A behavioural description of meaningful moments of interaction between people with profound intellectual disabilities and support staff.

BACKGROUND: It can be challenging for support staff to develop meaningful moments of interaction with people with profound intellectual disabilities. Gathering information on observable behaviour characterising such meaningful moments is expected to be beneficial. METHOD: Three staff-client dyadic interactions were videotaped for 30 min. During reviewing the recording, staff members indicated which moments of interaction they experienced as meaningful. Per dyad, one meaningful moment was microanalytically coded via a developed coding system, and behaviourally described. RESULTS: The coding system reliably coded behaviour at the micro level. Exploratory results indicated that looking, movement and touching were most shown, and that staff displayed this behaviour more frequently than their clients. Both exhibited behaviours substantially more often during meaningful moments than at their onset. DISCUSSION: People with profound intellectual disabilities are more engaged during meaningful moments of interaction compared to at their onset. In daily practice, cultivating circumstances increasing their involvement is important.

Postponement of the Newborn Hearing Screening during the COVID-19 Pandemic; Parental Experiences and Worries.

Early identification of hearing loss through newborn hearing screening followed by an early start of intervention has proven to be effective in promoting speech and language development in children with hearing loss. During the COVID-19 pandemic, newborn hearing screening was postponed for a group of newborns in the Netherlands. Therefore, meeting the guidelines for early identification was at risk. In this study, we examine parental attitudes, beliefs, and experiences concerning the hearing screening during the COVID-19 pandemic. Our results indicated that parents (n = 1053) were very positive about newborn hearing screening and their experiences with the screening, even during the COVID-19 pandemic. Parents' beliefs on the information provision around newborn hearing screening were more inconsistent. The results showed that parents with a postponed hearing screening felt less informed about the hearing screening than parents without a postponed screening. Furthermore, child and family characteristics affected how parents experienced newborn hearing screening. Parents with a premature child were more worried about the hearing abilities of their child before the screening took place. The results also indicate that deafness in the family might lead to parental worries around newborn hearing screening.

Socio-economic status and other potential risk factors for language development in the first year of life.

A wide variety of language skills has been shown to be compromised in children from low socioeconomic status (SES). However, few studies have investigated the effect of SES on language development in infants. The aim of this study is two-fold: to investigate when the first SES-effects on language can be observed and to explore the effects of three variables often claimed to be linked to SES - gestational duration, stress and parent-child interaction - on language development. Parents/caregivers of 539 Dutch-acquiring infants aged 8-13 months from mid to high SES backgrounds completed a questionnaire including the LENA Developmental Snapshot (Gilkerson et al., 2017a) and the Brigance Parent-Child Interaction Scale (Glascoe & Brigance, 2002). No association was found between SES and language development. However, the results suggest that corrected age and parent-child interaction positively influence language development at this early age.

Factors contributing to realizing valuable goals of students with dyslexia in higher education.

When students with dyslexia enter higher education, studying often creates challenges at different levels. Universities differ in the way they facilitate students with dyslexia in their educational careers. This study focusses on studying with dyslexia from a value-driven perspective. The aim of the study is to investigate valuable goals of students with dyslexia in higher education and the conversion factors that are stimulating and inhibiting in the realization of these valuable goals. Data were collected during focus groups: five focus groups of students with dyslexia (23 participants) and two focus groups of student counsellors (10 participants). Important values for students are their personal development and to prove they can succeed at university level. Not all students are able or being enabled to show their knowledge and skills and to grow within the educational system. Different personal and environmental factors are described that inhibit or facilitate the realization of valuable goals. The results are presented from two perspectives: of students and student counsellors. The implications of the results and guidelines for future research are discussed.

Meaningful moments of interaction with people with profound intellectual disabilities: Reflections from direct support staff.

BACKGROUND: High-quality, affective relationships are built on meaningful moments of interaction, which are challenging for support staff to establish with people with profound intellectual disabilities. Therefore, we explored what makes a moment of interaction meaningful to support staff and what circumstances facilitate meaningful moments of interaction taking place. METHOD: Five direct support staff took part in unstructured, in-depth interviews. The interviews were analysed using interpretative phenomenological analysis (IPA). Member checks were also conducted. RESULTS: Support staff experienced moments of interaction as meaningful because they felt a connection with a person with profound intellectual disabilities and/or they had the feeling of being meaningful for this person. Staff-related and contextual circumstances facilitating meaningful moments of interaction to take place were described. CONCLUSIONS: Meaningful moments of interaction are highly valued by support staff, who believe these moments are valued by persons with profound intellectual disabilities as well. Implications for daily practice are described.

Parents of young infants report poor mental health and more insensitive parenting during the first Covid-19 lockdown.

BACKGROUND: The Covid-19 pandemic has put an unprecedented pressure on families with children. How parents were affected by the first Covid-19 lockdown during the early postpartum period, an already challenging period for many, is unknown. AIM: To investigate the associations between Covid-19 related stress, mental health, and insensitive parenting practices in mothers and fathers with young infants during the first Dutch Covid-19 lockdown. METHODS: The Dutch Covid-19 and Perinatal Experiences (COPE-NL) study included 681 parents of infants between 0 and 6 months (572 mothers and 109 fathers). Parents filled out online questionnaires about Covid-19 related stress, mental health (i.e. anxiety and depressive symptoms), and insensitive parenting. Hierarchical regression models were used to analyze the data. RESULTS: Parents of a young infant reported high rates of Covid-19 related stress, with higher reported stress in mothers compared to fathers. Additionally, the percentages of mothers and fathers experiencing clinically meaningful mental health symptoms during the pandemic were relatively high (mothers: 39.7% anxiety, 14.5% depression; fathers: 37.6% anxiety, 6.4% depression). More Covid-19 related stress was associated with more mental health symptoms in parents and increased insensitive parenting practices in mothers. CONCLUSIONS: The results emphasize the strain of the pandemic on young fathers' and mothers' mental health and its potential negative consequences for parenting. As poor parental mental health and insensitive parenting practices carry risk for worse child outcomes across the lifespan, the mental health burden of the Covid-19 pandemic might not only have affected the parents, but also the next generation.

Mental health problems among Dutch adolescents of the general population before and 9 months after the COVID-19 outbreak: A longitudinal cohort study.

The aim of the present study is to examine whether the COVID-19 pandemic has increased the risk of mental health problems (MHP) in adolescents nine months post-outbreak. For this purpose, a longitudinal cohort study was conducted based on a probability sample of the Dutch population. We compared the prevalence and incidence of MHP in 16-20 year-old adolescents in November-December 2020 (N = 251) with the prevalence and incidence in adolescents in November-December 2012 (N = 346) and November-December 2016 (N = 253). Results showed a higher prevalence of moderate anxiety and depression symptoms in the 2020 than in the 2012 and 2016 cohorts, but differences in mean scores were absent or small. The prevalence of sleep problems, fatigue, use of medicines for symptoms did not differ between the three cohorts. The use of mental health services was more prevalent in the 2020 than in 2016 cohort, but there was already a statistical trend of higher use in the 2016 compared to the 2012 cohort. No differences in the incidence of any MHP, based on data of the previous year (2011, 2015, and 2019, respectively) were found. Results suggest a very limited negative effect of this pandemic on MHP among Dutch adolescents 9 months post-COVID-19 outbreak.

The role of cognitive appraisals in parental burnout: a preliminary analysis during the COVID-19 quarantine.

Counter-intuitively, sociodemographic characteristics account for a small proportion of explained variance in parental burnout. The present study conducted during the Covid-19 pandemic asks whether (i) sociodemographic characteristics are more predictive of parental burnout than usual in a situation of lockdown, (ii) situational factors, that is, the specific restrictive living conditions inherent in the context of lockdown, predict parental burnout better than sociodemographic characteristics do, and (iii) the impact of both sociodemographic and situational factors is moderated or mediated by the parents' subjective perception of the impact that the health crisis has had on their parenting circumstances. Results show that, within the context of lockdown, both sociodemographic and situational factors explain a negligible proportion of variance in parental burnout. By contrast, parents' cognitive appraisals of their parenthood within the context of the health crisis were found to play both a crucial mediating and moderating role in the prediction of parental burnout.

Chronic mental health problems and use of mental health services among adults with and without adverse childhood experiences: a 6-year longitudinal population-based study.

BACKGROUND: The negative effects of single and multiple adverse childhood experiences (ACE) on adult mental health are well-documented. However, little is known about the prevalence of chronic mental health problems (MHPs) and use of mental health services (MHSs) compared to adults without an ACE history. AIMS: Examine differences in the prevalence of chronic MHP and MHS use between adults without and with a single and multiple ACE history, and MHS use among ACE and no-ACE adults with chronic MHP. METHOD: A 6-year longitudinal study was conducted based on a random sample of the Dutch adult population (n = 2427). RESULTS: Multivariate logistic regression analyses showed that adults with a single (n = 280) and multiple ACE (n = 92) history suffered more often from chronic MHP such as chronic depressive and anxiety symptoms. Both ACE subgroups also made greater use of MHS than no-ACE adults (n = 2055). Multiple ACE compared to single ACE, increased the risk of MHP. However, among those with chronic MHP respondents with and without an ACE history did not differ in MHS use. CONCLUSIONS: ACE history is strongly related to chronic MHP and persistent use of MHS. However, MHS use among those with chronic MHP is not related to an ACE history.

Emotion regulation during the COVID-19 pandemic: risk and resilience factors for parental burnout (IIPB).

The COVID-19 pandemic has impacted families' lives around the world. The measures used to contain transmission have led to increased stress and put parents at increased risk for parental burnout (PB). The aim of the current study was to examine the association between COVID-related parental stress and PB, and to test whether emotion regulation (ER) moderated this association. We hypothesised that rumination, which is a generally maladaptive ER strategy, would act as a risk factor. In comparison, we hypothesised that reappraisal, which is a generally adaptive ER strategy, would act as a resilience factor. We assessed 8225 parents from 22 countries using an on-line survey, and focused on general stress and parenting stress. These stressors were associated with greater PB. Importantly, parental ER moderated these associations; rumination strengthened the link between stress-related variables and PB, whereas reappraisal weakened it. This study emphasises the negative effect COVID-19 has on parents and highlights key ER risk and resilience factors.

Child Care in Times of COVID-19: Predictors of Distress in Dutch Children and Parents When Re-entering Center-Based Child Care After a 2-Month Lockdown.

As a consequence of the outbreak of the Coronavirus Disease 2019 (COVID-19) child care facilities all over the world were temporarily closed to minimize the spread of the virus. In Netherlands, the first closure lasted for almost 2 months. The return to the child care center after this significant interruption was expected to be challenging, because earlier studies demonstrated that transitions into child care can be stressful for both children and their parents. The current paper retrospectively examined the distress of Dutch children (aged 0-4) and their parents during the first 2 weeks after the reopening of child care centers, and what factors accounted for individual differences in distress. In total, 694 parents filled out an online questionnaire about stress during closure and distress after the reopening of child care centers. Furthermore, questions regarding several demographic variables and child care characteristics were included, as well as questionnaires measuring child temperament, parental separation anxiety, and parental perception of the child care quality. Results showed that younger children and children with parents scoring higher on separation anxiety experienced more distress after the reopening, as reported by parents. Furthermore, children were more distressed upon return when they attended the child care center for less hours per week after the reopening, experienced less stress during closure, and grew up in a one-parent family. With regard to parental distress after the reopening, we found that parents scoring higher on separation anxiety and fear of COVID-19 experienced more distress. Moreover, parents experiencing less stress during closure and mothers were more distressed when the child returned to the child care center. Finally, concurrent child and parental distress after reopening were positively related. The results of the current study may help professional caregivers to identify which children and parents benefit from extra support when children return to the child care center after an interruption. Especially the role that parental separation anxiety played in predicting both child and parental distress deserves attention. More research is required in order to study the underlying mechanisms of these associations and to design appropriate interventions.

The risk and protective factors of heightened prenatal anxiety and depression during the COVID-19 lockdown.

While pregnant women are already at-risk for developing symptoms of anxiety and depression, this is heightened during the COVID-19 pandemic. We compared anxiety and depression symptoms, as indicators of psychological distress, before and during COVID-19, and investigated the role of partner, social network and healthcare support on COVID-19-related worries and consequently on psychological distress. A national survey, conducted during the first lockdown in The Netherlands, assessed COVID-19 experiences and psychological distress (N = 1421), whereas a comparison sample (N = 1439) was screened for psychological distress in 2017-2018. During COVID-19, the percentage of mothers scoring above the questionnaires' clinical cut-offs doubled for depression (6% and 12%) and anxiety (24% and 52%). Women reported increased partner support during COVID-19, compared to pre-pandemic, but decreased social and healthcare support. Higher support resulted in lower COVID-19-related worries, which in turn contributed to less psychological distress. Results suggest that a global pandemic exerts a heavy toll on pregnant women's mental health. Psychological distress was substantially higher during the pandemic than the pre-pandemic years. We identified a protective role of partner, social, and healthcare support, with important implications for the current and future crisis management. Whether increased psychological distress is transient or persistent, and whether and how it affects the future generation remains to be determined.

Joint Attention in the Context of Hearing Loss: A Meta-Analysis and Narrative Synthesis.

Joint attention is important for children's language development. We report two meta-analyses that demonstrate that the congruency in hearing status between parent and child affects the establishment and maintenance of joint attention. Dyads consisting of hearing parents and children with hearing loss, achieve fewer and briefer moments of joint attention in comparison to dyads of hearing parents and hearing children and dyads of deaf parents and deaf children. The theoretical and practical implications of these differences are discussed and placed in the context of two narrative syntheses. The first one focusing on parental strategies used to achieve and maintain moments of joint attention and the second one on the relation between joint attention and spoken language proficiency. We also expect that this review may serve as the start of quest towards a more detailed description (taxonomy) and operationalization of joint attention in the context of hearing loss.

Validity of the Parental Burnout Inventory Among Dutch Employees.

The purpose of this study was to validate the Parental Burnout Inventory (PBI) in a Dutch sample of working parents. The Dutch version of the PBI and questionnaires about work were administered to 627 working parents, with at least one child living at home. We investigated whether the tri-dimensional structure of the PBI held in a sample of male and female employed parents. Furthermore, we examined the relationships between PBI and the constructs work-related burnout, depressive mood, parenting stress and work-family conflict, which we assessed with widely used and validated instruments, i.e., emotional exhaustion [a subscale of the Dutch version of Maslach's Burnout Inventory], a Dutch Parental Stress Questionnaire and Work-Family Conflict. The results support the validity of a tri-dimensional parental burnout syndrome, including exhaustion, distancing and inefficacy. Low to moderate correlations between parents' burnout symptoms and professional exhaustion, parenting stress, depressive complaints and work-family conflict experiences were found, suggesting that the concept of PBI differs significantly from the concepts of job burnout, depression and stress, respectively. The current study confirms that some parents are extremely exhausted by their parental role. However, the number of Dutch employees reporting extreme parental burnout is rather low.

Maternal psychological distress after preterm birth: Disruptive or adaptive?

BACKGROUND: Maternal postpartum distress is often construed as a marker of vulnerability to poor parenting. Less is known, however, about the impact of postpartum distress on parenting an infant born prematurely. The present study investigated whether high distress levels, which are particularly prevalent in mothers of preterm born infants, necessarily affect a mother's quality of parenting. METHOD: Latent Class Analysis was used to group mothers (N=197) of term, moderately, and very preterm born infants, based on their levels of distress (depression, anxiety, and PTSD symptoms) at one month postpartum, and their quality of parenting at one and six months postpartum. Parenting quality was assessed on the basis of maternal interactive behaviors (sensitivity, intrusiveness, and withdrawal) using observations, and maternal attachment representations (balanced, disengaged, or distorted) using interviews. RESULTS: A 5-Class model yielded the best fit to the data. The first Class (47%) of mothers was characterized by low distress levels and high-quality parenting, the second Class (20%) by low distress levels and low-quality parenting, the third Class (22%) by high distress levels and medium-quality parenting, the fourth Class (9%) by high distress levels and high-quality parenting, and finally the fifth Class (2%) by extremely high levels of distress and low-quality parenting. CONCLUSIONS: While heightened distress levels seem inherent to preterm birth, there appears to be substantial heterogeneity in mothers' emotional responsivity. This study indicates that relatively high levels of distress after preterm birth do not necessarily place these mothers at increased risk with regard to poor parenting. Conversely, low distress levels do not necessarily indicate good-quality parenting. The results of the present study prompt a reconsideration of the association between postpartum distress and parenting quality, and challenge the notion that high levels of maternal distress always result in low-quality parenting practices.

MATERNAL INTERACTION QUALITY MODERATES EFFECTS OF PRENATAL MATERNAL EMOTIONAL SYMPTOMS ON GIRLS' INTERNALIZING PROBLEMS.

The role of mother-infant interaction quality is studied in the relation between prenatal maternal emotional symptoms and child behavioral problems. Healthy pregnant, Dutch women (N = 96, M = 31.6, SD = 3.3) were allocated to the "exposed group" (n = 46), consisting of mothers with high levels of prenatal feelings of anxiety and depression, or the "low-exposed group" (n = 50), consisting of mothers with normal levels of depressive or anxious symptoms during pregnancy. When the children (49 girls, 47 boys) were 23 to 60 months of age (M = 39.0, SD = 9.6), parents completed the Child Behavior Checklist (T.M. Achenbach & L.A. Rescorla, ), and mother-child interaction quality during a home visit was rated using the Emotional Availability Scales. There were no differences in mother-child interaction quality between the prenatally exposed and low-exposed groups. Girls exposed to high prenatal emotional symptoms showed more internalizing problems, if maternal interaction quality was less optimal. No significant effects were found for boys.

Longitudinal Associations Between Parental Bonding, Parenting Stress, and Executive Functioning in Toddlerhood.

Early executive functioning is an important predictor for future development of children's cognitive skills and behavioral outcomes. Parenting behavior has proven to be a key environmental determinant of child executive functioning. However, the association of parental affect and cognitions directed to the child with child executive functioning has been understudied. Therefore, in the present study we examine the associations between parental bonding (i.e., the affective tie from parent to child), parenting stress, and child executive functioning. At 26 weeks of pregnancy, and at 6 months and 24 months postpartum the quality of the maternal (N = 335) and paternal (N = 261) bond with the infant was assessed. At 24 months, postnatal parenting stress and child executive functioning were measured by means of parent-report questionnaires. Results indicated that for both mothers and fathers feelings of bonding negatively predicted experienced parenting stress over time. In addition, for both parents a negative indirect effect of bonding on child executive functioning problems was found via experienced parenting stress. These findings indicate the importance of monitoring parents who experience a low level and quality of early parent-child bonding, as this makes them vulnerable to parenting stress, consequently putting their children at risk for developing executive functioning problems.

The relationship between parenting stress and parent-child interaction with health outcomes in the youngest patients with type 1 diabetes (0-7 years).

UNLABELLED: To test whether parenting stress and the quality of parent-child interaction were associated with glycemic control and quality of life (QoL) in young children (0-7 years) with type 1 diabetes (T1DM), we videotaped 77 families with a young child with T1DM during mealtime (including glucose monitoring and insulin administration). Parent-child interactions were scored with a specifically designed instrument. Questionnaires assessed general and disease-related parenting stress and (diabetes-specific (DS)) QoL. HbA(1c) (glycemic control) was extracted from the medical records. Both general and disease-related parenting stress were associated with a lower (DS)QoL (r ranged from -0.39 to -0.70, p < 0.05), but not with HbA(1c) levels. Furthermore, with regard to the parent-child interaction, emotional involvement of parents (r = 0.23, p < 0.05) and expressed discomfort of the child (r = 0.23, p < 0.05) were related to suboptimal HbA(1c) levels. There was no clear pattern in the correlations between parent-child interaction and (DS)QoL. CONCLUSION: The results support the notion that diabetes does not only affect the child with T1DM: T1DM is a family disease, as parenting factors (like stress and parent-child interactions) are associated with important child outcomes. Therefore, it is important for health-care providers to not only focus on the child with T1DM, but also on the family system.

Continuous feelings of love? The parental bond from pregnancy to toddlerhood.

Both prenatal and postnatal parental bonding (i.e., the affective tie from parent to child) have important effects on parental and child functioning. However, research on the continuity and correlates of parental bonding is lacking. Therefore, the goal of the present study was to examine the stability of bonding levels and to explore distinct bonding patterns with a latent class analysis. Moreover, the correlates of these bonding patterns in the parental-, child-, and contextual domain were studied. Levels of maternal (N = 370) and paternal (N = 292) bonding and potential correlates were assessed at 26 weeks of pregnancy, 6 months, and 24 months postpartum. Results showed moderate stability of bonding from pregnancy to toddlerhood. For both mothers and fathers, 4 distinct bonding patterns were found. Parents with low bonding patterns were characterized by increased anxiety and parenting stress, less partner support, less adaptive personality profiles, and children with difficult temperament. These findings indicate the importance of monitoring young children's parents with poor levels of bonding as their bonding patterns remain stable from pregnancy until toddlerhood and because those parents experience problems in multiple domains.