Parents' emotion coaching beliefs, a validated construct in majority White samples emphasizing the value of expressing and teaching about emotion, generally predict positive outcomes among White ...children. However, a racially and culturally sensitive emotion socialization model suggests a need for further understanding of this construct and potential differential outcomes among different racial groups. This study investigated three-way interactions among parental emotion coaching beliefs, toddlers' baseline respiratory sinus arrhythmia (RSA), and child race (Black or White), in predicting preschoolers' behavioral problem tendencies 1 year later. Participants included 204 children (140 White and 64 Black) and their families, recruited from low-income, rural areas. When children were 2, child baseline RSA was collected, and both parents answered questionnaires concerning their emotion coaching beliefs. When children were 3, mothers answered questions about child behavioral problem tendencies. Path analyses revealed a three-way interaction among paternal emotion coaching beliefs, child baseline RSA, and race, in predicting child internalizing tendencies 1 year later. In particular, among Black children, paternal emotion coaching beliefs showed a double-edged effect. It predicted lower internalizing tendencies when child baseline RSA was low, but higher internalizing tendencies when child baseline RSA was high. These associations were not found among White children. Maternal emotion coaching beliefs predicted lower internalizing tendencies regardless of child race and RSA. Findings were discussed in the context of an expanded emotion socialization model, with significant implications for furthering conceptualization and clinical practices.
Objective To conduct a systematic review to determine whether clinical findings can be used to rule in or to rule out streptococcal pharyngitis in children. Study design Two authors independently ...searched MEDLINE and EMBASE. We included articles if they contained data on the accuracy of symptoms or signs of streptococcal pharyngitis, individually or combined into prediction rules, in children 3-18 years of age. Results Thirty-eight articles with data on individual symptoms and signs and 15 articles with data on prediction rules met all inclusion criteria. In children with sore throat, the presence of a scarlatiniform rash (likelihood ratio LR, 3.91; 95% CI, 2.00-7.62), palatal petechiae (LR, 2.69; CI, 1.92-3.77), pharyngeal exudates (LR, 1.85; CI, 1.58-2.16), vomiting (LR, 1.79; CI, 1.58-2.16), and tender cervical nodes (LR, 1.72; CI, 1.54-1.93) were moderately useful in identifying those with streptococcal pharyngitis. Nevertheless, no individual symptoms or signs were effective in ruling in or ruling out streptococcal pharyngitis. Conclusions Symptoms and signs, either individually or combined into prediction rules, cannot be used to definitively diagnose or rule out streptococcal pharyngitis.
This study examined the interplay between maternal depressive symptoms and emotion coaching in predicting preschoolers' emotion regulation skills. Participants included 126 preschoolers and their ...mothers, assessed at two time points, when children were 3 (T1) and 4 (T2). Mothers' coaching of sadness and anger was observationally assessed in a laboratory task at T1 under two categories, high and low elaborative styles of emotion coaching. Mothers also reported their depressive symptoms at T1. Children's emotion regulation was observed in laboratory tasks eliciting sadness and anger at T1 and T2. Path analyses revealed three-way interactions among maternal depressive symptoms, low elaborative emotion coaching, and high elaborative emotion coaching in predicting preschoolers' emotion regulation in both sadness- and anger-eliciting tasks 1 year later. Maternal low elaborative emotion coaching of sadness reduced children's focus on distress in the sadness-eliciting task only when mothers showed high depressive symptoms and used little high elaborative emotion coaching. In contrast, maternal low elaborative emotion coaching of sadness and anger predicted maladaptive child emotion regulation in both sadness- and anger-eliciting tasks, respectively, when mothers were depressed or used greater high elaborative emotion coaching. Findings highlight the importance of considering different types of maternal emotion coaching language styles in the context of maternal depression and have implications for intervention efforts.
The current study examined temporal associations between child emotion and maternal regulatory strategies in mother-child dyads. One hundred and 30 mothers and their 5-year-old children (46.1% boys) ...completed a challenging puzzle task, which was videotaped. Child positive and negative emotion as well as mothers' regulatory strategies including problem solving, providing approval, and comforting, were coded on a second-by-second basis from the videos. Multilevel modeling analyses were conducted to examine how maternal behaviors at a given time predicted the within-dyad variations of child positive and negative emotion 2 seconds later, controlling for the child's own prior emotion, as well as child emotion predicting subsequent maternal behaviors 2 seconds later, controlling for mothers' prior behaviors. In all models, child sex and negative emotionality as well as maternal depressive symptoms were included as between-dyad predictors, whereas maternal race and education were included as covariates. Results suggested that maternal approval and problem solving predicted within-dyad variation in subsequent child positive emotion. Both child positive and negative emotion was predictive of the within-dyad variation in mothers' subsequent use of strategies. Maternal depressive symptoms moderated the relations between prior and subsequent strategy uses for all three maternal behaviors. Our findings indicated that child emotion regulates, and is regulated by, maternal regulatory strategies.
The socialization of emotion in preschool-aged children is an important developmental task, which is associated with a number of socioemotional outcomes. This study examined the contribution of both ...fathers' and mothers' emotion coaching to their 3- to 4-year-old children's emotion socialization. Two time points of data were collected for 69 families. We employed a time sampling observational method to capture the emotion socialization process in the naturalistic home environment. Fathers' and mothers' emotion coaching and expression, as well as children's emotion expression, were assessed at home using an audio recording device. Children's emotion expressions were also captured during an emotion eliciting task in a lab setting 1 year later. Regression analyses revealed that children of more positively expressive fathers also showed more positive emotion expression concurrently. Paternal emotion coaching, but not maternal emotion coaching, was predictive of children's increased positive expression in the lab 1 year later. This study provides evidence for unique contributions of fathers, above and beyond mothers, to the emotion socialization outcomes of their children.
This study examined the development of self‐regulation during early childhood and the reciprocal relations between self‐regulation and maternal sensitivity. Data (N = 1,364) were drawn from the NICHD ...Study of Early Child Care and Youth Development (NICHD SECCYD). Children's situational and committed compliance were assessed in the laboratory at 24 and 36 months, delay of gratification at 54 months, self‐control at 54 months and kindergarten age, and maternal sensitivity was observed at 24, 36, and 54 months. Self‐regulation was characterized to progress from situational compliance to committed compliance and then to fully self‐motivated regulation. Findings also suggest that the development of self‐regulation reflects an ongoing transactional process in which child self‐regulation and maternal sensitivity mutually influence each other.
We identified familial risk profiles and examined interactions between these profiles and child emotionality in predicting child executive function (EF). Among 126 mother-child dyads (child mean ...age = 3.23 years), four profiles were found based on maternal education, family income-to-needs ratio, and maternal depressive symptoms, anxiety, and parenting stress: Higher SES-Lower Mental Health Risk, Lower SES-Lower Mental Health Risk, Lower SES-Average Mental Health Risk, and Lower SES-Higher Mental Health Risk profiles. We found that high child positive emotionality at age 3 predicted high inhibitory control and low attention flexibility a year later exclusively in the Lower SES-Higher Mental Health Risk profile. Overall, children in the Higher SES-Lower Mental Health Risk profile showed better inhibitory control and attention flexibility than those in the Lower SES-Higher Mental Health Risk. This study extends our understanding of how different constellations of familial risks interact with child emotionality to contribute to child EF development.
•Examined child executive function in relation to familial risks and emotionality•Found four profiles using family SES and maternal mental health indicators•Positive emotionality predicted inhibitory control in the high-risk profile.•Low positive emotionality predicted attention flexibility in the high-risk profile.
Dementia caregiving is thought to have a negative impact on health and wellbeing. This critical review of qualitative literature explored the lived experience of familial dementia caregivers from an ...occupational therapy perspective. The method was informed by systematic review and qualitative research methodologies and was structured within the occupational dimensions framework of doing–being–becoming–belonging. A comprehensive search of major databases was undertaken which identified 484 studies on the topic; 14 met the inclusion criteria and were included in the review. Ten themes emerged within the doing-being-becoming-belonging framework from the analysis of the studies. The occupational participation of caregivers is conveyed within the ‘doing’ domain. Ways in which caregiving impacts upon opportunities for self-nurture are presented within the ‘being’ domain. The ‘becoming’ domain elucidates ways in which caregivers redefine themselves, their values and their priorities through their caregiving role. The ‘belonging’ domain depicts ways in which caregivers’ connections with their care recipient and others are shaped over time. Practice implications for health and social care practitioners who work with familial dementia caregivers are presented in light of the findings.
Assistive technology and telecare have been promoted to manage the risks associated with independent living for people with dementia, but there is limited evidence of their effectiveness.
This trial ...aimed to establish whether or not assistive technology and telecare assessments and interventions extend the time that people with dementia can continue to live independently at home and whether or not they are cost-effective. Caregiver burden, the quality of life of caregivers and of people with dementia and whether or not assistive technology and telecare reduce safety risks were also investigated.
This was a pragmatic, randomised controlled trial. Blinding was not undertaken as it was not feasible to do so. All consenting participants were included in an intention-to-treat analysis.
This trial was set in 12 councils in England with adult social services responsibilities.
Participants were people with dementia living in the community who had an identified need that might benefit from assistive technology and telecare.
Participants were randomly assigned to receive either assistive technology and telecare recommended by a health or social care professional to meet their assessed needs (a full assistive technology and telecare package) or a pendant alarm, non-monitored smoke and carbon monoxide detectors and a key safe (a basic assistive technology and telecare package).
The primary outcomes were time to admission to care and cost-effectiveness. Secondary outcomes assessed caregivers using the 10-item Center for Epidemiological Studies Depression Scale, the State-Trait Anxiety Inventory 6-item scale and the Zarit Burden Interview.
Of 495 participants, 248 were randomised to receive full assistive technology and telecare and 247 received the limited control. Comparing the assistive technology and telecare group with the control group, the hazard ratio for institutionalisation was 0.76 (95% confidence interval 0.58 to 1.01;
= 0.054). After adjusting for an imbalance in the baseline activities of daily living score between trial arms, the hazard ratio was 0.84 (95% confidence interval 0.63 to 1.12;
= 0.20). At 104 weeks, there were no significant differences between groups in health and social care resource use costs (intervention group - control group difference: mean -£909, 95% confidence interval -£5336 to £3345) or in societal costs (intervention group - control group difference: mean -£3545; 95% confidence interval -£13,914 to £6581). At 104 weeks, based on quality-adjusted life-years derived from the participant-rated EuroQol-5 Dimensions questionnaire, the intervention group had 0.105 (95% confidence interval -0.204 to -0.007) fewer quality-adjusted life-years than the control group. The number of quality-adjusted life-years derived from the proxy-rated EuroQol-5 Dimensions questionnaire did not differ between groups. Caregiver outcomes did not differ between groups over 24 weeks.
Compliance with the assigned trial arm was variable, as was the quality of assistive technology and telecare needs assessments. Attrition from assessments led to data loss additional to that attributable to care home admission and censoring events.
A full package of assistive technology and telecare did not increase the length of time that participants with dementia remained in the community, and nor did it decrease caregiver burden, depression or anxiety, relative to a basic package of assistive technology and telecare. Use of the full assistive technology and telecare package did not increase participants' health and social care or societal costs. Quality-adjusted life-years based on participants' EuroQol-5 Dimensions questionnaire responses were reduced in the intervention group compared with the control group; groups did not differ in the number of quality-adjusted life-years based on the proxy-rated EuroQol-5 Dimensions questionnaire.
Future work could examine whether or not improved assessment that is more personalised to an individual is beneficial.
Current Controlled Trials ISRCTN86537017.
This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in
; Vol. 25, No. 19. See the NIHR Journals Library website for further project information.
This paper examined the moderating role of maternal parenting stress on the reciprocal relations between maternal emotion coaching and child emotionality. Participants included 126 preschoolers and ...their mothers, assessed at two time points, when children were three (T1) and four (T2). Mothers' coaching of positive emotion, sadness, fear and anger was observationally assessed in a laboratory task at T1 and T2. Mothers reported child emotionality at T1 and T2, and their parenting stress at T1. Path analyses revealed that low levels of maternal coaching of sadness predicted more prospective child sad emotionality, only at moderate and high levels of maternal parenting stress. Child angry emotionality predicted less future maternal coaching of anger, only among highly stressed mothers. Additionally, child fearful emotionality predicted more subsequent maternal coaching of fear. Findings supported the importance of maternal emotion coaching in the context of stress and highlighted areas for intervention programs.
•Mothers' parenting stress modifies the link between coaching and child emotionality.•Among stressed mothers, low levels of coaching predict more child sadness.•Among stressed mothers, elevated child anger predicts less maternal coaching.•Child fearful emotionality elicits more maternal coaching.•Considering the types of child emotionality is crucial in emotion socialization.
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