Julie Poehlmann

Children's Contact with Their Incarcerated Parents: Research Findings and Recommendations.

Approximately 1.7 million children have parents who are incarcerated in prison in the United States, and possibly millions of additional children have a parent incarcerated in jail. Many affected children experience increased risk for developing behavior problems, academic failure, and substance abuse. For a growing number of children, incarcerated parents, caregivers, and professionals, parent-child contact during the imprisonment period is a key issue. In this article, we present a conceptual model to provide a framework within which to interpret findings about parent-child contact when parents are incarcerated. We then summarize recent research examining parent-child contact in context. On the basis of the research reviewed, we present initial recommendations for childrens contact with incarcerated parents and also suggest areas for future intervention and research with this vulnerable population.

Incarcerated mothers' contact with children, perceived family relationships, and depressive symptoms.

Concurrent relations among contact with children, perceived family relationships, early experiences of relationship disconnection and trauma, and maternal depressive symptoms were examined in 94 incarcerated mothers with children between the ages of 2 and 7 years. Qualitative analysis revealed that most mothers experienced intense distress when initially separated from their children, although many women currently viewed the situation in a more balanced way. Quantitative findings indicated that fewer visits from children and early experiences of relationship disconnection and trauma were associated with elevated maternal depressive symptoms. Mother-child relationships were more positive when mothers had more frequent telephone contact with older children. Moreover, conflicted relationships with caregivers related to less contact between mothers and their children. Results highlight the need for mental health services for incarcerated women and suggest that interventions aimed at increasing contact between imprisoned mothers and their children should consider the quality of the mother-caregiver relationship.

Predictors of depressive symptom trajectories in mothers of preterm or low birth weight infants.

Predictors of maternal depression trajectories were examined longitudinally in families with an infant born preterm or at a low birth weight. A total of 181 mother-infant dyads enrolled in the study before the infants neonatal intensive care unit (NICU) discharge. Maternal depressive symptoms were assessed at 5 timepoints, and contextual variables and infant risks were assessed at NICU discharge. Hierarchical linear models revealed that mothers who experienced more risk factors reported more depressive symptoms just before their infants NICU discharge and showed less decline in depressive symptoms in the months immediately following the childs birth. Although cumulative risks predicted depression trajectories, this effect appeared driven by maternal and family sociodemographic risks rather than infant risks. Addition of family support as a covariate in the multilevel models with a subsample of families revealed that social support and depression covaried across time. However, most of the findings regarding the association between risk and depression remained consistent, whereas the effects of maternal race and multiple birth were slightly attenuated.

Attachment and caregiving relationships in families affected by parental incarceration

This longitudinal, mixed method study focused on 57 families of children who participated in a mentoring program for children of incarcerated parents. Children ranged in age from 4 to 15 years. Monthly interviews were conducted with children, caregivers, and mentors during the first six months of program participation, and questionnaires were administered at intake and six months to assess caregiver–child and incarcerated parent–child relationships, contact with incarcerated parents, and childrens behavior problems. Although some children viewed their incarcerated parents as positive attachment figures, other children reported negative feelings toward or no relationship with incarcerated parents. In addition, our assessments of children nine years old and older revealed that having no contact with the incarcerated parent was associated with children reporting more feelings of alienation toward that parent compared to children who had contact. Childrens behavior problems were a primary concern, often occurring in a relational context or in reaction to social stigma associated with parental imprisonment.

Family experiences associated with a child's diagnosis of fragile X or down syndrome: Evidence for disruption and resilience

Although previous findings have shown that parents react intensely to the initial diagnosis of their childs disability, studies focused on long-term outcomes and adjustment are needed. We interviewed 21 mothers whose adolescent or young adult was diagnosed with Down syndrome or fragile X syndrome. Qualitative analysis of data focused on the diagnostic process and the childs development revealed emergent themes: importance of context, variations in emotional reactions to the diagnosis, use of specific coping strategies, and changes in family adaptation over time. Results indicate most families experienced elements of disruption and resilience in their reactions to the diagnosis, although different patterns emerged for each syndrome group. Maternal descriptions highlighted positive attributes that contributed to family well-being and behavioral challenges that were a source of family stress.

The interaction of maternal and infant vulnerabilities on developing attachment relationships

The present study sought to document an example of how maternal and infant vulnerabilities interact in contributing to the quality of early attachment relationships. Maternal depressive symptoms, neonatal health characteristics, and infant mother attachment were assessed for 42 preterm, low birth weight infants and 42 full-term infants at 12 months postterm. Results indicated that preterm birth moderated the relation between maternal depressive symptoms and quality of infant-mother attachment, even controlling for level of neonatal health complications. Preterm infants with more symptomatic mothers were most likely to be classified as insecurely attached to their mothers, whereas no direct relation between subclinical depressive symptoms and attachment was found for full-term infants.

Parent-infant interaction as a mediator of the relation between neonatal risk status and 12-month cognitive development

The present study examined parent-infant interaction quality as a potential family mechanism through which the combination of perinatal and sociodemographic risks predicts cognitive development in LBW, VLBW, and full-term infants. Preterm LBW, VLBW and full-term infant-mother dyads were assessed when infants were 6 and 12 months post-term. Of the 117 infants seen at 6 months, 84 (72%) returned at 12 months (44 FT, 20 LBW, 20 VLBW). Level of neonatal risk was coded based on birthweight, Apgar scores, length of hospitalization and intubation, and presence of respiratory complications. At 6 months, mothers and infants were observed playing an interactional game which was scored for degree of reciprocity and engagement, and at 12 months, infant cognitive skills were assessed. Results indicated that, although maternal sociodemographic characteristics did not moderate the relation between neonatal risk and cognitive outcomes, quality of parent-infant interaction mediated the relation between neonatal risk and cognitive development. Reciprocal and engaging dyadic interactions significantly predicted higher cognitive scores, controlling for neonatal and maternal risks and the interaction between risks.

Emerging self-regulation in toddlers born preterm or low birth weight: differential susceptibility to parenting?

The differential susceptibility to parenting model was examined in relation to toddler self-regulation in a prospective longitudinal study of infants born preterm or low birth weight. We followed 153 mother-infant dyads across five time points between the infants Neonatal Intensive Care Unit stay and 24 months postterm. Assessments of infant temperament, quality of early parenting interactions, contextual variables, and toddler effortful control and behavior problems were conducted. Results supported differential susceptibility and dual risk models in addition to documenting main effects of early parenting on childrens emerging self-regulation. Our data suggested that preterm or low birth weight infants who were prone to distress or rated by mothers as more difficult were particularly susceptible to the effects of early negative parenting.

The paradox of prematurity: The behavioral vulnerability of late preterm infants and the cognitive susceptibility of very preterm infants at 36 months post-term

We explored associations among preterm status (very preterm infant (VPI: <30 weeks), moderate preterm (MPI: 30-33(6/7) weeks), late preterm (LPI: 34-36(6/7) weeks), parenting, and 3-year cognitive and behavioral outcomes. We hypothesized that LPIs would demonstrate better health and neurobehavioral outcomes compared with more premature infants, and that preterm status would moderate the association between parenting quality and 3-year outcomes. Sample included 123 preterm infants (gestation <37 weeks) and their mothers from a larger study of high-risk infants with measures of neonatal and socioeconomic risks at hospital discharge; maternal vocabulary at 9-months, child IQ and behavior at 36 months, and maternal depressive symptoms and parenting at all timepoints. Group differences were explored using MANOVAs while predictors of child outcomes were explored using hierarchical regression analyses. MANOVAs indicated that LPIs had more optimal neonatal health during the hospital stay, yet more externalizing (p=.043), aggressive (p=.006) and oppositional behaviors (p=.008) at 3 years compared with VPIs. There were no IQ differences between VPIs, MPIs and LPIs. However, preterm infants who experienced less negative parenting had higher IQs at 36 months (β=-3.245, p=.017), with the greatest effects seen in VPIs (β=0.406, p=.01) compared with LPIs (β=0.148, p=.381). LPIs manifested similar IQ, but more externalizing, oppositional and aggressive behavior symptoms compared to VPIs. VPIs appeared to be differentially susceptible to parenting effects, with VPIs demonstrating the highest cognitive scores in the context of more positive parenting.

Preterm infants who are prone to distress: differential effects of parenting on 36-month behavioral and cognitive outcomes.

BACKGROUND The differential susceptibility (DS) model suggests that temperamentally prone-to-distress infants may exhibit adverse outcomes in negative environments but optimal outcomes in positive environments. This study explored temperament, parenting, and 36-month cognition and behavior in preterm infants using the DS model. We hypothesized that temperamentally prone to distress preterm infants would exhibit more optimal cognition and fewer behavior problems when early parenting was positive; and less optimal cognition and more behavior problems when early parenting was less positive. METHODS Participants included 109 preterm infants (gestation <37 weeks) and their mothers. We assessed neonatal risk and basal vagal tone in the neonatal intensive care unit; infant temperament and parenting interactions at 9 months post-term; and child behavior and cognitive skills at 36 months post-term. Hierarchical regression analyses tested study hypotheses. RESULTS Temperamentally prone-to-distress infants exhibited more externalizing problems if they experienced more critical parenting at 9 months (β = -.20, p < 0.05) but fewer externalizing problems with more positive parenting. Similarly, variations in maternal positive affect (β = .25, p < .01) and intrusive behaviors (β = .23, p < .05) at 9 months predicted 36-month cognition at high but not at low levels of infant temperamental distress. Higher basal vagal tone predicted fewer externalizing problems (β = -.19, p < .05). CONCLUSIONS Early parenting behaviors relate to later behavior and development in preterm infants who are temperamentally prone to distress, and neonatal basal vagal tone predicts subsequent externalizing behaviors. These findings suggest that both biological reactivity and quality of caregiving are important predictors for later outcomes in preterm infants and may be considered as foci for developmental surveillance and interventions.