the association varied by interview support at retrieval. Five- to 6-year-olds completed attachment-relevant stories while parents provided information about their romantic attachment. Children's stories were coded for cohesiveness. A week later, children's memory for their stories was tested by either a supportive or non-supportive interviewer. When the interview was non-supportive, greater parental avoidance was associated with poorer memory, whereas when the interview was supportive, greater parental avoidance was associated with fewer errors. Findings provide insight into the context under which parents' attachment is most influential in shaping children's memory.