Margaret J. Harrison

Parent-Child Interactions, Parenting Stress, and Developmental Outcomes at 4 Years

This study examined the relationship of father-child and mother-child interactions, perceptions of parenting stress, socioeconomic status, and prematurity to development of 44 healthy preterm and 49 full-term Canadian children at 4 years of age. Preterm or full-term birth, infant sex, and parental age accounted for 30-32% of the variance in cognitive and motor scores, respectively, on the McCarthy Scales of Childrens Abilities. Parenting stress, father-child interactions at 12 months, and preterm and full-term birth accounted for 19% of the variance for expressive language on the Clinical Evaluation of Language Fundamentals-Preschool (CELF-P). For receptive language on the CELF-P, mother-child interaction at 12 months, mothers spousal relationship, and preterm and full-term birth accounted for 13% of the variance. Addressing early parent-child interaction and perceptions of parenting stress may improve child language development.

Caregiving In Transnational Context “My Wings Have Been Cut; Where Can I Fly?”

Migration often requires the renegotiation of familial and gender roles as immigrants encounter potentially competing values and demands. Employing ethnographic methods and including in-depth interviewing and participant observation, the authors explore the experiences of 29 South Asian and Chinese Canadian female family caregivers. Caregiving was central to their role as women and members of their ethnocultural community. The women were often engaged in paid labor that compressed the time available to fulfill their duties as caregivers. Women’s role in the transmission of cultural values that serve to shore up the boundaries of their ethnic community did not allow for significant renegotiation of their caregiving responsibilities despite disrupted family networks and increased demands. These caregiving arrangements are more costly to women in Canada than in their countries of origin.

Immigrant Women: Making Connections to Community Resources for Support in Family Caregiving

The purpose of this ethnographic study was to understand how immigrant women caregivers accessed support from community resources and identify the barriers to this support. The study included 29 Chinese and South Asian women caring for an ill or disabled child or adult relative. All experienced barriers to accessing community services. Some possessed personal resources and strategies to overcome them; others remained isolated and unconnected. Family and friends facilitated connections, and a connection with one community service was often linked to several resources. Caregivers who failed to establish essential ties could not initiate access to resources, and community services lacked outreach mechanisms to identify them. These findings contribute new understanding of how immigrant women caregivers connect with community resources and confirm the impact of immigration on social networks and access to support.

Parent-Child Interactions and Development of Toddlers Born Preterm:

Fathers and mothers of 49 healthy preterm and 54 full-term infants were observed interacting with their child at 3 and 12 months using the Nursing Child Assessment Teaching Scale. Each parent completed the Parenting Stress Index at both times. At 18 months adjusted age, the children were assessed using the Bayley Scales of Infant Development, Sequenced Inventory of Communication Development-Revised, and MacArthur Communicative Development Inventory. Preterm children scored significantly lower on the Bayley Mental scale and on the number of words produced. Early parent-child interactions contributed to the child’s development. Mother’s interactions with the child, child gender, and family socioeconomic status predicted 17% of the variance in the Bayley Mental score. Mother’s and father’s interactions with the child, child gender, and the child’s behavior with his or her mother predicted 22% of the variance in receptive communication skills.

Reciprocity and Social Support in Caregivers' Relationships: Variations and Consequences

Support from family and friends is important in caregiving and has been associated with positive health of the caregiver. Reciprocity is a dimension of support that may be restricted in the relationships of caregivers. The purpose of this study was to examine whether reciprocity exists in relationships with friends and family as well as with the care recipient. Two groups of women were included: 20 mothers of premature infants and 20 women caring for older persons with cognitive impairment. Perceptions of reciprocity were explored in in-depth interactive interviews with the caregivers over 18 months. This article describes the four variations in reciprocity and the process of monitoring that were identified from content analysis: reciprocity, generalized reciprocity, waived reciprocity, and constructed reciprocity. Constructed reciprocity was used only with the care recipient. Some caregivers provided care by obligation with no reciprocity. The article concludes with a discussion of implications for research and practice.

Safeguarding precarious survival: Parenting children who have life-threatening heart disease

The purpose of this study is to describe the process of parenting a child with life-threatening heart disease. Despite advances in pediatric cardiac sciences, hypoplastic left heart syndrome remains difficult and controversial to treat. The Norwood surgical approach is a developing technology, and little is known about how mothers and fathers experience parenting a child who survives this treatment. Constructivist grounded theory informed this Canadian study that involved multiple interactive interviews with 9 mothers and 7 fathers of children with hypoplastic left heart syndrome who were at various stages of treatment. Extraordinary parenting in a context of uncertainty was evident as parents simultaneously safeguarded their childs precarious survival as well as their own survival. As technologically advanced treatment contributes to the survival of children with complex health conditions, health care professionals must consider how to promote and support parenting strategies that benefit the new survivors of technology as well as their families.

Participation of Immigrant Women Family Caregivers in Qualitative Research

The recruitment of articulate, expressive participants is an essential part of methodology in qualitative research. This article presents the authors’ experience in the recruitment of immigrant women of Chinese and South Asian origin in an ethnographic study. The study included women caring for an adult or child family member who had a chronic health problem. Knowledge of women family caregivers’ health is restricted by the failure to include diverse groups of women in research. In this article, the authors discuss issues related to recruitment and participation of immigrant women in research, including establishing access to diverse groups of women, benefits for immigrant women, and placing the researcher and research process on the same level. Practical research strategies to address these issues and engage the women in research that portrays their perspectives are presented. The authors’ discussion concludes with reflection on their experience and that of other researchers.

Social coercion for weaning.

Research investigating the duration of breastfeeding is generally based on the assumption that if lactation is established, then the mother will breastfeed successfully. Longitudinal, qualitative research suggests, however, that it is the attitude of others towards the breastfeeding mother that determines the duration of breastfeeding. When the infant is a newborn, breastfeeding is encouraged. As the infant develops, the support of others towards the nursing mother is withdrawn and the mother is encouraged to wean. Further, the doula not only facilitates breastfeeding, but also, when the infant is perceived to be “old enough,” facilitates weaning.Abstract Research investigating the duration of breastfeeding is generally based on the assumption that if lactation is established, then the mother will breastfeed successfully. Longitudinal, qualitative research suggests, however, that it is the attitude of others towards the breastfeeding mother that determines the duration of breastfeeding. When the infant is a newborn, breastfeeding is encouraged. As the infant develops, the support of others towards the nursing mother is withdrawn and the mother is encouraged to wean. Further, the doula not only facilitates breastfeeding, but also, when the infant is perceived to be “old enough,” facilitates weaning.

Is ''Treat your child normally'' helpful advice for parents of survivors of treatment of hypoplastic left heart syndrome?

BACKGROUND Developing technology affords children with complex congenitally malformed hearts a chance for survival. Parents gratefully pursue life-saving options on behalf of their children, despite the risks to the life of their child, and uncertainty about outcomes. Little is known about how mothers and fathers experience parenting a child whose new state as a survivor may include less than optimal developmental sequels. METHOD Our study involved multiple interactive interviews with 9 mothers and 7 fathers of infants and preschool children with hypoplastic left heart syndrome who had survived the Norwood surgical approach. Qualitative methodology included grounded theory methods of simultaneous collection and analysis of data, and we used open and selective coding of transcribed interviews. RESULTS Parents used normalization in the context of uncertainty regarding the ongoing survival of their child. Parents described their underweight children as being on their own growth curve, and viewed their developmental progress, however delayed, as reason for celebration, as they had been prepared for their child to die. CONCLUSION There is growing evidence that children with congenitally malformed hearts who require surgical intervention during the first year of life may experience developmental delay. The use of normalization by their parents may be effective in decreasing their worry regarding the uncertain future faced by their child, but may negatively affect the developmental progress of the child if they do not seek resources to assist development. Advice from paediatric specialists for parents to view their children as normal needs to be balanced with assistance for parents to access services to support optimal growth and development of their child.

Cognitive and Language Development of Healthy Preterm Infants at 10 Years of Age

In this longitudinal study, forty-three Canadian 10-year-olds, 20 born preterm without significant health problems and 23 born at term, were compared. Cognitive development was measured by the Wechsler Intelligence Scale for Children-III. Language development was measured by the Clinical Evaluation of Language Fundamen-tals-3 (CELF-3) and language used in a 5 minute interview. The children born preterm had subtle delays. They scored significantly lower on Performance IQ and the CELF-3. The subtests on which they had lower scores appear to require visual-spatial skills. Early intervention focusing on parent behaviours that encourage language development and early screening for delays in visual-spatial skills may be useful.