Leslie A. Frankel

Parental Influences on Children's Self-Regulation of Energy Intake: Insights from Developmental Literature on Emotion Regulation

The following article examines the role of parents in the development of childrens self-regulation of energy intake. Various paths of parental influence are offered based on the literature on parental influences on childrens emotion self-regulation. The parental paths include modeling, responses to childrens behavior, assistance in helping children self-regulate, and motivating children through rewards and punishments. Additionally, sources of variation in parental influences on regulation are examined, including parenting style, child temperament, and child-parent attachment security. Parallels in the nature of parents role in socializing childrens regulation of emotions and energy intake are examined. Implications for future research are discussed.

Food parenting measurement issues: Working group consensus report

Childhood obesity is a growing problem. As more researchers become involved in the study of parenting influences on childhood obesity, there appears to be a lack of agreement regarding the most important parenting constructs of interest, definitions of those constructs, and measurement of those constructs in a consistent manner across studies. This article aims to summarize findings from a working group that convened specifically to discuss measurement issues related to parental influences on childhood obesity. Six subgroups were formed to address key measurement issues. The conceptualization subgroup proposed to define and distinguish constructs of general parenting styles, feeding styles, and food parenting practices with the goal of understanding interrelating levels of parental influence on child eating behaviors. The observational subgroup identified the need to map constructs for use in coding direct observations and create observational measures that can capture the bidirectional effects of parent-child interactions. The self-regulation subgroup proposed an operational definition of child self-regulation of energy intake and suggested future measures of self-regulation across different stages of development. The translational/community involvement subgroup proposed the involvement of community in the development of surveys so that measures adequately reflect cultural understanding and practices of the community. The qualitative methods subgroup proposed qualitative methods as a way to better understand the breadth of food parenting practices and motivations for the use of such practices. The longitudinal subgroup stressed the importance of food parenting measures sensitive to change for use in longitudinal studies. In the creation of new measures, it is important to consider cultural sensitivity and context-specific food parenting domains. Moderating variables such as child temperament and child food preferences should be considered in models.

Let's get technical! Gaming and technology for weight control and health promotion in children.

Most children, including lower socioeconomic status and ethnic minority children, play video games, use computers, and have cell phones, and growing numbers have smart phones and electronic tablets. They are comfortable with, even prefer, electronic media. Many expect to be entertained and have a low tolerance for didactic methods. Thus, health promotion with children needs to incorporate more interactive media. Interactive media for weight control and health promotion among children can be broadly classified into web-based educational/therapeutic programs, tailored motivational messaging systems, data monitoring and feedback systems, active video games, and diverse forms of interactive multimedia experiences involving games. This article describes the primary characteristics of these different technological methods; presents the strengths and weaknesses of each in meeting the needs of children of different ages; emphasizes that we are in the earliest stages of knowing how best to design these systems, including selecting the optimal requisite behavioral change theories; and identifies high-priority research issues. Gaming and technology offer many exciting, innovative opportunities for engaging children and promoting diet and physical activity changes that can contribute to obesity prevention and weight loss maintenance. Research needs to clarify optimal procedures for effectively promoting change with each change procedure.

Houston. We Have a Problem! Measurement of Parenting

Obesity is a dominant child health problem in the United States1 and virtually worldwide.2 Obesity in childhood is associated with a number of negative health outcomes,3,4 with substantially increased risk of adult obesity.5 The energy balance model indicates obesity is the result of overconsumption of calories, low levels of physical activity, and high levels of sedentary behavior, mostly high screen time (TV, videos, and videogames).6

Dimensions of Vegetable Parenting Practices among Preschoolers

The objective of this study was to determine the factor structure of 31 effective and ineffective vegetable parenting practices used by parents of preschool children based on three theoretically proposed factors: responsiveness, control and structure. The methods employed included both corrected item-total correlations and confirmatory factor analysis. Acceptable fit was obtained only when effective and ineffective parenting practices were analyzed separately. Among effective items the model included one second order factor (effectiveness) and the three proposed first order factors. The same structure was revealed among ineffective items, but required correlated paths be specified among items. A theoretically specified three factor structure was obtained among 31 vegetable parenting practice items, but likely to be effective and ineffective items had to be analyzed separately. Research is needed on how these parenting practices factors predict child vegetable intake.

TV parenting practices: is the same scale appropriate for parents of children of different ages?

PurposesUse multidimensional polytomous item response modeling (MPIRM) to evaluate the psychometric properties of a television (TV) parenting practices (PP) instrument. Perform differential item functioning (DIF) analysis to test whether item parameter estimates differed across education, language, or age groups.MethodsSecondary analyses of data from three studies that included 358 children between the ages of 3 and 12xa0years old in Houston, Texas. TV PP included 15 items with three subscales: social co-viewing, instructive parental mediation, and restrictive parenting. The multidimensional partial credit model was used to assess the performance. DIF was used to investigate the differences in psychometric properties across subgroups.ResultsClassical test theory analyses revealed acceptable internal consistency reliability (Cronbach’s α: 0.72 to 0.83). More items displaying significant DIF were found across children’s age groups than parental education or language groups. A Wright map revealed that items covered only a restricted range of the distribution, at the easier to respond end of the trait.ConclusionsTV PP scales functioned differently on the basis of parental education, parental language, and child age, with the highest DIF among the latter. Additional research is needed to modify the scales to minimize these moderating influences. Some items may be age specific.

The BabySeq project: implementing genomic sequencing in newborns

BackgroundThe greatest opportunity for lifelong impact of genomic sequencing is during the newborn period. The “BabySeq Project” is a randomized trial that explores the medical, behavioral, and economic impacts of integrating genomic sequencing into the care of healthy and sick newborns.MethodsFamilies of newborns are enrolled from Boston Children’s Hospital and Brigham and Women’s Hospital nurseries, and half are randomized to receive genomic sequencing and a report that includes monogenic disease variants, recessive carrier variants for childhood onset or actionable disorders, and pharmacogenomic variants. All families participate in a disclosure session, which includes the return of results for those in the sequencing arm. Outcomes are collected through review of medical records and surveys of parents and health care providers and include the rationale for choice of genes and variants to report; what genomic data adds to the medical management of sick and healthy babies; and the medical, behavioral, and economic impacts of integrating genomic sequencing into the care of healthy and sick newborns.DiscussionThe BabySeq Project will provide empirical data about the risks, benefits and costs of newborn genomic sequencing and will inform policy decisions related to universal genomic screening of newborns.Trial registrationThe study is registered in ClinicalTrials.gov Identifier: NCT02422511. Registration date: 10 April 2015.

Reconciling newborn screening and a novel splice variant in BTD associated with partial biotinidase deficiency: a BabySeq Project case report

Here, we report a newborn female infant from the well-baby cohort of the BabySeq Project who was identified with compound heterozygous BTD gene variants. The two identified variants included a well-established pathogenic variant (c.1612C>T, p.Arg538Cys) that causes profound biotinidase deficiency (BTD) in homozygosity. In addition, a novel splice variant (c.44+1G>A, p.?) was identified in the invariant splice donor region of intron 1, potentially predictive of loss of function. The novel variant was predicted to impact splicing of exon 1; however, given the absence of any reported pathogenic variants in exon 1 and the presence of alternative splicing with exon 1 absent in most tissues in the GTEx database, we assigned an initial classification of uncertain significance. Follow-up medical record review of state-mandated newborn screen (NBS) results revealed an initial out-of-range biotinidase activity level. Levels from a repeat NBS sample barely passed cutoff into the normal range. To determine whether the infant was biotinidase-deficient, subsequent diagnostic enzyme activity testing was performed, confirming partial BTD, and resulted in a change of management for this patient. This led to reclassification of the novel splice variant based on these results. In conclusion, combining the genetic and NBS results together prompted clinical follow-up that confirmed partial BTD and informed this novel splice sites reclassification, emphasizing the importance of combining iterative genetic and phenotypic evaluations.