The Relationship of Parental Warm Responsiveness and Negativity to Emerging Behavior Problems Following Traumatic Brain Injury in Young Children

Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
Developmental Psychology (Impact Factor: 3.21). 01/2011; 47(1):119-33. DOI: 10.1037/a0021028
Source: PubMed


Parenting behaviors play a critical role in the child's behavioral development, particularly for children with neurological deficits. This study examined the relationship of parental warm responsiveness and negativity to changes in behavior following traumatic brain injury (TBI) in young children relative to an age-matched cohort of children with orthopedic injuries (OI). It was hypothesized that responsive parenting would buffer the adverse effects of TBI on child behavior, whereas parental negativity would exacerbate these effects. Children, ages 3-7 years, hospitalized for TBI (n = 80) or OI (n = 113), were seen acutely and again 6 months later. Parent-child dyads were videotaped during free play. Parents completed behavior ratings (Child Behavior Checklist; T. M. Achenbach & L. A. Rescorla, 2001) at both visits, with baseline ratings reflecting preinjury behavior. Hypotheses were tested using multiple regression, with preinjury behavior ratings, race, income, child IQ, family functioning, and acute parental distress serving as covariates. Parental responsiveness and negativity had stronger associations with emerging externalizing behaviors and attention-deficit/hyperactivity disorder symptoms among children with severe TBI. Findings suggest that parenting quality may facilitate or impede behavioral recovery following early TBI. Interventions that increase positive parenting may partially ameliorate emerging behavior problems.

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    • "Families of lower SES might benefit more from EF interventions. Similarly, parenting behaviours play a critical role in the child's development, and parenting quality may facilitate recovery (Wade et al., 2011). Our results "
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    ABSTRACT: There is a lack of studies assessing executive functions (EF) using ecologically valid tests in children with frontal lobe lesions. This study aimed to (1) evaluate EF in children, adolescents and young adults treated for childhood frontal lobe tumours, (2) identify factors influencing performance, such as age at diagnosis or type of treatment, and (3) examine correlations between intellectual ability and classical and ecological tests of EF. Twenty-one patients, aged 8-27 years, treated for a childhood benign or malignant frontal lobe tumour, and 42 healthy controls (matched for gender, age and socio-economic status) were assessed using classical tests of EF, and the BADS-C ecological battery. Patients also underwent assessment of intellectual ability and parent and teacher ratings of the BRIEF questionnaire. IQ scores ranged from 45 to 125 (mean FSIQ = 84) and were lower in case of epilepsy, hydrocephalus and lower parental education. Patients displayed deficits in most, but not all measures of EF. Most classical and ecological measures of EF were strongly correlated to IQ. This study confirms the frequency of EF deficits in this population; it also highlights the utility of ecological measures of EF and some limitations of classical tests of EF in children.
    Neuropsychological Rehabilitation 08/2015; DOI:10.1080/09602011.2015.1048253 · 1.96 Impact Factor
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    • "There is evidence that poor parenting practices mediate this relationship between parental adjustment and child outcomes following pediatric ABI (Micklewright, King, O'Toole, Henrich, & Floyd, 2012). Poor parent and family functioning correlate with parenting styles characterized by high criticism, overreactivity, and laxness (Woods, Catroppa, Barnett, & Anderson, 2011); lower levels of parental warm responsiveness and facilitative teaching and higher levels of authoritarian, permissive, and overly negative parenting styles correlate with concurrent and emerging child cognitive, behavioral, adaptive problems (Gerrard-Morris et al., 2010; Micklewright et al., 2012; Potter et al., 2011; Wade et al., 2011; Woods et al., 2011). Yet, there has been limited research on interventions targeting either parent distress (Cole, Paulos, Cole, & Tankard, 2009) or parenting practices (Brown, Whittingham, Boyd, & Sofronoff, 2013a). "
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    ABSTRACT: Objective To consider the relationship of parental experiential avoidance (EA) to psychological symptoms and problematic parenting strategies after pediatric acquired brain injury (ABI). Methods Using available data from a randomized controlled trial of a group-based Acceptance and Commitment Therapy (ACT) workshop plus a behavioral family intervention (BFI) for parents of children with ABI (n = 59), correlational and mediational analyses were conducted to consider the role of parental EA as a process of change for parent outcomes. Results Parent EA positively correlated with ineffective parenting behaviors and levels of psychological distress, both cross-sectionally and longitudinally. Reductions in EA mediated the treatment effect on reducing ineffective parenting behaviors and parent distress, but issues of temporality were present. Conclusions EA is related to parent outcomes following pediatric ABI. A larger and methodologically rigorous study is called for to further elucidate this finding and specifically determine the benefits of targeting EA with interventions such as ACT, in conjunction with evidence-based BFIs.
    Journal of Pediatric Psychology 12/2014; 40(4). DOI:10.1093/jpepsy/jsu109 · 2.91 Impact Factor
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    • "Aspects of parenting style (i.e. warm responsiveness, negativity, permissiveness and authoritarianism) can impact on child behavioural , cognitive and adaptive outcomes following ABI, and evidence suggests that these parenting practices may mediate the relationship between parent distress and child functioning (Micklewright et al., 2012; Wade et al., 2011; Yeates, Taylor, Walz, Stancin, & Wade, 2010). Behavioural interventions such as positive behaviour support and contingency management may be considered evidenced-based treatment options following paediatric ABI; however, most reported research consists of uncontrolled trials or case studies, and the majority of interventions have been delivered by professionals in clinics, schools or residential facilities (Ylvisaker et al., 2007). "
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    ABSTRACT: Background Persistent behavioural difficulties are common following paediatric acquired brain injury (ABI). Parents and families also experience heightened stress, psychological symptoms and burden, and there is evidence of a reciprocal relationship between parent and child functioning, which may be mediated by the adoption of maladaptive parenting practices. Despite this, there is currently a paucity of research in family interventions in this population. The aim of this study was to determine the efficacy of Stepping Stones Triple P: Positive Parenting Program (SSTP), with an Acceptance and Commitment Therapy (ACT) workshop, in improving child outcomes and parenting practices following paediatric ABI.Methods Fifty-nine parents of children (mean age 7 years, SD 3 years, 1 month; 35 males, 24 females) with ABI (Traumatic injuries 58%, Tumour 17%, Encephalitis or meningitis 15%, Cardiovascular accident 7%, Hypoxia 3%) who were evidencing at least mild behaviour problems were randomly assigned to treatment or care-as-usual conditions over 10 weeks. Mixed-model repeated-measures linear regression analyses were conducted to compare conditions from pre- to postintervention on child behavioural and emotional functioning (Eyberg Child Behavior Inventory, Strengths and Difficulties Questionnaire) and dysfunctional parenting style (Parenting Scale). Assessment of maintenance of change was conducted at a 6-month follow-up. The trial was registered on Australian New Zealand Clinical Trials Registry (ID: ACTRN12610001051033, time-by-condition interactions were identified on number and intensity of child behaviour problems, child emotional symptoms and parenting laxness and overreactivity, indicating significant improvements in the treatment condition, with medium-to-large effect sizes. Most improvements were maintained at 6 months.Conclusions Group parenting interventions incorporating Triple P and ACT may be efficacious in improving child and parenting outcomes following paediatric ABI.
    Journal of Child Psychology and Psychiatry 03/2014; 55(10). DOI:10.1111/jcpp.12227 · 6.46 Impact Factor
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