Paul R. Swank

Predicting cognitive-language and social growth curves from early maternal behaviors in children at varying degrees of biological risk.

Growth modeling was used to examine the relation of early parenting behaviors (averaged across 6 and 12 months) with rates of change in childrens cognitive-language and social response and initiating skills assessed at 6, 12, 24, and 40 months. Groups of full-term (n = 112) and very low birth weight children, divided into medically low (n = 114) and high risk (HR; n = 73), were included to evaluate whether children who vary in their rate of development are influenced in different ways by early parenting styles. Parenting behaviors that were sensitive to childrens focus of interest and did not highly control or restrict their behaviors predicted greater increases and faster rates of cognitive-language and social development, with relations stronger for the HR versus the other two groups. These maternal behaviors may provide the support all infants need to establish an optimal early foundation for later development and the specific support HR children need to learn in spite of early attentional and organizational problems.

Watch, Discover, Think, and Act: Evaluation of Computer-Assisted Instruction To Improve Asthma Self-Management in Inner-City Children

An interactive multimedia computer game to enhance self-management skills and thereby improve asthma outcomes in inner city children with asthma was evaluated. Subjects aged 6-17 were recruited from four pediatric practices and randomly assigned to the computer intervention condition or to the usual-care comparison. The main character in the game could match the subject on gender and ethnicity. Characteristics of the protagonists asthma were tailored to be like those of the subject. Subjects played the computer game as part of regular asthma visits. Time between pre- and post-test varied from 4 to 15.6 months (mean, 7.6 months). Analysis of covariance, with pre-test scores, age, and asthma severity as covariates, found that the intervention was associated with fewer hospitalizations, better symptom scores, increased functional status, greater knowledge of asthma management, and better child self-management behavior for those in the intervention condition. Interactions with covariates were found and discussed in terms of variable efficacy of the intervention.

Relation of infant feeding practices, cigarette smoke exposure, and group child care to the onset and duration of otitis media with effusion in the first two years of life

The relation of infant feeding practices, cigarette smoke exposure, and group child care to the onset and duration of otitis media with effusion (OME) was evaluated in a cohort of 698 healthy infants prospectively monitored by tympanometry in the home every 2 to 4 weeks until 2 years of age. Except for an experimental group of children who were offered early tube placement, the study children received conventional care from their personal physician or clinic. We used LISREL, a structural equation modeling procedure (computer software), to explore associations between environmental variables and OME onset and duration while controlling for interrelations among the variables. Supine feeding position and early initiation of group child care were associated with earlier onset of OME. Shorter duration of breast-feeding, increased packs of cigarettes smoked per day in the home, and increased hours per week in group child care were associated with an increase in the amount of time with OME during one or more of the age blocks studied (birth to 6, 6 to 12, 12 to 18, and 12 to 24 months). For a decrease in the amount of time with OME during the first 2 years of life, prolonged breast-feeding and upright feeding position should be encouraged, and cigarette smoke exposure should be minimized. Limiting early child care in large groups might also be advisable.

High Versus Low Implementation of Instructional Support Teams A Case for Maintaining Program Fidelity

In 1990, the Commonwealth of Pennsylvania implemented a statewide instructional support team (IST) process to provide prereferral assessment and intervention for at-risk students in 500 school districts. The current study examined the academic performance of students affected by this process as contrasted with other at-risk students who did not have access to it. The dependent measures were academic learning time (time on task, task completion, and task comprehension). The results indicated that students supported by ISTs had greater levels of academic performance only when their schools implemented the IST process to a high degree. Low IST implementation produced no differences in academic performance in schools that had not implemented IST. The importance of implementing a promising program according to critical design features is discussed.

Variability in Adjustment of Children of Battered Women: The Role of Child Appraisals of Interparent Conflict

The present study evaluates relations between childrens appraisals of interparent conflict and child adjustment problems in families characterized by extreme interparent violence. Participants were 154 children (age 8–12) and their mothers. Children completed measures of their appraisals of interparent conflict (self-blame, threat, fear of abandonment) and mothers and children completed indices of child adjustment. Our results indicate that child self-blaming for interparent conflict correlates positively with mothers reports of externalizing child problems. Self-blame, threat, and fear of abandonment appraisals each correlate positively with child self-reports of anxiety/depression. In addition, child age moderates relations between each of the measured child appraisals and mothers reports of child adjustment problems, with the appraisals being more positively related to problems of older children.

Effects of Social Context and Mothers' Requesting Strategies on Down's Syndrome Children's Social Responsiveness.

Social context and maternal style of requesting and responsiveness were examined in teaching and social interactions in relation to 28 Downs syndrome (DS; 30 to 69 months old) and 28 mental-age matched normal childrens cooperation and social initiative. Compliance for DS children was similar to normal children for child-initiated exchanges but decreased during mother-initiated exchanges, particularly in less structured situations. The DS children initiated fewer exchanges but were comparable on self-directed behavior. Differences in mothers requests and childrens social competence related to risk, language skills, and social situation. The DS but not normal children were more likely to increase compliance with directive vs. suggestive requests, but only in the structured situation

Effects of medical risk and socioeconomic status on the rate of change in cognitive and social development for low birth weight children

Using Hierarchical Linear Models (HLM) analysis, this study evaluated the effects of medical risk at birth and socioeconomic status (SES) on the rate of change in cognitive and social development over the first three years of life in premature children with low birth weight (LBW). Children with LBW (n = 79) with both high (HR) (n = 37) and low (LR) (n = 42) medical risk were compared to healthy full-term (FT) (n = 49) children. Children were assessed longitudinally at 6, 12, 24, and 36 months for cognitive development with the Bayley Scales of Infant Development and the McCarthy Scales for Childrens Abilities, and for social initiative and responsiveness with observational measures. The HR LBW group had slower rates of increases in cognitive scores than did the LR LBW and FT groups and showed more deceleration in cognitive development by 36 months of age. Children with LBW, regardless of medical risk, had lower social initiating scores and slower rates of increase in initiating across the first 36 months than did FT children. As predicted, the groups did not show different rates of change for measures of social responsiveness. Higher SES was predictive of better cognitive and social development for all children. The difficulties encountered by children with LR and HR LBW in developing social initiating skills are discussed in relation to the link between learning to take initiative and early executive function skills.

Self-Management of Cystic Fibrosis: Short-Term Outcomes of the Cystic Fibrosis Family Education Program

This study tested the efficacy of the Cystic Fibrosis Family Education Program, a cystic fibrosis self-management program, on improving participants knowledge, self-efficacy, self-management behavior, health, and quality of life. A quasi-experimental pretest-posttest nonequivalent comparison group design was employed. Participants made up 104 patient-primary caregiver dyads from the intervention site cystic fibrosis center and 95 from the usual care comparison center. The intervention, a self-paced print curriculum based on social cognitive theory, targeted behavioral capability, self-efficacy, and outcome expectations and was implemented as an integral part of medical care. Parents, early childhood, middle childhood, and adolescents received separate materials on respiratory, nutrition and malabsorption, communication, and coping issues. Significant intervention effects were found on the knowledge scores for caregivers, adolescents, and children; caregiver and adolescent total self-management scores; Child Behavior Checklist total score; one parent coping scale score; the modified NIH score; NIH pulmonary factor 1; and the Brasfield total score. Significant interaction effects were evident in the self-efficacy scores for caregivers and children.

Correlates of Postsecondary Employment Outcomes for Young Adults with Learning Disabilities

The purpose of this study is twofold: (a) to examine the efficiency of a set of selected variables for predicting postsecondary employment success for young adults classified as learning disabled in high school and (b) to provide a portrayal of employment adjustment in the first years after exiting high school. Data on both employment stability and job status were gathered through telephone interviews. Of the 284 students with learning disabilities who exited the four participating high schools between 1986 and 1989, contact was made with 175 (62%). This sample was composed of 75% males, who ranged in age from 18 to 23 years. Statistical tests reveal that students (a) with high math ability, (b) who were employed during high school, and (c) whose parents actively participated in their education were more likely to experience employment success after high school. Overall, 86% of the sample was employed either full- or part-time, with the majority in entry-level, unskilled jobs. In terms of postsecondary education, 26% completed at least one semester of college or technical school, though at the time of follow-up only 13% were enrolled in school.

Breast Feeding and Children's Intelligence

Breast feeding was reported in 1992 by Lucas, et al. to provide advantages for the development of intelligence in children of low birth weight, possibly through nutrients or other biological factors found in human breast milk but not cows milk. Research on breast feeding and intelligence in children of normal birth weight has yielded mixed results, probably because measurement of environmental influences has not been thorough and the range of intelligence components measured has been limited. Our research with 204 3-year-old children of normal birth weight included control measures for the environment and maternal intelligence (Hollings-head socioeconomic status, Home Observation for the Measured Environment, Shipley) and two measures of childhood intelligence (Stanford-Binet Fourth Edition and Peabody Picture Vocabulary Test-Revised). Controlling for environmental variables and maternal intelligence, initiation of breast feeding predicted scores on intelligence tests at age three. Breast feeding was associated with 4.6-point higher mean in childrens intelligence.