Impacts of the Smart Beginnings Parenting Program on Early Childhood Special Education Evaluation and Service Referral.

Objective: Little is known about how parenting interventions might influence families' access to related health care services during early childhood. This study describes the effects of a parenting intervention, Smart Beginnings (SB), on referrals to early intervention (EI) or early childhood special education (ECSE) after evaluation within a predominantly Black/Latine sample with low incomes. SB is a tiered intervention integrating a universal parenting program delivered in primary care clinics (PlayReadVIP) with a targeted home-visiting program (Family Check-Up).

Exploring how pregnant people in recovery from opioid use disorder describe their child during pregnancy.

Objective: Understanding parenting strengths and challenges among pregnant people in recovery from opioid use disorder supports effective intervention delivery. How parents think and feel about their child prenatally has implications for postnatal parenting. In our past work, greater use of positive compared to negative or neutral prenatal descriptors of the child during pregnancy was associated with higher sensitivity, warmth, and engagement during caregiver-infant interactions 12-months postpartum.

Data representing expert ratings of emotional tone in adjectives used to describe infants and young children.

The way caregivers think of their infants and young children may impact caregiving behavior. One way to assess caregivers' thoughts of their young children is to prompt them to describe the child's personality. Popular methods to analyzing valenced language include the use of software approaches, which have limitations in scoring and application.

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Opioid use disorder (OUD) among pregnant people has increased dramatically during the opioid epidemic, affecting a significant number of families with young children. Parents with OUD commonly face significant challenges as they are often balancing the stress of caring for young children with maintaining recovery and co-occurring psychosocial challenges (e.g.

Structure of Psychopathology in Romanian Preschool-Aged Children in an Epidemiological and a High-Risk Sample.

Objective: Research on bifactor models of psychopathology in early childhood is limited to community samples with little longitudinal follow-up. We examined general and specific forms of psychopathology within 2 independent samples of preschool-aged Romanian children. Within a sample with children exposed to psychosocial deprivation, we also examined antecedents and longitudinal outcomes of the general factor.

General and subspecialist pediatrician perspectives on barriers and strategies for referral: a latent profile analysis.

Background: Children in need of pediatric subspecialty care may encounter multiple barriers, and multiple strategies have been suggested to improve access. The purpose of this study was to describe the perceptions of general and subspecialty pediatric physicians regarding barriers to subspecialty care and the value of strategies to improve subspecialty access.

Methods: We surveyed a national sample of 1680 general pediatricians and pediatric subspecialists in May and June 2020 regarding 11 barriers to subspecialty care and 9 strategies to improve access to subspecialty care, selected from recent literature.

Profiles of Early Childhood Adversity in an Urban Pediatric Clinic: Implications for Pediatric Primary Care.

Pediatricians are well-positioned to screen for early childhood adversities, but effective responses to positive screens require an understanding of which adversities typically co-occur, and to what extent they are associated with other risk or protective factors. Among children seen at an urban academic pediatric practice, this study aimed to (1) examine the prevalence of different types of early adversity and protective experiences reported by primary caregivers, and (2) define latent classes of co-occurring adversities. Of 1434 children whose parents completed the Safe Environment for Every Kid (SEEK) at well-child visits during November 2019-January 2021, three classes of adverse experiences emerged, including those reporting low adversity (L; 73%), caregiver stress (CS; 17%), and both caregiver stress and depression (CSD; 10%).

Validation of Parenting Your Baby and Parenting Your Toddler and Associations with Engagement in Parenting Intervention.

Infants and toddlers are dependent on supportive and nurturing parenting to promote optimal child development. Assessments of parenting can identify need for parenting intervention, however measures are needed that can predict whether parents reporting challenges will engage in intervention. We validated the Parenting Your Baby (PYB) and Parenting Your Toddler (PYT) parenting measures and examined associations with engagement in parenting intervention.

A Comprehensive Multilevel Analysis of the Bucharest Early Intervention Project: Causal Effects on Recovery From Early Severe Deprivation.

Objective: The Bucharest Early Intervention Project is the first randomized controlled trial of foster care as an alternative to institutional care. The authors synthesized data from nearly 20 years of assessments of the trial to determine the overall intervention effect size across time points and developmental domains. The goal was to quantify the overall effect of the foster care intervention on children's outcomes and examine sources of variation in this effect, including domain, age, and sex assigned at birth.

Foster care leads to sustained cognitive gains following severe early deprivation.

This study examined longitudinal data from the Bucharest Early Intervention Project, a randomized controlled trial of foster care as an alternative to institutional care following exposure to severe psychosocial deprivation. We report data from 135 participants assessed in early adulthood (age 18 y). We find that 16 y after randomization occurred, those who had been randomized to high-quality foster care had significantly higher IQ scores (9 points, 0.

Individual differences in symptoms of maternal depression and associations with parenting behavior.

Links between global levels of maternal depressive symptoms and parenting behavior in early childhood are well established. However, depression is a heterogeneous disorder and little is known about how individual differences in depression symptoms may be differentially associated with different types of parenting behavior. We aimed to uncover nuance in the relationship between depression and parenting behavior by examining individual differences in symptoms of maternal depression and associations with parenting behavior with 2- and 3-year-old children.

Maternal secure base scripts predict child attachment security in an at-risk sample.

Accumulating evidence indicates that individuals possess attachment, or secure base, scripts based on experiences with attachment figures, and these attachment scripts predict important outcomes such as caregiving behaviors and offspring social-emotional adjustment. However, less is known about the association between parents' secure base scripts and child attachment security within at-risk samples, i.e.

Caregiver regulation: A modifiable target promoting resilience to early adverse experiences.

Background: Experiences of adversity in early life are associated with increased risk for negative outcomes; yet, the impact of early adversity on any given child is difficult to predict given the considerable heterogeneity in functioning found even among children with similar exposures. Thus, although early adversity is associated with increased risk for negative outcomes on average, many children are resilient. While researchers have highlighted individual differences in children's internal characteristics that may relate to risk and resilience, external characteristics of the environment that differ between children are mutable factors that are also important for understanding heterogeneity in children's outcomes.

The emotional tone of child descriptions during pregnancy is associated with later parenting.

Introduction: How parents think and feel about their young children has implications for the parent-child relationship. We examined prospective associations between prenatal descriptions of the unborn child's personality and later parenting behavior.

Methods: Pregnant women (N = 120; mean age = 26.

Disrupted caregiving behavior as a mediator of the relation between disrupted prenatal maternal representations and toddler social-emotional functioning.

The development of maternal representations of the child during pregnancy guides a mother's thoughts, feelings, and behavior toward her child. The association between prenatal representations, particularly those that are disrupted, and toddler social-emotional functioning is not well understood. The present study examined associations between disrupted prenatal representations and toddler social-emotional functioning and to test disrupted maternal behavior as a mediator of this association.

Maternal Psychological Well-Being and Infant Emergency Department Utilization.

Background: A mother's psychological well-being impacts her own and her infant's health. Challenges to maternal psychological well-being (eg, depression, anxiety) are associated with increased infant emergency department (ED) utilization. It is not known if other maternal psychological factors, such as relational health and past maltreatment during one's own childhood, are also associated with child ED utilization.

Psychiatric outcomes following severe deprivation in early childhood: Follow-up of a randomized controlled trial at age 16.

Objective: Early psychosocial deprivation is associated with increased risk for psychopathology, yet few studies have examined outcomes in adolescents.

Method: At baseline (M age 22 months), 136 children from Bucharest, Romania, living in large institutions, were randomized into foster care (FCG) or to care as usual (CAUG). Caregivers completed psychiatric interviews regarding their children (52 FCG; 51 CAUG) at age 16 years (M = 16.

Psychosocial deprivation and receptive language ability: a two-sample study.

Background: The quality of early caregiving experiences is a known contributor to the quality of the language experiences young children receive. What is unknown is whether, and if so, how psychosocial deprivation early in life is associated with long-lasting receptive language outcomes.

Methods: Two prospective longitudinal studies examining early psychosocial deprivation/neglect in different contexts (i.

Adverse caregiving in early life: The trauma and deprivation distinction in young children.

Knowledge and understanding about the impact of cumulative adverse experiences on the health and wellbeing of children, adolescents, and adults has rapidly expanded over the past 30 years. Despite the invaluable attention and support this proliferation has drawn to the importance of early childhood experiences, we believe that it is time to move beyond broad indices of risk and toward more specific and individualized understanding of how risk exposures are linked to clinical outcomes in young children. Within infant and early childhood mental health, there is a need for greater specificity in linking adverse caregiving experiences in early life to psychopathology in children.

Commentary: Increasing diagnostic precision in reactive attachment disorder - a commentary on Allen & Schuengel (2019).

A study by Allen and Schuengel in this issue of the journal replicates and extends previous findings by Woolgar and Baldock (2015) indicating that community practitioners are far more likely to diagnose reactive attachment disorder in symptomatic children than are specialists using well-validated measures. We consider historic variability in how this disorder is defined but note an emerging consensus in nosologies and among researchers. We consider how more systematic assessments might improve diagnostic efforts to specify the kinds of clinical phenomena that are associated with neglect and deprivation.

Prenatal Identification of Risk for Later Disrupted Parenting Behavior Using Latent Profiles of Childhood Maltreatment.

A history of maltreatment during childhood (e.g., physical and sexual abuse, neglect) can threaten the fundamental human need to form and maintain relationships across development, which ensure safety and security.

Early caregiving quality predicts consistency of competent functioning from middle childhood to adolescence following early psychosocial deprivation.

Adverse developmental outcomes for some children following institutional care are well established. Removal from institutional care and placement into families can promote recovery. However, little is known about how positive outcomes are sustained across adolescence among children with histories of severe deprivation.

Disinhibited Social Engagement Disorder in Early Childhood Predicts Reduced Competence in Early Adolescence.

Psychosocial deprivation is associated with the development of socially aberrant behaviors, including signs of disinhibited social engagement disorder (DSED). In longitudinal studies, signs of DSED have been shown to decrease over time, especially as children are removed from conditions of deprivation. What is less clear is whether signs of DSED in early childhood are associated with poorer functioning in early adolescence, including among children who no longer manifest signs of DSED at this age.

Effects of Intimate Partner Violence and Home Environment on Child Language Development in the First 3 Years of Life.

Objective: Intimate partner violence (IPV) can adversely affect children's cognitive development, but links between IPV exposure and language development in the earliest years of life remain unknown. The present study examined the effects of IPV and the quality of the home environment on children's language development at age 3 years.

Methods: In a prospective, 5-panel, longitudinal study of 79 mother-child dyads assessed prenatally to age 3 years, we examined standardized measures of receptive and expressive language development at age 3 years.

Signs of attachment disorders and social functioning among early adolescents with a history of institutional care.

Background: Institutional rearing is associated with increased risk for reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED). Disorders of attachment involve disturbances in children's primary caregiving relationships, and are likely to disturb multiple domains of social functioning.

Objective: To examine associations between signs of RAD and DSED and social functioning in early adolescence.