Lara R. Robinson

Using a Digital Frame and Pictorial Information to Enhance the SafeCare[R] Parent-Infant Interactions Module with a Mother with Intellectual Disabilities: Results of a Pilot Study

Parents with intellectual disabilities (ID) are disproportionately represented in the child welfare system. Parents with ID can be better served by developing curricula that support various modes of learning. Technology offers a potentially effective tool because it is visual, interactive, and self-instructional. SafeCare® is an evidence-based parenting program with flexibility to adapt its curricula while maintaining fidelity. This research presents the results of a pilot study that examined the effectiveness of an adaptation to the SafeCare® parent-infant interactions (PII) module for a mother with ID by using a digital picture frame with pictures of the mother and her infant engaged in skills that met the performance criteria for PII. A multiple-probe design across behaviors was used with the mother and her infant, showing a dramatic increase in PII skills that was maintained across 3 monthly follow-ups. Although further research is necessary, the preliminary data suggest the digital picture frame enhancement to the SafeCare® PII module may be a promising instructional tool for parents with ID.

Cognitive and emotional contributors to intimate partner violence perpetration following trauma

Exposure to potentially traumatic events often leads to a wide range of interpersonal difficulties, including the perpetration of intimate partner violence. Maladaptive, threat-relevant thoughts and beliefs regarding the trauma or its sequelae can play an important role in a persons emotional and behavioral responses. Among 185 trauma-exposed study participants who were currently in an intimate relationship, levels of maladaptive posttraumatic cognitions were associated with the perpetration of psychological aggression and physical violence in their current relationships. These links were mediated by misappraisal of anger in auditory emotion stimuli and emotion-regulation deficits. Results support a cognitive model of posttraumatic pathology, with implications for clinical intervention and a broad conceptualization of the effects of trauma.

Effortful Control, Behavior Problems, and Peer Relations: What Predicts Academic Adjustment in Kindergartners from Low-Income Families?

This study used a short-term longitudinal design to examine the role of effortful control, behavior problems, and peer relations in the academic adjustment of 74 kindergarten children from primarily low-income families. Teachers completed standardized measures of childrens effortful control, internalizing and externalizing problems, school readiness, and academic skills. Children participated in a sociometric interview to assess peer relations. Research Findings: Correlational analyses indicate that childrens effortful control, behavior problems in school, and peer relations are associated with academic adjustment variables at the end of the school year, including school readiness, reading skills, and math skills. Results of regression analyses indicate that household income and childrens effortful control primarily account for variation in childrens academic adjustment. The associations between childrens effortful control and academic adjustment do not vary across the sex of the child or ethnicity. Mediational analyses indicate an indirect effect of effortful control on school readiness through childrens internalizing problems. Practice or Policy: Effortful control emerged as a strong predictor of academic adjustment among kindergarten children from low-income families. Strategies for enhancing effortful control and school readiness among low-income children are discussed.

Chronic Neglect and Services Without Borders: A Guiding Model for Social Service Enhancement to Address the Needs of Parents With Intellectual Disabilities

Child neglect has negative effects throughout the life span. Although an argument for a link between intellectual disabilities and neglectful parenting can be made, this article argues for a more fine-grained view of the cognitive problems that underlie child neglect perpetration and provides evidence for a social information processing model of its etiology. Based on this model and what is known about the efficacy of behaviorally based interventions, implications for enhancements to the social service system to adapt to the needs of parents with intellectual disabilities are presented. The areas covered include improvements to screening and assessment of parents, provision of adapted services, and changes in selection processes and training of staff. Future directions for integrating social information processing elements into interventions are discussed with examples from empirically supported treatment and prevention programs.

Narrative story stems with high risk six year-olds: Differential associations with mother- and teacher-reported psycho-social adjustment

Childrens responses on a Narrative Story Stem Technique (NSST) were coded using scales reflecting essential attachment constructs, specifically, attachment, exploratory, sociability, and caregiving behavioral systems, as originally conceived by Bowlby (1973, 1982) and elaborated upon by his followers (Cassidy, 2008). NSST responses were examined in relation to both mother- and teacher-reported psycho-social adjustment and risk using the MacArthur Health & Behavior Questionnaire (HBQ). Forty-six children participated (average age 6 years 10 months), 19 of whom had high-risk backgrounds, and the rest demographically matched. Findings indicate that NSST scales were associated with behavior on certain HBQ scales, in expected directions. NSST responses appeared to differentiate socially competent children from children with the specific psycho-social risks of externalizing behavior problems and social isolation, according to mother-reports, on the one hand, and peer vulnerability and internalizing problems, according to teacher-reports, on the other. Implications for clinical applications are discussed.

News from CDC: the Legacy for Children™ parenting model, partnering to translate research to practice for children in poverty

Approximately 16 million US children currently live in poverty [1]. Children living in poverty experience significant disparities on indicators of physical and mental health and academic success [2–6]. The importance of positive early experiences and the benefits of early intervention to mitigate the life-long effects of poverty have been confirmed in biologic [7], economic [8, 9], and social models [10]. Unfortunately, early childhood interventions have historically been limited in producing impacts when taken to scale. This has been attributed in part to a lack of quality assurance when moving from research to practice [11] and poor attention to scalability and dissemination when developing programs [12].

CDC Grand Rounds: Addressing Health Disparities in Early Childhood

Research suggests that many disparities in overall health and well-being are rooted in early childhood (1,2). Stressors in early childhood can disrupt neurologic, metabolic, and immunologic systems, leading to poorer developmental outcomes (1). However, consistent, responsive caregiving relationships and supportive community and health care environments promote an optimal trajectory (3,4). The first 8 years of a childs life build a foundation for future health and life success (5-7). Thus, the cumulative and lifelong impact of early experiences, both positive and negative, on a childs development can be profound. Although the health, social service, and education systems that serve young children and their families and communities provide opportunities to support responsive relationships and environments, efforts by these systems are often fragmented because of restrictions that limit the age groups they can serve and types of services they can provide. Integrating relationship-based prevention and intervention services for children early in life, when the brain is developing most rapidly, can optimize developmental trajectories (4,7). By promoting collaboration and data-driven intervention activities, public health can play a critical role in both the identification of at-risk children and the integration of systems that can support healthy development. These efforts can address disparities by reducing barriers that might prevent children from reaching their full potential.

A qualitative study of cultural congruency of Legacy for Children™ for Spanish-speaking mothers

In recognition of the need to reach more families, the Legacy for Children™ (Legacy) program was translated and culturally adapted for Spanish-speaking Hispanic mothers and their infants. This study examined the cultural adaptations and logistical supports needed for successful implementation with Spanish-speaking mothers. The research team used purposive techniques to sample Hispanic bi-lingual providers (N = 14) and supervisors (N = 5) of local home-based parenting programs (Healthy Families, Parents as Teachers, and SafeCare®). The goal of the study was to determine from providers and supervisors the social validity (satisfaction, relevancy, importance, and acceptability of the intervention) and cultural congruency of the adapted Legacy curriculum. Researchers conducted a qualitative analysis of the transcriptions using a template approach within NVivo 10 software to identify broad themes within focus group data. Overall, results indicated many positive aspects of the Legacy program including content, approach, pace, topics, structure, social engagement, and straightforward curriculum language. Emergent themes from the focus groups included best practices in identifying, recruiting, and approaching Hispanic mothers, as well as key engagement strategies. Recommended revisions of the adapted Legacy curriculum focused on enhancing visual and auditory supplements, making minor improvements to lower the reading level, and reducing barriers to attendance. Implications for cultural adaptation of parenting programs are discussed.